Exfoliacion como, cuando, donde y con que?

Skin Health

Exfoliation the 'little black dress' of skin care: How to do it right

Maren ShapiroTODAY

March 20, 2015 at 10:22 AM ET

Walking down the skin care aisle of the drug store can be overwhelming. With new pricey creams and serums popping up every day touting the benefits of peptides and sophisticated antioxidants, it can be hard to know what to choose.

There's one classic skin care remedy that can do wonders for skin and is often overlooked—exfoliation, according to dermatologist Dr. Mary P. Lupo, Clinical Professor of Dermatology at Tulane University School of Medicine. As Lupo puts it, "It's the dermatologist's equivalent to the basic black dress."

Exfoliation works by removing the outermost layer of dead skin cells. Not only does this immediately leave your skin looking brighter and healthier, but according to Lupo, it also helps "improve the penetration of topical active ingredients." That means it makes all those fancy face creams more effective by allowing them to penetrate deeper into the skin's surface. 

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There are three big categories of exfoliators, all of which you can get at your local pharmacy. 

• Chemical peels, mostly in the form of acids like glycolic and salicylic acid, tend to be the strongest and work by encouraging the superficial layer of skin to blister and peel off. 
• Enzymatic peels, like bromelain extract from pineapples, contain natural compounds that dissolve proteins and gently encourage an acceleration of the skins natural exfoliation process. 
• And finally mechanical exfoliation—in the form of facial brushes or scrubs—uses friction to slough off dead skin cells.
  

While exfoliation can smooth and brighten skin, not every type is right for everyone. In certain cases, it can do more harm than good.

At the Annual American Academy of Dermatology Meeting in San Francisco, Friday, Lupo discussed the benefits — and potential dangers — of exfoliating with dermatologists. She shared her expert tips with TODAY. 

Consider your skin type

How you exfoliate depends on your skin type, says Lupo:

• Normal — if your skin is not to oily or not too dry, you can probably handle a stronger chemical peel, such as glycolic acid.
• Dry — if you have dry skin, but not super sensitive, lactic acid is a great choice, because it's more hydrating than glycolic acid.
• Oily, acne prone — salicylic acid is a great option here. It's lipophilic, meaning it can break through that oil barrier. As an added bonus, it's related to aspirin, so it has anti-inflammatory properties that can help calm acne-prone skin.
  
• Black heads — this is where mechanical exfoliants, like face scrubs and skin brushes, work best to help open pores.
  
• Sensitive — if you are prone to broken capillaries or rosacea, it's probably a sign you have thin, delicate skin. Avoid strong peels or scrubs and opt for something gentler like an enzymatic peel. Look for ingredients like bromelain, papain or ficain.
  

Get the timing right

How often you can exfoliate depends on both on your skin type and the strength of your treatment method. Those with oily, hearty skin can probably get away with daily exfoliation, while sensitive skins types should stick to no more than a few times per week. 

How do you know if you've overdone it? 

If your skin turns very red or starts to discolor, you may want to tone it down. Those with dark skin may notice darker spots after exfoliating — this is known at postinflammatory hyperpigmentation and is a sign that your skin may not be up for such aggressive treatments.

Finish strong

The best time to use any skin product, especially moisturizers, is right after exfoliating, because "your skin just sucks it in," says Lupo. She recommends looking for ingredients like glycerin or hyaluronic acids.  

"Sun protection is mandatory for all patients, but especially when you exfoliate," says Lupo, because you're removing a protective layer. So opt for moisturizers that contain SPF 30 or greater, based on recommendations from the American Academy of Dermatology.

When in doubt, ask an expert

Exfoliating isn't for everyone. Certain skin conditions—like inflammatory acne, cold sores, or warts—can actually be made worse by exfoliating. If you have any redness, rash or irritation on your face, Lupo recommends checking in with a dermatologist first to see whether your skin is safe for scrubbing.

Benjamin Hidalgo-Matlock

Skin Care Physicians of Costa Rica

4000-1054

2208-8206

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