Exfoliation - To Do or Not To Do

I counsel patients regularly and post on social media about the risks of over-exfoliating your skin. It is also the case that some people may be able to exfoliate regularly while others may not need to at all, though many people will benefit from at least some exfoliation, so how do you do it right? Personally I have combination - oily skin and I like to integrate chemical exfoliation in my routine. There are many ways you can exfoliate and you have to find what works best for you (please don’t use all of these!)

First off, what is exfoliation? Exfoliating involves the removal of dead skin cells from the skin's surface and can be accomplished using physical friction - a washcloth, loofah, or scrub would all qualify as physical exfoliation - or chemicals that react with the skin to remove layers of dead skin cells. The most common chemical exfoliants are alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs) and more recently you may have heard about polyhydroxy acids (PHAs). Glycolic and lactic acid are two of the most common AHAs and salicylic acid is the primary BHA. For those who find AHA / BHA too irritating for their skin then PHAs may offer a gentler exfoliating option.

So how can you incorporate chemical exfoliants in your routine?

One option is a cleanser that contains exfoliating acids. For this sort of short contact therapy daily use is likely ok. Another popular option is a toner, or liquid exfoliant, that can be applied to the skin after cleansing. While some people may tolerate daily use I would generally suggest using a few times per week. A number of companies offer exfoliating pads as another option. I personally find them convenient and I like to use them at the end of the day to remove oil & makeup. Lastly are leave on treatments (e.g. overnight treatment featuring glycolic acid or lactic acid). Generally these should be used 2-3 times per week and if you are using a retinoid you may want to consider using on alternate nights.

While exfoliation can offer benefits, especially for those with more oily skin and those prone to clogged pores, if you overdo it you can risk damaging your skin barrier. So when in doubt take it easy. And be aware of how many products in your routine may contain exfoliating acids.