Should you use a stronger (AHA/BHA) exfoliator?

THE ANSWER IS YES AND NO. Yes if you have a stubborn condition that needs stronger and stronger treatment, and No if your condition is well controlled using the strength that you are presently using. Also No if your skin is becoming more sensitive due to the use of an alpha or beta hydroxy acid.

This is where first hand knowledge of your skin helps me in the assessment… The skin care goal is also important. If severe dry skin is impacting acne, strong sebaceous activity is creating cysts under the skin (that are not bacterial and thus not inflamed), or very pigmented (sun damaged) skin is creating uneven skin tone, then getting you to a stronger exfoliator will be ideal in most cases.

Depending on the strength of your skin, or the extent of the condition you need to correct, I may suggest starting off with an exfoliant that you use 3 nights a week for 2 weeks, then 5 nights a week for 2 weeks, then 7 nights a week. Sometimes I may even have you use it 7 nights a week at the outset. For severe acne or pigmentation issues, I may even have you use an exfoliator in the a.m. and p.m. The proviso is always that if your skin becomes too sensitive due to the use of the exfoliator, then you back off and use it 3 nights a week for a while until your skin stabilizes.

There are some people that I start off with a milder exfoliant like Clear Skin Ultra Gel (5% Glycolic + 5% Lactic + 2% Betaine Salicylate at 3.9pH) and then move up to Age Limit (5% Glycolic + 5% Lactic at a 3.5pH) and after the skin is accustomed to that level of exfoliation at 5 – 7 nights per week, then I will probably suggest moving up to Glyco-A-Gel (10% Glycolic at 3.2pH). Of course, after working on your skin, I may see that it is strong enough to start out with a more intense exfoliator. The lower the pH and the higher the concentration of Glycolic the more intensive the sensation and affect will be on the skin. In some cases I may suggest moving up to a 30% Glycolic if I feel that we need to be more aggressive because the skin issue is not responding as well as I would like it. When I have done this I have usually been able to achieve the goal that we set out to achieve. In the vast majority of cases it is foolish to shock the skin with an intensively strong exfoliant from the outset.

In some cases we will move to a strong chemical peel to create even more dramatic results, but peels have to be planned. See the post-peel home care regimen to see what a strong chemical peel involves.

As an added benefit, acid exfoliators that are less than 3.9pH are also anti-bacterial. This is ideal in youth acne where bacterial activity is one of the many factors that play a roll in the level of acne breakouts experienced.

Finally, there may be a reason to back down from intensive exfoliators to something milder. Firstly, if your skin becomes too irritated with a high % and low pH acid exfoliator. Irritated skin does not help you solve any problem because irritated skin will not repair and heal quickly or effectively. Secondly, if we achieve the goal of eliminating dry skin that is clogging pores, or if we have successfully lifted sebaceous cysts, or effectively evened out skin tone by lightening hyperpigmented areas.

Daily exfoliation is always a good idea, especially as we age, so the option of no-exfoliation is non-negotiable unless you have a severely unbalanced skin in which case I prefer that we balance and strengthen the skin before even contemplating exfoliation. Don’t ever rush things. Treat the skin gently, get it strong and healthy, and it will take care of itself.

Please check out the other posts on exfoliators in this blog.

The information provided here is not meant to diagnose or cure any medical conditions.

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