"IPL is a safe way to get rid of unwanted hair," says dermatologist Barbora Grillová, who advises people on how to care for their skin properly and without unnecessary risks
MUDr. Barbora Grillová is one of the doctors who perceive beauty and skin health as two sides of the same coin. After graduating from the 2nd Medical Faculty of Charles University, she joined the Dermatovenerology Clinic of the Na Bulovce Hospital. She also gained experience in private centres, where she focused on the treatment of skin diseases and aesthetic dermatology. She is a certified expert in the application of botulinum toxin, fillers, mesotherapy or plasma therapy and also specializes in working with lasers and IPL technologies. In this interview, she explains why SPF is the best anti-aging product, what mistakes people make in their daily skin care routine, and why tanning beds should remain a relic of the past.
Barbara, what originally led you to dermatology in the first place?
I've always been close to dermatology because my dad is also a dermatologist and allergist-immunologist. In addition, my mother suffered from severe atopic eczema, so I saw from childhood what a torment it can be with the skin. That combination left a deep impression on me, so when I went to medical school, I was already thinking a little bit about the field. But I told myself I wanted to broaden my horizons first. It wasn't until my fourth year, when med students have a dermatology internship, that I got into the skin department. I was there for two weeks and I was hooked right away.
Plus there were great people there, so it all came together nicely. Dermatology grew on me and after medical school I knew I wanted to do it.
And in the end you decided to focus on aesthetic medicine, right?
Actually not really, it's not that I'm only focusing on aesthetics - it's more one of the areas I'm pursuing. I enjoy everything about dermatology and I didn't want to deprive myself of anything. I'm a person who has a lot of interests and I enjoy it when the work is varied. So I still do classic skin medicine - I examine moles, I do prevention, I treat eczema and other diseases. But I also add aesthetic medicine to that, because in aesthetics we have a lot of materials and devices that also help in treating various skin problems. So it all makes sense to me and I enjoy that combination.
How much do you think medicine and aesthetics are intertwined today? Is it even possible to separate one from the other anymore?
I don't think you can separate the two anymore. Aesthetic dermatology is a regular medical field that combines anatomy with dermatology, partly with surgery or biochemistry - because you have to know exactly what substances you are applying - and also with physics to understand the devices you use to treat patients. It is, in short, a field that has a strong place in medicine and needs to be approached as such. Here in the Czech Republic, aesthetic procedures can only be performed by doctors, and rightly so. It is illegal for aestheticians or other non-medical staff to perform these procedures.
Let's move on to the topic that probably interests our readers the most - everyday skin care. What do you think people most often do wrong?
The biggest mistake is definitely not cleansing the skin enough. A lot of people just use micellar water or cleansing gel in the evening, but they don't cleanse their skin enough. The right thing to do in the evening should always be a two-step routine, the so-called "double cleansing". That's the very basics. The second fundamental mistake is that people don't use a cream with SPF, or sun protection, every morning. That's really the most important thing you can do for your skin. Because UV rays penetrate even through glass or clouds. Using SPF is the best prevention not only against skin aging, but also against skin tumors.
So even if I'm sitting at home all day, should I still put on SPF?
Exactly. Today, it's proven by studies - about 90% of all signs of skin aging are due to UV rays.
But many people have very complex skincare routines and use different products, like retinol. However, there have been discussions recently that retinol may not be suitable for everyone, especially young people. So what is it?
You're right, this is a very hot topic right now. Retinol is a great substance - one of the most effective in fighting aging, pigmentation and acne. But the "less is more" principle applies here. If you're starting out with retinol or using it long-term, applying it once or twice a week is perfectly sufficient. It's definitely not necessary every day. The important thing is to combine it with moisturizing and soothing products so that your skin doesn't get irritated. And just as you say - nowadays even kids around nine or ten are interested in cosmetics, often because of the influence of social media. On the one hand, it's great that they already know how to take care of their skin, but we have to be careful because children's skin is thinner and more sensitive than adults. If retinol needs to be included, for example because of acne, more gentle forms must be used and always with caution.
How many steps do you think a person should have in their daily skin care routine to look good even at 50? Is it more of a multi-step routine or the opposite of simplicity?
Everyone should find what works for them, but if you follow the three basic steps - cleansing, moisturising and sun protection - you're good to go. Everything else is just a matter of whether you enjoy cosmetics. I have a lot of patients, men and women, who enjoy skincare - they double cleanse in the evening, use toner, serum, cream, and are happy to do it. But just as fine is the attitude of those who don't get into cosmetics, treating it more like a routine akin to brushing their teeth. They have a two-step cleansing in the evening, a moisturizer with peptides or anti-age ingredients, then a cleansing and SPF cream in the morning.
Today is great at this - even SPF creams themselves already contain nourishing or anti-aging ingredients, so if you don't want a complicated routine, there's no need. The important thing is that you enjoy the skincare and that you do it regularly, morning and night. If you don't enjoy it, simplify it as much as possible, but do it honestly. And if you enjoy it, do it in detail, step by step.
Is it necessary to have a separate moisturiser for day and another for night? Or do you just use the same one?
Just the same one. Just remember that the moisturiser should be followed by a moisturiser with SPF in the morning. Some people have a cream that already contains SPF, others add it separately - both are fine. When using two different products, wait until the first one has soaked in before applying SPF.
So SPF should always be the last step in your morning routine?
Exactly. And then you can apply your makeup if you want, or just head out.
Let's move on to the next topic - laser and IPL. A lot of people are dealing with just hair removal. What is the difference between laser and IPL?
IPL stands for Intense Pulsed Light. It is a non-invasive method that does not damage or burn the skin. The light from the device inhibits hair growth but does not completely destroy the hair bulb like a laser, which is much more invasive - especially those used in larger clinics. IPL, on the other hand, is gentle and suitable for almost everyone, even people with sensitive skin. It can be used all year round, it just shouldn't be applied to tanned skin where it could cause temporary depigmentation. Otherwise, it's a great, safe method that can be used virtually anytime.
Could you say which method is better or more suitable for certain types of people? It is often said that IPL is less effective than laser - is this true?
It depends on the particular device. There are many types of IPL devices with different intensities. The at-home ones are obviously weaker than the clinical ones, so it's important to have an experienced professional working with them in the office - with higher powers, there's already a risk of complications such as burns or hyperpigmentation. Whichever method you choose, however, you need to take into account that hair removal is not a matter of two or three visits. Usually five to six sessions are done, sometimes more depending on the location.
And after such a series of treatments, do I have peace of mind forever, or do I need to repeat it after a while?
Usually, the treatment needs to be repeated after some time - perhaps after six months or a year. It depends on the type of skin and hair. Also, some people may not be comfortable being treated by a stranger, especially in more intimate areas, so they choose a home IPL machine for this reason as well. The home versions are no less effective - they just use a weaker light to avoid irritating the skin. But in terms of results, they are very good.
From the reactions of my patients and followers on Instagram, nine out of ten people are very happy with home IPL epilation. But it's important to know that IPL, like laser, doesn't work on everything. If you have darker skin and light hairs, or even grey hairs, the results won't. The light works on the pigment, so if it's missing, there's nothing to target.
So the ideal candidate is someone who has lighter skin and darker hair?
Exactly. IPL works on dark hairs on lighter skin. That's why you shouldn't have tanned skin - the light targets the dark pigment, and if it's not there, the treatment won't be effective.
Is IPL also suitable for men, who generally have thicker and thicker hair than women?
Yes, definitely. It works for everyone. For men, it's often more practical because their hair is darker and more pronounced. IPL is a great option for them too, whether it's on the back or on the chest.
And can IPL really be used on all parts of the body? Like the underarms, groin or genital area?
Yes, IPL is designed for full-body treatments. It just shouldn't be used directly on the mucous membranes - otherwise you can treat the skin in the groin area, underarms, chin, back or arms. Virtually all common locations where hair bothers.
If I already have the right type of skin and hair, how often should I repeat the treatment?
In the beginning, about once every four weeks. Some devices allow shorter intervals in the beginning, perhaps after two or three weeks, but the ideal is always to let the skin regenerate. In addition, the devices nowadays often advise themselves - they have sensors that evaluate the skin type and suggest the ideal intensity and frequency.
How long does one such treatment last?
It depends on the area to be treated. If it's the whole leg - so calves and thighs - we're talking about 15 to 20 minutes. Smaller areas, like the armpits or groin, can be done in 5 to 10 minutes.
And what does it actually look like in practice?
The machine looks a bit like a bigger gun. Nowadays, it's partly equipped with artificial intelligence - you put it on your skin, like on your arm, and it assesses how fair your skin is and how dark your hair is, and adjusts the intensity. Then you just press a button that triggers a flash of light, and gradually swipe over the area bit by bit.
Barbara, you're quite active on Instagram. What's it like to be a doctor who also interacts with her audience like an influencer?
I appreciate that you feel that way. But first of all, we're still doctors - not influencers. Social media like Instagram, TikTok or other platforms are not a goal for me, but a tool. They help me stay in touch with patients and followers, educate them, showcase our work, and occasionally showcase some of my free time. I think people enjoy it because it humanizes the doctor - patients aren't as nervous then, they know you, they know who you are and if they like you. Personally, I really enjoy it and it brings me a lot of inspiration and new work projects.
On the other hand, I have to admit that sometimes it's hard to reconcile it all - you're in the office all day, then you want to do that part too, but at the same time you have family, friends, hobbies, sports, music. It's important to find a balance. But I find it really fulfilling and it gives me positive energy. And as far as the negative reactions - I think doctors have an advantage in this, we rarely get hits.
But on social media, there's a lot of pressure on how you look. Do you sometimes feel you have to look perfect?
Of course I feel the pressure. I'm in aesthetic medicine and on social media, so it's a double pressure. But you have to have self-reflection and a healthy distance - to realise that what we see on the networks is often not reality. Photos and videos go through edits, filters, it depends on the light, the angle, the makeup... All of this creates an illusion of perfection that has little to do with who a person really is.
How do you take care of your skin when you're out of the office?
I really like skincare, it's relaxing for me at the same time. And I think that's what I can offer my patients - that I don't just deal with the medical side of things, but also the practical, domestic side. Because that's half the success. You can invest a lot of money in yourself in aesthetic procedures, but if you don't follow the right care at home, the effect will never be as nice or long-lasting. I love trying new products, so I rarely reach for the exact same cream when I run out.
There are a lot of really good quality cosmetics on the market today, and it's rare for me to find something that doesn't suit me. But it's also because I already know my skin well - I know it's more oily and prone to breakouts, so I automatically choose lighter textures that don't clog my pores. I also already know exactly when something doesn't suit me - for example, if my skin starts to itch or is over-dried, I immediately discontinue the product.
So the ideal is to find out what my skin type is first, and then choose products accordingly?
Exactly. That's the basics. And then I personally like products that are "smart" - like peptides or new, scientifically developed molecules. I like research and innovation behind cosmetics. That's what I enjoy.
Winter is coming and a lot of people are now starting to go to tanning salons to keep their summer tan. What do you think? Is it really as harmful as people often say, or is it "everything in moderation"?
Tanning is an absolute no for me. If I could, I'd ban it altogether. And I'm not just saying this out of personal conviction, but on the basis of scientific studies. From a dermatological point of view, tanning is one of the most damaging things you can do to your skin.
UV rays in a tanning bed have a whole host of consequences - they accelerate skin aging, cause pigment spots, can aggravate acne, dilate blood vessels, damage pores and contribute to rosacea. But above all, it significantly increases the risk of skin tumours. Fortunately, today most people are moving away from the ideal of the "perfect tan". We all have a different phototype, a different skin tone, and it's perfectly fine that way. The important thing is to keep your skin healthy. If you're after a tanned look, reach for a good quality self-tanner instead. Let's not treat sunbeds as normal anymore - they just don't belong in the 21st century. They are unnecessarily risky and harmful.
