Exfoliate and Hydrate

This transcript was exported on November 8, 2023 -view latest version here.

Skincare can sometimes feel overwhelming, whether it’s finding the right products, ingredients, or treatments. There’s a lot out there, but not always for people of African, Hispanic, Middle Eastern and Eastern South Asian descent. That’s why I set out to educate myself and others so that we can all feel beautiful in our skin. Hello and welcome back to The SKIN Report.

I’m Dr. Simran Sethi, an internal medicine doctor, mom of three and CEO and founder of ReNewMD Medical Spas and SKIN by Dr. Simran Sethi. Today we will revisit our favorite skin renewing team, exfoliants and moisturizers. For this episode, I want to remind our returning listeners and inform any new ones about the ultimate skincare duo. That is of course, exfoliants and moisturizers, two routine steps that go hand in hand to help refine and nurture your skin.

Before we dive into these types of products, let’s go over the skin renewal cycle. The skin renewal cycle is a natural skin process by which new skin cells replace dead ones. Exfoliation methods can support the cycle by helping your skin to slough off the dead cells and built up debris from its surface. On the flip side, moisturizing nurtures your skin barrier. I explained the skin renewal cycle in the very first episode of The SKIN Report.Listen to this clip where I break down the science behind this important process.

So what is the skin renewal cycle and why is it so important? Simply put, the skin renewal cycle is the natural process of new skin cells replacing dead ones after a certain time period. When you are around your twenties, this process takes about three weeks. By the time you reach your mid-thirties, your renewal cycle has extended to around 28 days. The cycle will slow to 45 to 60 days in your forties and 50.

My approach to skincare is to create treatment plans with the renewal cycle in mind and to better understand that we must first understand the different layers of the skin, the epidermis, the dermis, and the hypodermis. The epidermis is the thinnest and outermost layer of skin. It is made up of four layers [inaudible 00:02:24], but that is something we will go more into depth in a later episode.

The superficial cells of your epidermis replace around every 28 days. The dermis is the middle layer of skin. It is full of blood vessels that move oxygen and nutrients throughout the body. This layer of skin contains collagen as well as elastin. Collagen and elastin are well-known skin proteins, each of them having its own properties. Collagen is important for the integrity and strength of the skin, while elastin gives skin its bounce and elasticity. The hypodermis consists of connective and fatty tissues.

As you age, the fatty tissue in your hypodermis begins to decline leading to skin sagging. For people of color, the skin renewals process requires safe and specialized care. Darker skin and concerns for darker skin are often under diagnosed and overlooked by medical practitioners and skincare companies. In order to truly address skin conditions and treatments and leave your skin glowing, we need to make sure all three layers of skin are healthy and happy so that you can feel healthy, happy, and beautiful.

Up next, we’ll talk more about how exfoliants can support our skin’s natural processes and contribute to its beauty. Exfoliants are skincare ingredients, tools, or substances that can help your skin along its cell renewal by removing the cells on its surface. This in turn reveals a newer and more radiant skin beneath. On season one, episode 14, I did a deep dive on the different types of exfoliants and how they work to support the skin’s natural renewal process.

Take a listen. Where does exfoliation come into play? Everyone actually has a natural exfoliation process. Our skin will remove these dead skin cells. However, depending on our age and other factors, we all exfoliate at different rates. In younger people who are more acne prone, their skin tends to not exfoliate at a rapid enough rate, and as a result, dead skin and debris gets mixed with sebum and clogs their pores to create pimples.

Even as we age, our natural exfoliation process may not be efficient enough to get rid of all the dead skin cells. Factors out of our control, such as pollution, can often interfere with our skin renewal process and its effectiveness. Therefore, we must help our exfoliation process by providing extra exfoliants. No matter your skin type or tone, exfoliant accomplishes two important goals.

It removes our dead skin cells to give a more radiant, clearer glow, and most importantly, it improves skincare product penetration. This second point is something most people are not aware of, but in my opinion is equally if not more important than point number one. In fact, I always recommend a monthly facial that includes some sort of microdermabrasion to remove the dead skin cell layer off to optimize product penetration throughout the month.

Exfoliation in general can also help to reduce the appearance of acne scars, hyperpigmentation and more. Removing dry and dead skin over time smooths out your texture as well as evens out the skin’s appearance. And as I said, the exfoliant will help other products penetrate the skin more, thus helping to target other skin insults better. Exfoliating can have other benefits that happen below the skin that leave you feeling your best on the inside and out.

By removing dry and dead skin cells, you can boost your circulation and increase cell turnover, meaning that your fresh healthy skin cells will be at the surface of your skin. Some studies have shown that long-term exfoliating can increase collagen production leading to glowing vibrant skin. But remember, these studies have been done primarily on lighter skin tones. With darker skin tones, taking a more conservative approach to exfoliation has been shown to be safer and has better yield.

It’s essential to practice skincare with your skin type and tone in mind as the success of your skin may be influenced by factors such as melanin production. Later on in this episode, I educated listeners on the different types of exfoliants, physical and chemical. First, I want to discuss physical, otherwise known as mechanical exfoliants, which may be the first thought that comes to many of our minds when we think of exfoliants.

This type of exfoliant mechanically breaks down bonds between dead skin cells and debris to polish off the dead skin layer. In order to accomplish this polishing, this exfoliant uses small particles or granules to buffer away dead skin cells. They tend to be the scrubs that populate the shelves of drugstore and makeup outlet, using particles of different sizes such as drowned up apricot seeds or rice particles.

Even a face cleansing brush like the Clarisonic brush is considered a mechanical exfoliant. No matter how oily your skin may be or how gentle the exfoliant is, you should not use it every day. Otherwise, you will strip your skin of essential oils and moisture and irritate it. Start by using a physical exfoliant one to two times a week for a month until your skin has adjusted. Then you can start building up to three to four times a week.

I would not go beyond this as more frequent mechanical exfoliation can strip down your skin’s protective lipid barrier no matter how gentle the product is. Overall, mechanical exfoliants are safe and effective to use. However, like frequency, the size of the particle is an important factor in achieving healthy and clear skin with mechanical exfoliation. For melanated skin, the particle size is the most important consideration.

Products with large particle sizes such as St. Ives apricot facial scrub are too harsh and as a result, create microtears in the skin. Today, even though the St. Ives facial scrub is not as popular, it has been replaced by some other brands that are equal culprits. microtears directly irritate the epidermis and stimulate more melanin production and as we’ve discussed on the show before, leads to excess pigment production in darker skin tones.Chemical exfoliants loosen up chemical bonds that help bind dead skin cells together so that they can fluff or wash off the skin more effectively. The most common chemical exfoliants available in skincare products are Alpha-Hydroxy Acids like glycolic or lactic acid and beta hydroxy acid like Salicylic acid. Using such ingredients can break down the enzymes in dead skin cells to help dissolve them, which can minimize the look of pores as a result.

They’re a great way to help smooth and refine our texture, brighten skin, and boost skin cell turnover as we’ve said. Depending on the concentration in a product, they can either be gentle or strong. A chemical peel, for example, is a very strong version of a chemical exfoliant. While a strong exfoliant has more power to it, it can also strip off the natural skin lipid barrier.

When picking a chemical exfoliant, pay careful attention to the concentration the way you would with particle size of a physical one. Like physical exfoliants, how often you use a chemical exfoliant also matters. When it comes to concentration and frequency, what should you keep in mind? If you have drier sensitive skin, you may experience a burning sensation as the skin already has a compromised skin barrier and microtears. This does not mean you can’t use a chemical exfoliant.

It just means that you need to use a very low concentration and should definitely start by using it only one to two times a week for a good four to six weeks so that your skin has the opportunity to repair its lipid barrier. Even still, you may experience a stinging sensation when you try a stronger exfoliant. For anyone starting out, I encourage what I do for most new product, start low and slow.

For skin of color, I always recommend using a very mild one to 10% concentration of AHA or BHA as these exfoliants only work in the topless layer of the skin, the epidermis, which also houses our melanocytes. As we’ve discussed, melanocytes are more active in darker skin tones, so any irritation in the epidermis will cause more pigmentation. I find that higher strength AHAs or BHAs are too aggressive in darker skin tones for daily use.

I have seen so many acne prone patients with excessive pigmentation and a lot of skin sensitivity, mainly because they’re using high strength chemical exfoliants and sometimes two different types of chemical exfoliants, an AHA and a BHA. The first thing that I do in this scenario is have them stop the exfoliant completely for two weeks and then start them on a gentle formulation from my line. Their skin very quickly responds by becoming clearer, calmer, and essentially happier.

Whether you choose to go with chemical or physical, incorporating an exfoliant into your routine can greatly improve your skin. Still, users should take precautions to avoid over exfoliation. We’ll go over this more coming up. Moisturizing is an essential step in any well-balanced skincare routine, but this is especially necessary if you’re using exfoliants.

Moisturizers nurture the skin’s moisture barrier, which can otherwise become compromised due to over exfoliation. Take a listen to a clip from season one episode six where I break down the importance of moisturizing and locking in moisture to retain it throughout the day. In order for a skincare routine to be effective, it should mimic the skin renewal cycle, which we discussed in our very first episode. An effective skincare routine for your skin renewal cycle should include these steps.

Start with cleansing, then moisturizing, then applying something that locks in your moisture. And last but not least, a full spectrum sunblock, which provides UVA, UVB and HEV protection. Once your skin is clean, the second step of the skincare routine is to apply a serum and or moisturizer. The ideal serum and moisturizer will nourish and repair the skin throughout the day and night.

The third step in a good skincare routine is one that many people skip over probably because it’s rarely discussed. This step is moisture protecting or moisture sealing. Using a serum that contains hyaluronic acid helps lock in skin’s moisture, and natural oils. This ingredient is important for every skin type and skin tone because hyaluronic acid protects your skin barrier. So you’re probably wondering why does moisture need to be protected on our skin?

Humans are warm-blooded and warm bodied, which means that our skin is constantly losing moisture to the air. You experience this every day but may not realize it. Have you noticed that soon after applying a moisturizer, your skin feels soft but then starts feeling dried just a few hours later? This happens because the moisturizer evaporates off your skin within just a few hours of application.

This moisture loss does not only happen on dry or normal skin, but also occurs on oily skin. If you have oily skin and you wash your skin, your skin probably feels normal, but after a few hours, it forms a new layer of oil and sebum. This happens because cleansed skin will start losing your naturally produced moisture to the air, and this signals your skin to produce more oil to prevent the skin from getting dehydrated.

As a result, there is a thicker layer of oil and sebum on the skin within just a few short hours. To prevent loss of moisture in every skin type, it’s important to apply a moisture protectant like hyaluronic acid, which is a large molecule that holds up to 1000 times its weight in water. This effectively means that one molecule of hyaluronic acid can bind to 1000 molecules of water.

By binding to water, it keeps water from escaping from the surface of the skin. Hyaluronic acid can come in serums, balms, and even injectables. Though hyaluronic acid is so important, people frequently use it in the wrong step in their skincare routine. Many apply it before or with their moisturizer or serum, but it actually works best when applied over a serum or moisturizer.

By doing so, it’ll protect and lock in moisture on the skin and also prevent overproduction of oil in oily skin and excess skin dryness in dry or combination skin. So basically, it completely balances the moisture and oil levels in the skin, leaving it plump and healthy no matter what skin type you are. For the sake of time and relevancy, I only included some clips from this episode here, but the episode also provides a lot of helpful guidance for creating a well-rounded skincare routine that contains both exfoliation and hydration.

I’ll have this and all of the other episodes discussed today linked in the show notes, and I hope you check it out. To close out this refresher episode, let’s remember the basics. Exfoliants and moisturizers work together to keep the skin healthy by supporting the skin’s renewal cycle and nurturing the skin’s natural lipid barrier. However, these two elements can also help to counteract the negative side effects that could occur if you were to use them alone.

Exfoliation on its own can dry out the skin and destroy its natural lipid barrier leading to irritation and hyperpigmentation in darker skin tones. Proper moisturizing can prevent this by hydrating the skin and strengthening its natural protective barrier. Meanwhile, simply moisturizing alone can lead to a buildup of oils, dead skin cells, and other debris on the skin surface causing clogged pores and dullness.

But healthy exfoliation will aid your skin in removing this buildup from its surface so it stays bright and blemish-free. Also, remember, all the debris on your skin surface is blocking proper penetration of your skincare products. So exfoliating effectively will also significantly increase the penetration of any serums or creams that you’re applying.

I’ve provided a lot of information on both exfoliants and moisturizers on The SKIN Report Podcast so far with episodes that expand on topics like the types of exfoliants, retinol, and buyer’s guides for moisturizers. I will provide links to some of my most moisturizer and exfoliant heavy episodes in the show notes so that you can expand your knowledge on this powerful skincare duo.

I hope you’ve enjoyed this episode and that it helps you in understanding the importance of striking the right skincare balance with both exfoliants and moisturizers. Thank you as always for tuning in, and until next time, love your skin, love yourself, and celebrate your beauty. If you’d like to learn more about science-backed skincare or medical aesthetic treatments, please subscribe to and turn on notifications for The SKIN Report so you always know when a new episode is up.

We have a newsletter that you can sign up for on skinbydrsethi.com so that you can stay up to date on all our latest products and more. Additionally, if you have a skincare question or want to make an episode topic recommendation, please message me at theskinreportbydrsethi.com, which is linked in my show notes, and I’ll be sure to answer your questions in an episode soon.

Transcript by Rev.com