Recommendations for a few clients with sensitive skin who are looking for all-in-one type products

I am looking for a hydrating night cream that will also provide some exfoliation or cell renewal. My skin is reasonably sensitive, so I can’t use retinol products. What would you recommend for face and body?

The conventional approach for this person would be to put her on an alpha hydroxy acid (AHA) cream that would both moisturize and have some exfoliating abilities. But conventionally is not the way I would help her. She has already told me her skin is sensitive, so any of the acid products (including AHAs, topical vitamin C, and products with retinol in them) would not be wise for her to use. These types of ingredients will simply further her sensitivities.

I am not a fan of a product having several jobs. I think a moisturizer should moisturize and, in this case, a separate exfoliator would be in order to give this woman the exfoliation and cell renewal she is looking for. Why is it that we want all-in-one products? Because exfoliation is so important to all skin and ages, it is imperative to do this step separately, rather than use a moisturizer with exfoliation capabilities. Those abilities are limited, I assure you.

My recommendation for this person would be to get a good night cream that is appropriate for her particular skin type, and also purchase a good exfoliator that she can use on the sensitive skin she describes. This is where a gel-type peel or gommage comes in handy. It will do an excellent job of getting rid of the dead cells, which also helps to step up cell renewal, while at the same time not irritating her sensitive skin.

My skin seems to be a little red lately on the cheeks. I am 55 years old, so my skin needs some firming abilities and a good moisturizer. Can you give me some ideas?

Do you use AHAs or Retin-A on your skin? The cheek area usually seems to show the signs of capillary damage more so than other parts of our faces. I think this is primarily because when we get flushed, it usually shows up in the cheeks. So be sure not to use AHAs or any other irritating ingredients, including retinols and topical vitamin C products. Also if you get your face in the hot shower water, over time this will definitely cause redness in the cheek area, among other places.

As far as firming, there is nothing short of surgery that will truly lift the skin or firm it up. At 55 you are probably showing the signs of what 55-year-old skin looks like. This may not be consistent with how you want it to look, however.

There really is no cream that will tend to all of the needs of this client. She wants something to help with redness, sagging skin, and hydration. As an aesthetician, I would try to tackle the most prominent problem first. If, for instance, this person really did have a lot of redness, that is where I would concentrate my efforts. Any cream she uses will have moisturizing abilities, but no cream will really be able to firm flaccid skin. I would counsel her on the need to keep hot and cold water off her face and to be aware that sun exposure also affects capillaries, along with alcohol, smoking and caffeine. These can all affect the redness on her cheeks.

If her skin was dehydrated and true-dry and the redness was minimal, I would probably concentrate on having her exfoliate to alleviate any dead cell buildup that may be inhibiting superficial hydration. If her skin was true-dry (oil-dry), I would give her a hydration booster (a glycerin or even oil-based liquid) and an overall good moisturizer for her skin—one that had the capability to help the redness.

It’s not uncommon for people to try and get as much as they can from one product. But when it comes to skin care, especially the facial skin, you always need to start with skin type (how much oil your skin is or isn’t producing) and then look at any other particulars. With this information hopefully you will be able to make informed decisions when it comes to your skin care products.

For more information, see:

• Determining Skin Type 
• One product for ALL SKIN TYPES: this is simply NOT possible!
• Age-appropriate products

Pregnancy: all links so far

pregnancy

• Acne, medications, pregnancy—“I need your help!” (new!)

• Can you get facials while you’re pregnant? In a word: YES!

• “I’m pregnant! How will my skin change?”

• New mommies have no time!

• Post-pregnancy skin sensitivity

• Pregnancy & Chloasma

• Pregnancy and Skin Care

• Pregnancy & stretch marks

• Pregnancy & tired legs

• Pregnancy: Some factors that may be affecting your skin

• Pregnant with Problem Skin

• Proactiv—Solution? Part I —this includes a story about one of my pregnant clients and her skin issues

Medications Oral & Topical: all links so far

Medications: Oral & Topical

When it comes to taking or applying prescription medications, the best source for information is your doctor writing the prescription. Any and all information in these articles is coming from clients and my opinions as an aesthetician on how they might best take care of their skin. In that, I will give the following statement that is also in both of my books:

Disclaimer: The author of this blog is not a physician, and the ideas, procedures, and suggestions in this blog and in these specific articles are not intended as a substitute for the medical advice of a trained health professional. The author is not responsible for any damages, losses, or injuries incurred as a result of any of the material contained in this blog and disclaim any liability arising directly or indirectly from the use of this blog. Consult your physician before adopting the suggestions in this blog, as well as asking about any condition that may require diagnosis or medical attention. By following the instructions contained herein, the reader willingly assumes all risks in connection with such instructions.

If specific medications are mentioned, they are listed in parentheses.

• Accutane: all links so far

• Acne, medications, pregnancy—“I need your help!” (Oracea) (new!)

• A confused client needs help: “Dry? Acne? Rosacea? What is going on with my skin?” (antibiotics)

• Azelaic acid for acne, hyperpigmentation, and rosacea: does it work? (new!)

• Benzoyl Peroxide: Use it or lose it? Although not a prescription medication, it is often recommended by dermatologists. Also mentioned is prescription Benza-Clin

• Dermatitises (skin inflammations) explained (Hydrocortisone cream, Tetracycline)

• Dermatology, skin care & 2 sets of belief systems

• Eczema anyone? (Hydrocortisone cream)

• Hydroquinone skin bleaching cream (OTC & prescription) (coming soon)

• My experience with Prometrium (“natural” progesterone hormone) (new!)

• Oral Antibiotics: Good for clearing up your skin or not?

• PLEASE: Don’t take Premarin! (new!)

• Problem Skin Q & As—Monthly Breakout (Benzamycin)

• Products and rosacea: What to use—Part II (MetroGel, Tetracycline)

• Product talk with a new client: Helping her with Yonka specifically and her routine in general (Spironolactone)

• Renova the Retinoid to the rescue? (upcoming)

• Retin-A: Q & A (coming soon)

• Rosacea case study: Suzanne (MetroCream, Tetracycline)

• Stress plus going off the Pill can equal breakouts—a client profile

• Teenage Skin Problems Q & As (Accutane, Retin-A, Tetracycline)

• Tetracycline—does it help with problem skin or is it just a temporary fix? (new!)

• Treating Rosacea: Eliminate? Control? Fix? Cure? (MetroGel & MetroCream)

• What is Folliculitis? (antibiotic cream)

Also see

• Skin Care Procedures—Misc: all links so far

• Trends & Fads: all links so far

Acne: all links so far

acne

• Accutane: Jennifer’s story

• Acne and imbalance—What to do

• Acne, medications, pregnancy—“I need your help!” (new!)

• A confused client needs help: “Dry? Acne? Rosacea? What is going on with my skin?”

• Acne Q & A—“How long does it take to clear up problem skin?”

• “Adult Acne” explained

• Azelaic acid for acne, hyperpigmentation, and rosacea: does it work? (new!)

• Getting rid of BACK BREAKOUT: facials, nutrition, and client questions (new!)

• Is Accutane good for acne?

• MYTH: Sun clears up acne (new!)

• Problem skin? ASK YOURSELF THESE QUESTIONS & become a skin care sleuth—updated

• Tetracycline—does it help with problem skin or is it just a temporary fix? (new!)

• Treating acne is twofold (new!)

• What is acne? Acne explained

Acne can definitely be a balancing act

Acne, medications, pregnancy—“I need your help!”

I have acne on my chin area and have struggled for years to address it. I don’t eat a lot of sugar and don’t eat dairy and eat very little wheat. My dermatologist has me on Oracea, which is an oral antibiotic that is 40mg doxycicline. It’s supposed to act as an anti-inflammatory and it has reduced my breakouts. He also has me using a benzoyl peroxide 4% wash once a day, and a clindamycin topical. I still always have about 2-3 breakouts on my chin at all times, and when some heal, others form. They tend to be puss-filled.

I read your book and had read many entries on your blog, and I know that all of this is contrary to what you recommend. Yesterday I got a facial and started using Yonka Gommage, which already feels great. I also use a clay mask. I plan to use the gommage and clay mask regularly. 

What I’m wondering is how I can smoothly transition away from the oral and topical antibiotics to a more natural skin regimen without creating major disruptions. I have a few events coming up this summer and I don’t want to make a radical shift that will cause my skin to get worse. Do you have suggestions for how to make this transition? For example, should I stay on the oral medication for another month while weaning off of the topical?

First, if you have a special event coming up, I recommend staying on everything you are using since it sounds like it does have a positive effect. You can always quit using it, but you might not get you skin back in control if you go off. There’s no reason to cause extra stress, wondering what your skin will do if you go off the medications before your events. You have the rest of your life to change things! Stay on the meds from your derm, and do use the gommage and mask—frequently.

With that said, the medications are probably just keeping things at bay. The real issue to me is why are you breaking out in the first place. Without finding out this crucial piece of information, you are just mopping up the mess every time something spills—but you want to find out why the spills are happening in the first place. (Is it the cat?!) Answering that question is where time and experimentation will come into play.

I agree that I don’t want to disrupt things if the meds are keeping things at bay. One thing that really concerns me is that I’d like to try to get pregnant in the next 6-12 months, so I know I need to get off the meds but don’t know how to make the transition.

Have you talked to your pediatrician? Are topical antibiotics a no-no for sure? Even tho you said you don’t eat much sugar, I’d like to know about that part of your diet. What, how much, and any other specific information you can give me.

I think topical antibiotics are okay but the oral is definitely not okay.

Opps, sorry. I misread and didn’t see one is oral. Yes—not while pregnant!

Another question in my mind is how the gommage works with the benzoyl peroxide wash. My doctor wants me to use the 4% wash once a day, but since it’s an exfoliant, can I use the gommage in addition to that? I think the BP and clindamycin are supposed to work in concert. Can I incorporate the gommage into my regimen with all of the other things I use or will my skin be confused?

I don’t eat any processed sugar but I do eat dried fruit. I eat LÄRABARs, which I think are high in sugar. I usually eat one or two apples a day as well. I sometimes eat raisins or dates or figs, but always in moderation. I wonder if that is contributing to the problem?

I looked up “a” LÄRABAR. Unfortunately they contain a whopping 23 grams of sugar, which is not only a lot, it is almost more than the recommended daily allotment of sugar. If you are sensitive to sugar, and you probably are, that alone can cause problems.

I always say anything grown and eaten as it is grown in nature is fine. Apples, even grapes, which are high in sugar, won’t be the culprit in a breakout condition. But dried fruits—not as nature really intended—are high in concentrated sugars and obviously void of water. As you might have read in this post (Sugar in your precious Frappuccinos!) although raisins are obviously not the big offender with that client in that article, they may have been contributing—well they were contributing to her daily intake of sugar.

All of this is extremely helpful and I welcome any more information you might have! Thanks again. 

If you want to see if (how) sugar is affecting your skin, stop ingesting any and all sugar for a month at least (longer would be better) and see the effects. Anything that comes in a package would be out. Dried fruit, because of the concentrated sugars, is out. Apples, or any fruit that is in its natural state is (always) fine. Without quitting sugar for a considerable time—at least a month or more—it’s hard to see the effect. But this is a huge commitment and not one I would go into when fairly soon you will be pregnant and your skin may go haywire anyway.

Probably a more relaxed approach is needed here. If you weren’t planning on having a child soon, my advice would be more proactive. But it’s almost futile to do a lot of sugar abstinence when in a few months or so you are hopefully pregnant and then your skin and how it reacts to the hormone surges is unknown.

With all changes going slowly sometimes is the best idea vs. being in a rush. Perhaps the fact you have some important events coming up will end up be a blessing in disguise. Although you will probably stay on the medications until you’re ready to try going off them (with your doctors advice, as well, of course), going off sugar or at least lessening your intake can be done now and that alone will probably help with your skin problems.

For more information, see:

• “I’m pregnant! How will my skin change?”
• Hidden Sugar: Sugar in Unsuspected Places
• Doing The Next Best Thing