Skincare
Here is everything useful I've learned about skincare in the last few months
Some quick context:
I had eczema for most of my twenties, this eventually got so bad I went to a dermatologist and got diagnosed with sub-erythrodermic eczema. Which is where eczema is covering almost all of your skin. This led to me being put on some crazy strong meds (normally given to organ transplant recipients) to turn my immune system off and give my skin a chance to calm down and heal. Yes, this was during Covid, and I had basically no immune system. Fun.
One side effect of these meds was my pores stopped cleaning themselves out properly. So when I got off the meds I had a face full of clogged pores, plus some general damage from the eczema.
Being a rugged alpha male my first reaction was to try to get scrape the sebum (that's nerd for face goo) out with my thumbnail. This did not help. In fact it just messed my pores up further.
The failure of this plan, along with the general aging anxiety that comes with turning 30, led me to risk the rocks in my head getting hot and actually research how to do this properly.
Here is everything I learned.
Some quick disclaimers:
- This is just going to cover face skincare. I haven't looked into the rest of the body as much. All I can advise is to apply sunscreen before going into the sun (ideally a moisturising one), and moisturise after showing, as drying off after a shower is usually when your skin dries out the most.
- This article is mostly the result of a few months of interest and research. In skincare terms that's tiny as most products can take months to really work. And most products will last a few months so I haven't really had much time to try out a comprehensive selection of what's out there.
OK let's start with some actionables. Here's what to do in increasing order of complexity.
The effective minimum:
Morning:
- Apply sunscreen to face (I use Cerave AM)
That's it. This might give you about as much (long term) benefit as everything else I'm going to explain combined. Sun damage is the main cause of skin aging and irritation. Just do this and you'll probably age better than the majority of people (particularly if you are a guy). Wash your face before bed because sunscreen can clog your pores and cause acne.
Notes and info about sunscreen:
- Make sure the SPF of the sunscreen is at least 30
- 50 is ideal but not a big deal.
- Make sure the sunscreen covers UVA and UVB
- This is often called "Broad Spectrum". Apparently some only protect against UVA, but I think this is a USA exclusive problem. I've never seen a sunscreen without both in the UK. Apparently consumer choice is when you can trick people into buying a worse product with no upsides.
- Ideally use a moisturising sunscreen
- This will protect your skin against dryness and irritation damage (particularly if it's a cheap sunscreen). And it should give you a much more immediately visible benefit compared to the longer term benefits of SPF. Which can help with sticking with the habit.
- A proper face cream is ideal but anything is much better than nothing
- A sunscreen designed for the face will usually provide a lot of smaller and more immediately noticeable benefits, and be more gentle on your skin.
- If you find your sunscreen stings when you apply it, you may want to spend the extra money on a fancy face cream. Though be aware this doesn't guarantee it won't sting, I'll list some ingredients to watch out for later.
- But if you don't want to spend the extra money, or just really like what you already use for whatever reason, then just use whatever you have. As long as the SPF is high enough, you'll get the majority of the benefit of the single most effective skincare product.
- If you have a darker skin tone then you may have problems with sunscreens causing a white cast on your face. I am pale as the driven mayo so I haven't had much personal experience with this problem, but here's what advice I can give you:
- Try a tinted sunscreen. Some people also use these as makeup foundation replacements. The iron oxides often used in tinted sunscreens can also help prevent hyperpigmentation, especially in dark skin.
- Try a sunscreen specifically formulated for dark skin. For example Black Girl Sunscreen.
- If you are from the USA then maybe look at Korean sunscreens. White cast is generally caused by mineral (inorganic) UV filters, and companies in the USA don't have much choice in using them as the requirements to get government approval for new UV filters are out of date and difficult to pass. Korean sunscreens are fairly easy to import and often use much newer chemical (organic) filters. Beauty of Joseon is often recommended.
Intermediate:
morning
wash face (optionally with cleanser)
apply moisturising sun screen to face
before bed
wash face with cleanser
apply retinoid
apply moisturiser
The main products we're introducing here are retinoids (the second most effective skincare product), and a cleanser. The moisturiser has standalone benefits but is mostly to counteract the side effects of the retinoid.
Notes and info about cleansers:
The basic idea of a cleanser is pretty obvious, it cleans your skin. Ideally more effectively and more gently than soap. A good cleanser is like a combination shampoo/conditioner for your skin; You first remove all of the dirt and oils on your skin, and then replace them with some clean oils to keep things protected and healthy. With this in mind it's best to find a cleanser with moisturisers, particularly humectant moisturisers.
If you are having problems with clogged pores and acne, try a cleanser with salicylic acid. This is very good at dissolving the sebum that causes these issues. Just bear in mind this can make the cleanser slightly harsher on your skin, so don't use it more than once a day if you start to have issues with dry/tight skin after trying it.
You can also use cleansers in the shower. There are even cleansers specifically made for your scalp and for your body but from what I gather they tend to be harsher than cleansers made for your face. So maybe try using a face cleanser first and see how your skin tolerates it.
Notes and info about retinoids:
Retinoids are a forms of vitamin A with an absurd number of skin benefits. Tightening pores, minimising/preventing signs of aging, helping with acne, the list goes on. The downsides are some potential irritation and dryness, plus they break down in the sun and increase sun sensitivity so you generally need to apply them at night. It usually takes a month or two for you to start seeing the benefits, plus there is an adaptation period for the first few weeks where you skin can appear worse (more on that in a bit).
The (probably) most effective and most studied retinoid is tretinoin. Unfortunately it's also prescription only. So I haven't used it and haven't looked into it much (basically it's the same as other retinoids, but the normal benefits and negatives are stronger). So I will be mostly talking about cosmetic/commercial retinoids.
It's worth noting that most commercial retinoids work by breaking down into tretinoin in your skin. Generally speaking, the more chemical changes it has to go through to turn into tretinoin, the weaker the retinoid is. On the upside, the further it starts from being tretinoin, the more stable and longer expiry the retinoid will usually have, as tretinoin is not very stable. This breakdown process can also help to moderate and space out the dose of tretinoin being exposed to your skin, this can help prevent overapplying the retinoid and getting irritated or even peeling skin.
WARNING
Retinoids increase your skin's sensitivity to the sun. If you are using a retinoid, make sure you are also using a sunscreen during the day.
The retinoid "uglies"
One of the main ways retinoids improve your skin is by increasing your skin cell turnover rate. This means that when you first start using retinoids, skin problems that would normally take a few months to fully emerge will now be compressed into a timeframe of a few weeks. So your skin can appear to be getting worse. But if you stick through this adaptation period your skin will be much better afterwards. This also means that future skin problems like spots will move through their normal lifecycle within this compressed timeframe and be gone faster.
There are a few different kinds of retinoid, here they are from weakest to strongest:
Retinyl Ester
The weakest but also gentlest type of retinoid. The main product you'll hear about using this as it's active ingredient is A313 cream.
Retinol
The most common type of commercial retinoid. Medium strength, medium irritation/dryness. Easily available and pretty well studied.
There are also some proprietary variants like granactive retinol, which has the alleged benefits of being less irritating while potentially being stronger than most retinols as it undergoes fewer chemical changes to become active tretinoin. However the research on these is minimal and mostly done by the manufacturers. The main thing this variant was developed for was stability, so a longer shelf life after opening is the most probable benefit you'll actually get from a granactive. I have been using a granactive retinol for the past few months and appear to have gotten some benefit from it, but so far the only other retinoid I've used is the much weaker retinyl ester based A313.
Retinal
This is the strongest retinoid easily available over the counter. It's often used as an ingredient in more targeted products like eye creams, but some companies will sell it on it's own as their advanced skin care nuclear option. I haven't tried a retinal yet. I'll try moving on to one once I've run out of my current retinol and report back.
There are some other retinoids like adapalene and tazarotene. However, these are closer to tretinoin in strength and much more of a medical intervention (though some are available over the counter). So I haven't looked into them much.
It's generally advised to start with a weaker retinoid and work your way up the strength hierarchy. This helps to minimise adverse reactions (irritated skin, redness, even peeling skin), and will hep to stick to using them.
Advanced:
morning
wash face with cleanser
apply anti-oxidant serum
apply moisturising sun screen to face
before bed
wash face with cleanser
apply retinoid/Alpha hydroxy acid
apply humectant
apply emollient
This routine introduces an anti-oxidant serum to enhance the effects of the sunscreen, and two complementary types of moisturiser. Once a week the retinoid is swapped for an alpha hydroxy acid. The ingredients don't actually conflict with each other, but both can be irritating so applying both at once could be damaging for your skin. There also isn't much of a benefit to using an alpha hydroxy acid more than once a week, but there is a higher risk of irritation. So it substitutes the retinoid just once a week.
Notes and info about anti-oxidant serums:
The purpose of an anti-oxidant serum is to act as a second line of defence, neutralising any free radicals generated by solar radiation that got past your sunscreen. They can also have additional benefits, such as improving skin brightness and reducing the appearance of wrinkles via collagen growth.
By far the most researched anti-oxidant (for skincare) is vitamin C, aka ascorbic acid. So vitamin C based products have the strongest guarantee of working. There are however, quite a few downsides:
- It can be an irritant. What with ascorbic acid being (in skincare terms) a strong acid, it can cause irritation and stinging on sensitive or damaged skin. It won't dissolve your skin or anything, but it can hurt.
-It isn't very stable. There are some more stable variants I'll mention later, but standard L-ascorbic acid (which is the most studied form of vitamin C) can oxidise and lose effectiveness quickly, especially when exposed to oxygen and sunlight. As there's a lot of both around, this this means they (should) come in protective packaging; UV resistant (usually dark brown) glass, or ideally an airless pump. You can usually tell how oxidised it is by the color. Most vitamin C serums will start out clear and become increasingly dark and orange/brown over time.
The go to L-ascorbic acid based serum is the Skinceuticals C E Ferulic serum. Their big breakthrough was discovering that lowering the pH below 3.5 significantly increased absorption into the skin, and that combining it with other antioxidants like ferulic acid and vitamin E increased it's stability. It is crazy expensive though.
There are also some (less researched) variants of vitamin C, other than normal L-ascorbic acid:
-Sodium Ascorbyl Phosphate. This has normal vitamin C's benefits while being more stable and possibly providing an anti-acne effect by preventing UV oxidation of sebum. It tends to be used in more budget oriented products.
-3-0 Ethyl Ascorbic Acid. This also has normal vitamin C's benefits while being significantly more stable. It is also water and lipid (oil) soluble, making it available in oil based (anhydrous) and water based formulas. This seems to be the recommended variant for people who find L-ascorbic acid too harsh on their skin.
-Tetrahexyldecyl Ascorbate. Similar to Ethyl Ascorbic Acid this variant is more stable and lipid soluble. However it is much less researched than the others.
The ideal concentration of vitamin C in a serum is somewhere between 8-20%. Any lower may not be effective, and any higher will increase irritation with no guarantee of better results.
Vitamin C should not be used with benzoyl peroxide (a common acne treatment), hypochlorous acid, or copper peptides. Nothing bad will happen, the vitamin C will just stop them from working properly.
Some other antioxidants include:
- Niacinamide. This is a form of vitamin B3. It has a lot of useful skincare effects outside of being an antioxidant, particularly if you want to reduce the appearance of your pores. The good news is because of these huge number of benefits it's already mixed into a lot of skincare products now. Even fairly cheap SPF face creams often have it.
- Resveratrol & Ferulic Acid. These are usually mixed together (antioxidants often work best when combined). Ferulic acid is derived from cereals and resveratrol is derived from grape skins.
- Pycnogenol. This is a pine bark extract. A lot of people seem to like the smell of this one. But I have also seen reports of it being irritating for some people.
- EUK-134. This is an antioxidant molecule that is capable of renewing itself. Most antioxidant molecules can only neutralise one free-radical and then become oxidised. EUK-134 however can return to an unoxidized state and work again. This sounds pretty neat and there is actually some (though I'm not sure how much) research backing it up. The big downside is it's very pH sensitive which makes it difficult to combine it with other ingredients. The main things you will want to avoid are direct acids (salicylic acid, glycolic acid, lactic acid, azelaic acid etc), copper peptides, and vitamin C. I have used this myself and my skin did seem to get noticeably brighter.
Notes and info about moisturisers:
There are three main categories to be aware of when looking at moisturisers:
- Humectants. These are moisturisers that are very hydrophilic and draw/bind moisture into the skin. This can either be water already on the skin (i.e. applied to damp skin), the water that would normally evaporate out and be lost from skin cells (transepidermal water loss), or water mixed in with the humectant product.
Humectants won't dry out your skin more if applied to dry skin, as mentioned above they will instead capture the moisture your skin loses naturally, or from moisture in the air.
Examples: Glycerin, Hyaluronic acid, Salicylic acid, Lactic acid, Urea, Propanediol,
Hyaluronic acid
This an extremely hydrophilic molecule that is naturally produced by your skin, so it's very unlikely to be irritating. The factoid you'll usually hear about hyaluronic acid is a quarter-teaspoon of it "holds" about one and a half gallons of water. I'm not totally sure what that means in real life. I assume if you dropped a tablespoon of it in a pond, the pond wouldn't form into a grape like jelly bubble, but suffice to say hyaluronic acid is a great humectant.
- Emollients. Emollients fill in any gaps in damaged skin and can replace missing skin oils. This helps to smooth the skin out and reduce irritation and itching from skin damage. They also help to seal moisture into the skin, though not as strongly as occlusives. As an eczema sufferer I've used a lot of these. They tend to be thicker than humectants.
Examples: Jojoba oil, Ceramides, Stearic acid, Isopropyl isostearate, Cocoa butter, Squalane, Propanediol,
Squalane
Squalene (with an "e") is a lipid naturally produced in your skin, with it's production gradually declining once your reach your 30's. Squalane (with an "a") is made from squalene and hydrogenated to make it more stable and better tolerated when added to (rather than produced by) the skin. It's also less likely to clog your pores as it's more resistant to oxidation. It is a humectant, emollient and occlusive, it even has some anti-oxidant properties. It does a bit of everything and is a great last step in a skincare routine, particularly if you're using strong active ingredients and don't want to risk overexposing your skin to them by using a stronger occlusive like petrolatum.
- Occlusives. Occlusives seal in moisture as well as other active skincare ingredients.
They can be basically just very thick emollients (there doesn't seem to be a clear threshold where an emollient becomes an occlusive), but the term can also refer to external occlusives like cotton pads and plastic wrap.
Examples: Petrolatum, Shea butter, Dimethicone,
As you may have guessed there's a lot of crossover between these three categories. It's generally best to use humectants first and then use emollients and occlusives. Especially as many humectants are water based/soluble and most emollients and occlusives are lipid/wax/silicone based. If you use water based products after applying an oil/silicone based one it may not absorb very well.
Slugging
A term you may occasionally come across in skincare is "slugging". This is when you use an occlusive (usually a petrolatum based one) as the final step in a skincare routine to seal in all of the other products and increase their effectiveness, by reducing evaporation and oxidation of the ingredients (it also reduces the risk of the ingredients rubbing off in your sleep). It's generally recommended to only to do this with moisturisers and other active ingredients with very little irritation risk. I did slug with a retinoid before I found out this is a bad idea. I seem to have gotten away with it but it was a granactive 2% retinoid which is very gentle.
Physical occlusives like cotton pads and plastic wrap greatly increase the risk of overexposure if used with an irritating active ingredient. There are videos of people getting chemical burns from taping a cotton pad with salicylic acid (which is fairly mild) on their faces overnight.
Notes and info about alpha hydroxy acids:
Alpha hydroxy acids (also referred to as AHAs) main use are as toners; Improving the texture of the skin by reducing pore size and smoothing our roughness and bumps. They do this by promoting collagen production and by exfoliating dead skin. They can also prevent acne, reduce hyperpigmentation and even increase skin thickness.
If the idea of putting acid on your skin worries you, your skin is naturally acidic. There is a layer on top of your skin literally called the "acid mantle", it provides an ideal environment for beneficial microorganisms and a hostile one for less helpful microorganisms. Your skins pH is usually between 4-6 (pH 7 is neutral).
Some of the milder AHAs are also used for lots of other things; Citric acid and tartaric acid are commonly found in food and drink, and malic acid is often paired with L-citrulline in pre-workout mixes.
Why is exfoliating necessary?
The topmost layer of your skin is called the "stratum corneum". It is 10 to 20 layers of dead skin cells forming a Warhammer-esque protective wall of corpses. Your skin produces about 1 new layer a day, so a layer at the top has to be removed to make room. This top layer not coming off causes flaky and rough feeling skin. Alpha hydroxy acids help to break up these dead skin cells, making them come off more easily and also making the debris smaller and smoother feeling.
The main AHAs you will encounter prominently listed as an active ingredient in skincare are glycolic acid and lactic acid. Citric acid is also very commonly used but tends to be more of a support ingredient.
Glycolic acid:
This is the most studied AHA. It also has the smallest molecule; This allows it to penetrate more deeply (and easily) into the skin and have a greater effect. The downside of this is it also has a greater potential for irritation. It is used as an ingredient in lots of skincare products but can also be applied on its own. Just saturate some cotton wool with it and swab it across your face. I have done this, and if I'm careful I have no problems. However it's very easy to overapply it and cause (temporary) redness. Lactic acid is probably a better choice for people with sensitive skin like me.
Lactic acid:
While not quite as studied or effective as glycolic acid, lactic acid is still effective while also being much gentler on your skin and even acting as a humectant moisturiser. It also increases production of ceramides in your skin, these are skin oils that help protect and moisturise your skin. These properties mean it's absolutely everywhere in skincare products. However it's still worth being aware if it's in a product because:
WARNING
Alpha hydroxy acids increase your skins sensitivity to sunlight. Even very mild AHAs like citric acid (the acid you find in citrus fruit like lemons) can make sunburn much worse. If you're using AHAs or a product that contains them, make sure you wear sunscreen afterwards to protect your skin.
Other AHAs:
Malic acid, citric acid, tartaric acid, mandelic acid,
A note on strength:
So I recently changed from a 7% glycolic acid to a 10% lactic acid, and despite lactic acid generally being gentler that 3% increase in acid strength meant it stung to apply in a way the glycolic acid never did (though it did cause less redness). So be aware that even if you're using a gentler AHA, it can still sting if it's strong enough.
Common irritants
First of all I'd like to be clear that this isn't a list of ingredients to always avoid. These ingredients are used for a reason and if they get removed other similar ingredients have to be used instead.
Parabens are a great example. Parabens are used as preservatives, and can be mildly irritating. At some point a few years ago some companies started using "paraben free" as a marketing tactic, citing a study that showed some build up in tissues and maybe a cancer/endocrine disruption risk. That study was considered to not be very well designed and subsequent studies haven't had the same findings, but the damage was done. And now parabens are much rarer because consumers have been told it's a bad ingredient and will avoid it. The problem is parabens are really good preservatives and can have a useful effect in tiny amounts, they are also (in pharmaceutical terms) quite an old chemical technology (they've been used as preservatives since 1924) so their long term health effects are much better established than most of their replacements. And so now the parabens are gone, they've been replaced with larger quantities of other perversities, which may be more irritating and less studied. Hooray for marketing.
Why can't they just not use irritants/preservatives?
Money. Preservatives extend the shelf life of the product, thus widening the window where it has the potential to be sold. And also mean the company is much less likely to be sued for giving someone a fungal infection through their eye cream. Any company not using preservatives will quickly be pushed out the market by ones that do, or sued into the ground for selling unsafe products. Maybe one day you can buy a moisturiser with a 3 day shelf life and a botulism waiver, but it's unlikely.
Alcohols
OK this one is going to be confusing. You probably already knew that alcohol can sting and be irritating. However, some alcohols are actually really good for your skin as they are emollients and can make products less irritating. These are called fatty alcohols, a phenomenally unappealing name for the best kind of alcohol.
Common fatty alcohols:
Behenyl alcohol
Cetearyl alcohol
Cetyl alcohol
Cetyl Esters Wax
Decyl Alcohol
Hexyldecanol
Isostearyl alcohol
Lauryl alcohol
Myristy alcohol
Octyldodecanol
Polyglycery
Stearoyl Lactylate
Stearyl alcohol
Not easy names to remember I know. I usually just look out for Cetyl/Stearyl somewhere in the name.
The "bad" alcohols
Again, these aren't flatly negative. They can be irritating and sting like crazy, but if your skin can tolerate them (and many people can), then they are fine and probably preferable to the alternatives. I think it's safe to say the health effects of alcohol are well established at this point.
Potentially irritating alcohols:
Denatured alcohol/alcohol denat/SD alcohol
Isopropyl alcohol
Benzyl alcohol (this one is less irritating than the others, even I can tolerate this one)
Fun fact, denatured alcohols are derivatives of Ethyl alcohol (the kind you drink), but are denatured so the cosmetics using them aren't taxed as beverages.
Some other useful terms to know:
Non-comodenic
Comedo is a term for a blocked pore, and so non-comodenic means a product is less likely to clog your pores. Usually they'll just print "non-comodenic" somewhere on the packaging or sometimes companies will use a Comedogenic rating with 0 being low clog risk and 5 being high clog risk.
It's worth noting that this is not an absolute guarantee that it won't cog your pores, it only indicates it's less likely to. There is no regulation or standard that companies need to adhere to in order to use the term on their products.
If your skin's barrier is damaged in some way then non-comodenic products can still clog it as your skin's self cleaning abilities' are impaired.
My current routine:
morning
wash face with CeraVe gentle moisturising cleanser
apply The Ordinary EUK 134 anti-oxidant serum
apply CeraVe AM sun screen to face
before bed
wash face with CeraVe gentle moisturising cleanser
apply The Ordinary retinal 0.2% emulsion, or once a week The Ordinary AHA 30% peeling solution
apply CeraVe PM
apply The Ordinary "B" Oil