A patient comes into the office and says, “Dr. B, I've never had acne in my life. But all of a sudden, I've been having breakouts, and my skin is so dry.”
I reply, “Can you tell me a little about your skin care regimen?”
“I moisturize every morning and have a nice exfoliating cleanser. I use a serum and night cream in the evenings. I've been using them forever.”
“Any exfoliating brush?”
“Of course, I use my brush every day. Why?”
In our office, we hear this on a daily basis. While new onset acne can be due to various reasons, over-exfoliation-based skin issues are becoming increasingly common. Companies like Clarisonic, Clinique and Olay have redefined home exfoliation for millions of people around the world. With the advent of new technologies, it's becoming easier to unclog your pores and free yourself of unwanted dead skin cells.
So, how much is too much?
This is a tricky question. No dermatologist will argue that exfoliating is bad. After all, unclogging your pores is the key to maintaining great skin health. We also applaud companies for putting out new mechanisms that improve the process. Harsh procedures in the past led to significant downtimes and mixed results.
So, what happens if you overdo it? With continuous over-exfoliation, the body starts losing the excess oils that function to protect your skin (Note: Not all oils are bad.) This can lead to two things:
1. Compromised integrity of the epidermis (the most superficial layer of the skin). This leads to increased exposure to environmental toxins.
2. Potentially compensatory hyper-secretion of oils from the glands. Even if you have oily skin, your body is tricked into thinking it needs to produce more oil. This cascade can lead to increased pore blockage and uncharacteristic breakouts that were never previously an issue.
So, how should one handle cleansing and exfoliating?
Each morning and night, you should use a gentle cleanser that cleans and hydrates the skin. For patients with particularly sensitive skin, I typically recommend brands like Neutrogena (the Ultra Gentle line is great) or Cetaphil. If you're removing makeup, I recommend products like the Neutrogena ultra-light cleansing oil or gentle wipes. These products remove both daily pollutants and any superficial debris that could lead to inflammatory reactions later on.
It's recommended that, at most, exfoliating should be done two to three times per week. It's important to remember that products that contain alpha or beta hydroxy acids are all potent exfoliators.
While they are great at what they do, adding in a brush or mask amplifies the effect. I generally recommend patients start with exfoliating two times a week (such as Wednesdays and Sundays).
If you start drying or breaking out, I recommend completely stopping the exfoliation. Instead, stick to gentle cleansers and moisturizers as often as needed.
As the skin begins to repair itself, you can resume exfoliating once weekly and go from there. If you still have issues, I recommend coming in for an appointment. This way, we can go over a tailored plan that works for you. Every person is different, so what works for some may not work for others.
Clarisonic and other brush technologies are wonderful products, and they're great for your skincare routine. As with most things, moderation is key. You may need to tinker, but all people can find the perfect combination of products and treatments to get the skin they have always wanted.
Feel free to follow me on Twitter for more tips, and let me know if there are other skincare questions you would like me to write about.