Everything You've Ever Wanted to Know About Exfoliation

If you want to look smoother, brighter, and younger, you gotta exfoliate. Find out exactly how, because every face needs some slough love.

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What do nearly all glowy-skinned women have in common? They exfoliate. Yes, whisking away dead cells can give you a lit-from-within look without dermatologist help or an Instagram filter. It becomes even more important when you hit your thirties and forties.

"Around that time, skin's natural exfoliation slows down and cells tend to stick together more," says Tina Alster, MD, a clinical professor of dermatology at Georgetown University Medical Center in Washington, D.C.

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Sloughing off those clumps makes for a more even, light-reflecting surface. So use this exfoliation primer, starting with two methods: mechanical and chemical.

MECHANICAL EXFOLIATORS

That's the technical name for anything that rubs across your skin's surface and banishes dead cells — a cleansing brush, a scrub, or just an ordinary washcloth. All of these give you fast results by getting rid of cells that are already loose and ready to fall off. (They're possibly less irritating than chemicals — more on this later.)

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So many scrubs! Which do I use?

Look for a scrub that has small, smooth, beads with no ragged sides, such as jojoba. Earthy ingredients like apricot pit particles can be jagged and rough, causing little ­microtears on the skin's surface. "These tiny scratches can trigger acne by letting bacteria in and causing inflammation," says Heidi Waldorf, MD, an associate clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York. Also important: Jojoba is environmentally safe, unlike plastic microbeads, many of which have trickled into waterways and ended up in fish and, later, us. (The government has banned the use of these beads in scrubs, starting the middle of next year.)

How do I actually do it?

Buff gently — don't sand yourself down. Using light pressure, work your scrub over wet skin in circular motions, avoiding the eyes and any other sensitive areas. "It shouldn't be painful, and you shouldn't end up red or puffy," Waldorf says. "Scrub for two minutes, max. One minute is enough for most people."

Do those beauty brushes work?

You bet. Alster uses a sonic one regularly: "I think it's the best way to exfoliate. It gently vibrates dirt out of your pores, rather than swirling it in, which rotary brushes tend to do." Plus, you're not stripping your face of its natural protective oils or using a potentially irritating chemical. Waldorf recommends looking for a brush with soft, gentle bristles and a timer, so you won't overdo it. Most important, go over your face just once: "There's really no reason to cover the same area multiple times," Waldorf says.

How often should I exfoliate?

It depends on your skin. "If you've got acne and oily skin, you could probably exfoliate daily," Alster says. But even dry or sensitive types can benefit from a once-a-week sloughing: Exfoliation can help get rid of flaking and peeling, says Dana Sachs, MD, a professor of dermatology at the University of Michigan Health System in Ann Arbor. If you're super dehydrated and flaking heavily, though, a scrub could make it worse. "In this case, moisturize," says Waldorf.

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When do I exfoliate?

Waldorf suggests doing it in the A.M. unless you're using a brush to remove makeup (in which case, exfoliate before bed). "You sweat a lot while you sleep," she says. "This way, you'll have a fresh face." Oh, and cleanse first, then scrub. (Some websites suggest trying things the other way around. Please don't — you'll just be swirling dirt and oil around your face.) Then be sure to apply an SPF before heading out to start your day, since exfoliation can make your skin more sun sensitive.

Do exfoliating cleansers do the same thing?

They sure do. An exfoliating face wash just has cleansing ingredients added to its base, says Waldorf, and gentle versions are fine for all skin types to use daily. Coarser, grittier formulas are best for oily skin with large pores that are prone to clogging.

CHEMICAL EXFOLIATORS

They speed up skin's natural shedding process by dissolving the protein bonds that hold dead skin cells together (swoosh, dullness gone). These exfoliators typically contain acids and come in the form of cleansers, serums, moisturizers, and peels. Downside? They can sometimes be more irritating to the face than the mechanical kind of exfoliation, says Zoe Diana Draelos, MD, a consulting professor of dermatology at Duke University School of Medicine in Durham, NC. So if you have sensitive skin, you might skip these. They also can make your skin more reactive to UV light, so sun protection is essential.

Which chemical exfoliating ingredients are best?

Alpha hydroxy acids (AHAs) such as glycolic or lactic acid are the most common, but you'll find products with other AHAs, including fruit acids like malic, tartaric, and citric. Dermatologists are fans of all these ingredients for fading brown spots and smoothing uneven texture. You may also see ingredients like papain and bromelain on the label — they're exfoliating enzymes that are fine for all skin types except sensitive. For those with acne, dermatologists reach for salicylic acid; it's attracted to the trapped oil in pores, dissolving it and flushing it all out.

So which to choose — a cleanser, serum, moisturizer, or peel?

If it's convenience you want, an exfoliating cleanser is your best bet. It's not as strong as the other products, so you'll need to use it for a few weeks to see a difference. And don't rinse too quickly. "I tell my patients to leave it on their skin for a few minutes," says Sachs. Want right-now results? Peels are the heavy hitters that can penetrate into the deeper layers of skin. You get major exfoliation — just know there's a greater risk of a cranky skin reaction.

Doesn't retinol exfoliate too?

Yes, retinoids (vitamin A derivatives like prescription Retin-A and OTC retinol ­products) stimulate cell turnover, a.k.a. ­exfoliation. But they often cause some mild flaking, and that's where another ­exfoliator can help. Choose mechanical or chemical, just take a day off from your ­retinoid when you use the exfoliator. If you notice that your skin is red or inflamed, skip both and just moisturize.

My skin's irritated; now what?

"Skip a day or three until it passes, use moisturizer, and apply cortisone cream if necessary," Waldorf says. After that, she advises restarting your routine, but only once or twice a week (and keep moisturizing!).

What do I put on after?

Apply moisturizer and sunscreen, for sure. But wait a few minutes first. "If you moisturize immediately, it may dilute the ­chemical exfoliator," says Alster. You're good with most anti-aging ingredients, such as peptides and antioxidants. Just avoid retinol, as noted above, as well as ­vitamin C, also a potential irritant.

This story originally appeared in the November 2016 issue of Dr. Oz The Good Life.

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