I Rated 12 Popular Skin Treatments: Here’s What I Actually Think & Why

Written by Founder, Amir Karam MD

Every year there’s a new skin treatment promising tighter skin, more collagen, or the equivalent of a “non-surgical facelift.”

Some are genuinely useful. Some are massively overhyped. And some work well only in very specific situations — despite how aggressively they’re marketed online.

As a facial plastic surgeon, I spend a lot of time helping patients separate real skin science from marketing. And honestly, I understand why people are confused. The skincare and aesthetics world has become incredibly noisy.

So I thought it would be useful to go through some of the most popular skin treatments I get asked about almost daily and rate them honestly based on what I’ve consistently seen work over decades of treating patients.

Not based on trends.
Not based on sponsorships.
Just based on results.

01.

Retinol - 10/10

If I could recommend only one anti-aging skincare ingredient, it would probably be retinol.

Very few ingredients have the level of scientific evidence behind them that retinol does. It stimulates collagen, improves skin texture, softens fine lines, helps with pigmentation, and even improves acne.

It’s one of the true foundational ingredients in skincare.

The biggest issue is irritation. A lot of people try retinol, overdo it, get inflamed, and quit too early. That’s actually one of the reasons I developed the KaramMD Trifecta system. I wanted patients to be able to use powerful active ingredients consistently without constantly battling irritation and barrier damage.

Because consistency matters more than intensity.

02.

Sunscreen - 10/10

This is non-negotiable.

If retinol is the best corrective ingredient, sunscreen is the best preventative one.

UV exposure breaks down collagen, worsens pigmentation, accelerates aging, and increases skin cancer risk. And the reality is that many people spend hundreds of dollars on skincare while skipping the one thing that protects their skin the most.

The problem usually isn’t sunscreen itself. It’s that people don’t apply enough or fail to reapply it consistently.

Healthy skin long term starts here.

03.

Sculptra - Mixed

This is where things start getting more nuanced.

Sculptra can work well in certain patients when subtle volume replacement is needed. But I’m personally very cautious with it.

I’ve seen too many cases where overuse creates heaviness, lumpiness, or an unnatural look over time.

In the wrong hands, it can age the face instead of rejuvenating it.

One of the biggest misconceptions in aesthetics is the idea that every aging face simply needs more volume.

That’s often not true.

04.

Botox - 9/10

Botox remains one of the most effective non-surgical tools we have.

Used subtly and correctly, it softens forehead lines, crow’s feet, and frown lines while helping prevent deeper wrinkles from forming over time.

The key is restraint. The best Botox is usually the Botox nobody notices.

The downside is maintenance. It’s temporary and requires ongoing treatment every few months. But overall, Botox has absolutely earned its place in facial rejuvenation.

05.

Collagen Supplements- 4/10

I’m not against oral collagen supplements, but I do think they’re oversold.

Some studies show mild improvement in hydration or elasticity, but the results are inconsistent and nowhere near transformative.

Meanwhile, people often ignore the fundamentals that matter far more: sunscreen, retinoids, sleep, exercise, nutrition, and long-term consistency.

If you enjoy collagen supplements, that’s perfectly fine. I just wouldn’t expect miracles.

06.

Microneedling - 7/10

Microneedling is a treatment I generally like, especially for acne scars and texture.

Done correctly, it can stimulate collagen and improve fine lines, texture irregularities, and scarring over time.

But this is not a one-treatment solution.

Results depend heavily on technique, consistency, and realistic expectations.

And importantly, microneedling improves skin quality — not significant skin laxity.

That distinction matters.

07.

RF Microneedling - Depends What You’re Treating

This may be one of my more controversial opinions.

For superficial skin quality improvement, shallow RF microneedling can sometimes help texture and mild rejuvenation. But for deep tissue tightening? I’ve personally never been very impressed.

This category highlights a much larger issue in aesthetics: people desperately want non-surgical solutions for surgical problems. And that’s where a lot of overpromising happens.

08.

Chemical Peels - 7/10

Chemical peels have been around for decades because they work.

They can improve pigmentation, dullness, texture, and overall skin clarity very effectively when properly selected.

The tradeoff is downtime and sun sensitivity, which is why I usually prefer them outside peak summer months.

Not every peel needs to be aggressive to be beneficial. Sometimes consistency with lighter treatments produces the best long-term skin health.

09.

Red Light Masks - 3/10

I know these are extremely popular right now, but I remain fairly skeptical.

Do I think they may have some mild anti-inflammatory benefits? Possibly.

Do I think most people are going to see dramatic anti-aging results from an at-home mask? Probably not.

In many cases, these devices feel more like a wellness ritual than a truly transformative treatment.

And there’s nothing wrong with rituals — as long as expectations are realistic.

10.

Gua Sha - 2/10

Gua Sha is heavily overhyped online.

Facial massage can temporarily reduce puffiness and improve circulation, but the effects are short lived. It does not fundamentally change collagen production or facial aging long term.

If you enjoy it as self-care, great. I just wouldn’t confuse temporary de-puffing with true rejuvenation.

11.

UPF Clothing - 8.5/10

Honestly, this is one of the most underrated anti-aging tools available.

UPF clothing provides reliable passive sun protection without relying entirely on sunscreen reapplication.

I especially recommend it for outdoor activities, travel, exercise, and post-procedure recovery.

Sometimes the least glamorous anti-aging strategies are actually the smartest.

12.

Hydrafacials - 7/10

I actually like Hydrafacials.

They’re not transformative, but that doesn’t mean they don’t have value. Patients leave with brighter, cleaner, more hydrated skin and essentially no downtime.

I think they’re great for maintenance, events, or refreshing the skin.

You just have to understand that the results are temporary.

My Overall Philosophy on Skin Treatments

One of the biggest mistakes people make is looking for a single treatment that “solves aging.”

That treatment does not exist.

Aging is multifactorial. Skin quality changes. Collagen declines. Pigmentation develops. Facial structure changes. Skin laxity increases.

That’s why I constantly talk about the difference between skin and shape.

Skincare and skin treatments can absolutely improve skin quality. But they do not necessarily correct structural aging or sagging. Those are different biological processes.

Ultimately, the people who age the best are usually not the people chasing every new trend online. They’re the people who consistently protect their skin, use proven active ingredients, live healthy lifestyles, and stay patient over time.

That’s really the secret.

Not hype. Not magic.

Just consistency and good skin science.

Amir Karam MD

Board Certified Facial Plastic Surgeon
Founder / Creator of KaramMD Skin

Dr. Amir Karam is a world-renowned facial plastic surgeon specializing in facial and skin rejuvenation. With over two decades of experience, he has helped countless patients achieve a naturally youthful, refreshed appearance. As an innovative surgeon, researcher, textbook author, and speaker, he is a leading authority in his field. Beyond performing surgical procedures that restore a youthful facial shape, he emphasizes the importance of skin quality, ensuring a comprehensive approach to facial rejuvenation. As the founder of KaramMD Skin, he is dedicated to making advanced skincare simple, effective, and accessible—helping you look as young as you feel.

17 comments

Dawn

Hi, thank you for the update. Which collagen supplement do you recommend as their is so much on the market .
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KaramMD Skin replied:
Hi Dawn—Thanks for your comment! Dr. Karam doesn’t recommend a specific collagen supplement. When shopping for collagen, prioritize hydrolyzed collagen peptides for optimal absorption. Look for targeted, clean formulas backed by third-party testing to ensure purity and effectiveness.

June 15, 2026 at 10:55 am

Alyssa Brennan Brennan

Thank you for this article. Id like the next one to cover Ultherapy, Thermage anc any/all skin tightening type devices
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KaramMD Skin replied:
Hi Alyssa — Thank you for your comment and for the suggestion! We’ll make sure to pass this along to the team as a future Journal topic. In the meantime, you may find his existing articles on energy devices and skin laxity a helpful starting point: https://karammdskin.com/blogs/expert-advice/

June 2, 2026 at 2:18 pm

Janet Tucci

Thank you so much for your input and expertise! As a post menopausal woman who has fought hard to care for her skin, I would love to hear your input on anything that really helps build collagen. Unfortunately, my financial resources are limited so please keep that in mind as well. Thank you!
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KaramMD Skin replied:
Hi Janet — Thank you for your kind words and for sharing your story. The dedication you’ve shown to caring for your skin is something to be genuinely proud of. Post-menopause brings a significant drop in estrogen, which directly accelerates collagen loss , so your instinct to focus on collagen support is exactly right. The most clinically proven topical ingredients for stimulating collagen production are Retinol, Vitamin C, and peptides. The good news is that the Trifecta delivers all three in a single, simple system specifically formulated to work together for maximum efficacy. Quench supports natural collagen synthesis through its triple-action Vitamin C complex, while Illuminate combines encapsulated Retinol, Acetyl Tetrapeptide-2, and over a dozen other active ingredients to improve skin firmness, elasticity, and overall collagen density over time. Beyond topical skincare, daily SPF is non-negotiable. UV exposure is the single biggest accelerator of collagen breakdown, so protecting what you’re building is just as important as building it. We understand that budget matters, and we’d love to help you find the right starting point. Please don’t hesitate to reach out to our team directly at customerservice@karammdskin.com and we’ll make sure you’re taken care of.

June 2, 2026 at 2:16 pm

Rhoda Jones

Essentially the only true skin care that can give you the best results is a facelift. The other hard musts are as you listed above. I’ll be saving up my $$ by investing. I hope to be ready by age 65. I need one now, unfortunately, I’m not ready yet.
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KaramMD Skin replied:
Hi Rhoda — Thank you for your comment and for your honesty! Dr. Karam couldn’t agree more that a well-performed facelift, when the time is right, remains the gold standard for meaningful structural rejuvenation. The exciting news is that the time between now and then is anything but wasted. The skin you arrive at surgery with has a direct impact on your results and your recovery. Patients who commit to a consistent, clinically tested skincare routine like the Trifecta before their procedure consistently see better outcomes, faster healing, and longer-lasting results. Think of it as the best possible investment you can make right now toward the surgery you’re planning , you’ll thank yourself at 65.

June 2, 2026 at 2:10 pm

Priscilla Hungerford

What do you recommend for neck bands???
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KaramMD Skin replied:
Hi Priscilla — Thank you for your comment! Neck bands are caused by the underlying platysma muscle becoming more prominent over time, which is a structural change that skincare alone cannot fully address. For significant banding, the most effective solution is a surgical procedure performed by an experienced surgeon who can address the muscle directly. That said, the Trifecta,applied consistently to the face and neck, plays an important supporting role by improving skin quality, hydration, and firmness in the neck area, which can soften the overall appearance over time.

June 2, 2026 at 2:08 pm