Send us Fan Mail Dermatologist Dr. Muneeb Shah returns to Skin Anarchy to break down what actually works in skincare, how GLP-1 medications affect the skin, the truth about trending ingredients, and how to spot credible science communication online. Below are the biggest questions answered in this episode. Why did Dr. Muneeb Shah start his own skincare brand, Remedy? After years of educating patients one at a time in clinic and then millions online, Dr. Shah saw a gap between how dermatologists actually treat skin and how most products are formulated. Remedy was built to combine multiple ingredients backed by evidence into single formulas, control ingredient sourcing, and remove emerging allergens as the science evolves. He frames it as the natural next chapter of his work: "Content was a hill at one point, and this is my new hill... building a brand that really becomes a legacy brand." Why do so many skincare products feel identical? Because many of them are. Dr. Shah explains that contract manufacturers offer white label stock formulas, so any brand with capital and distribution can put its label on an existing product and launch it. "It's not hard to launch products if you have the capital and the distribution network to support it," he says. "It's hard to launch good products." When an ingredient trends, brands rush to license the same stock formula, which is why the market floods with nearly identical products around every viral ingredient. Remedy's policy is to never use white label formulas and to start from a patient need rather than a trend. Which skincare ingredients are actually backed by science? According to Dr. Shah, the strongest evidence still sits with the tried and true ingredients: retinoids like retinol and tretinoin, alpha hydroxy acids like glycolic acid, select peptides but not all of them, ceramides for the skin barrier, niacinamide, and azelaic acid. His formulation philosophy anchors everything around these proven actives first, with marketing layered on only afterward, never the reverse. "The products have to be really great products that people will use forever, and they have to use ingredients that truly have the efficacy studies on them." Is PDRN worth the hype? Dr. Shah does not dismiss PDRN, noting it has real traction in East Asia, where dermatologists champion it, particularly in injectable form. "I'm not saying that doesn't have validity or evidence. Time will tell if this is something that stands the test of time." His caution is about how trends work: brands slap labels on stock PDRN formulas to ride the moment, and an ingredient trending is not the same as an ingredient being proven. What does "next generation biomimetic surfactant technology" actually mean? Usually nothing. Dr. Shah points out that "they're using the same surfactants everybody's got in their formulas... no one's inventing new surfactant technologies." Terms like this are marketing language designed to make a formula seem more advanced or worth a higher price, and even sophisticated consumers fall for it because there is not enough public knowledge about what these formula components actually do. What do GLP-1 medications like Ozempic do to your skin? Rapid weight loss from GLP-1 medications can outpace the skin's ability to retract, leading to crepiness, laxity, and undulations where fat volume was lost beneath otherwise healthy skin. Dr. Shah notes dermatologists saw similar effects with gastric bypass, but it was rare enough that it never needed a name. That is no longer the case: "Now that it's 12 percent of the population, we have to really contend with this." What skincare should you use while on a GLP-1? Dr. Shah recommends topicals that support collagen throughout the weight loss period: a retinoid such as retinol or tretinoin, an alpha hydroxy acid like glycolic acid to stimulate collagen production, and peptides with collagen evidence such as Matrixyl. "Anything that's gonna support your collagen and elasticity, maybe even like a copper peptide due to the elasticity element of the skin." These support the epidermis and dermis, but he is clear that topicals alone cannot compensate for significant fat and muscle volume loss underneath. Can loose skin from GLP-1 weight loss be fixed? Sometimes it resolves on its own if weight loss is gradual, but Dr. Shah notes many patients are started on doses that are too high. "When you lose 30 pounds in a month, there's really no skin treatment that can account for that loss of weight to make your skin snap back." For skin that does not recover, professional options include lasers, deeper chemical peels, and in some cases filler around bony structures to restore support. Slower weight loss gives the skin the best chance to keep up. Why does nutrition matter so much on a GLP-1? Because appetite drops sharply, patients risk falling short on protein and essential nutrients during a period of significant muscle and fat loss. "Anyone that's on a GLP really needs to optimize their nutrition while they're on it," Dr. Shah says, "because you're eating less, but what you're eating really then matters." He argues nutrition is a layer dermatologists need to be discussing with every GLP-1 patient, ideally in collaboration with nutritionists, gastroenterologists, and weight loss specialists rather than working in silos. Do GLP-1s cause immune reactions? "A lot of people actually develop antibodies to GLPs... your body recognizes it's a foreign invader and tries to neutralize it," Dr. Shah explains, which can produce injection site reactions, fevers, muscle aches, or symptoms that feel like the flu after injecting. This immunologic layer is rarely discussed, and he draws a parallel to PD-1 inhibitors in oncology, where he and Dr. Maxfield published an early case report of a patient developing type 1 diabetes from the immune system attacking the pancreas, a side effect now well documented in the literature. Are chemical sunscreens safe? Dr. Shah personally wears chemical sunscreens and prefers how they look on his skin, but he refuses to speak in absolutes in either direction. The data shows chemical filters absorb into the body more than previously thought, and no one yet knows whether that matters. At the same time, no study has shown actual harm in people, which is why they remain on the market. "To absolutely say these are completely safe and nothing bad will ever happen to you, that's a dangerous absolute to live in, in my mind." Is longevity just antiaging rebranded? Largely, yes, in Dr. Shah's view: "Longevity is really just similar to antiaging and to bodybuilding in the sense that it's a more extreme form of maximizing your health." He compares it to how looksmaxxing extended bodybuilding culture to the face, the same pursuit taken further. What has changed is access. Anyone can now watch a billionaire biohacker's routine on YouTube and order peptides from a telehealth site, which is exactly what makes this moment both exciting and precarious. Are injectable peptides from telehealth sites regulated? Not in the way most consumers assume. "I'm excited about the technology that's coming out as a scientist," Dr. Shah says. "As a doctor, I'm nervous about the access and lack of regulation." He predicts a regulatory correction, whether imposed by government or by the industry itself, after enough people experience negative consequences from unvetted peptides and unregulated med spas. He expects consumers will eventually start asking where products come from, seeking FDA approved options, and vetting the credentials of anyone treating them. What is the danger of telehealth prescribing without integrated care? Dr. Shah gives the example of someone with hair loss who researches online, requests minoxidil, finasteride, or spironolactone through a telehealth platform, and receives it at their door. "Turns out they have thyroid disease. No one asked the question... this element of integrated medicine is being completely removed." As telemedicine grows, conditions get treated at the surface while underlying diagnoses are missed entirely. How do you know which skincare experts to trust online? Dr. Shah's rule: be wary of anyone who speaks in absolutes. "When you speak in absolutes, most of the time you're gonna be wrong because there's not enough information out there." On polarizing topics like parabens, fragrance, or chemical sunscreens, both the "completely safe" and "completely toxic" camps overstate what the evidence supports. Trustworthy communicators caveat their claims, resist being first to react before information is complete, and publicly correct themselves when new data proves them wrong. He cites the erosion of trust in medicine during COVID as the cost of premature certainty. Listen to the full episode with Dr. Muneeb Shah on Skin Anarchy, available wherever you get your podcasts. Shop Remedy Skin Don’t forget to subscribe to Skin Anarchy on Apple Podcasts, Spotify, or your preferred platform. Reach out to us through email with any questions. Sign up for our newsletter! Shop all our episodes and products mentioned through our ShopMy Shelf! Support the show
