Soaps – Dermatologist Recommended

NYC dermatologist Novick, Nelson

By Dr. Nelson Lee Novick, M.D., FAAD,

New York, New York 10028

Physician, Dermatology

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Toilet soap, which is available in opaque bars, is plain old soap and is composed of the salts of animal or vegetable fats and olive oils (tallow). Palm kernel or coconut oils are often added to enhance lathering. About half of all currently available toilet soaps are milled soaps. Milling is the process by which soap chips are thoroughly blended and then compressed by machinery into bars to ensure that moisture is removed and the basic ingredients and additives are evenly distributed. Ivory is probably the best- known brand of toilet soap.

In general, toilet soaps do what they are supposed to do—that is, they help to clean off grease, grime, and cosmetics. They also tend to be quite inexpensive. However, these soaps as a rule are rather alkaline (basic, as opposed to acidic) and have the potential to be irritating; overusing them can lead to irritation by affecting the skin’s acid mantle. Fortunately for most people with normal skin, natural skin acidity returns to normal very shortly after the soap is rinsed off. If you have especially sensitive skin<, or if you are using drying acne medications, however, you may find basic toilet soap too irritating.

There is an additional problem with toilet soaps for those who live in a hard-water area—that is, one where the water contains naturally high amounts of calcium or magnesium minerals. Sticky and potentially irritating residues resulting from the chemical interaction between toilet soap and hard water may be deposited on your skin and in sink basins. If you choose to use toilet soaps under these circumstances, I advise you to rinse your skin with copious amounts of water. Using synthetic detergent soaps (pages 34—35) or conditioning your water are alternatives.

SUPERFATTED SOAPS

Superfatted soaps are essentially toilet soaps to which moisturizers such as cold cream, lanolin, mineral oil, olive oil, cocoa butter, and other neutral fats have been added. The amount of fatty material added varies widely among different brands. While most soaps ordinarily contain less than 2 percent fat, superfatted soaps contain somewhere between 5 percent and approximately 15 percent fat. The fatty moisturizers in superfatted soaps are intended to counter the degreasing effects of the soap—a difficult task to accomplish. Some people complain that superfatted soaps deposit a greasy residue on their skin and leave them feeling unclean, but there are many who do prefer these soaps, finding them gentler to the skin. For those of you who like superfatted soaps, I have found Purpose, Dove, and Basis satisfactory.

Transparent soap is a special form of superfatted soap. In addition to a higher fat content, often in the form of castor oil or resin, these soaps contain ingredients such as glycerin (at least 10 percent more than other soaps), alcohol, and sugar. The higher glycerin content is responsible for the soap’s soft consistency and transparency.

Transparent soaps do not seem to be any better for sensitive skin than other superfatted soaps. In fact, because glycerin (in high concentrations) and, even more so, alcohol may draw water from the skin, these soaps can paradoxically be too drying for some people. For this reason, transparent soaps are best reserved for individuals with sensitive but oily skin.

In general, transparent soaps lather poorly. Moreover, they frequently melt into unmanageable globs if you leave them in the soap dish. However, you can extend their life by drying them after each use. Neutrogena soap is a well-known brand of transparent soap.

SOAPLESS SOAPS

Also called synthetic detergent soaps, cakes, or’ bars, soapless soaps are derived from petroleum materials, fatty acids, and other substances. Cosmetic and pharmaceutical chemists have attempted to formulate detergnt soaps to make them less irritating, less alkaline, and richer lathering than plain toilet soaps. Most soap- less soaps perform satisfactorily and have the additional benefit, as I mentioned earlier, of not interacting with hard water to leave scummy residue on your skin or in the sink, In contrast with transparent soaps, they lather reasonably well and usually don’t melt as readily in the soap dish. They also don’t leave the greasy film that many people complain of after washing with superfatted soaps. For these reasons, and especially because they tend to be gentler than toilet soaps, I generally recommend soapless soaps for most of my patients who have normal, dry, or sensitive skin. Lowila cake is one product that I found quite satisfactory as an all-purpose skin cleanser.

WASHABLE CREAMS AND LOTIONS AND LIQUID SOAPS

Washable creams and lotions share many of the same ingredients as bar soaps, but in general tend to be more expensive. They are basically moisturizers to which soaps or detergents have been added. Moisturizing ingredients are the major components of washable creams; washable lotions are simply washable creams to which more water has been added to make them thinner and easily spreadable. Both are intended to be rinsed off with water.

These days, some of the major cosmetic manufacturers seem to be focusing their attention on liquid soaps, which are also made to be rinsed off with water. Liquid soaps have a higher soap or detergent content than washable lotions and usually contain glycerin. They tend to be more expensive than their bar counterparts but possess no particular advantage over them, although they come in pump dispensers and are convenient to use.

Washable lotions can be helpful for some people. If you have dry or sensitive skin, you might try alternating the use of regular soap and a washable lotion, cleansing with soap in the morning and the washable lotion at night. Or, you might use soap one day and a washable lotion the next, depending upon your individual needs. Because they contain moisturizers, I do not advise washable creams or lotions for persons with excessively oily skin as they may aggravate the condition. Cetaphil lotion is a very useful washable lotion.

Washable lotions and liquid soaps should not be confused with cleansing creams or lotions, These are primarily moisturizers used mainly for cleaning purposes. Basically they are variations on the old cold-cream formula and are meant to be applied and then wiped off with a facial tissue or soft towel, rather than washed off with water. Liquefying creams are simply cleansing creams that contain oils and waxes that melt upon contact with skin heat. Otherwise, they differ little from cleansing creams and have no special properties. The word liquefying makes great ad copy, but that’s all.

Like many moisturizers, cleansing lotions (and liquefying creams) tend to be greasy, and can leave a film on your skin; in addition, because they contain little or no detergent, they generally clean poorly. Cleansing creams and lotions can be useful, however, for removing makeup, particularly oil-based or heavy theater makeups and powders. If you use them for makeup removal, I suggest you follow with a gentle soap and water cleansing. They may also be useful if you have extremely dry or sensitive skin and absolutely cannot tolerate any form of soap or detergent cleanser. Overall, I seldom recommend cleansing lotions.

DEODORANT SOAPS

Deodorant soaps, which are intended to suppress or mask body odor, contain two major types of ingredients: antiseptics for controlling bacteria and perfumes. Body odor results from the action of skin bacteria on the secretions of the apocrine sweat glands (as discussed in chapter 1), The apocrine sweat itself is odorless; the bacterial breakdown products of apocrine sweat are the culprits of body odor. To slow bacterial growth, the major brands of deodorant soaps contain the antiseptics triclosan or tnclocarban, Deodorant soaps tend to be drying, and since apocrine glands are not found in facial skin, you do not ordinarily need to use deodorant soaps on your face. However, they make excellent body soaps, especialiy if you tend to perspire heavily. Occasionally, your dermatologist may recommend using them as part of the treatment regimen for certain skin infections such as folliculitis.

Deodorant soaps can be problematic. They may cause allergic eruptions or rashes in people with sensitive skin. In addition, the antibacterials in them can be absorbed into your bloodstream through the skin. While the amounts absorbed are minimal, the long-term effects of this absorption remain unknown. Finally, the perfumes in some of these soaps can be irritating. I recommend deodorant soaps only if you have a very difficult odor problem or if you are advised to use one by your dermatologist. For most people, washing with basic toilet soap usually proves satisfactory for cleansing and odor control. Dial and Safeguard are two well-known brands of deodorant soaps.

SOAPS WITH ADDITIVES

An array of so-called organic, herbal, and other natural additives, medications, and abrasive particles have been added to soaps and cleansers supposedly to provide additional benefits. In general, despite the ad copy, these soaps do little else for you than part you from your money.

Fruit, vegetable, and herbal soaps amount to nothing more than, in the words of the Immortal Bard, “sound and fury, signifying nothing.” The “natural” or organic ingredients, fruit juices, vitamins and minerals, and so on, are supposed to conjure up images of healthy living; the advertisements for them usually show people enjoying life outdoors and looking incredibly fresh on a sunny spring day in the country. In actual fact, herbal, fruit, and vegetable soaps clean no better than conventional soaps and provide no additional benefits.

During the soap manufacturing process, the herbs, fruits, or vegetables added to these cleansers are strained, sterilized, alcohol-purified, and mixed with preservatives. By the time the process is complete, the end product is so far removed from the original natural ingredient that artificial colorings and fragrances must be included to simulate the real thing. The bottom line: Unless you are crazy about the artificial smell and color of herbs, fruits, and vegetables in your soaps, don’t waste your money on them.

Medicated soaps are cleansers that contain topical drugs in addition to the cleansing agent. They are advertised as being helpful for treating a variety of common skin conditions. These soaps may contain sulfur, resorcinol, salicylic acid, benzoyl peroxide, or antiseptics—the medications successfully used to treat a number of medical conditions such as acne, bacterial and fungal infections, and certain forms of eczema. In order to be of value, however, a medication must remain in contact with your skin for an extended period of time. Since soaps are intended to be lathered up quickly and rinsed off almost immediately, the ingredients in them do not remain on your skin long enough to do much of anything. In addition, medicated soaps tend to be drying and irritating. If you have a specific skin condition, see your dermatologist. Don’t play around with soaps.

Abrasive cleansers, or exfoliating cleansers as they are also known, contain tiny particles or grains that are supposed to abrade your skin mildly and slough off the surface layer of dead cells. Some abrasive soaps may contain as much as 25 percent pumice (ground volcanic rock); this is intended to leave you with a smooth, glowing complexion. For many people, abrasive soaps can be too harsh and drying, but if you have extremely oily skin, you may find them helpful when used occasionally. However, if you have acne or other types of inflammation, the use of these abrasives can aggravate your condition. Abrasive cleansers should be used with great care. If used too often or too vigorously, or if used in conjunction with certain potent antiacne medications, your skin may become very dry, flaky, or cracked; in extreme cases, “broken” blood vessels may even result. Once again, I suggest that you consult with your physician before using these kinds of cleansers.

BUBBLE BATHS

Bubble bath products are simply detergent cleansers that contain ingredients capable of making your bathwater foam. Appealing as a bubble bath might seem, however, sitting for prolonged periods of time in the degreasing detergent environment of a bubble bath can be quite irritating, especially for people with sensitive or dry skin or eczema. You should use no more of the detergent than is recommended by the manufacturer—do not dump in half the bottle. An over concentrated solution of bubble bath can irritate skin and mucous membranes. Be sure to distribute the bath product thoroughly before going into the tub. A moisturizer should be applied after the bath. If any skin irritation develops, stop using the product and consult your dermatologist.

BEYOND SOAP: ALCOHOL-BASED PRODUCTS

Fresheners, toners, bracers, astringents, and clarifying lotions are intended to cleanse and freshen your skin and shrink pores. However, they actually do little more than make your skin feel temporarily cool, tight, and tingly.

Fresheners, toners, and bracers are essentially clear, liquid alcohol solutions. The alcohol in them helps dissolve dirt, oils, and cosmetics. In addition, the evaporation of the alcohol causes the cooling and tightening sensations of the skin that people experience moments after applying these products. Glycerin is frequently added for its cooling and moisturizing effects.

Astringents, also called pore refiners or refining lotions, contain more alcohol than fresheners and toners. They may also contain other ingredients to enhance their cooling, tingling, and tightening functions, such as zinc and aluminum salts, witch hazel, acetone, boric acid, menthol, and camphor. The addition of these chemicals causes a slight irritation and swelling of the openings of your pores, tightening them temporarily. Virtually the same effect can be obtained by pinching or patting your cheeks. Mint, eucalyptus, and lemon fragrances are often added to astringents to increase product appeal.

Since astringents can be irritating to dry or sensitive skin, I generally do not recommend them. However, they may be of some value for persons with oily skin who want to remove excess oil between regular skin cleansings.

Clarifying lotions are water, alcohol, and glycerin solutions to which certain keratin-dissolving chemicals have been added for smoothing your skin. These may include saucy/ic acid, resorcinol, and benzoyl peroxide, all of which are helpful antiacne ingredients. They may also contain papain, a keratin-dissolving enzyme, which is extracted from papaya plants. Clarifying lotions can be highly irritating, especially to dry or sensitive skin, so I suggest avoiding them. If you need any of these ingredients, your dermatologist can prescribe or recommend a host of other more effective medications that contain them.

PROPER WASHING AND BATHING

Americans are the most over bathed, over washed people in the world. If cleanliness is next to godliness, we should be pretty near the seventh level of heaven by now. Most people shower or bath at least once a day and, for relaxation, love to soak in very hot water. But is so much washing, showering, and bathing really necessary or good for you? The answer is no.

Madison Avenue would have us believe that if we skip even one washing, we’re not only going to look and feel dirty, but even worse, we’re going to offend others. The “don’t you wish everyone did?” idea adds to our body odor paranoia. Yet the truth may surprise you. The armpits, groin, anal, genital, and foot regions of the body are the only significant odor-producing areas. If you were to sponge bathe these areas each day with just a water-dampened cloth to wipe away sweat and odor-producing bacteria, you would not smell. And so long as you continued to sponge bathe in this manner you wouldn’t smell, even if you never bathed or showered at all. But of course, washing isn’t simply about smell, it’s also about dirt and sweat (the kind that soaks you during exercise, say) and the need to feel clean. And face it—there aren’t too many of us who wouldn’t opt for a shower on a hot, sticky day! Many people “need” to shower or bathe daily just to relax; others can’t conceive of not doing it every morning upon arising.

Fortunately, those of you with normal or oily skin are probably resilient enough to rebound from your daily cleansing frenzy. On the other hand, if you have dry or sensitive skin, daily, or even worse, twice daily showering or bathing has the potential for causing significant irritation. Bathing tends to be even more drying than showering because people tend to sit and relax for long periods in a tub.

To prevent skin abuse in the name of cleanliness, you should wash gently, and not more than twice each day. Wash with your fingertips only and use the gentlest soap that does the job. Whenever possible, shower instead of bathe, use lukewarm rather than hot water, and stay in only as long as it takes you to clean yourself. Concentrate on the odor-producing areas of your body; let plain water rinse off the rest of you. Your skin is not a greasy steak plate and does not need harsh soaps, super scrubbing, detergents, and hot water to get it clean. Always pat your skin dry; don’t buff it with a towel. If you find that your skin remains dry and sensitive, limit showering to every other day or even every third day and just sponge bathe the odor-producing areas. Avoid wash cloths or abrasive polyester sponge pads or cloths. These merely abrade and irritate your skin. Finally, follow with a moisturizer regularly.

Excerpted from Super Skin–A Leading Dermatologist’s Guide to the Latest Breakthroughs in Skin Care, by Nelson Lee Novick, M.D.