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Less is more when it comes to skincare

January 09, 2020 | UCI Health
woman applying moisturizer to face

When it comes to skin care, more isn’t always better.

“Very few skin care ingredients have actually been shown to benefit patients clinically,” says Dr. Amber Leis, a UCI Health plastic surgeon and assistant professor at the UCI School of Medicine.

“The only ones that are supported by good scientific data are retinols — Retin-A is included in that — exfoliators, vitamin C (when properly formulated) and sun protection.”

About retinols

Even when using effective products, it’s important to use them correctly and not combine them in ways that can harm the skin.

“Retinols and Retin-A products are the ones most likely to cause irritation,” Leis says of these vitamin-A derived products. “They can cause redness and flaking, which is not always bad. Sometimes we actually use that inflammatory process to treat bad pigmentation or bad acne.”

For patients looking to reverse signs of aging, she recommends applying retinol products only once a week at first, then gradually increasing the frequency as you see how your skin reacts.

However, people with certain skin conditions, such as rosacea and eczema, should be extremely cautious with retinol products because they are likely to experience significant skin irritation after using them.

Exfoliate with care

Exfoliation involves removing dead skin cells, usually with a chemical or granular material. Exfoliating products, such as chemical peels and scrubs, can reduce fine lines and pigmentation when used carefully and in moderation, notes Leis.

Avoid scrubs containing ground nut shells, though, because the irregular edges cause skin damage. Scrubs with rounder particles are gentler on the skin, she says.

However, exfoliating products should not be used at the same time as retinols.

“Using exfoliants in conjunction with retinols can make skin extremely irritated,” Leis says. “It’s best to use them on alternating days or at different times of the day.”

Skip DIY chemical peels

At-home chemical peel agents are particularly dangerous, she warns.

Because topical chemicals are designed to remove the outer layer of skin, there is a high risk for causing burns and permanent skin pigment changes with at-home use.

“Chemical peels should only be applied by trained professionals,” Leis says.

Vitamin C serums

Prized for its anti-oxidant properties, vitamin C has become popular as a topical treatment to brighten skin, reduce redness and even help fade dark patches of skin called hyperpigmentation.

Vitamin C serums are also thought to boost the production of a skin protein called collagen, which may help to minimize fine lines and wrinkles – and even restore some elasticity.

Like retinols, they may also irritate the skin, so it’s best to start gradually. Whatever you do, though, don’t apply vitamin C serums and retinols at the same time. The reason? Vitamin C is an acidic agent and is likely to be inactivated if mixed with retinols.

Leis recommends using products containing vitamin C in the morning, before applying sunscreen.

Beware of fad products

“One thing I see a lot is the use of fad products such as home chemical peels, oral supplements and subscription skin care services,” says Leis.

“Patients see these products on Instagram or other social media and spend a lot of money on them, but there's no evidence behind them.”

Some products can make things worse. “Cleansing oil will worsen the skin of a significant number of patients, leading to acne and dermatitis.”

Other products, especially skin-bleaching agents, should only be used under the supervision of a doctor, Leis notes. The ingredients in these agents affect the production of melanin. Overuse or improper use may have lasting consequences.

They can be very effective but should be administered carefully by a board-certified dermatologist or plastic surgeon to avoid problems.

“Skin bleaching agents normally require a prescription, but sometimes patients will purchase products online from a pharmacy in another country and will use them incorrectly for long periods,” she says. “This can cause permanent discoloration of the skin.”

A healthy skincare regimen

Leis says a healthy skincare regimen should consist of:

  • A gentle, PH-balanced cleanser
  • A vitamin C-containing serum or anhydrous cream, if you can tolerate it
  • A gentle moisturizer tailored for your skin type
  • A daily sun screen protection (SPF 30 or higher)
  • An exfoliant, such as an alpha/beta hydroxy cream or a fine-grit scrub
  • A retinol or Retin-A product, if your skin can tolerate it
  • An eye cream

She recommends using a cleanser, vitamin C serum and sun protection each morning, with reapplications of sunscreen throughout the day.

In the evening, after cleansing your skin, use either a retinol/Retin-A or exfoliating cream.

Invest in a skin assessment

Even within the basic regimen, reactions to specific products will vary based on each person’s skin type.

“Both dermatologists and plastic surgeons have training to really understand the skin cycle and the elements of skin health,” notes Leis. “It’s worth seeing a professional to get a good assessment of your baseline, to promote your skin health and to perform skin cancer screening.

“He or she can determine the best and safest ingredients for your skin type and how they should be applied to maximize benefits.”

Overall, she notes, making this investment will save patients money in the long run, since they will avoid buying products that aren’t right for them.

One must-use product

Above all, the most important thing people can do for their skin is to protect it from the sun’s ultraviolet rays – even in wintertime and when skies are overcast.

Apply sunblock daily and reapply it if you’ll be in the sun more than two hours,” Leis says.

“It’s absolutely the best thing for maintaining skin health and for preventing wrinkles, sun spots and other aging concerns.”

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