Harvard Health

Q. I wash my face very little because I've heard soaps, no matter how mild, dry out the skin. What do you think? What should I wash my face with?

A. Most facial skin is quite sturdy and stands up to repetitive trauma very well. It has many pores and heals quickly and well after injury. But as time passes, the effects of chronic exposure to the environment become evident. The skin thins and becomes less elastic and a bit more porous. Other effects of chronologic aging and cumulative photodamage include freckling, subtle changes in the lines of expression, and fine lines and wrinkles. We get concerned about the appearance of "aging," so the question arises about what is the best way to clean the face.

Excessive cleansing of the skin with soap and water or solvents can interfere with the barrier function of the skin, leading to redness and dryness. However, it's a problem that usually affects the hands, not the face, and people who are exposed to water frequently or who wash their hands often for work, such as surgeons and nurses and bartenders -- as well as the occasional person who is obsessed with cleanliness. Washing your face, even if you do it fairly often, shouldn't cause a problem unless you have an underlying disorder, such as eczema (atopic dermatitis).

Still, it's a good idea to be a little more careful about what you wash your face with. Washing with just water is usually not sufficient because dirt sticks to the skin. Besides, many people need a cleanser of some kind because they have oily skin resulting from active sebaceous glands.

Using regular soap is fine in many cases. Chemically, soap is either a sodium or potassium salt (salt in the sense of being a compound consisting of an acid and a base), and the two most common varieties these days are sodium tallowate and sodium cocoate. Soap is alkaline (it has a pH of 9 to 10), so it can be irritating even to normal skin, which tends to be slightly acidic (with a pH of 5.6 to 5.8).

Synthetic soaps -- often identified on the package as being "soap-free" -- are a better choice for some because the pH is closer to that of normal skin. The synthetic products are definitely worth a try if your skin is reacting badly to regular soap.

Facial scrubs that clean and remove the outer layer of skin (exfoliate) are OK, but I've seen many patients who use them too enthusiastically, so their skin gets irritated. The same is true of rough washcloths and loofahs. And regardless of the type of soap you use, or how you use it, it's best to use warm, not hot, water.

Some people do go through life without using soap on their faces. My mother-in-law would break a vitamin E capsule into a jar of Pond's Cold Cream and clean her face with that mixture, never soap, and she had wonderful looking skin well into her 90s. Of course, some people are blessed with great skin. How they take care of it may have little to do with its appearance.

There's no end to the myths, folktales, and marketing ploys about proper skin care, especially as it concerns the face. It's good, hard facts that are in short supply. -- Kenneth Arndt, M.D., SkinCare Physicians, Chestnut Hill, MA

 

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