Evaluate Before You Exfoliate

April 2, 2015 Updated: April 2, 2015

Information provided by board-certified dermatologist Mary P. Lupo, MD, FAAD, clinical professor of dermatology, Tulane University School of Medicine, New Orleans. 

Exfoliation is the process of removing the topmost layer of dead skin cells. This can be achieved chemically, by applying an acid that dissolves those cells, or mechanically, by using a brush or scrub to physically remove the cells.

Dr. Lupo says results are immediate after an exfoliation treatment, as the removal of dead cells leaves the skin looking brighter. Exfoliation also can improve the effectiveness of topical skin treatments, which can penetrate deeper once the topmost layer of skin is removed. Long-term benefits of exfoliation can include increased collagen production, resulting in younger-looking skin.

According to Dr. Lupo, individuals who may benefit from exfoliation treatment include those who have experienced premature aging due to sun exposure and those with noninflammatory acne, which is acne with only blackheads and whiteheads. 

Proceed With Caution

On the other hand, Dr. Lupo says, individuals with inflammatory acne, which includes cysts and pustules, should consult a board-certified dermatologist before selecting an exfoliation method. More aggressive chemical or mechanical treatments could actually make their condition worse. The same is true of people with rosacea, as many forms of exfoliation may increase facial redness.

Before you exfoliate, you really need to understand your skin and skin type.
— Dr. Mary P. Lupo

In some individuals, more aggressive forms of exfoliation may result in postinflammatory hyperpigmentation (PIH), or the appearance of dark spots on the skin. People with skin of color or those who notice such dark spots after burns or bug bites may be prone to PIH. Dr. Lupo recommends that these individuals avoid aggressive exfoliation treatments.

Additionally, exfoliation may aggravate other skin conditions like herpes simplex, molluscum contagiosum and warts, because these conditions include raised, fluid-filled bumps that could open and become infected. Before beginning an exfoliation regimen, Dr. Lupo recommends consulting with a board-certified dermatologist, who can evaluate an individual’s medical history and recommend the best exfoliation options.

Dr. Lupo’s Exfoliation Advice:

Consider your skin type.
If you have dry or sensitive skin, Dr. Lupo recommends sticking with milder chemical exfoliation options, such as a salicylic acid peels administered in a dermatologist’s office. Those with oily, thicker skin may be able to use stronger chemical treatments, such as an over-the-counter 2 percent salicylic acid wash, or mechanical exfoliation methods, such as a motorized brush or a scrub that contains exfoliating particles. 

Get the timing right.
How often should you exfoliate? Dr. Lupo says that depends on both your skin type and the strength of your treatment method. Those with oily, thicker skin may need to exfoliate as often as once a day, while those with dry or sensitive skin may need to limit at-home treatments to once or twice a week. The more aggressive the procedure, she says, the less often it needs to be done. For example, chemical peels and microdermabrasion procedures performed by a dermatologist are generally administered just a few times over a couple of weeks, with long-lasting results.

Be careful what you buy.
There are a wide variety of exfoliation products available in stores and online, but not all of them are safe and effective. Dr. Lupo suggests doing your homework to confirm that the product you’re about to buy comes from a recognized, reputable company. She also recommends buying over-the-counter chemical products with a low acid concentration — no higher than 10 percent glycolic acid or 2 percent salicylic acid.

See a dermatologist.
A board-certified dermatologist can help you choose an at-home exfoliation option and perform a variety of exfoliation procedures in the office. Plus, Dr. Lupo says, your dermatologist may decide to combine exfoliation with other treatments, like laser therapy, to give you the best possible results. 

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