The skin you’re in
EXFOLIATING ISN’T NECESSARY, BUT IF YOU DO IT, FOLLOW THE TIPS FROM THESE DERMATOLOGISTS
If you follow the advice of such magazines as Vogue and Harper’s Bazaar, social media “skinfluencers,” or your favourite skin-care brands, you may have read that exfoliating — the process of detaching dead skin cells — is a vital step in achieving healthy skin. These sources say exfoliation can amplify the results of serums, masks and moisturizers and other topical products, boosting the skin’s “glow” and “radiance,” as well as cutting down on acne and signs of sun damage.
But dermatologists will tell you that not only is exfoliation usually an unnecessary step, but also many people overdo it.
“Our skin cells naturally exfoliate on their own,” said Chicago-based dermatologist Caroline Robinson. The skin cells migrate from the deepest layers to most superficial layers, and slough off roughly every 28 days, she said, although the process can take longer as we get older. “Products and tools that help us exfoliate are designed to encourage a healthy behaviour our skin does naturally.”
Exfoliants are either chemical or manual (or physical), or a combination of both. Chemical exfoliants usually use hydroxy acids to dissolve the bond between skin cells, loosening dead skin for removal.
There are also enzyme exfoliants, which come from such fruits as papaya, pineapple and pumpkin. These tend to be gentler than hydroxy acids and may have anti-inflammatory properties.
Manual exfoliation uses a product such as a face scrub or a tool such as a mechanical face brush to “scrub” and loosen the dead skin cells. Microdermabrasion and dermaplaning are manual exfoliation treatments performed in-office.
The shelves of beauty retailers and drugstores are stocked full of exfoliating options: facial cleansers and toners; facial scrubs made with such ingredients as rice-based enzyme powder; and body scrubs that contain salt or sugar granules.
In 2020, facial exfoliant sales were up nine per cent yearover-year, said Larissa Jensen, vice-president of beauty at the NPD Group, a market research firm. Facial exfoliants were “the only segment to gain among the larger facial skin-care category, which includes cleansers, face creams and face serums,” she said.
“We are living in a society of over-exfoliators,” said Joshua Zeichner, a New York-based dermatologist and director of cosmetic and clinical research in dermatology at Mount Sinai Hospital. Consumers have unrealistic expectations, Zeichner said: “People try and achieve the ‘radiance and glow’ from exfoliation that they see in images and videos on social media, and unfortunately we do not have an objective way of measuring these terms.”
Atlanta-based dermatologist Tiffany Clay said she has seen an increase in facial over-exfoliation in her patients over the past year. “Patients who follow these ‘skinfluencers’ come into my office with compromised skin barriers due to exfoliating too often and with something too abrasive,” she said.
Clay said she prefers chemical exfoliants over manual exfoliants for the face, because they give more control. “When it comes to manual exfoliation, it’s all about pressure.” If you’re grinding a manual or physical exfoliant into your skin, you can create micro-tears in the skin and disrupt its barrier, she said.
Just because a product label tells you to exfoliate twice a day doesn’t mean you should, said Ranella Hirsch, a dermatologist based in Cambridge, Mass. “If you blindly exfoliate, you risk tearing apart your barrier, which is made up of functional skin cells that tightly regulate what comes into the body.”
Damage from over-exfoliation can present in many ways, including tightness, shininess, stinging, redness and increased sensitivity, Hirsch said. “We tend to grossly overestimate what our skin can handle.”
That’s why she recommends that people new to facial exfoliation “start low” with a low-percentage exfoliant, “start gentle” with less-irritating ingredients and “go slow” by beginning with one night a week and then gradually adding more only if your skin tolerates it.
While, again, exfoliating your body isn’t necessary, Hirsh said that hands, feet and sometimes arms and legs can benefit from regular exfoliation. You don’t have to show the same caution with those body parts as you do with your face, neck and chest, she said.
Clay recommends being careful with certain foot treatments. “Some people with very thick layers of skin on their feet may need a jump-start with a pedicure or at-home chemical foot peel. These should be done in moderation because although the soles of the feet may seem very thick, too much exfoliation may cause the skin to become too thin, leading to tears, cuts and infections.”
After exfoliating your face or body, it’s important to always follow up with a moisturizer, said Zeichner, who usually pairs exfoliating products with moisturizers that have skin-repairing ingredients such as niacinamide, ceramides and/or oatmeal. He recommended moisturizers from Cerave, La Roche-posay and Aveeno. And, the experts said, you should always apply sun protection when using exfoliants.
Because it’s easy to over-exfoliate at home, some dermatologists prefer in-office treatments, seeing them as a controlled burn compared with a wildfire. New York-based dermatologist Macrene Alexiades said she recommends exfoliation as an option for people with oily skin, large pores and, in some cases, wrinkles. “Specifically, with respect to sun damage and wrinkles, I use exfoliation (in-office) as an artist tool to resurface the skin and induce new collagen,” she said.
She and Robinson both recommend in-office chemical peels — which use one or more exfoliating chemicals to create an injury of a specific skin depth with the goal of stimulating new skin growth and improving surface texture and appearance. “When I administer a medical peel in-office, I get a full thickness resurfacing of the skin, and then we allow the skin to rejuvenate itself over a 28-day cycle,” Alexiades said.
“Chemical peels are one of my favourite in-office procedures because they are so simple to integrate and I can use them on all skin types,” Robinson said. They also can speed up your product results, she said.
Zeichner emphasized patience when it comes to seeing the benefits of exfoliation. “To see an improvement in texture, tone, hyperpigmentation or lines could take several weeks to months of regular use,” he said. But there is only one way to achieve perfect skin: using a good social media filter.
WE ARE LIVING IN A SOCIETY OF OVER-EXFOLIATORS.