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SUMMARY POINTS
What’s Important?
Cleansers play an important role in skincare regimen efficacy.
Cleansers increase penetration of the products that follow in the regimen.
Surfactant type determines irritation potential of cleansers.
What’s New?
Increased water temperature increases cleanser irritation.
Hard water causes skin irritation while ultrapure soft water does not.
Water filters will remove Ca2+ and reduce cleanser irritancy.
What’s Coming?
Use of low-pH cleansers in the morning to increase efficacy of the products that follow.
Natural saponins that cleanse without irritation are being identified as demand for organic products increases.
More patient education about proper cleansing is needed.
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Cleansing is one of the most important steps in any skincare routine because it prepares the skin for the application of topical products. Cleansers affect the efficacy and the side-effect profile of the products that follow them in the skincare routine by influencing penetration of skincare ingredients. Cleanser choice is particularly important when treating an individual with medications that render them more susceptible to inflammation. For example, acne medications are better tolerated when the proper cleanser is used. The following discussion focuses on the various types of cleansers.
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THE EFFECTS OF CLEANSERS ON SKIN
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Cleansers prepare the skin for subsequently applied products. Foaming cleansers surround lipids and remove them from the skin’s surface. This temporarily injures the skin barrier, increasing transepidermal water loss and penetration of applied ingredients. Creamy cleansers, referred to as nonfoaming cleansers in this chapter, deposit lipids on the skin that help nourish and strengthen the skin barrier. All cleansers, especially when applied with a cloth, loofah, or facial brush, promote exfoliation, removing desquamated skin cells from the surface of the skin. The amount of friction, type of water (hard vs. soft), and the temperature of the water all play a role in how much exfoliation the cleanser causes. Of course, the type of cleanser influences the amount of exfoliation that occurs. Low-pH cleansers, like hydroxy acid cleansers and salicylic acid cleansers, loosen the attachments between cells, promoting exfoliation. All cleansers promote exfoliation but there are two classes of cleansers that excel at enhancing desquamation through exfoliation.
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There are two types of cleansing products that promote desquamation and exfoliation: mechanical exfoliators and chemical exfoliators. Mechanical exfoliators use friction. These include loofas, washcloths, and facial brushes. Facial scrubs, invented by dermatologist Dr. Rose Saperstein, are also examples of mechanical exfoliators.1 Low-pH ingredients such as glycolic, lactic, and phytic acids act as chemical exfoliators and were first described as such by dermatologist Dr. Eugene Van Scott and Ruey Yu, PhD.2 These hydroxy acids are often used as exfoliating cleansers. A second type of acid, known as beta hydroxy acid (BHA) or salicylic acid, is also used to exfoliate skin.
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Cleansers and Irritation
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The surfactants in cleansers can irritate the skin. ...