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Exfoliating With Eczema: Is It Safe?

Medically reviewed by Meredith Plant, M.D.
Posted on September 11, 2023

“Does anyone use an exfoliating scrub to help get the dead skin from flaky eczema off?” asked one member of MyEczemaTeam. People with atopic dermatitis, the most common type of eczema, often look for skin care products to soothe and reduce itchy, inflamed skin and prevent flare-ups. Exfoliation is a skin care technique that can make skin appear smooth and radiant almost immediately. But is it safe to exfoliate if you have eczema?

When it comes to exfoliating with eczema, there are considerations to keep in mind. In this article, we explore types of exfoliating products, as well as the risks and benefits of exfoliating eczema-prone skin.

What Is Exfoliation?

Exfoliation involves eliminating the outer layer of dead skin cells from the skin’s surface. The skin naturally sheds dead cells regularly — up to 200 million cells every hour, to be exact — but exfoliation can help. This process is meant to reveal newer, fresher skin underneath.

The two main types of exfoliation are physical and chemical exfoliation. With physical exfoliation, you use gritty substances or tools to physically scrub away dead skin cells. On the other hand, chemical exfoliation relies on special acids or enzymes to dissolve and remove the top layer of skin. You’ll want to weigh the pros and cons of each method to choose the one that’s right for your skin type and concerns.

Physical Exfoliation

Physical exfoliation means using rough materials to scrub away dead skin cells by hand. Physical exfoliants are scrubs with abrasive particles, or tools such as brushes, sponges, or washcloths. Common physical exfoliants you may find in a store include coffee, sugar, and sea salt scrubs. Tools for physical exfoliation may include a pumice stone or brush. When using a physical exfoliant, be gentle to prevent irritation, and choose the right areas on your body to apply it carefully.

Gentle physical exfoliation means pressing down lightly with a circular motion or brushing the skin for no more than 30 seconds on any particular area. Avoid scrubbing the skin, as this may make the inflammation worse.

When shopping for a physical exfoliant, look for products with smooth, rounded particles rather than sharp ones to reduce the risk of microtears in the skin. Look at all the ingredients to make sure that a particular product doesn’t contain anything you know will irritate your skin.

If you are like some MyEczemaTeam members, you may even want to make a scrub at home. One member said, “I make my own scrub for my hands with a mixture of colloidal oatmeal and jojoba oil. This scrubs off the dead skin from flaky eczema, makes it smoother, and helps with the itching.” Another said, “I make a scrub from coconut oil and sugar when my hands get ultra dry and flaky.” It’s usually a good idea to skip essential oils on children’s skin, which is extra sensitive and has the potential to absorb these oils, possibly resulting in significant side effects. This is especially true in children with skin conditions, such as eczema, or breaks in their skin — the oils could be absorbed quicker and at higher doses.

Many members of My EczemaTeam choose to use physical exfoliants after taking a lukewarm — but not hot — bath or shower to reduce irritation during the exfoliation process. With physical exfoliation, results can be seen almost immediately, which is why so many people choose this method of exfoliation.

Chemical Exfoliation

Chemical exfoliation uses mild acids to dissolve and remove dead skin cells. Unlike physical exfoliants, chemical exfoliants usually appear as a smooth substance (including a liquid, gel, or cream) without particles. Chemical peels help exfoliate skin because they typically contain alpha hydroxy acids (AHAs) or beta hydroxy acids (BHAs). AHAs, such as glycolic acid and lactic acid, work on the skin’s surface, while BHAs, like salicylic acid, can penetrate deeper into the pores. These are generally not recommended for use in younger children. Older children and teenagers can start using them slowly in a trial area and more generally if they do not cause irritation.

Some natural products can also work as chemical exfoliants. “I use aloe vera juice as a toner to gently exfoliate my face,” a member said. These acids help to dissolve dead skin cells, can be milder on sensitive skin compared to physical exfoliants, and take multiple uses to make the skin appear smoother. However, chemical exfoliants should still be used with caution.

Risks of Exfoliating With Eczema

Be aware of the risks when considering physical or chemical exfoliation if you have eczema. These methods might make your sensitive skin worse and cause more irritation and discomfort. It’s a good idea to talk with a dermatologist before you give exfoliation a try. They can help you choose the right approach and avoid making your eczema symptoms worse.

Triggering Eczema Flares and Worsening Symptoms

Exfoliation can trigger eczema flares or make existing symptoms worse, especially if not done with caution. The process of exfoliating may irritate already sensitive skin, leading to redness, inflammation, and increased itchiness. Do not exfoliate more than once a week if you have sensitive skin, and pay attention to how your skin reacts in both the short and long term. Moisturize well after you exfoliate to protect the new skin underneath.

Contact Dermatitis

Contact dermatitis is an itchy rash caused by direct contact with a substance, or an allergic reaction to something that touches the skin. So if you are prone to contact dermatitis, be careful with what ingredients you use on your skin. Some exfoliating products may contain ingredients that can cause irritation and allergic reactions, leading to contact dermatitis. Patch testing new substances in a small, less noticeable area is recommended before applying to a larger area.

Benefits of Exfoliating With Eczema

Despite the potential risks, there may be some benefits to exfoliating for individuals with eczema. Proper exfoliation can help remove dead skin cells that might otherwise clog pores and lead to further skin issues, such as itchiness.

One member shared, “Exfoliating my skin helps me get the dead skin off my body, making my skin smooth.” Another said that gently exfoliating before moisturizing “helps with the burning and itching.” When done carefully and with the right products, exfoliating can be a beneficial part of your skin care routine.

Exfoliating also helps your skin soak up moisturizers and other skin care products, which can be a bonus for tackling eczema. One member shared how exfoliating is part of their skin care routine: “I put an aloe vera toner on with a clean cotton pad to gently exfoliate, add refrigerated organic aloe vera gel, and put Aquaphor on the most severe cracked areas.” Some people can tolerate exfoliating along with moisturizing products.

Precautions To Take Before Exfoliating

Exfoliation can be a beneficial skin care technique for some people, but it requires careful consideration for those with eczema. Although exfoliation may offer advantages in promoting smoother skin and helping with product absorption, it also carries potential risks of triggering eczema flare-ups and making existing symptoms worse. Therefore, if you have eczema, approach exfoliation with caution, consult a dermatologist or your medical team for advice, and always prioritize the health and sensitivity of your skin.

Apply Exfoliators Gently

As mentioned, when applying an exfoliating product, be gentle to your skin to prevent irritation. Use small, circular motions — or short strokes with a brush or sponge — for about 30 seconds, and then rinse the product off with lukewarm water. Try not to exfoliate too long, hard, or often, or you will notice your skin becoming red and inflamed.

When it comes to exfoliation, location matters. For instance, areas with thicker skin, like the soles of the feet or palms of the hand, may tolerate gentle exfoliation better than more sensitive areas, like the face or neck.

After exfoliating, hydration is essential because the skin is at its most vulnerable. Make sure to trap in moisture with a good ointment or moisturizer to prevent additional eczema symptoms.

Avoid Exfoliating Broken Skin

The American Academy of Dermatology does not recommend exfoliating broken, sunburned, or inflamed skin, as this can worsen the condition, increase the risk of infection, and delay the healing process.

People with eczema in particular should avoid scratching skin that is actively experiencing eczema. At this stage, it’s more important to use moisturizers and topical steroids to relieve itch and pain and retain as much moisture as possible. It’s crucial to allow your skin to heal before attempting any type of exfoliation.

Consult With Your Dermatologist or Eczema Medical Team

If you’re thinking about exfoliation, check with your medical team first. They can recommend suitable products and techniques based on your specific skin condition, current treatment regimen, and skin type. Working with your medical team when choosing new skin care products is the best way to promote healthy skin and prevent further irritation.

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, more than 49,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Have you tried exfoliating your skin while living with eczema? Do exfoliating products help or hurt your skin? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on September 11, 2023
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Meredith Plant, M.D. specializes in mental health, including prevention measures and treatment of ADHD, depression, and anxiety. Learn more about her here
Scarlett Bergam, M.P.H. is a medical student at George Washington University and a former Fulbright research scholar in Durban, South Africa. Learn more about her here

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