Dry Face

August 11, 2016 7:06 AM

I'm dealing with near painful dry skin on my face. Will getting a facial at a local spa help me?

I suffer from Keratosis Pilaris Rubra Faceii, which has the result of really red cheeks. Because of this I try my best not to wear or use any products with dyes or scents.

• I recently had VSG surgery. Because of this, I'm on a daily double dose of multivitamin, as well as calcium, and weekly doses of B12 and Vitamin D.
• I first noticed I was having dry skin issues bout two months ago, this is when I started implementing the routine listed farther down.
• I drink lots of water. (TMI: my pee is pale yellow)
• I don't wear sunscreen. I actively avoid sunshine, and the only exposure I get is going to and from my car.
• I don't wear makeup.
• I don't suffer from acne.
• I don't want to escalate this to a Dermatologist just yet
• I change my sheets and pillow cases out bi-weekly

Current skincare routine is: (only at nighttime about 30-60 minutes before bed)

1. Wash with a Paula's Choice Hydralight cleanser.
2. Use Paula's Choice Hydralight toner every other day
3. Use a 2% BHA exfoliant (use to be Paula's Choice gel, then liquid, and now Red box Stridex)
4. St. Ives Timeless Skin Facial Moisturizer (entire face)
5. Vaseline Intensive Care Advanced Repair Lotion (painful dry areas)

This originally started out on my forehead and in between my eyebrows. That has gotten significantly better, but now the area right under my bottom lip (and on the sides of my eyes/temples) are getting into the painfully dry stage.

Facials cost a lot of money (often more then a pedi or mani!), are they really beneficial? Is there a type or kind I should get?

posted by INFJ to Health & Fitness (32 answers total)

Can you explain your reluctance to see a dermatologist? A solution that's covered by insurance and likely to be effective seems like the obvious choice over an expensive option with some random facialist who may or may not do anything useful. Going to the doctor for an issue is not "escalating", it's step one.
posted by brainmouse at 7:08 AM on August 11, 2016 [11 favorites]

A dermatologist is the person to see about skin problems. Facials are for fun, and maybe light stuff like zit extraction or exfoliation, but they can't diagnose and treat medical issues. Plus your co-pay should be a lot less than a facial.
posted by fingersandtoes at 7:15 AM on August 11, 2016 [8 favorites]

I loooove me a good facial, but I don't think they make a good substitute for medical care. In my experience a good facial will help with minor acne (via extractions) or mildly problematic skin (via exfoliation/peel/steam/moisturizing), but doesn't do much for more serious or complex issues. They leave your skin feeling great, but the feeling is usually pretty short-lived.

You have a lot of steps in your skincare routine. Have you considered reducing the number of products you're using?
posted by schroedingersgirl at 7:18 AM on August 11, 2016 [3 favorites]

Instead of your last two products (the moisturizers), try CeraVe, the kind that comes in a tub that looks like this. It's amazing and is the best face moisturizer I've ever used. You should moisturize more than once a day. Certainly in the morning, certainly after you shower or any time you wash your face.

I also would absolutely absolutely NOT go get a facial expecting it to fix this. Aestheticians aren't going to fix a medical problem. They're for expensive pampering fun.
posted by phunniemee at 7:22 AM on August 11, 2016 [1 favorite]

Would strongly recommend against the BHA exfoliant right now - I know it's a low concentration and you feel the need to get that dry scaling skin removed, but if you have really sensitive skin at this time, it just makes things so much worse - skin gets irritated, problem is exacerbated.

I would also suggest leaving off the toner for a bit - it can also be drying, even if it doesn't have alcohol.

Instead, try products with hydraluron, which helps the skin retain moisture. One example you might try are those inexpensive cloth facial masks ("moisture" masks) - before bed, leave on clean skin for 15-20 minutes, rub in the excess (don't rinse off), and put your moisturizer on top.
posted by lizbunny at 7:22 AM on August 11, 2016 [13 favorites]

Response by poster: why not dermatologist: mostly cost. I'm on a high deductible plan (HDHP), which I haven't met yet.. so in the grand scheme of costs, a facial is cheaper than a doctor at this time. And while the skin is painful, it doesn't feel like it's at the "time to get doctors involved" stage? I feel like this is mostly a moisturizing issue.

I was mostly hoping that a facial with a peel would be the answer, but answers like the one from lizbunny have me thinking it might be the routine/products?
posted by INFJ at 7:39 AM on August 11, 2016

Yeah, that sounds like a lot of products to me, too. Especially since you don't have acne. Give your skin a break and see if things improve.
posted by chaiminda at 7:41 AM on August 11, 2016 [2 favorites]

Don't get a facial, especially not a peel. You want to be doing fewer things that could possibly irritate your skin, not more.
posted by rachaelfaith at 7:48 AM on August 11, 2016 [12 favorites]

Oh god, absolutely do not get a facial right now.

When I had horrible eczema on my face and neck, I cut way way way back on the products I used and switched to a gentle CeraVe cleanser, then Eucerin moisturizer formulated for eczema, then Aquaphor over. That was it (well, I did use zinc oxide sunscreen in the day). Cleared up fairly quickly after that. I mention this because I think when you're having skin problems, fewer products are way better.

I would definitely cut out the chemical exfoliant, especially Stridex red box, yikes! That stuff is full of alcohol and not something to be putting on angry skin.
posted by holborne at 7:51 AM on August 11, 2016 [16 favorites]

It might be worth checking if any of your skincare products contain oats. According to my dermatologist, 25% of people have unpleasant skin reactions to oat-containing products.
posted by Sockpuppets 'R' Us at 7:58 AM on August 11, 2016

I looked up images of your condition and it reminds me a lot of how a friend's face looked for years until she found a derm who put her on antibiotics for many months and finally for the first time in her life her skin was clear.

I'm not telling you this is an answer to your problem, just a possibility to investigate.
posted by Dragonness at 8:13 AM on August 11, 2016

Definitely cut out the BHA, the toner, and the two moisturizers. Switch to Cerave in the Tub.
posted by pintapicasso at 8:20 AM on August 11, 2016

Hello from a lifer with super-dry-skin and eczema! Not a rocket scientist or dermatologist, but it sounds like your skincare routine is drying your skin out. I can't use toner or most chemical exfoliators. Just totally counterproductive. What I use instead is a shit-load of unfashionable old lady moisturizers (Eucerin)/ moisturizing cleansers (hello Ponds) or just--- oil. It seems crazy to rub olive oil all over your face given that 90 percent of skincare wisdom says DO NOT CLOG YOUR PORES WITH OIL but that same 90 percent of the skincare wisdom-- basically, the cleanser-toner-exfoliator trifecta you describe-- turns my face into a horrible snake-mask complete with visible flaking skin and actual fissures. So, there's a data point for you.
posted by athirstforsalt at 8:21 AM on August 11, 2016 [8 favorites]

I have a couple patches of ezcema on my face and have found that straight jojoba oil applied while my skin is still moist (from cleansing with a gentle cleanser) has kept it at bay. Still, a dermatologist will help get you on a good path. Most doctors will offer discounts to cash paying patients if you ask (and I'm willing to bet it would be pretty close to a high end spa's facial fee).
posted by PorcineWithMe at 8:33 AM on August 11, 2016 [1 favorite]

I was mostly hoping that a facial with a peel would be the answer

Do not do this with dry, peeling skin. Use a 100% pure moisturiser with no alcohol in it before bed: Vaseline petroleum jelly, olive oil, jojoba oil, coconut oil, etc.
posted by DarlingBri at 8:35 AM on August 11, 2016

I like to get facials when I am on vacation, so I have been to a wide variety of aestheticians. I have been to exactly 1 aesthetician who was knowledgeable or empowered enough to deal with my minor skin issues (primarily rosacea and hormonal acne) and actually improve them. She was the owner of a therapeutic spa in Palm Springs. Every other aesthetician, from high-end independent spas to hotels to strip mall, seems to have a set routine that they follow with only minor variations, even after I tell them that I have very sensitive skin and rosacea. Facials really are for clarifying and toning already-healthy skin, not for repairing dry, damaged skin.

Pure oil moisturizers are not good for my skin (hence "sensitive skin") so I use oil-free CeraVe moisturizer or Oil of Olay. Cancer patients experiencing dry, damaged skin from radiation are recommended to use Aquaphor.
posted by muddgirl at 8:39 AM on August 11, 2016 [1 favorite]

The last time I went for a facial it was a bad decision for my Retin-A treated skin.

I asked friends for a referral to a very competent facialist. I booked the very expensive service with a highly regarded practitioner that had been in the business many years.

I talked to her extensively about my Retin A usage and the nature of my skin. She seemed somewhat unfamiliar with medical issues and skin. She used very high end products that are available at salons and some in Sephora.


An hour after I got home, my entire face was in flakes. I applied straight oil to my face for a couple days until it recovered.


Unless the derm recommends a facial, I wouldn't risk it. And I would only get a facial in a derm's office. You also could try to do a home facial on yourself using products you know work for you.
posted by littlewater at 8:40 AM on August 11, 2016

Wow those are a lot of drying products! Nthing the suggestion to change your skincare routine. Is there a particular reason you're using a cleanser meant for normal to oily skin? In my experience, my skin got less oily when I moisturized it more and used gentle cleansers like an almond/jojoba oil mix or Cetaphil or this one from Paula's Choice.

I would take it down to: hydralight cleanser, BHA on only select areas that you feel you need it (just your cheeks?) and then I'd put this mask on my face every night and sleep in it. In the morning just rinse your face with water.

Some other ultra moisturizing products I've used on my sensitive face when it's been dry and chapped from a cold: Eucerin in the tub and this butter from Paula's Choice.

One wrinkle that kind of concerns me: Did the onset of dry skin correlate with your VSG surgery? Are you feeling okay otherwise? How are your energy levels?
posted by purple_bird at 9:10 AM on August 11, 2016

That list of products sounds pretty drying. I had a similar problem a few years ago and it turns out one of the products I was using with BHA was pretty much burning my skin. The problem went away on its own when I cut that out.

These days I'm pretty much using Cerave face wash and moisturizer (thanks to the fine folks here on the green) and my skin hasn't looked so good since I was a wee baby.

And yeah, skip the facial until your skin heals up.
posted by futureisunwritten at 9:18 AM on August 11, 2016

The products you're using aren't particularly drying - I'm wondering why people are saying that in this thread - but the fact that your issues started when you began this routine suggests that you're sensitive to one or more of the products you're using.

So, to answer your direct question: depending on the type of facial you get, it can't hurt, but it's not going to help you in the long run. I'm also kind of curious about what you mean by 'painfully dry'. Is your skin flaking? Does it have an odd, tight, 'cling-wrap' feeling to it? I sometimes get 'cling-wrap' skin when I'm overdoing it with the chemical exfoliants.

Things you can do in the long-run:

- Roll back your skincare routine like whoa. Something in there is irritating you. I'd drop the BHA for now. If you've got a bad case of the flakies, a mild AHA would be better for you - something like this CosRX AHA is very very gentle, but be sure to patch test thoroughly before you start using it full-face.

- Seriously consider seeing a dermatologist if this is really bothering you.

- Once your skin has settled down a bit, try layering a few different products - but add them gradually and PATCH TEST. For me, this has made the biggest difference in dryness/dehydration. A hyalauronic acid toner like Hadalabo Gokujyun underneath a richer, more emollient and occlusive moisturiser might help - I just pour a little into the palm of my hand and pat all over my face.

- In the short term, sheet masks will feel lovely and refreshing and will probably give you the same feeling as a facial - for much less money. You can't go wrong with a good old fashioned My Beauty Diary mask. The black pearl is my favourite 'flavour', but ingredients-wise they're all much of a muchness.
posted by nerdfish at 9:21 AM on August 11, 2016 [1 favorite]

I was a long-time user of alpha/beta hydroxy acid face creams, as it helped a lot to keep my acne at bay. I've gone off it a few times, and getting back into using it has sometimes resulted in my skin reacting very badly, causing red inflamed dry skin. I found that the only fix was to stop using the hydroxy cream entirely until the skin irritation went away, then gradually acclimatizing my skin to it again by only using it every few days.

Daily exfoliating with this product might be too often for your skin. Stop using it until your skin normalizes, and then if you want to try using it again, do it only once or twice a week. If your skin flares up again, I guess it's a no-go for you.

Again, wouldn't use exfoliants until your inflammation is taken care of, but there are much gentler exfoliants to use than the peel-type. I've really liked the results from enzymatic exfoliants with cellulose or rice powder. The ones I've used were available at Sephora, where they will provide you with samples if you're interested.
posted by lizbunny at 10:03 AM on August 11, 2016

The skin on my face has recently been affected by stress and has been very red and dry. I've been using Kiehl's calendula toner, which I've found to be incredibly soothing and gentle.
posted by essexjan at 10:12 AM on August 11, 2016

A few questions: were you taking any post-surgery meds that make your skin photo-sensitive? Could this possibly have started as a sunburn?

Also, your age is relevant: I think I used oily/combo skin products too long past my teen years, when my skin wasn't anymore.

My suggestion, similar to others, is to cut way back, to three products: a very gentle soap (and don't scrub!); a heavy nighttime moisturizer; and a morning moisturizer with sensitive skin sunscreen or heavy moisturizer and then sunscreen.

You might even try a nice thick layer of aloe on your skin. I'd also re-apply the moisturizer or aloe to the dry areas at least once mid-day.

Don't wash your face in the morning; splash with water only if necessary.

If this doesn't help in a week or two -- or it gets worse -- then consider a dermatologist.

Do you have visits scheduled with your post-surgery doctor? You might ask them for insight, too, in case this is related. You might also call their office.

Good luck, with your skin and surgery recovery!
posted by bluedaisy at 10:12 AM on August 11, 2016

depending on the type of facial you get, it can't hurt,

Sorry, no offense, but this is just flat wrong. I once got a horrible infection from a bad facial, and (squick alert) the skin on my face peeled of in sheets for a couple of weeks. I'll repeat my advice above: do not get a facial right now. Even putting aside the possibility of infection (which is probably fairly slight), you don't know what products they're using; a lot of facialists use essential oils, which can irritate the shit out of your skin, especially if it's something like peppermint.
posted by holborne at 10:16 AM on August 11, 2016 [2 favorites]

I only answered your original question about facials, but now that I'm looking at your list of products, I agree with everyone, you gotta get off that complicated regimen. I'd stop using anything at all for a couple of days - just water - and then try Pond's cold cream to clean at night, and a basic unscented Eucerin-type moisturizer during the day, something with no sunscreen or perfume.
posted by fingersandtoes at 10:38 AM on August 11, 2016

When I get ultra dry itchy patches, my choice of last resort is a hydrocortizone cream, as recommended by my doctor. However, it will make your skin very sun sensitive, so only use if you plan on supplementing with a sun cream.

I can understand the use BHA use given your Keratosis Pilaris Rubra Faceii. Try reducing the frequency of use - I personally use BHAs and retinols, and have been told by my derm that more frequent use isn't always better. Its about finding the right mix for your skin.

It may be worth checking if your insurance offers a telephone service you can just call into and chat with? Sometimes they can give good advice.
Good luck!
posted by troytroy at 11:45 AM on August 11, 2016

You're putting a ton of ingredients on your face, and that makes it much harder to isolate what's going on. My feeling is, if you don't wear makeup or sunscreen, go for an oil cleanser instead. Skinactives makes a good one. They also make a good Redness Reduction Serum. Avoid moisturizers with fragrance, because that can be an irritant. If you're worried about too much oil Sea Kelp Coral is great for soothing and moisturizing skin. I use Silk Naturals Argan Moisturizer because it's basic, but has collagen and hyaluronic acid and is priced really well. This is true of the Skin Actives products as well: great price point for all the actives you get, and no strange extras or fillers.
posted by oneirodynia at 1:02 PM on August 11, 2016

While you're figuring out the right skincare routine, you may want to consider changing to baby shampoo. Whenever my mom has a flare up from trying the wrong lotion/face wash, if she doesn't change to baby shampoo her skin stays irritated. After a few weeks she can go back to her normal hair products.

I also find when my skin gets really irritated I need to take a weekend off, hide from the world and do nothing: no face wash, no hair washing, etc.
posted by ghost phoneme at 1:06 PM on August 11, 2016

FYI, I pay $200 to see a dermatologist on my high-deductible health plan (before maxing out my deductible), and a good facial will cost about the same. If your local spa is significantly cheaper, especially if less than $100, then I would be skeptical of the quality.

But anyway, you shouldn't be getting a facial right now. Nthing everyone who says to cut WAY back on the skincare routine. Apply moisturizer that contains hyaluronic acid (I use Cerave PM Facial Moisturizing Lotion under a separate sunscreen, don't buy the AM version which is formulated differently), that's it. Since you actively avoid the sun, I think you're OK not using sunscreen. So, no sunscreen, no makeup, no acne = you will be OK not even cleansing (besides water) for a week. Give your skin time to heal, then add in ONE product for a week at a time.
posted by serelliya at 1:23 PM on August 11, 2016

Ooh would drop the exfoliation and try a moisturizer that has at least 5% urea.

Also would def recommend incorporating seabuckthorn oil in your diet as well as fish oil. Flax is also dandy but tastes awful. Walnuts, avocados etc etc

Theres also the oil cleansing method everyone is going nuts for, but i cant vouch for it because im still figuring it out
posted by speakeasy at 2:30 PM on August 11, 2016

BHAs are drying so I'd skip that for now, or cut back to using it on your less-dry areas only (nose, perhaps). AHAs are often a good choice for dry skin - Paula's Choice has a few, since you like that brand. Go sloooow though - start off every third night or so. They can be drying at first, but eventually they help your skin retain moisture better.

Also, it sounds like you might have a compromised/damages moisture barrier. Google to find blog posts discussing that - basically, all sorts of things can damage your skin in a way that makes it prone to drying out and very sensitive.
posted by insectosaurus at 4:26 PM on August 11, 2016

There is no way that you will be happier with anything other than seeing a dermatologist. Facials are absolutely awful for any kind of real skin condition, I've never had one that did more than disrupt my skin, make me breakout, and regret all the money I wasted.

I have dry skin, and gave up with all washing products. I use a sensitive cleansing cloth (Olay brand) at night, and a splash of water, and nothing in the morning. This has actually been the best thing for my overly dry skin. Toner and BHA are both awful for dry skin in my experience, so I would cut all of that out completely. In fact I would cut out everything but water+cloth cleansing and moisturizer.

But really, nothing will be better than a dermatologist who can actually prescribe something for the skin condition that you have. Best of luck.
posted by ch1x0r at 4:51 PM on August 12, 2016