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

Priscilla Hungerford

Are your products medical grade? I have been told that’s what I need… I have used Rhodan& Fields for years.i tried another medical grade line and my skin looked dry and wrinkly unlike I had seen before.. Thoughts!
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KaramMD Skin replied:
Hi Priscilla — Thank you for your comment and for sharing your experience! The term “medical grade” in skincare is largely a marketing label rather than a regulated standard . What truly matters is the quality, stability, and clinical efficacy of the ingredients themselves. KaramMD products are formulated using cosmetic-grade ingredients, which are specifically optimized for safe and effective topical application and are fully compliant with EU regulatory standards, the most rigorous in the world. What sets the Trifecta apart isn’t a label, it’s the science: a surgeon-developed, clinically tested system with third-party studies demonstrating real, measurable results across all skin types. As for the dryness and wrinkling you experienced with another line, this is often a sign that the products were too aggressive for your skin without adequate barrier support, or that the active ingredients weren’t properly balanced. The Trifecta is specifically formulated to deliver powerful results while maintaining skin hydration and barrier integrity, so many customers who’ve had similar experiences find it a much more comfortable and rewarding transition. We’d love for you to give it a try , you can explore the clinical results here: https://karammdskin.com/pages/clinical-study

June 2, 2026 at 2:07 pm

Mary Harris

Thank You !
You left out Trifecta !
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KaramMD Skin replied:
Hi Mary — Thank you for reading! And you’re right, the Trifecta truly is the foundation of long-term skin health . Consistent, twice-daily use of a clinically tested, surgeon-developed system is the most powerful thing you can do for your skin over time. We’re so glad to have you on this journey with us!

June 2, 2026 at 2:02 pm

Victoria Truchan

Do you do eye surgery (lower eye) for out of state patients?
If so, how do I get the necessary information?

Thanks
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KaramMD Skin replied:
Hi Victoria — Thank you for your comment! Yes, Dr. Karam does see out-of-state patients. The best next step is to submit a consultation request through his website, where you can share your photos and goals and his surgical team will guide you through the process from there: https://www.drkaram.com/getting-started/

June 2, 2026 at 1:56 pm

masha bardacos

Thank you for the learning curve. You are always on point. You have a library in your brain all things related to face and skin. Listen Dr. Karem please address the LYMA LASER It is not instead of a face lift at all. It is to maintain and keep your skin Tight and toned. It is for home use and is expensive but if it delivers then it would be worth it. Yes of course our Martha Stewart at 85 is really into it. Also several girlfriends as well when going somewhere special. They use Preparation H . Under their eyes. You know the Hemroid cream. You wash it off before going to bed. Gives a nice overall effect.

June 2, 2026 at 1:51 pm

Heather Mouzourakis

I’ve been using your trifecta for over a year now and LOVE IT! My only complaint would be packaging waste. The bottles a beautiful and refills could easily be sold so we weren’t throwing away the outer bottles every month. Just extremely wasteful.
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KaramMD Skin replied:
Hi Heather—Thank you for your comment and for your loyalty over the past year — it truly means everything to us! Your feedback on packaging is something we hear and take seriously. The airless, opaque design is essential to protecting the integrity of our clinically tested active ingredients , particularly Retinol and Vitamin C, which degrade quickly when exposed to light and air , but we completely understand that sustainability matters, and a refillable system is absolutely something we’re exploring for the future. Thank you for caring about both your skin and the planet , feedback like yours is exactly what shapes where we go next.

June 2, 2026 at 1:50 pm