How to reduce skin texture

What kind of texture are you treating?

• Flaky, itchy or rough skin can be dry skin. Moisturizing is a useful starting point.
• Small facial bumps, whiteheads and blackheads can be comedonal acne, meaning pores blocked with oil and dead skin cells. Salicylic acid and retinoids are treatment options.
• Small, rough bumps on the upper arms, thighs or bottom can be keratosis pilaris, where keratin, a skin protein, plugs hair follicles. It can also appear on the face and be mistaken for acne.

Start with a gentle daily routine

1. 1Wash gently in the morning and evening, and after exercise. Do not scrub acne bumps, and remove makeup before bed.
2. 2Apply moisturizer after washing. For clogged pores, choose oil free, water based products marked noncomedogenic, meaning formulated not to clog pores.
3. 3Wear sunscreen every day. If using a retinoid, also seek shade and wear clothing that protects exposed skin.

Should you exfoliate?

Exfoliation removes dead surface skin cells. Chemical exfoliators use acids to dissolve them; scrubs and brushes remove them physically. Exfoliation is optional, not an entrance exam for having a skincare routine. Dry, sensitive or acne prone skin can find mechanical exfoliation too irritating, so a mild chemical exfoliator can be a better choice. Avoid aggressive exfoliation if you have darker skin or develop dark marks after irritation.1

Apply a rinse off exfoliator gently, rinse with lukewarm water and moisturize immediately afterward. There is no single schedule: frequency depends on your skin and the method, with stronger exfoliation used less often. Do not exfoliate sunburned skin or open wounds. Retinol, prescription retinoids and benzoyl peroxide can already cause sensitivity or peeling; adding exfoliation can worsen dryness and breakouts. Stop exfoliating if skin becomes red or irritated.1

When does retinol make sense?

Retinol is a type of retinoid, a vitamin A related ingredient used to improve uneven texture and pigmentation. For acne, adapalene is available in prescription and nonprescription forms; tretinoin requires a prescription. Start with the least intense formula you can find, every other night, and increase gradually as tolerated. Use retinoids at night, with moisturizer and daytime sun protection.2

Do not use retinoids during pregnancy. If you have skin allergies, significant dryness, redness or inflammation, ask a dermatologist about alternatives before starting. Irritation can trigger dark marks in darker skin. Moderate or severe acne scarring needs a dermatologist's assessment rather than choosing a retinoid yourself.2

What helps rough bumps on your body?

For keratosis pilaris, moisturizers soften the skin, while creams containing urea, lactic acid or salicylic acid can help soften and flatten bumps or loosen the scale blocking follicles. Use mild, unperfumed washing products and lukewarm showers. Gentle use of a washcloth can help, but harsh scrubbing, picking and rubbing can make the condition worse. Treatment improves keratosis pilaris temporarily rather than curing it.357

How long does improvement take?

Comedonal acne can start improving after eight to 12 weeks of persistent treatment, but clearing it can take months. Keratosis pilaris also often takes months to improve, and bumps commonly return when treatment stops. Do not squeeze or extract clogged pores yourself: this can cause scars, infection and further pore damage.46

See a healthcare professional if treatment is not helping, you develop medication side effects or you are unsure what the bumps are. For suspected keratosis pilaris, a pharmacist can help choose a cream and advise whether itchy or inflamed skin needs a doctor.45