THE 101: Microneedling

Microneedling has been around for over ten years, but over the past two years it has gained popularity (the infamous Kim Kardashian selfie maybe had something to do with that). There are two different methods of application. The first, is when microneedling is done as procedure using a device (I use Rejuvapen or rollers made by Environ) performed in our office during a facial treatment, although it can also be done without a facial for those patients that are coming in for a series of treatments. It takes about 20 minutes in total. The second way micro needling is done is at home with a dermaroller, which looks like a tiny paint roller, but with little needles. 

In the office setting, microneedling is fully customized for your skin depending on your skin concerns, as we can control the depth of the needle penetration and how many passes we do over the skin. The tip that fits on the end of the Rejuvapen is disposable and a new one is opened for each patient. I am sure you are thinking "um, OUCH" but this treatment actually isn't painful, nor are you a bloody mess afterwards! Two things are achieved with microneedling. The first is that because we are creating little temporary invisible  'channels' so that a cocktail of ingredients (stem cells, growth factors, vitamins, etc) penetrate your skin faster and deeper. The second is that these microscopic controlled 'injuries' to your skin prompts your body to repair and create more collagen, very similar to how fractional laser works, but without the heat. This treatment is great for improving texture, and certain types of scars including acne scars, but all skin types (except if you have active acne) can benefit from it. Just like most treatments, a series of 3 to 6 are recommended. You will be a little pink after, possibly a little puffy with a tight feeling, but it subsides after 24 hours.

Another way we use microneedling to treat fine lines and wrinkles is to combine it with PRP, which stands for Platelet Rich Plasma. This treatment starts with one of our physicians. The PRP is a concentrated serum processed from your own blood. It is obtained by taking a small vial of blood from your arm, then placed in a vial and spun in a centrifuge to separate the red blood cells and plasma. The process concentrates the platelet count to about 4X normal. It is this platelet-rich plasma, often called “liquid gold”, that is then activated and injected into the skin as a natural filler for volume and plumping fine lines. I then use micro needling to infuse the remaining PRP into the skin. PRP has been used for years to speed joint, tendon and tissue repair and is a popular treatment for professional athletes. 

At home, microneedling done at home is with the use of a dermaroller. I recommend rollers from Environ for their quality, they use ultra fine needles of the highest grade stainless steel.  They are also much shorter needles then the versions used in the office, about .1 to .2 in length so they don't tear or break the skin. They also make a stamp version, but I think the rollers are easier to use. It can be used from once a week to every other night and in the nighttime only. Use your roller during your skin regime after taking off makeup, cleansing, and toning, and before applying skin care moisturizers or specialized products as recommended by your esthetician or dermatologist.  Normally we recommend to start by rolling twice a week and slowly increase to using a few times a week. Divide the area you wish to treat into sections - on the face, forehead, the nose, the cheeks and the mouth area. On the face, start on the forehead and roll vertically.  Gradually move across the skin until the forehead has been totally treated in a vertical direction.  Then roll at an angle and finally horizontally, rolling over each area of skin at least two to five times in each direction. Treat each area sequentially until the whole face, neck and decollete have been treated thoroughly and evenly for 3-5 minutes in total. The roller is individually owned and cannot be shared and is only used on clean skin.  It is important to rinse the roller after each use with water and once a week using a special cleaning solution, then storing it in the cool dry storage it comes in. When using a roller a few times a week: toss it out and replacing it everymonth; if used less frequently used rollers will last longer.

The Environ rollers we recommend can ONLY be bought through a doctor or esthetician. They dont sell products or rollers online. I feel this helps my patients be thoroughly informed on what they are doing. The rollers also come with very detailed instructions. There are many retailers of dermarollers onine, with really long length needles meant for treating stretch marks, scars, even cellulite. Please talk with your esthetician or dermatologist before using such intense treatments like those at home.

When ingredients from whatever you apply after needling go deeper into skin, the risk of possible irritation goes up, which is why you should do a patch test of all products you wish to apply after micro-needling. Also never use this tool on skin that is irritated, inflamed, has active eczema, or active acne & breakouts.

THE 101: Chemical Peels

The word 'chemical' itself generates a negative image for most people who have never had a peel, however the chemicals come from very natural sources. For example, most glycolic acid (a common peel ingredient) comes from sugar cane. There are a LOT of options when it comes to chemical peels varying in ingredients and strengths. Some peels I perform on brides the day before a wedding and some will require a week of peeling and flaky skin. Your esthetician or dermatologist will help you decide what is right for you depending on the results you want. We will explain what to expect, and the post-peel care (if any).

The most common acids used in chemical peels are glycolic, lactic, trichlorocetic (tca) and salicylic acid. Lactic acid is my go to for dry skin, tca or salicylic for acne, and glycolic for everyone else. We can even use different acids on different areas of the face for a customized peel treatment. Peels are an effective way to smooth texture, even out skin color, brighten, reduce fine lines, and even improve acne scars.

A question I get a lot from clients is "Do I need a facial or a peel?" Almost every facial treatment I perform incorporates some type of gentle, 'no downtime' chemical peel.  For clients that have a lot of pigmentation/dark spots, scars, or wrinkles, we will do a monthly peel (or a series of peels) to get their skin into shape, and then maintain the results with facials. If doing a peel during a facial treatment, there will be a tiny bit of stinging for a moment, and then its neutralized. For a peel without a facial, these will usually be 'self neutralizing' which happens in a few minutes but is left on the skin until you wash your face that evening. 

Some of my favorite peels come from Skin Medica, a skin care brand from Allergan (yep the pharma company that makes Botox). They have three options from light to strong, here is a chart explaining each one in depth.

Complications with chemical peels are very rare, especially the superficial ones. Sun exposure after a peel, can result in hyper-pigmentation, so diligent application of spf is mandatory! Another issue that can arise is post-inflammatory hyper-pigmentation, which is a temporary overproduction of melanin following any type of inflammation. Your esthetician or dermatologist will discuss your skin care routine and history to greatly reduce the risks of these complications.  

THE 101: Korean Beauty

Fashion trends are a funny thing, and I’ll be the first to admit I’ve had my share of trendy impulse buys. Skincare trends, like anything else, come and go - but with such a heavy push from advertising, social media, bloggers, and beauty stores- this is one trend I foresee sticking around for a while. Some of these brands have exceptionally well formulated products (Dr Jart, Amore Pacific, SK-II), and will most likely remain staples at popular stores like Sephora. I picked some of the ‘best-sellers’ from a few different Korean beauty specialty websites to review.

IMAGE: sephora

A few more thoughts...

• While there are absolutely some unique and new ingredients that have come out of Korea (think snail secretions and fermented everything) they are not only to able acquired and used by brands made in Korea. Also to note, a lot of these unique ingredients don't have much research, if any, behind them yet to back up the claims.

• In my opinion, the generalization that Korean women (and lots of other asian nationalities) seem to have more youthful skin then other nationalities is most likely because they seem to be more dilligent with their sun protection, which would explain a LOT.

• A lot of Korean items I am seeing are just renamed! For instance, 'essences' are very similar to toners (not the astringent toners that may come to mind, but the hydrating ones), 'patches' are usually masks, and 'sleeping masks' are usually thick night creams.

 

MIZON ALL-IN-ONE SNAIL REPAIR CREAM  

Snail Secretion Filtrate, Cetearyl Olivate, Sorbitan Olivate, Cetearyl Alcohol, Stearic Acid, Glyceryl Stearate, Hydrogenated Vegetable Oil, Dimethicone, Triethanolamine, Carbomer, Butylene Glycol, Peg/ppg-17/6 Copolymer, Polyacrylate-13, Polyisobutene, Polysorbate 20, Sodium Polyacrylate, Caprylyl Glyocol, Adenosine, Ethylhexylglycerin, Tropolone, Sodium Hyaluronate, Portulaca Oleracea Extract, Betula Platyphylla Japonica Juice, Arnica Montana Flower Extract, Artemisia Absinthium Extract, Achillea Millefolium Extract, Gentiana Lutea Root Extract, Alcohol, Camellia Sinensis Leaf Extract, Centella Asiatica Extract, Copper Tripeptide-1, Rh-oligopeptide-1, Propylene Glycol, Rubus Idaeus (Raspberry) Fruit Extract, Beta-glucan, Palmitoyl Pentapeptide-4, Disodium Edta

The company claims that the first ingredient, the snail secretion, makes up 92% of the product, and will reduce acne scars. Also to note, this company, along with many other brands use snail secretion in different forms- masks, serums, night cream, you name it. The ONE and only published research I could find on this used snail secretion from a little creature called “Snail Cryptomphalus Aspersa” or SCA. They concluded daily application of topical products tested  on 25 people containing SCA proved effective and well tolerated for improvement in some wrinkles but did not report a significant difference in the quality of their skin. What species of snail goo is this brand using- is it the same as the snails from the study? Are the snails harmed? Too many unanswered questions, not enough research. This also contains some ingredients that could potentially clog pores, AND it is also packaged in a jar, which means some of the actual researched ingredients (even in the tiny amounts that are present here) can go bad quickly anyway. Bottom Line: I wouldn't recommend using snail products until more research is shown that this is proven to be beneficial. 

 

BANILA CO. CLEAN IT ZERO

Mineral Oil, Cetyl Ethylhexanoate, PEG-20 Glyceryl Triisostearate, PEG-10 Isostearate, Polyethylene, Butylene Glycol, Water, Rubus Suavissimus (Raspberry) Leaf Extract, Bambusa Arundinacea Stem Extract, Aspalathus Linearis Leaf Extract, Viscum Album (Mistletoe) Leaf Extract, Angelica Polymorpha Sinesis Root Extract, Carica Papaya (Papaya) Fruit Extract, Malpighia Glabra (Acerola) Fruit Extract, Epilobium Angustifolium Leaf Extract, BHT, Butylparaben, CI 16255, CI 15985, Fragrance

if you wear a lot of makeup and find there is still residue after you wash, then a ‘double cleanse’ or using a 'precleanser' may be right for you. All ‘double cleanse’ means is using two different products to wash, the first pre cleanse being geared towards removing makeup (like cleansing oils or balms) and the second to cleanse the skin once all that makeup is off and to remove any traces of the first cleanse (usually gel or foamy formulas).  This particular product would be the first step in your double cleanse to get off makeup, it is mineral oil base and comes in solid form, but starts to liquify into a oil when you start rubbing it together. I wouldnt rely on this as my only cleanser because it does leave a little residue, and needs a gel or foam to really get off any traces of it. There are some antioxidants present, but in a cleanser those ingredients are useless because they don't stay on the skin long to do much. This product has a faint citrus smell and does contain a small amount fragrance. Bottom Line: If your need to thoroughly remove makeup and your cleanser isnt cutting it, this is a safe and effective option as a precleanser.

CAOLION BLACKHEAD O2 BUBBLE PORE PACK

Water, Cyclomethicone, Cetyl Ethylhexanoate, Ethyl Perfluorobutyl Ether, Ethyl Perfluoroisobutyl Ether, Butylene Glycol, Caprylic/capric Triglyceride, Cetearyl Alcohol, Glycerin, Glyceryl Stearate, Sodium Myristoyl Glutamate, Glyceryl Stearate Se, Polysorbate 60, Polyethylene, Dimethicone, Avena Sativa (oat) Kernel Flour, Charcoal Powder, Allantoin, Hydrogenated Lecithin, Panthenol, Peg/ppg-18/18dimethicone, Peg-100 Stearate, Cyclopentasiloxane, Palmitic Acid, Sorbitan Sesquioleate, C12-16 Alcohols, Phenoxyethanol, Chlorphenesin, Hyaluronic Acid, Ginkgo Biloba Leaf Extract, Glycyrrhiza Glabra (licorice) Root Extract, Portulaca Oleracea Extract, Prunus Mume Fruit Extract, Rhus Semialata Gall Extract, Sodium Polyacrylate, Trideceth-6, Disodium Edta

There are quite a few products referred to as ‘packs’, which is usually just another name for mask! The first few ingredients are what gives this product the fizzy bubbling sensation on the skin, then follows some cleansing detergents and some emollients. The inclusion of charcoal has oil absorbing properties. The directions say to apply it to the skin, wait for it to start getting fizzy, massage it in (there is a slight grit to this, so you will get a mild exfoliation), wait a few more minutes then rinse. Bottom Line: This won't do much for your blackheads, but it's a fun option as a mask for normal to oily skin as a way to exfoliate and absorb excess oil.

CREMORLAB MINERAL TREATMENT ESSENCE

Water, Rosa Centifolia Flower Water, Butylene Glycol, Niacinamide, Glycerin, Betaine, Chamomilla Recutita (matricaria) Flower Water, Saccharomyces Ferment, Aspalathus Linearis Extract, Lilium Candidum Flower Water, Centaurea Cyanus Flower Water, Paeonia Albiflora Root Extract, Diospyros Kaki Leaf Extract, Glycerin, Betaine, Peg/ppg-17/6 Copolymer, Caprylyl Glycol, Peg-40 Hydrogenated Castor Oil, Butylene Glycol, Pvm/ma Decadiene Crosspolymer, Potassium Hydroxide, Adenosine, Biosaccharide Gum-1, Phenoxyethanol

Essences are used like toners, they are liquids that are applied after cleansing but before lotions/creams/serums. These ingredients can absolutely be found in those products also, but for normal to oily skin which normally shies away from creamy textures, essences are a great way to give the skin a dose of vitamins, antioxidants, and hydration. The Rosa Centifolia Flower Water which makes up most of this essence, is different from the widely used traditional rose or rose oils which are a huge concern for irritation- this one works as an antioxidant. Niacinamide, which is prevalent in a lot of essences I looked at is an amazing cell-communicating ingredient with a ton of anti-aging properties. The rest of the list reads as safe with proven anti-irritants, and more antioxidants. Bravo! Bottom Line: Safe and effective for all skin types, essences can be a nice booster before your current routine. I'll be using these types of products in the humid weather instead of a lotion.

PRIMERA MIRACLE SEED ESSENCE

Nelumbo Nucifera Germ Extract, Niacinamide, Glycereth-26, Glycerin, Ethylhexylglycerin, Disodium Edta, Adenosine, Sodium Hyaluronate, Saccharomyces Ferment, Methyl Gluceth-20, Citric Acid, Xanthan Gum, Sodium Citrate, 1,2-hexanediol.

This is an essence geared towards dry skin, as the first ingredient (nelumbo nucifera germ extract) which will make up most the product, is a humectant and will attract moisture. The niacinamide in this comes in as second on the list, one of my favorite cell communicating ingredients that can even out skin tone and improve elasticity. Followed by some more hydrating ingredients like glycerin and  sodium hyaluronate, and finishing with a ferment (antioxidant) and some more preservatives. Bottom Line: Safe, effective, and could be a great booster for dry skin before your other moisturizers/treatments, or even used solo.

 

MISSHA TIME REVOLUTION FIRST TREATMENT ESSENCE

Saccharomyces ferment Filtrate, Bifida Ferment Lysate, Propanediol, Niacinamide, Polyquaternium -51, Ulmus Davidiana Root Extract, Betaine, Amaranthus Caudatus Seed Extract, Pirper Methysticum Leaf/Root/Stem Extract, Beta vulgaris (Beet) Root extract, Phellodendron Amurense Bark Extract, Cassia Alata Leaf Extract, Hydrogenated Lecithin, Sodium Hyaluronate, Pentylene Glycol, Water, Trehalose, Disodium EDTA, Hydrolyzed Corn Starch, Adenosine, Ethylhexylglycerin, Butylene Glycol, Glycerin, Raffinose, Tromethamine, Acetic Acid, Lactic Acid, 1, 2 - Hexanediol, Caprytyl Glycol, Hexapeptide - 9 Phenoxyethanol, Potassium Sorbate

The first two ingredients are ferments that are skin conditioning agents, also with limited research saying they have some antioxidant capabilities. Next up is a propanediol (humectant) and the superstar niacinamide. The rest of the list has some additional antioxidants, anti-irritants, and hydrating ingredients. Bottom Line: This is a great way for all skin types to hydrate and give your skin a dose of necessary ingredients used solo or before applying a cream/lotion or serum. If you choose to add an essence or toner to your routine, try putting a few drops in your palm and swiping it onto the skin. Using a cotton pad tends to waste a lot of product.

TONYMOLY PANDA DREAM EYE PATCH

Water, Glycerin, Butylene Glycol, Niacinamide, Sorbitol, PEG-60 Hydrogenated Castor Oil, 1,2-Hexanediol, Phenoxyethanol, Xanthan Gum, Carbomer, Triethanolamine, Caprylhydroxamic Acid, Fragrance, Disodium EDTA, Allantoin, Erythritol, Trehalose, Bambusa Vulgaris Shoot Extract, Bambusa Vulgaris Water, Solanum Tuberosum (Potato) Pulp Extract, Aloe Barbadensis Leaf Juice, Cucumis Sativus (Cucumber) Fruit Extract, Ethylhexylglycerin, Magnesium Ascorbyl Phosphate.

I love seeing glycerin and niacinamide within the first five ingredients, but the excitement stops there. Next listed is a few preservatives and slip agents followed by ‘fragrance’. If fragrance was the last ingredient, I wouldn’t be concerned, but I dont want to see it before the nice array of antioxidants and hydrating ingredients. Bottom Line: I personally wont be using these cutesy eye patches due to the excessive amount of fragrance, but if your skin isn't sensitive to fragrance, these can absolutely be a refreshing and hydrating treat for your under eyes.

RE:P BIO FRESH MASK WITH REAL CALMING HERB

Water, Kaoline, Butylene Glycol, Cetearyl Ethylhexanoate, Polyglyceryl-3 Methylglucose Distearate, Glyceryl Stearate SE, Methyl Glucose Sesquistearate, Stearic Acid, Hydrogenated Vegetable Oil, Behenyl Alcohol, Cetearyl Alcohol, 1,2-Hexadiol, Artemisia Annua Extract, Calendula Officinalis Flower Extract, Symphytum Officinale Leaf Extract, Helichrysum Arenarium Extract, Azadirachta Indica Leaf Extract, Glycerin, Zanthoxylum Piperitum Fruit Extract, Pulsatilla Koreana Extract, Usnea Barbata (Lichen) Extract, Melissa Officinalis Flower/Leaf/Stem Water, Anthemis Nobilis Flower Water, Calendula Officinalis Flower Water, Rosa Damascena Flower Water, Triticum Spelta Seed Water, Calendula Officinalis Flower, Anthemis Nobilis Flower Powder, Disodium EDTA, Xanthan Gum, Acrylates/C10-30 Alkyl Acrylate Crosspolymer, Tromethamine, Phenoxyethanol, Ethylhexylglycerin, Safflower Yellow, Gardenia Red, Fragrance

This is a kaolin clay based mask, and Kaolin has absorbent properties which makes it a nice option for oily skin. Following the clay come a few emmolient and emulsifying ingredients to keep this product creamy and in its solid form. The herbs/plant extracts and the rest of the ingredients following are safe in low concentrations, but antioxidants and anti-inflammatories work best when they are left on the skin, instead of rinsing off them, which you have to do when using a mask! The inclusion fragrance and coloring are miniscule amounts which arent cause for concern since they are the last three ingredients listed. Bottom Line: This mask can absolutely help control excess oil when used once or twice a week without overdrying.

MIZON GOOD NIGHT WHITE SLEEPING MASK

Aqua, Cyclomethicone, Butylene Glycol, Niacinamide, Trehalose, Glycerin, Alcohol, Dimethicone, Sodium Hyaluronate, Polysorbate 20, Ammonium Acryloyldimethyltaurate/vp Copolymer, Triethanolmaine, Carbomer, Sclerotium Gum, Broussonetia Extract, Morus Alba Bark Extract, Pantethine, Placental Protein, Natto Gum, Biosaccharide Gum-1, Disodium Edta, Methyl Parabven, Propyl Paraben, Ci17200, Ci42090, Fragrance

Sleeping masks or sleeping packs appear to be thick night creams, normally geared towards dry skin. The high amount of cyclomethicone (a silicone emollient) in this Mizon product is going to prevent moisture loss without suffocating skin. Next up is niacinamide (a cell communicating ingredient with multiple anti-aging benefits), trehalose (a water binder), and glycerin to prevent dryness. The alcohol present isn't cause for concern since it's surrounded by so many hydrators. After another silicone, comes a nice dose of sodium hyaluronte, which has cell-communicating abilities and can boost skin’s moisture content, reduce inflammation, and help prevent moisture loss. The few antioxidants and anti-inflammatories follow a few more thickeners, and the fragrance and colorants are the last three ingredients so cause for irritation is very minimal. Bottom Line: This could be a deeply hydrating night product but I would layer it on top of other treatment products like antioxidants and retinoids than relying on this solely to give your skin everything it needs.

THE 101 : Botox

For me, Botox is as commonplace as toothpaste, but from some, the idea of freezing your muscles is still terrifying! Here's what you need to know.

What exactly is it and how does it work? Botox is a brand from the pharmaceutical company, Allergan. Its botulinum toxin (a purified version of the bacteria that causes botulism) that prohibits nerves from delivering their signal to muscles, typically in your face. Its also referred to as a 'neurotoxin'.  It blocks the ability of the nerve ending to secrete acetylcholine, which the muscle needs in order to contract.  By blocking these nerve endings, the muscles in your face  stay in a relaxed position so you stop scrunching, and when you stop scrunching, the wrinkle disappears. It can be used preventatively if you do happen to have really strong muscle movement; Botox essentially freezes the muscle, so leaving you unable to make a scrunching wrinkle-causing expression, any wrinkles from these muscles will take longer to develop. 

How long has it been around, and how we do we know its safe? Scientists have been playing around with this stuff for over a hundred years! In 1989, it got approval to treat eyelid spasms. Throughout the nineties, it was used to treat bladder spasms, writer's cramp, excessive sweating, even cerebral palsy in kids. Finally, in 2002, Botox got approved by the FDA to treat wrinkles, and continues to get FDA approvals for other uses. 

Where in your face do you get it and does it hurt?  Though Botox can be used many places, the most common areas are crow's feet around the eyes, frown lines between the eyebrows, and furrows on the forehead. Some doctors can make lines on the neck smooth out also! If you have excessing sweating, Botox can also get injected into the glands under the arms. Getting needles in your armpits totally hurts for a minute but is really nice to sweat less during those really hot months. Injections on the face are much easier, you feel each pinch, but as soon as its done, there is zero pain. There can be a bit of bruising, but its rare, and staying off anything that can thin your blood for 48 hours prior can help minimize bruising. 

How long does it last? Botox typically wears off in three to four months. If you're using it under your arms, it can actually last up to nine months.When it does wear off, everything will go back to normal but it won't happen overnight.  

What are the side effects? Any drug can have side effects. The most common issues are headaches and bruises, poking needles in your face will usually do that..

Are there any alternatives?  Nothing can relax the muscle like Botox, but certain skin care treatments can improve the look of wrinkles. High doses of vitamin A applied topically (like retinoids) are the most studied topical skin care ingredient to improve wrinkles. Treatments like micro-current devices done in a facial, or home care gadgets can improve these types of lines, but need to be done consistently to keep the results looking good.

What age should I start getting Botox? These type of procedures aren't for everyone, and thats ok! If you are interested in anti-aging procedures, and want to stay ahead of pre-mature aging, Botox can be a really great, inexpensive treatment for you. There is no right or wrong age, Botox isn't an age thing, its a muscle thing. I have seen teenage girls with deep forehead wrinkles, that doesn't mean they should be doing it, but just to give an idea that there isn't a particular age when wrinkles appear due to strong muscles. On the flip side, I've seen women in their fifties and sixties with super smooth foreheads, who may never need Botox. Again, its all about how much muscle movement you have. Personally, my forehead has been getting Botox since I was about 25, and can actually go longer now in between treatments instead of exactly every 4 months.

The nurse at my dentist offers Botox, can I do it with them?  I wouldn't. I saw a sign in my gyno's office that they now offered Botox. I get it, everyone wants a piece of the pie. Over 6 million Botox procedures were performed in 2014 and surely reports of next year will be even higher. Your dentist and gyno both get extensive medical training, but there are specialities within medicine for a reason. So even though a nurse can administer this, but they don't have anywhere near the training a doctor has. See a board certified (very important!) dermatologist or plastic surgeon.

THE 101: Exfoliation

Would you like to smooth out bumpy skin? Lessen clogged pores? Have a constant enviable glow? Then you should be exfoliating! Getting rid of the excess built up dead skin and improving those cells to turn over is key for almost all skin types. There's a few easy ways to do this, and a some products that that fit the bill. Let's go over the basics..

There are two common types of exfoliation. The first one is referred to as manual  (scrubs, clarisonic, microdermabrasion, washcloth) The second type is referred to as chemical exfoliation (enzymes, or alpha&beta hydroxy acids in the form of a peel that is rinsed or a leave-on product) and instead of scrubbing, the chemical does all the work. Ideally you should be doing one of each. Alternating them will give you the best results. Scrubs can be used once or twice a week, where chemical exfoliators can be used almost every night. 

If you have normal to dry skin, try a serum, cream or lotion containing an alpha-hydroxy acid, these work by dissolving the substance that holds skin cells together. If you have oily or acne-prone skin, you'll get better results with a product containing beta hydroxy acid (aka salicylic acid) because they can penetrate oil and get inside your pore. An effective formula must be the right pH, and should contain a blend of other skin beneficial ingredients like antioxidants and anti-irritants. 

Manual Exfoliants for all skin types  

At the drugstore, you can find Aveeno Positively Radiant Skin Brightening Daily Scrub or Olay Regenerist Detoxifying Scrub. Both are gentle and don't contain any weirdly shaped and harsh nut shells or particles. If you live near a target store, you can find another well formulated option from Boots called Expert Sensitive Gentle Smoothing Scrub. If you want to splurge, my luxury picks are Remede's Sweep or Kiehl's Epidermal Re-Texturizing MicroDermabrasion. Another option is to use a soft washcloth with your regular cleanser. I really love these soft muslin cloths from Liz Earle. You get a two pack for $6. Last but not least is the trusty Clarisonic, the sensitive skin brush heads are effective but gentle enough for the most sensitive skin.

Chemical Exfoliants for normal to dry skin

Hands down my favorite drugstore find is Olay's Regenerist Night Resurfacing Elixir. It has a nice blend of glycolic acid and antioxidants in a lightweight serum texture. If you have really dry skin, you will may need a moisturizer over this. Another excellent option is Peter Thomas Roth's Glycolic Acid Moisturizer. This contains glycolic acid too, but is also time-released, which makes it perfect for anyone, but especially great for sensitive skin. 

Chemical Exfoliants for oily or acne prone skin

I'm sure if you have oily skin, or have ever had a pimple, you've heard of salicylic acid. Unfortunately there are not many well-formulated products out there! To be effective, the salicylic acid must be the correct pH, and contain the right amount of actual acid. My go-to is by philosophy, called clear days ahead oil-free salicylic acid acne treatment & moisturizer, it has a nice silky texture and its fragrance free. Another great product and even gentler option is Clinique's Mild Clarifying Lotion. Its a liquid (I don't know why they call it a lotion) and just apply with a cotton ball after washing, it also contains aloe for major soothing to your skin.