Q. “I'm interested in upscale skin care lines sold at department stores. Can I use these with the ABC's?”

ANSWER

I visited a popular high-end department store today and spent two hours reviewing several featured skin care lines. I explained that I was interested and asked various sales representatives the question, “How do you moisturize a person with very dry and sensitive skin?” I was surprised. Most skin care lines were dermatologist approved, and interestingly, though each line expressed their uniqueness, they each emphasized a similar dry skin care program of skin exfoliation via some type of salicylic acid / butylene glycol based lotion.

Most products were perfumed. Nothing was said about skin barrier repair or the need to avoid allergic items.

Each suggested cleansing the dry area with a special cleanser. Some contained harsh sodium lauryl sulfate. Most advised some type of salicylic acid / butylene glycol based lotion exfoliation of the entire body. Nothing was mentioned of bathing or showering to restore moisture. After total body exfoliation, most lines recommended covering with a lotiony emulsion made of triglycerides, dimethicone, vitamin E, lanolin, propylene glycol, butylene glycol, mineral oil, dyes, fragrances, and scant petrolatum. The importance of applying a heavy cream was not mentioned.

The gentle cleansing was fine, but we could have done without the sodium lauryl sulfate. The exfoliating acid probably did do some good in removing built up corneocytes and allowing the emulsion to penetrate the skin more effectively. But, the exfoliation was really not necessary for basic dry skin. As the dry skin rash is stripped with small fissures and skin areas that are open down to the dermis, exfoliators will irritate most dry and sensitive patients with the dry skin rash. The skin barrier is opened and toxins can easily pass through. Exfoliating will eventually worsen this already stripped and fissured dry skin.

Exfoliators are not for everyone with dry skin, but they can help certain types of dry skin. Exfoliators can enhance the absorption of moisturizing creams. Patients with thickened skin conditions like keratosis pilaris and icthyosis vulgaris can benefit from skin exfoliation. Certain patients with sun damaged skin can benefit from exfoliation. Patients with sebaceous gland blockage or acne type skin can benefit. On the other hand, patients with Retin-A™ type dryness or diabetic dryness should not exfoliate without seeing a dermatologist. What I’m trying to explain is that exfoliation is good for certain patients, but if you have dry and sensitive skin, your dermatologist should make the decision whether or not to exfoliate.

An important question: Is total body exfoliation really necessary? In my opinion, exfoliation can benefit because it improves the appearance of dry skin. Scale is removed, and this makes dry skin look better. But in most cases, if your skin is consistently well cared for by ABC true moisturization, it will exfoliate naturally without the need for expensive artificial exfoliation.

Interestingly, what I witnessed at the cosmetic counter was both good and not so good.

Good: The combination of exfoliation plus triglyceride lotion emulsion restored to the skin a supple smooth quality. The skin actually looked better, afterwards.

Not so good: The emulsion was not occlusive enough to allow restoration the lipid bilayers, and the depleted skin barrier was forgotten in the skin care equation.

Overall, the department store skin care program exemplified how good looks can give a false sense of moisturization. Your skin can look and feel moisturized, but your skin barrier can suffer from neglect and inadequate lipid nourishment. Most people shouldn’t need to exfoliate on a daily basis if they carefully follow their daily ABC’s and moisturize with True Moisture® Clinical Lipid Therapy® Cream for their body and True Moisture® Clinical Lipid Therapy® Gentle Facial Lotion for their face.

So, to answer the question of whether or not the ABC’s can be followed using cosmetic counter skin care products, we must consider this: High-end skin care products are lots of fun, exciting, and often a pleasure, but beware of any skin care product that is potentially allergic, irritating, or inadequate. You can use the department store products as long as you are not bothered by their fragrance, salicylic acid, and allergens. I am not opposed to cosmetic counter moisturizing programs for non-sensitive skin, but I would be selective. In general, superior stores such as Nordstrom, Macy’s, Neiman Marcus, Dillard’s, Saks Fifth Avenue, Bloomingdale’s, Sephora, and Harrods will provide you with higher quality better educated sales people.