The Elements of Exfoliation: A Conversation with Dr. Suzan Obagi

SUZANOBAGIMD Retivance Skin Rejuvenating Complex

In the ever-changing world of skincare, few figures are as influential as Dr. Suzan Obagi. As the Chief Medical Director at Obagi Cosmeceuticals and the Director of the University of Pittsburgh Medical Center (UPMC) Cosmetic Surgery & Skin Health Centers, Dr. Obagi is a respected leader in cosmetic dermatology. She shared with us her views on the importance of exfoliation in maintaining the look of vibrant, healthy skin.

"Exfoliation is essential as we age because our rate of cell turnover slows down," Dr. Obagi explains. "It helps remove dead, dull skin cells, leaving the skin smoother and more radiant." Well-exfoliated skin also improves the efficacy of skincare products by allowing the products to penetrate more deeply and be better absorbed by skin. "It’s crucial to remember that different skin types require different exfoliation strategies," Dr. Obagi notes.

Our skin consists of three layers: the epidermis, the dermis, and subcutaneous tissue. The epidermis, the top layer of skin, acts as a protective barrier, contains melanin (the pigment that gives skin its color), and continuously produces new skin cells. The dermis, the middle layer of skin, is approximately 90 percent of skin’s thickness. It contains collagen and elastin, nerve receptors that detect temperature and pain, and sweat glands. The hypodermis, or subcutaneous tissue, cushions and connects muscles and bones and regulates body temperature.

As seen in the image below, our skin undergoes a complete cycle every six weeks, with keratinocytes (the cells making up the epidermis) using this time to divide and multiply at the basal layer (the lowest level of the epidermis) before they mature and reach the stratum corneum (the top layer of the epidermis).


Cellular Components of Skin

As we grow older, however, this process decreases, leading to a build-up of dead skin cells and a duller complexion. Environmental factors like pollution and smoking further intensify the slowdown. "The key to combating this is a well-formulated, regular skincare regimen," says Dr. Obagi. She highlights the importance of incorporating retinoids at night, as well as alpha, beta, and poly-hydroxy acids to boost cellular turnover and aid in breaking down the bonds between skin cells.

For those still battling lackluster skin despite following a consistent skincare routine, Dr. Obagi suggests gentle exfoliation. "Incorporating an exfoliating cream or lotion daily can make a significant difference," she advises. “The key is to balance exfoliation without excessive irritation.”

On acne-prone skin, beta hydroxy acids (BHA) like salicylic acid are effective in unclogging pores. Oily skin benefits from glycolic acid, while normal skin does well with phytic or polyhydroxy acids. Dry skin works best with glycolic acid in a hydrating base, and sensitive skin types may find polyhydroxy acids gentler and less irritating.

Obagi offers several options, such as Obagi Nu-Derm® Exfoderm® Forte (glycolic acid-AHA), Obagi Nu-Derm® Exfoderm® (phytic acid-AHA), Obagi-C® Fx C-Exfoliating Day Lotion (glycolic acid-AHA), and SUZANOBAGIMD™ Intensive Daily Repair (polyhydroxy acids including gluconolactone and lactobionic acids). These products, used daily in the morning, help disrupt the bonds between the keratinocytes in the upper dermis and stratum corneum. This induces them to slough away dead skin, thereby creating a smoother, more compact stratum corneum that allows subsequent skincare steps to penetrate more deeply and evenly.

Beyond the use of daily lotions, cleansers and wipes can also begin the exfoliation process. Those containing salicylic acid (betahydroxy acid-BHA) or plant-derived enzymes, like papain, an enzyme derived from papaya, deliver a low level, yet effective concentration of exfoliant to the skin. These work best for blemish and acne-prone skin because salicylic acid (BHA) is more effective than AHAs at penetrating through the lipids that are part of the skin barrier to help unclog pores, clear away dead skin, and penetrate blemishes. Choices include Obagi360® Exfoliating Cleanser, formulated with linked papain (a stabilized form of papain that uses crosslinking to improve exfoliation), which helps break down proteins in dead skin cells and promote skin cell turnover; CLENZIderm M.D.® Daily Foaming Cleanser and CLENZIderm M.D.® Pore Therapy (both containing salicylic acid, a BHA); and no-rinse SUZANOBAGIMD™ Acne Cleansing Wipes (salicylic acid-BHA).

When greater exfoliation is desired, Dr. Obagi suggests using an exfoliating polish once a week and gradually working up to two or three times per week as needed, or an at-home peel every two weeks. Options for deeper exfoliation include the Professional-C® Microdermabrasion Polish + Mask or the Blue Brilliance® Triple Acid Peel. Dr. Obagi warns against overuse, especially during cold, dry winter months and using extra care with dry, fragile, or sensitive skin. "Exfoliation should never leave the skin feeling stripped, raw, or uncomfortable," she cautions.

Post-exfoliation care is equally important. She advises choosing the appropriate moisturizer for your skin type from the Obagi Hydrate Collection after using an exfoliating polish or peel. “By applying a moisturizer, you’re helping to seal in moisture and avoiding further irritation to the skin.” Dr. Obagi encourages daily application of sunscreen, particularly when using strong exfoliants like glycolic acid or after stronger exfoliating polishes or peels that can leave skin more susceptible to sun sensitivity. Dr. Obagi also recommends waiting 24 hours before resuming any topical retinoid.

Should skin become over-exfoliated, it may feel sensitive, raw, or irritated. To help soothe skin, switch to gentle cleansers like Obagi Nu-Derm® Gentle Cleanser or one that helps hydrate skin like SUZANOBAGIMD™ Foaming Cleanser and apply a moisturizer up to two to three times per day. Obagi® Rebalance Skin Barrier Recovery Cream helps soothe any irritation while restoring and rebalancing the skin’s microbiome.

When it comes to in-office peels, Dr. Obagi sees them as a complement to a consistent home skincare regimen but not as a substitute. She recommends starting in-office peels only after establishing a solid home routine for at least three to four weeks, or six to ten weeks for darker skin types who are more at risk of developing hyperpigmentation in response to skin injuries including peels. Establishing a consistent skincare routine that includes a topical cream to suppress pigment formation by melanocytes (pigment cells) before peels reduces the risk of post-procedure hyperpigmentation. Once the routine is established, light in-office peels can be started. These peels will help deliver results faster than creams alone, especially for skin with acne, blemishes, or hyperpigmentation.

Dr. Obagi also addresses a growing trend: at-home DIY peels and exfoliating treatments. "While these types of DIY treatments are on the rise, so are complications like infections and scarring," she warns. She similarly advises against at-home microneedling from kits found online which are often hard to sterilize and can result in scarring, granulomas, and infections. "It's essential to approach skin treatments with caution and when in doubt, always seek professional advice."

It’s clear that a customized, consistent exfoliation regimen not only boosts our skin’s natural radiance, but gets us even closer to the healthy, glowing complexion everybody wants. Dr. Obagi’s expertise helps us choose the elements we need from the overwhelming number of skincare options so we can develop a daily routine to meet our specific needs.



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