Skin exfoliation

What is Exfoliation?

Exfoliation is the process of removing dead skin cells from the surface of our skin.

According to the American Academy of Dermatology, exfoliation can leave the skin looking brighter and improves the effectiveness of topical skin care products by improving absorption.

Regular exfoliation can help prevent clogged pores, resulting in fewer breakouts and minimizes the size of the pores.

In the long-term, exfoliating increases collagen production.  Collagen is a protein that promotes skin health and elasticity. This protein is also responsible for minimizing the appearance of fine lines related to skin aging. 

The layers of human skin can be categorized as the epidermis (outer layer), the dermis (middle layer) and the hypodermis (most inner layer).

Cell turnover slows dramatically as we age from approximately 20 days when we’re younger to every 30 days in older adults. Our skin produces new skin cells in the hypodermis pushing the dead cells to the epidermis where they usually fall off during normal daily activities such as removing a sweater.  However, not all the decommissioned cells fall off readily, creating layers of accumulation. This accumulation of dead skin cells will affect the skin’s appearance and texture in a variety of ways; from fine lines and wrinkles, flaky patches, acne from clogged pores or hyperpigmentation.

In order to remove the layers of dead surface skin, some type of exfoliation is in order. However, care must be taken when exfoliating as our skin is the protective barrier that helps protect the inside of our body from environmental insults. One must take extra precautions when dealing with the surface of the skin on our faces as it is of the more sensitive and delicate areas of our bodies and it can be easily damaged.  

Types of Exfoliation:

Mechanical (scrubs, brushes, gloves, sponges, wash cloths)

Enzymatic (Papain, Pumpkin)

Chemical (AHA, BHA, Combination)

Pads soaked in chemical material

Derma planning (exfoliating with a small blade)

Skin may be exfoliated either manually or chemically at home or be part of a daily skin care routine.

How to exfoliate safely at home:

• Ensure that your face is clean prior to exfoliating to open up the pores.
• Be gentle.
• Avoid the tender areas around the eyes and lips.

Manual exfoliation can be done using a tool such as a sponge, a wash cloth or glove.  Take an ordinary wash cloth or natural sponge, moisten with warm water then use this to rub the skin gently in small circles. Apply gentle pressure to prevent irritation. This will be enough to remove most dead skin cells that are no longer firmly attached to the surface.

Scrubs

Exfoliating face scrubs can also be used with caution so as not to damage the skin.  Some ingredients may cause irritation or micro tears.  Avoid products that do not dissolve such as nut shells.  Many people also make their own scrubs using salt, sugar or oatmeal. Recipes for these are readily available on line. Sugar or salt based scrubs will usually dissolve well and are gentle on the skin providing they are used sparingly such as once per week. People with sensitive or dry skin should take extra care with scrubs and may want to use them even less frequently.

Chemical Peels:

Chemical peels are one of the most effective ways to address skin changes caused by an accumulation of decommissioned skin cells.  However, they are not a one-size-fits all treatment.  Optimally they should be strong enough to remove the outermost layers and stimulate cell renewal and turnover thus improving skin’s texture and appearance.

These should be used by trained health professionals as they can possibly cause severe skin inflammation, burns and hyperpigmentation.

Depending on the treatment desired, a chemical peel can be:

1. Very superficial – used to treat acne, hyperpigmentation and fine lines and wrinkles
2. Superficial – used to treat signs of aging, acne and hyperpigmentaion
3. Medium depth – used to treat superficial scars and solar keratosis as well as hyperpigmentation and signs of aging
4. Deep – to be used by trained medical professionals to treat severe photo aging, deep wrinkles and scars

Chemical Peeling Agents:

Alpha Hydroxy Acids (AHAs)

The most common AHA is Glycolic Acid. Lactic Acid, Mandelic Acid and Malic Acid are other AHAs.  AHAs are water soluble and can be used at differing concentrations for different effects on the skin. They can be used for daily skin routine at home at lower concentrations to act over time.  Used at higher concentrations by professionals, they exfoliate the epidermis more quickly. They can also make your pores appear smaller and minimize the appearance of fine lines.

Beta Hydroxy Acids (BHAs)

Salicylic Acid is a common type of BHA and is oil soluble. For this reason, they are well suited for people with mostly oily skin as they penetrate right into the pores to dissolve the oils and clear the pores.  They are often used to treat conditions like acne and can be found in some over the counter preparations in a diluted format for daily use.

Retinol

Retinol is a vitamin A derivative that can be used for as a chemical exfoliation.  Many skin care preparation contain a lighter concentration of retinol for regular skin care routine.

It can cause inflammation to the skin, therefore if you have other inflammatory conditions like eczema, rosacea or psoriasis you should avoid using it.

Special Cautions:

• Stop using products containing retinol or benzoyl peroxide at least one week prior to booking for a chemical peel.
• Avoid exfoliating damaged skin such as sunburnt skin. Test the exfoliant on a small patch of skin prior to use.
• Moisturize after exfoliating and use a mineral or a combination of mineral and chemical sunscreen to protect the skin. All types of exfoliation increase the skin’s sensitivity to all ultraviolet rays.
• Exfoliate before shaving or using other methods of hair removal.  This helps prevent dead skin cells from blocking pores that are opened during shaving or hair removal.
• Avoid exfoliating especially with chemical peels within a few days of an important event as there will be redness, irritation or even peeling of the skin.