Bellevue Acne Clinic | The truth about exfoliation

The truth about exfoliation

How often should you exfoliate?

In this article we will explore an innovative way of thinking about your skin. I will teach you to take over the job of moisture balance on behalf of your skin, which will give your skin and the rest of your body the ability to heal itself, clear the toxins, and lead to a healthy complexion.

How often do patients with acne-prone skin need to exfoliate? In a word...Never!

Your skin's job is to form a barrier between what's inside (blood, muscle, nerves) and what's outside (germs, extreme temperature, pollution). As part of its regular duties, your body makes new skin cells and gets rid of old ones. As new skin cells are born, old ones get pushed up from the inner layers of your skin to the surface. These old, shriveled skin cells undergo a shedding process (also known as sloughing off) at a rate of up to 50,000 each minute. If the sloughing off process is not as efficient as it could be, there may be extra cells on the surface. These can cause the skin to appear a bit dull or dingy.

External exfoliation is a simple process to understand. A person uses some form of abrasive, either chemical or mechanical, to traumatically scrape off the top layer of skin, supposedly to expose the younger, healthier skin underneath. There are many types of chemical exfoliants. These products generally feel a bit gritty on the skin. Descriptors commonly found in product names include 'exfoliating,' 'beads,' and 'scrub.' Mechanical exfoliants include brushes, loofahs, and electronic devices with rotating heads.

If exfoliation leads to better-looking skin, then why NOT exfoliate three times a day? It's not that exfoliation is expressly forbidden for everybody. There are certainly people who exfoliate daily and still have great skin. However, those people do not end up as patients in Bellevue Acne Clinic (and therefore aren't as likely to be reading this article at this very moment). Our patients have acne, and individuals with acne should be avoiding the type of rigorous external exfoliation discussed in beauty magazines and websites.

Two big factors in acne physiology are excess oil production and inflammation. If you have acne and you start stripping off the top layers of skin, you are going to cause irritation (which leads to inflammation). Your skin responds to irritation and inflammation by releasing more oil, in an effort to replace the moisture that was removed during the harsh exfoliation. Of course, having acne-prone skin means that your skin already has a tendency to overproduce oil, and so it will overcompensate even more after you exfoliate. The end result is more zits and an unhappy patient. Sometimes patients are led to believe that if they just exfoliate more, the acne will get better, but unfortunately they just make it worse and worse.

How do you break the cycle? Strive for a healthy skin barrier. When you over-wash and over-exfoliate your skin, it gets dry and irritated and becomes unhealthy. Unhealthy barriers are inefficient at keeping nutrients and moisture inside the skin, and allow too much to evaporate or otherwise escape.

An unhealthy skin barrier allows external chemicals to flow too easily into the inner skin, leading to increased absorption. Since products like moisturizers and acne medicine are intended to absorb into the skin, so you might think that improved absorption is a good thing. However, a weak barrier is cracked and permeable, and too much medicine or product gets absorbed, which can cause irritation and restart the inflammation cycle. Also, think about products like makeup and some sunscreens that are intended to sit on the skin rather than be absorbed. If a cracked, weakened barrier causes those chemicals to be absorbed, this could lead to inflammation.

What steps can you take to promote barrier health?

Wash your face with an appropriate soap twice a day, and moisturize well. If you use the right products you can take over barrier duties on behalf of your skin, and your skin can devote its energy to the natural healing process and improve your complexion. Your skin needs you, its owner, to use soap to REMOVE debris (oil, grime, dead skin cells). If the soap you choose is too gentle, you will not be removing enough, your skin won't be clean enough and your pores will still clog. If the soap is too rough or the mechanical exfoliant too abrasive, you will remove too much, and your skin will overcompensate by producing oil and becoming irritated.

If you can more optimally match your product choices with your skin's needs, your skin will be able to relax and heal itself, instead of always trying to respond to the onslaught of harsh chemicals or abrasive brushes that you subject it to.

How do you determine the perfect combination of products? That is not always an easy question to answer, and you may need the help of a dermatologist or dermatology nurse practitioner, like the ones at Bellevue Acne Clinic. If you pay close enough attention, your skin will tell what the right combination of products is. If your skin feels too dry and irritated, your regimen is too harsh. If your skin never feels clean (even after cleansing), your product choices may be too gentle.

Remember, acne-prone skin does not require harsh external exfoliation. Limit exfoliation to twice a month or less. Instead, try to find the right combination of soap and moisturizer that leaves your skin feeling clean but not irritated and inflamed. If you do the heavy lifting for your skin, your skin will begin to heal itself and clear the acne.