(A version of this article originally appeared on Dermascope.com)

has been touted as a “must do” skin-care step for long enough now that nearly
every skin-care customer realizes it is a recommended part of their regimen. But
knowing a product or step is beneficial doesn’t always mean we're will adopt
it. In fact, in my practice and in my work with Lexli, I often encounter individuals who simply reject the idea of exfoliation:

“My grandmother didn’t exfoliate and she had
gorgeous skin.”

“I’ve heard that exfoliation causes your
skin to thin.”

“I have sensitive skin that can’t tolerate

“I tried it and it made me break out.”

“I’m in the public eye and cannot have my
face constantly peeling.”

of these sound familiar?

Such rebuttals to exfoliation just reiterate the misconceptions and misinformation that abound on the topic. My goal is to set the record straight.

Exfoliation in History

many believe exfoliation to be a relatively new trend in skin care, the reality
couldn’t be further from the truth. History abounds with anecdotes of
exfoliation practices. For example, Cleopatra took frequent milk baths to
maintain her complexion. Little did she know that her positive results were due
to the milk’s lactic acid content, which gently exfoliated her skin. In ancient
Egypt, wine was applied to the skin, the tartaric acid content of which helped
to minimize the signs of aging. Ancient Greeks and Romans applied a mix of
pumice and oils to their skin, which allowed them to mechanically exfoliate. 

more modern days, dermatologists began using chemicals to minimize the signs of
aging in the late 1800s and by the 1970s, dermabrasion was introduced as a
professional treatment. The selection of properly formulated at-home
exfoliation products was limited, however, to harsh facial scrubs until the
early 1990s when alpha-hydroxy acids (AHAs) entered the market by way of moisturizers.
It is that singular development that dramatically changed the skin-care
industry. Today, AHAs are found in nearly all skin care product categories,
with a vast selection of exfoliation products available for at-home use. Many
of these exfoliators provide excellent results that complement professional
treatments and, in some cases, even rival them.

Making Sense of the Exfoliation Process

On a
simplistic level, exfoliation is the process of removing the outermost layer of
dead skin cells to reveal the softer, fresher looking skin below. The mechanism
by which exfoliation works is far more involved, however.

skin is constantly undergoing a natural exfoliation process whereby cells are
produced deep within the skin and rise through the layers until they are
eventually sloughed off the surface. In healthy skin, this process takes
approximately 30 days to complete. However, as we age and/or as skin becomes
damaged due to excess sun exposure, pollution, smoking and more, this cellular
turnover slows, causing the buildup of dead skin cells (hyperkeratosis).
Because the skin must maintain a consistent thickness, as the keratin layer
builds up, the dermis layer thins.

the factory of our skin where beneficial skin proteins like collagen and
elastin are formed, a healthy dermis is vital to beautiful skin. When it is
compromised due to aging and damage, dermal function slows. The result? Skin
begins to show characteristics associated with aging, including fine lines and wrinkles,
enlarged pores, dryness, redness, uneven tone and texture, broken capillaries,
breakouts and more.

a regular exfoliation practice that uses properly formulated products is
introduced, the keratin layer is forced to thin. This process prompts the
dermis to again thicken, thereby ramping up its production of the proteins that
give skin its strength and elasticity. From
an aesthetic standpoint, the removal of the outermost layer of dead skin
softens fine lines, improves skin tone and texture, minimizes pore size and

Exfoliation and Sensitive Skin

to a 2011 survey by the International Society of Dermatology, 50.9% of women
and 38.2% of men claim to have sensitive skin. Most of these cases are
self-diagnosed, which makes it impossible to know the specific cause of their sensitivity.
However, sensitive skin can generally be attributed to genetics (in a small
percentage of cases), skin disorders like rosacea or eczema, allergies,
improper skin function or a weakened skin barrier. While many dermatologists and estheticians will tell you
that sensitive skin should rarely be exfoliated, there are exceptions to that
rule. In fact, in some cases, exfoliation may be just the thing sensitive skin

skin barrier (stratum corneum) is an outer layer comprised of dead skin cells,
each surrounded by skin oils. By forming an impenetrable barrier, it keeps the
good stuff inside our skin (moisture) and the bad stuff out of it
(environmental toxins). The skin’s barrier function is easily weakened due to the
over-use of aggressive skin care products or clogged pores. When barrier weakness
is due to improper skin care, such as over-washing with harsh cleansers or
exfoliating too frequently with products that contain ingredients known to
cause inflammation, the best medicine is to go back to a simplistic skin care
regimen that focuses on moisturization. Otherwise, as counterintuitive as it
may sound, exfoliation should be considered.

Exfoliation’s ability to thicken the dermis, thus repairing
skin function, is a factor that alone can lead to an improvement in sensitive skin
symptoms. However, exfoliation also helps to eliminate much of the debris that
clogs pores, and in doing so, it improves barrier function while allowing
moisturizers and skin care treatments to work more effectively, thus helping to
heal damage. A regimen that includes regular exfoliation along with the frequent
use of emollient-rich moisturizers and serums will allow many with sensitive
skin to see a marked improvement in their conditions. They key is to monitor
the situation so over-exfoliation doesn’t become a factor, as it could lead to
a worsening of symptoms.

Side Effects

exfoliation, just as in professional exfoliation treatments, is not without side
effects, such as redness, dryness and, in some cases, peeling. Those with
clogged pores may find that as the exfoliation process removes blockages from
the skin, the debris that was suppressed in the hair follicle is purged,
leading to breakouts. As skin function normalizes, these symptoms become
less prevalent and, within approximately a month, they should disappear
completely. (Those who continue to experience side effects from an exfoliator
beyond that period of time, product use should be stopped, as an allergic reaction could be to blame.)

Selecting an Exfoliation Product

mentioned earlier, there is no shortage of exfoliators on the market and, for
that reason, trying to select the best one can be confusing. For
the most effective at-home exfoliation, I recommend selecting a product
formulated with alpha- or beta-hydroxy acids (AHAs and BHAs) over the use of a
scrubbing polish or facial brush. While many individuals claim to see positive
results from the latter methods, these products have the potential to create
microscopic tears in the skin. This can lead to inflammation, which in turn
leads to other skin issues. What’s more, these products don’t have the ability
to exfoliate as effectively as chemical exfoliants.

and BHAs are well tolerated by most individuals. The key is to find a product
that offers a pH that is acidic enough to generate an acceptable level of
exfoliation. Many exfoliation formulations for at-home use include a minimal
amount of acid to avoid the risk of burning or peeling. However, these products
don’t provide much of a benefit to the skin. This is why I suggest generally looking
for a product that offers a pH in the range of 2.0 – 4.0 – a level that is significantly
more acidic than the skin (pH=5.0). Lexli AloeGlyC® meets this requirement, while featuring a high concentration of pharmaceutical-grade aloe vera to counteract the potential for burning or inflammation. 

There really is a sound rebuttal to nearly every excuse that one could make for avoiding an exfoliation practice. With an abundance of safe and
effective exfoliators on the market today, you have the opportunity to
achieve healthier, more beautiful skin at home, as long as you exfoliate properly and regularly.

I encourage you to post your exfoliation questions (and rebuttals!) in the comments below. I'll be happy to provide answers.