Caring For Your Skin With Exfoliation

By Dima Ali, MD

Two commonly asked questions in my practice are “Should I be using facial scrubs?” and “How often?”

We usually “scrub” our skin to clean it and remove dead skin cells to achieve a healthy, radiant glow and softer skin. For all skin types, I recommend using a combination of physical and chemical exfoliation methods to achieve the best results. “Normal” skin types tend to be able to tolerate more frequent and stronger types of exfoliation than sensitive skin.

Remember that our skin naturally exfoliates daily and about once a month we have the pleasure of a new epidermis. When selecting an over the counter product to assist with this process, keep in mind that natural is not always better. Some products with “natural” scrubbing particles such as sugar, salt, almond meal or fruit kernels do not have uniform surfaces and can often be too large and abrasive for the face.

Choosing an exfoliant with uniform particles is best for the face and neck. You can test products by rubbing a little between your thumb and index finger. These products can be purchased over-the-counter, however those obtained from a dermatologists office are going to be better matched for your skin and generally more powerful.

With regard to frequency, my recommendation for normal skin is “as tolerated” but at least twice a week. If no dermatologic skin conditions exist that require treatment, such natural products are usually fine to use on the body. Personally, I use a loofah in the shower about three times a week. You should determine how much you can tolerate and what feels right for you. It's similar to driving a manual shift car you shift gradually or you mess up the gears. Take it slow and see how it goes.

Exfoliation that leaves your skin soft, smooth and glowing is better than exfoliation that results in calling your doctor complaining of pinpoint bleeding on the facethis can happen if you decide to use a pot scrubbing sponge (true story). This may be fine for calluses but not your face. This kind of abrasiveness can result in a process called PIH or post inflammatory pigmentation. You don't want to exchange dead skin cells for brown spotsbalance is always best for an at home regimen.

Without getting into too much detail about more clinical/physical and chemical grades of exfoliation, I am a proponent of vibradermabrasion that employs a very effective oscillation technology.

My only other caution would be not to purchase chemical exfoliants on the internet that should only be used by a trained physician or skin specialist. I've had several patients try to save money by purchasing products on the internet and using them at home. They all resulted in chemical burns, which required prescription topical medication and laser treatments to reverse.

The bottom line is that assisting the natural exfoliation of your skin is a good thing but, sometimes, too much of a good thing can also be bad. If you're not sure how much is too much, consult your doctor.