How to choose a moisturiser for combination skin

Which parts of your face need moisturiser?

Combination skin has dry areas and oily areas. The usual pattern is an oily forehead, nose and chin, called the T zone, with drier cheeks or skin around the eyes. The reverse pattern also counts: dry skin through the centre and oilier cheeks. Follow the areas you actually have, rather than the diagram on the packaging.3

To get a rough sense of your pattern, wash your face, dry it and notice how each area looks and feels after about 30 minutes. Dry skin can feel tight or look scaly, while oily skin looks shiny or feels greasy. Blotting paper can help show where oil collects, but it is optional. There is no single universal skin type test. Redness, itching, burning or stinging suggest sensitivity, which can exist alongside combination skin rather than replacing it.3

Should you choose a gel, lotion or cream?

Choose the texture for the degree of dryness, not just the words "combination skin" on the front. A lotion can suit mild dryness, while a cream is more useful for persistent dry patches. Using different textures on different areas is a valid approach, not a failure to find the one jar that has apparently been appointed to manage everything.23

Which ingredients are useful?

Moisturisers work through several kinds of ingredients. Humectants, such as glycerine, increase the water held in the outer skin layer. Occlusives slow water loss by leaving a protective layer on the surface. Emollients soften and smooth skin. These jobs complement each other: adding moisture and keeping it from escaping are both useful for a dry patch. A richer product is more occlusive, so the amount of dryness matters when choosing it.24

Look for a fragrance free formula, particularly if your dry areas are easily irritated. Glycerin and hyaluronic acid are useful moisture holding ingredients, and ceramides help keep moisture in the skin. If you are prone to spots, look for "noncomedogenic", meaning designed not to clog pores. Treat that wording as a selection aid, not a promise of a breakout free result.35

Sensitive combination skin needs extra care with exfoliating ingredients. Urea and lactic acid can sting scratched, cracked or inflamed skin. Fragrances can cause irritation or allergic reactions, and salicylic acid can irritate sensitive skin. Retinol is an optional active, not something you need to add just to moisturise; it can cause irritation, especially in sensitive skin.25

Before putting a new cream on your face, try it on your inner arm for a few days to see how your skin reacts. Natural ingredients can also cause allergies, so "natural" is not a useful substitute for checking tolerability. Familiar brands can be as good as expensive alternatives, which leaves the fancy packaging with the less demanding job of looking fancy.5

How to apply moisturiser

1. 1Wash with a gentle cleanser. For dry areas, use a non soap cleanser rather than hot water and soap, which remove skin oils.
2. 2Gently pat your face dry. After a bath or shower, apply moisturiser promptly while the skin is still moist to help retain water.
3. 3If you use a skin medication or treatment, generally apply it after cleansing and before moisturiser. Follow any specific instructions for your medicine.
4. 4Smooth moisturiser onto the dry areas rather than rubbing vigorously. Leave comfortably oily areas untreated; use a richer texture only where the dryness calls for it.
5. 5Include broad spectrum sunscreen with SPF 30 or higher during the day. Apply makeup after moisturiser and sunscreen, if you use it.

Prescription directions can change the order. For topical corticosteroids used for contact dermatitis, NHS directions are to apply the emollient first and wait around 30 minutes before the steroid. Follow your doctor's instructions and the medicine leaflet rather than treating a general layering order as universal.6

How often should you use it?

Match frequency to dryness. Slightly dry skin can need only a light moisturiser at night, while more troublesome dryness needs more frequent application. The moisturising benefit is greatest in the first six hours after application, and two to three applications a day can be needed to maximise it. Reapply to the areas that need moisture rather than automatically coating the oily areas each time.4

Expect moisturiser to reduce dryness, soften skin and support the skin barrier, the outer layer that helps keep water in. Moisturiser also provides a base for makeup. Very greasy, occlusive products can aggravate acne or cause folliculitis, inflammation around hair follicles. If a heavy texture causes problems, reconsider that texture rather than assuming every dry area needs the richest option.4

Reassess when the weather or your skin changes. Skin type can shift with the seasons, age, hormones, pregnancy, breastfeeding or certain medicines. The cream that suited winter is not automatically the right choice for summer; the jar does not get tenure.3

When should you stop or get help?

If a moisturiser causes a skin reaction, stop using it and ask a pharmacist about an alternative. Persistent reactions to ingredients such as fragrance or preservatives can need assessment, including patch testing for contact allergy. If dryness does not improve, or becomes painful, cracked, bleeding, persistently stinging or very irritating, see a dermatologist. Peeling dry skin needs moisture rather than extra exfoliation.146