Aestheticians have a big responsibility to their clients’ well-being in the treatment room as well as after they leave. While facial scrubs may be the most often employed method of exfoliation in the professional environment, knowing how scrubs affect the skin and how critical it is to properly treat the skin post-scrub can be the difference between exfoliation that can improve skin conditions and a procedure that promotes oxidation and aging.
Scrubs are ingredient compounds usually formulated with small, hard particles suspended in a cream, gel, or lotion, often containing a light surfactant cleansing agent plus skin conditioners and moisturizers.
Ingredients often used in these formulas to provide the “scrubbing action” include polyethylene beads, rice bran wax, carnauba wax, beeswax, and jojoba wax. You also will find scrubs that use almond meal, brazil nuts, walnut shells, apricot seeds, and even pumice from volcanic rock. Other forms of scrub compounds include simple sugars and sugar-like particles that come in various sizes and break down as they are applied. The one thing all scrubs have in common is that they are intended to cause a physical impact on the surface layers of the skin.
Facial Scrubs are Barrier Irritants
Scrubs, by definition, are physical irritants just as alpha hydroxy and beta hydroxy acids are chemical irritants. Irritants in products that are used and sold by skin care professionals have the potential to be the most dangerous land mines in the skin care industry if the aesthetician and client are not fully aware of the effect these products have on the skin and how to minimize negative outcomes.
Traditionally, aestheticians were taught to include a scrub procedure with most facials, making scrubs the most common irritant, besides fragrance, used in aesthetics and spas. More recent trends show a decrease in the use of scrubs on the face in the treatment room, even though scrubs continue to be the most common form of exfoliation seen in the professional environment. While many clients enjoy the occasional scrub at home, using the light pressure of their finger tips with little irritation, a scrub used in conjunction with serious facial services and active ingredients can result in inflammation and irritation beyond the expectations of the professional and the client. 
To get the best results from exfoliation treatments, perhaps the most important consideration for skin care professionals and their clients is this: Do not make radical exfoliation a lifestyle. This includes scrubs. While mild exfoliation may sometimes be necessary to assist with ingredient absorption, to help deep cleanse problem conditions and to address certain types of damage or scarring, most clients rarely, if ever, actually need aggressive exfoliation and, when they do, it should be very carefully done.
In my classes, I ask aestheticians why they promote chemical and physical peels to remove the protective layers of skin. The most common reply is to “stimulate collagen.” Stimulating collagen is nature’s way of healing wounds; but I am concerned that we as an industry have led the public to believe that stimulating collagen is worth the frequent removal of the protective surface layers of skin, without thoroughly weighing the short-term benefits against the long-term damage that can result.
A better approach would be to focus on barrier repair as opposed to barrier removal as a lifestyle choice. We rely on our skin as our first line of defense against oxidation and physical harm. Every time we contemplate the use of a tool, procedure or ingredient, we have to consider the action that procedure, or ingredient has on the skin and how appropriate it is to the condition we are attempting to treat, to the lifestyle of the client, and to the overall health of the client’s skin. Skin is Not Hair
Some skin care suppliers have convinced professionals and consumers that skin is much like hair, suggesting that the dead layers exposed to the environment should be regularly removed to “reveal youthful proteins.” While indeed hair and skin are both made of keratin protein, there is one fundamental difference: Hair is a series of connected keratin proteins whereas every skin keratin protein is born independently and then dies as it moves to the skin surface layers.
In hair, as a new protein is formed, the series of hair proteins gets longer until it breaks, due to oxidative damage, or is cut. Most of us choose to cut our hair every month or so once a desired length is achieved, and while we need a hair cut regularly to control the appearance of our hair, the skin does a pretty good job of discarding its own excess and does not necessarily need a radical removal of keratin protein from its protective layers to improve its appearance.
Every day, skin keratin proteins are born. Within a couple of days, a newer protein is born in that very same place forcing the previous “baby” protein to begin its migration upward through the dermis of the skin. As each protein moves up through the spiny layer, it changes shape and begins to die. When it is dead, it flattens as it moves through what we call the granular layer.
The dead protein becomes part of the stratum corneum, among millions of other dead proteins stacked in layers with lipid-oils, which hold them together to form a barrier much like a brick wall. This “wall” is what protects the underlying layers of the skin, including the reproductive process of new proteins, and allows our skin to function in a healthy, normal manner.
We live in an oxidizing environment, and oxidation is the cause of most disease and damage, not just to skin, but to our overall biological function. The stratum corneum provides vital protection against excessive UV radiation, chemical penetration, and exposure of the lower layers of the skin to reactive oxidative species (ROS), which can damage cell reproduction, causing disease and what we call aging.
So why do some believe that the frequent removal of these protective surface layers of skin is a good thing when even one single stratum-corneum-stripping treatment followed by exposure to UV and/or ROS could lead to advanced aging and even skin cancer?
Scrubs: A Gentler Option to Be Used with Care
A good scrub should be no harsher than a washcloth on facial skin. Scrubs should be used judiciously, always taking into consideration everything the client’s face may be subjected to following the procedure, as well as other products which are, or may be used on the same face. Caution is required when combining exfoliation treatments within a service. The use of a scrub cleanser prior to a chemical peel, laser, or microdermabrasion treatment is rarely needed; and clients should be advised not to use a scrub prior to an exfoliating mask or home exfoliation procedure.
Scrubs come in many different formulas, with a myriad of natural and synthetic variations and with various sizes and types of particles. One statement or position regarding their use cannot possibly apply to all scrubs. However, it is imperative that skin professionals realize every scrub is intended to be a physical irritant and that a full analysis of ingredients and particle size must accompany the decision as to which scrub is appropriate for which condition or purpose.
Care Following the Use of Physical Irritants
Scrubs are essentially mini-peels that can result in small tears in the skin surface, which reduce protection from oxidizing elements and which can allow bacterial access. To help protect the skin after the use of any exfoliation – in the treatment room or at home – skin barrier repair, antioxidants, and trans-epidermal sealing moisturizers are critical.
Probably the most protective ingredient you can apply to the skin to help reduce oxidative damage and stimulate normal activity, including collagen production, is a powerful but appropriate antioxidant in nature-identical form. I recommend vitamin C in its ascorbic acid form because this is what nature uses to protect the reproductive process from the oxidizing environment. In nature, every seed is thoroughly surrounded by vitamin C as it develops, as is every cell. Adding ascorbic acid to compromised skin is intended to help to recreate the optimum environment for cellular reproduction.
When choosing an ascorbic acid product for this purpose, however, be aware of two things: First, choose a product that you activate at the point of application to ensure that you have a minmum of 10 percent active C in the product. Premixed vitamin C is very difficult to stabilize and will decrease in potency over time. A good indicator of the potency of a vitamin C product is color: If the product is starting to turn yellow or brown, the vitamin C has aged and may no longer be active.
Second, know that areas on the skin usually will sting slightly when vitamin C is applied following exposure to a barrier irritant. This is not a bad thing; it is an indicator that the surface layers now contain weak or compromised areas that are sensitive to the mild acidity in the vitamin C.
Restoring moisture to the skin after irritating treatments is important, but the choice of hydrators is complicated by the added ingredients included in most formulas, which may cause greater irritation or adversely affect healing. Skin is very resilient and, as a general rule, creating an environment conducive to the skin’s natural functions for self-hydration and healing will get the best results.
To accomplish this, follow the antioxidant application with a five percent vitamin E deep moisturizer that produces a good trans-epidermal seal, or with another option such as jojoba oil, if your client has an inflammatory condition such as rosacea or acne. (Vitamin E oil can exacerbate these advanced conditions and can be moderately comedogenic in oily-prone skin.) The trans-epidermal seal will retain moisture and help to replenish the lipids which hold the stratum corneum together.
While cleansing is necessary to remove bacteria and other irritants that could invade a compromised skin barrier, only sensitive-skin cleansers free of fragrances and sulfates should be used. Explain to your clients how critical it is for them to protect themselves with physical cover, plus vitamin C and vitamin E which provide a trans-epidermal seal to mitigate further damage when any scrub or barrier irritant is used.
Currently, there is a debate raging about the use of sunscreens following barrier irritant treatments because organic sunscreens could increase free-radical activity particularly on a weakened or compromised stratum corneum. The better choice is a physical sunscreen containing zinc oxide or titanium dioxide which help scatter the sun rays, minimizing exposure in the first place. Only recommend a sunscreen with organic chemicals if the client is going to experience extended exposure to the sun. Better yet, recommend that your client postpone any type of barrier irritant treatment if they plan extended exposure to the sun in the days following.
The Last Word on Scrubs
Remember that aggressive scrubs, like any form of radical exfoliation, should not become a lifestyle because they can lead to accelerated “aging” and even skin disease down the road. Consider the need for a scrub on a service-by-service basis, because in the context of most facial treatments, skin often does not need nor benefit from such a procedure. Where possible, consider approaches to “normalize” the natural exfoliation cycle, such as antioxidant treatments, rather than attempting to speed exfoliation through the use of barrier irritants.
Tom Porter is the founder and CEO of Malibu Wellness, author of the book, You’re Not Aging, You’re Just Oxidizing, and developer of the Total Oxidation Management system. He has been researching the action of ascorbic acid and other antioxidants as they apply to skin, scalp, and hair since the early 1980s when a serious car accident allowed him to experience first-hand the healing qualities of these powerful nutrients. For more information, contact Malibu Wellness at 800-622-7332 or visit www.malibuwellness.com.
