In each installment of Ask a Doctor, your burning questions about hormones, menopause symptoms, sleep, sex, and more are answered by doctors who specialize in treating women in midlife.
This week: Dermatologist Dr. Sarvenaz Zand explains how to adjust your skincare routine in midlife.
Dear Doctor,
I’m in my 40s and spend half my skin care regimen exfoliating the crap out of my face. But recently, I read that I should be protecting my skin barrier and exfoliate only sparingly! I’m officially confused. How do I know if I'm exfoliating too much?
Dr. Zand says:
This is a very tricky question. In our 40s and during our menopausal transition, our skin stops shedding its top layers and our pores get clogged more heavily, causing it to look dull.
My skin started to change when I turned 37 and I started to notice that if I didn’t exfoliate, my skin would look lackluster. So, it is important to remove that top layer of dead skin, but there are lots of ways to do it, some gentler than others. So, you can protect your skin barrier in your 40s and 50s while exfoliating — you just might have to change your routine.
How to Adjust Your Exfoliation Game
The first step I’d recommend is identifying your skin type and whether your skin is sensitive. For example, if someone has sensitive skin or rosacea, then exfoliating those areas is probably not a good idea, and they should prioritize protecting the skin barrier there instead.
There are two kinds of exfoliation — mechanical and chemical. When most people think of exfoliation, they think of mechanical — say, an apricot scrub to “scrub” all the dead skin away from the surface. And that kind of exfoliation is fine to do three times a week for those who don’t have sensitive skin and aren’t reactive and prone to redness.
You can also use a topical chemical exfoliant like alpha hydroxy acid (my personal favorite is 15% glycolic acid) and again, I suggest using this three times per week. I like this because it removes that top-dead layer and adds that glow back to the skin, without physically rubbing and irritating the skin.
Retinoids are not considered a form of exfoliation, but because they help remove that top dead layer, they have the same result. My favorite combo is a retinoid plus an acid used three times per week. I also use something like a Buff Puff which is a sort of gentle physical exfoliant which removes that top layer of skin. It’s great (and gentle) in conjunction with a retinoid to loosen that top layer.
In terms of skin barrier protection, I like to apply a thick layer of moisturizing cream after exfoliating — and this is true whether I am exfoliating mechanically (the Buff Puff) or chemically (the acid). When you’re in your 40s or 50s, you use a heavier moisturizer to maintain the skin’s barrier and use exfoliation as needed when your skin is looking dull or feeling rough and bumpy.
If you’re looking for a great physical exfoliation treatment in your doctor’s office, I recommend HydraFacial. It also has suction, which is amazing for those of us in our 40s and 50s (and beyond) because it truly cleans out the deeper layers of our skin. Whatever you do, avoid scrubs that have sharp pieces or contain plastic because they are harmful to the environment and get into our water system.
