Why Cetaphil Isn’t As Awesome As It Seems

cetaphil gentle skin cleanserMany of my clients are surprised when they find out that I don’t love Cetaphil. I mean, it can’t be all bad if your dermatologist recommended it, right?

I generally don’t get worked up over cleansers, simply because they rinse off. Of all the steps in your skin care routine, I’m more concerned about the stuff that stays on your face, like serums and moisturizers. I always tell my clients that as long as it’s getting you clean, not irritating your skin, and not drying your skin out, I’m fine with it. But let’s take a quick look at the ingredients in the cleanser that claims to be “gentle and non-irritating.”

Cetaphil Gentle Skin Cleanser

Water, cetyl alcohol, propylene glycol, sodium lauryl sulfate, stearyl alcohol, methylparaben, propylparaben, butylparaben.

(from cetaphil.com)

Breaking down the ingredients list is pretty easy. There’s not a lot here. First we see water, which is standard for most cosmetic formulas. Cetyl alcohol and stearyl alcohol are both fatty alcohols, used for emulsifying and moisturizing.

The next ingredient that catches my attention is sodium lauryl sulfate. Sodium lauryl sulfate is a surfactant, meaning it releases oil and dirt from the skin and creates that foamy texture we love so much. The problem is that SLS can be stripping for dry skins (which may explain the inclusion of cetyl and stearyl alcohol to neutralize the stripping effects), and it can also be an irritant. I’ve talked about SLS before, and my number one recommendation for irritated skin is stop using products that contain SLS. So why would you include this in a product that claims to be gentle?

The final ingredients are preservatives, which are three different parabens: methylparaben, propylparaben, and butylparaben. While I am not someone who is concerned about parabens as a toxic ingredient, and I believe they are generally safe to use, I do know that parabens are an allergen for a percentage of the population. Because of this, I generally recommend that my clients with hyper-allergic skin avoid products with parabens.

The truth about Cetaphil is that dermatologists recommend it for two reasons. The first reason is that it doesn’t have any of the obvious irritants in it like synthetic fragrances or dyes. But the primary reason your derm may have told you to use Cetaphil is that the makers of Cetaphil ship thousands of samples to dermatologists across the land, making that recommendation easy. Amazingly, dermatologists know more about disorders of the skin than they do about products (generally speaking, of course there are exceptions), and they often have neither the time or the desire to shop the drugstore shelves to figure out what cleanser is best for every skin type and concern you may have. Also, most dermatologists (especially male derms) don’t consider a cleanser’s ability to remove makeup in their recommendation.

My beef with Cetaphil is pretty basic. First, I take issue with any line claiming to be gentle while using the harshest surfactant out there. Second, before I became an esthetician, I tried Cetaphil. I found it drying, and it stung my eyes. Additionally, I think it does a terrible job removing makeup. I hate to use a makeup remover and a cleanser; I want one product to do the whole job. So for me, Cetaphil never cut it. If you absolutely love it, and it’s not irritating your skin, I don’t have a problem with my clients using it. But keep these things in mind, and if you find yourself suffering from dryness or irritation, you may want to swap your cleanser.

 

Speak your mind! Do you love your Cetaphil cleanser? Leave a comment below or join the conversation on Facebook and tell me what you think!

The Ingredient Chronicles: Benzoyl Peroxide

Chances are, if you’ve ever tried an acne treatment product, you’ve used something with the active ingredient benzoyl peroxide.acne ingredient benzoyl peroxide

Benzoyl peroxide is an active ingredient used in many prescription and over-the-counter acne treatments. It kills p. acnes, the bacteria that causes acne. By killing the bacteria, you eliminate a major cause of frequent breakouts. Some experts classify benzoyl peroxide as a topical antibiotic, but many dermatologists use benzoyl peroxide to help enhance the performance of other topical antibiotics like clindamycin and erythromycin. Because benzoyl peroxide is primarily used to kill bacteria, it is most effective on inflammatory acne.

Although we don’t fully understand the mechanisms of how benzoyl peroxide works, we do know that it seems to kill bacteria by adding oxygen to the skin. When benzoyl peroxide is applied to the skin, it breaks down into two parts- oxygen and benzoic acid. Since the p.acnes bacteria thrives in an oxygen free environment, adding oxygen to the skin essentially kills off the bacteria.

I’ve heard many people complain that benzoyl peroxide seems to stop working. I used to think that you could develop a resistance to benzoyl peroxide, as consistent use would eventually cause more resistant bacteria (think: MRSA and other super bugs). But while researching this article, I’ve learned that, while there is concern about resistant p. acnes bacteria, benzoyl peroxide appears to be the solution, rather than the cause. Many researchers feel that the resistance comes from ingredients like clindamycin and erythromycin, and that benzoyl peroxide lessens that likelihood.

Benzoyl peroxide has some other functions that can be helpful for acne control. It also works as an exfoliant, helping to unclog pores and reduce the appearance of blackheads. I feel that benzoyl peroxide is not as effective at unclogging the pores as salicylic acid, so if you have a lot of blackheads, you may want to introduce that ingredient into your routine.

Benzoyl peroxide comes in all forms. You can find it in cleansers, spot treatments, moisturizers, and serums. If you’re using a wash, you can leave the cleanser on your skin for a few minutes as a mask. If using a serum, it can be applied all over the skin or just on spots. You can even just treat the areas of the face that break out the most often. You can find it in strengths from 2.5% to 10%, though many studies have shown that higher percentages are no more effective than lower ones, but higher percentages often cause more adverse reactions, such as redness, flaking, and dryness.

Though this ingredient can be very effective, like many ingredients, benzoyl peroxide has its downside. I find that many of my clients react adversely to benzoyl peroxide, more so than other common acne treatments. I’ve even found that people can use benzoyl peroxide for years before suddenly developing adverse reactions. Because of this, I like to recommend that you limit your usage as much as possible. If you have been using it twice daily, try cutting your usage down to once a day once your skin starts to clear. If you remain breakout free, try going to every other day. Eventually, you may be able to stop using benzoyl peroxide entirely. Or you find that you need to stay on a routine that uses benzoyl peroxide just a few times a week.

It’s also important to remember that benzoyl peroxide includes…peroxide. This means that it will bleach clothing, sheets, and towels. It is one of the biggest complaints about benzoyl peroxide, but it’s also the easiest to fix. You can get some cheap white pillow cases or towels to use. If you’re applying it to the body, apply it at night and wear inexpensive white tee shirts to sleep. Also keep in mind that if you’ve tinted your brows or lashes, benzoyl peroxide may cause the tinting to fade faster.

If you’ve been using benzoyl peroxide and you’re suffering from adverse reactions, I have a few ideas. First, try using a lower percentage. Research shows that lower percentages are just as effective as higher ones and equally effective. Less isn’t always more when it comes to skin, so don’t worry about backing off a little. Next, try using the benzoyl peroxide less frequently. If you’re using it twice a day, try once. Once a day, try every other day. If cutting the number of applications down doesn’t work, try a light weight, oil free moisturizer underneath your benzoyl peroxide product. Finally, if these tips don’t work, try something that stays on the skin for a shorter period of time, like a wash just a few times a week. You’ll still get the bacteria eliminating benefits without as much irritation.

A final thought to keep in mind. Benzoyl peroxide and retinol don’t mix. If you’d like to use both ingredients, make sure that you use one in the morning and one at night. It will help to minimize irritation, as well as maintaining the integrity of the individual ingredients.

 

 

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The Ingredient Chronicles: Retinol

retinol skin care ingredientOne of the ingredients I love in my personal routine is retinol. It is always present. I recommend it for many different skin concerns. Let’s take a deeper look and see what it does.

Retinol and Retin-A, or the class of ingredients called retinoids or retinoic acid, are Vitamin A derivatives. These ingredients work primarily as exfoliants. They are special because they exfoliate the surface of the skin as well as the interior of the pore, unlike salicylic acid, which works just in the pore or glycolic, which works mostly on the surface. Because of the way they exfoliate, they are especially good at getting rid of deep clogs and textural acne.

Retinol is the over-the-counter version of retinoic acid. Retin-A is the prescription form of retinoic acid. However, don’t take this to mean that Retin-A is better than retinol. Some skin types may find that they can tolerate the lower doses in an OTC retinol product.

Retinoids have many benefits aside from just their amazing pore-cleaning abilities. Retinoids are the only FDA-approved anti-aging ingredient. It was being studied for acne prevention when people started noticing that their wrinkles were going away. When you have damage to the skin, the skin responds by creating scar tissue. Scar tissue is essentially collagen that has grown back irregularly, like you see in wrinkles or in acne scars. Healthy collagen is spiraled like a slinky, and it lines up in straight lines. Damaged collagen has grown back over- or under-spiraled, and it starts to bundle together and collapse on itself. Retinoids work on these irregularities by breaking down the damaged collagen and encouraging the growth of healthy, properly spiraled, perfectly aligned collagen. So retinoids are great for decreasing the depth of wrinkle and repairing acne scars.

Retinoids also help to control melanin production, which makes them great to repair the uneven pigmentation that many people see after years in the sun. For acne sufferers, especially those with deeper complexions (think: olive skin tones and deeper), it can fade the marks that remain long after blemishes have healed.

But here come the cautions. Retin-A is aggressive. Many people experience flaking, redness, and sensitivities while they are using it. Retinol (the OTC version) may be easier to tolerate for these skin types. It takes longer to see results than the prescription strength products, but avoiding the adverse side effects may be worth it.  Retinoids are also contraindicated for waxing, since it sensitizes and may cause lifting of the skin (read: a big patch of no skin… not the brow look you were going for!) Retinoids are absolutely contraindicated for pregnancy.

Retinol should always be used as part of your nighttime routine. It can cause photosensitivity, so you need to be diligent about applying a sunscreen every day (even if you get minimal sun exposure). Dermatologists usually recommend using the product every day, but more sensitive types might not tolerate that much. Stop using your retinoids if you’re going on a big beach vacation or if you’re planning on getting or have just gotten a deep chemical peel.

I really believe that everyone can find a retinoid that works for them, but you may need to try some variations to your routine or the way you use the product to minimize the adverse side effects. Here are some tips for dealing with the irritation that retinoids may sometimes cause.

  • Try using it less frequently. Try it twice a week, and slowly work your way up to more frequent usage. Once you start to see the results you want, you may want to dial your usage back again.
  • Apply a light moisturizer before the prescription. The moisturizer will act as a buffer between your skin and the prescription, slowing down the absorption. That can actually make a huge difference in the level of irritation.
  • Use a gentle enzyme mask to dissolve away the flakiness. This will help you control your urge to pick and keep your skin hydrated and smooth.
  • Try a soothing hydrating mask. Dry skin types can definitely use this help. Even acne prone skin types need this boost. Masking more frequently can help to give your skin that extra hydration and soothing that it needs.

Retinol and Retin-A are my hero ingredients. You can’t beat the multiple benefits that you get from one product. But it is an ingredient where less is definitely more, so find the balance your skin needs.

 

 

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Just the FAQs: If I Get A Chemical Peel, Will I Look Like Samantha From Sex and the City Did?

Samantha gets a chemical peelThe episode of Sex and the City where Samantha decides to get a “freshening” peel just days before Carrie’s book launch party is probably one of the most iconic moments in skin care. Not only did it put chemical peels on the map, it struck fear in the hearts of women everywhere, leading them to ask estheticians, even ten years later, “If I get a chemical peel, am I going to look like Samantha did when she got one?”

I love to recommend peels. Chemical exfoliation is my preferred way to get rid of dead skin cells. But without a doubt, people are nervous when they hear the word peel. Visions of red, flaking skin flash through their minds, and who wants to look like that? So what should you expect if you get a peel? The answer is, as always, it really depends.

First, it depends on who’s giving you the peel. The law governs who can do what peel in what strength. My license doesn’t even allow me to do a peel that would give you the severe redness and flaking that you see in this episode. Barring an adverse reaction, the most I can do without a doctor’s supervision is cause a bit of flakiness and flushing for a few days. If you’re at a dermatologist’s office, you are more likely to get a peel with “downtime,” or, a peel that will make you want to hide under a black veil for a few days.

Next, it depends on the strength of the peel. This is the tricky part to predict. Someone who is used to exfoliating (a regular glycolic or retinol user) will probably be more tolerant of stronger peels. Someone who’s recently used a prescription though, may find that their skin reacts more noticeably. Generally I recommend that if you’re going to get a peel, you should stop all prescriptions for seven days beforehand.

Samantha hides her chemical peel under a veilMild flaking is not the end of the world. It just means that your skin is healing. Remember that we break the skin down in order to build back stronger, and flaking is just a sign that stronger skin is growing. I will camouflage flaking with a great primer with lots of dimethicone, an ingredient that conceals texture by laying on the surface and filling in. Try Smashbox Photo Finish Primer if you need some help.

As a reader of this blog, you are obviously a savvy consumer. And savvy consumers ask lots of questions. Before agreeing to a peel, you need to ask about it. Specifically, how much flaking should I expect? How red will I be, and for how long? What home care should I use in the following days? How much pain can I expect?

The only mistake that Samantha made here was making her “impulse purchase” without thoroughly considering the side effects. Her skin probably looked great after ten days. Chemicals peels need to be thought about for an extra minute or two, but they are nothing to be afraid of.

 

 

 

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Battle of the White Jackets: Dermatologists versus Estheticians

dermatologist speaks to patient about skin Dermatologists and estheticians both treat the skin. But we each treat the skin differently. As an esthetician, my license allows me to only treat the epidermis, or the outermost layer of the skin. I treat the layer of skin that you see. Doctors can treat anything from the epidermis down to the deepest layers of the skin. They treat the layers that support the visible layer of the skin.

Dermatologists cure medical conditions, while estheticians focus on the beautification of the skin. [Tweet this!]

I can help you control chronic conditions like eczema, acne, or rosacea, but I cannot prescribe medicine if that’s what you need. I can help you build a routine around a prescription. People can tolerate different levels of prescription meds, and I can help you to balance your routine around your new treatment. I can offer alternatives if your prescriptions are causing your skin to be sensitized, or experiencing excessive redness, flaking, or tenderness. I can help fill in the holes in your routine if you’re still not seeing theesthetician applies aloe mask in a facial results you want.

I don’t see this as an either/or kind of question, but lots of dermatologists seem to. To be fair, there are many dermatologists that respect what estheticians do. There are plenty of dermatologists that recommend great products. But there are times that the recommendations some dermatologists make are aggressive and over-drying. I have seen dermatologists put patients on a daily Retin-A and a glycolic pad (nevermind that AHAs and retinoids break each other down, making both ingredients ineffective) or Retin-A without a moisturizer. I believe that if you are on an aggressive product like a prescription, you may need to go more gentle with other aspects like cleanser or moisturizer. I feel some dermatologists neglect to help their patients with the entire picture.

So what does this mean to you? If you have a chronic condition or a funny mole, see a dermatologist. If you are concerned about a dull complexion or just not looking your best, see an esthetician. Ultimately, we can all work together to get you your best glow.

 

 

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