Care for oily and combined (mixed) skin of the face

The basic principles of home care for these skin types include regular cleansing, adequate moisturizing, and photoprotection. It is necessary to thoroughly but gently cleanse the skin of the face and neck using cosmetic milk, gel, foams, and solutions that do not contain alcohol, corresponding to oily or combination skin. Such solutions, as a rule, have an anti-inflammatory effect, and are also prescribed for additional cleaning and moisturizing of the skin. At home, it is recommended to use infusions of medicinal herbs and thermal waters (preferably in the form of a spray). Cleansers must meet certain requirements: remove scales and sebum without increasing its secretion and without overdrying the skin, have anti-inflammatory and keratolytic effects, and not cause a vascular reaction. The question of prescribing various antibacterial soaps and foams should be decided individually. As a rule, patients with combination skin do not tolerate washing with these products well. In some patients with oily skin, especially complicated by acne, erythematosquamous rashes may appear or acne may worsen when using antibacterial soap. Such hyperhygienic measures lead to delipidization, a decrease in the barrier properties of the skin and a worsening of acne. For the care of oily and combination skin, medicinal cosmetics should be recommended.

Cosmetics and medical products for oily and combination skin should not be greasy and sticky, the most preferable form is an emulsion such as "water in oil" or gel. As a rule, patients with oily and combination skin complicated by acne require appropriate pharmacological correction. All external therapy products are applied to the entire face (except for the skin of the eyelids) and only after preliminary cleansing of the skin. Most products dry out the skin, so it is necessary to additionally use moisturizing creams. Skinoren (in the form of a 15% gel), widely used today for the treatment of acne, in addition to the antibacterial effect, has a moisturizing effect, so its use, as a rule, does not require additional moisturizing of the skin

It should be noted that make-up should be used with caution due to the potential comedogenic effect of decorative cosmetics. Patients can be recommended only high-quality skin care products and decorative cosmetics that do not have a comedogenic effect.

You can prepare face masks at home yourself or use professional masks suggested by a cosmetologist, the use of which is allowed at home (the so-called "homework"). To prepare a mask at home, use only high-quality and fresh products. The mask is prepared immediately before use. Storing mask leftovers in the refrigerator is not allowed. The freshly prepared mask is applied to cleansed skin of the face and neck for 15-20 minutes. Then the mask is washed off with cool water. The face is treated with a toner for oily or combination skin or herbal infusions and a moisturizer is applied. It is recommended to do masks no more than 1-2 times a week. It should be remembered that plant extracts and some food products (honey, egg yolk and white, citrus juices, strawberries, tomato pulp, etc.), often used to prepare masks and tonic liquids for oily and combination skin at home, are allergens.

Examples of masks for oily and combination skin

Yeast mask - half a pack of fresh yeast is mixed in warm milk until a creamy mass is obtained, which is applied to the skin of the face for 15 minutes, then washed off with warm water.

Curd mask: thoroughly grind a tablespoon of fresh cottage cheese and a teaspoon of honey, apply the resulting mass to the skin of the face for 20 minutes, then wash off with warm water.

Protein mask: a freshly prepared mixture of egg white and one teaspoon of lemon juice is applied to the skin of the face for 20 minutes, then washed off with warm water. Fruit masks are shown (strawberry, cucumber, carrot, etc.).

As for peeling creams, their use at home should be individualized. The main contraindications for the use of peeling creams are the presence of inflammatory elements (papular, papulopustular), as well as viral, bacterial and fungal skin diseases, multiple malformations, melanoma-hazardous nevi and other malignant neoplasms of the facial skin, as well as pronounced telangiectasias. These procedures should not be prescribed in severe frosts, as well as with active insolation. In the absence of contraindications and good tolerance, peeling creams can be recommended as a means of care for both oily and combination skin, no more than once a week. Classic mechanical peelings include freshwater sponge loofah, the use of which causes an exfoliating effect, and also helps resolve deep infiltrates. Masks with loofah can be recommended to patients to use at home (under the supervision of a doctor). The powder of the sponge is mixed with boiled water or 3% hydrogen peroxide solution to form a mushy mass with foam. The resulting mass is applied with a swab or fingers in rubber gloves to the skin of the face with light rubbing movements and left for 15-20 minutes. The mask is removed with warm water, then the skin of the face is wiped with a toner. It should be noted that any rubbing movements on the skin provoke the appearance of fresh rashes. Systematic use of medicinal creams containing keratolytics at home allows you to avoid the appointment of mechanical peelings.

Patients with combination and oily skin can be recommended lotions, water-alcohol chatterboxes and powders containing salicylic, boric acids, resorcinol, sulfur, ichthyol, with the addition, if necessary, of antibiotics. With a combination skin type (with pronounced dryness of the skin in the cheek area), these products are applied only to areas with increased secretion of sebum (forehead, nose, chin - "T-zone").

Basic physiotherapeutic procedures used for the care of oily and combination skin

To implement a comprehensive intensive care program for oily and combination skin of the face and neck, the following physiotherapeutic procedures are carried out in a cosmetology office.

• Desincrustation. The method is based on the principle of galvanization, using solutions of sodium bicarbonate or chloride (2-5%) or a special desincrustation solution on the negative electrode. Due to therapeutic electrolysis, an alkali is formed on the negative pole, changing the pH of the skin, which facilitates the dissolution and removal of sebum from the excretory ducts. Weekly desincrustation can significantly reduce the number of open comedones and prevent the formation of new ones.
• Vacuum spray. With the help of vacuum action, skin is cleaned and massaged. The disadvantage of vacuum cleaning is low efficiency and significant traumatization of surrounding tissues. Working in the spray mode with the use of lotions appropriate for oily and combination skin types has a tonic and moisturizing effect, improves microcirculation and skin nutrition, and enhances lymphatic drainage.
• Darsonvalization for oily and combination skin is performed over talc over a dry antiseptic mask and a finishing cream using a contact labile and stable technique. The use of remote darsonvalization is limited due to the cauterizing effect. For flabby skin, contact labile darsonvalization over a finishing cream is used, which has a slight lifting effect. The duration of the procedure for oily skin is on average 10 minutes, and for combination skin - 5-7 minutes, per course of 10-15 sessions, every other day.
• Ultrasound and iontophoresis enhance the effects of cosmetics and medications. Ultrasound is used for peeling procedures.
• Myostimulation is included in a complex of cosmetic procedures for the care of oily and combination skin of the face, as a rule, before applying a mask, both for the prevention of age-related changes and to combat existing signs of skin aging. For flabby skin, it is advisable to use myostimulation in combination with plastic massage and paraffin masks. It should be noted that myostimulation is not recommended for patients aged 35-40.
• Paraffin masks also help resolve infiltrates and have a lifting effect; they were previously used before mechanical cleaning. Paraffin masks are contraindicated in rosacea, infectious skin diseases (pustular, fungal, viral), skin neoplasms (including benign), hypertrichosis, severe cardiovascular and neurological pathology, and glaucoma. Paraffin is heated in a water bath to 60 °, then applied layer by layer to the skin of the face with a brush (except for the skin of the eyelids), for 20-25 minutes. A correctly applied mask is removed completely after cooling, representing a kind of cast of the face in shape. The procedure is carried out every other day, for a course of 10-20 sessions,
• Microcurrent therapy (the procedure is performed every other day, a course of 10-15 sessions), as well as electrostatic massage; therapeutic laser and aromatherapy with essential oils are widely used to care for oily and combination skin of the face and neck.
• Indications for cryomassage with liquid nitrogen are deep indurative elements and flabbiness of the skin. With a cotton swab on a wooden rod, make light stroking movements for 1-2 minutes along each massage line, without pressing or stopping, periodically immersing it in a thermos with liquid nitrogen. The procedure is carried out on dry skin of the face, 2 times a week, for a course of 10-15 sessions. The use of carbonic acid snow for cryomassage is not recommended due to the high risk of burns. Cryomassage is not prescribed during active insolation.

Vaporization and brushing are used to a limited extent. Direct exposure to ultraviolet radiation is contraindicated.

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Care for oily and combination (mixed) skin of the face in a cosmetology facility

According to research, about 90% of visits to a dermatocosmetologist are made by patients with oily and combination skin types aged 12 to 60 years. The most common complaints are increased oiliness of the skin, rashes on the face, chest and back. As a rule, difficulties arise when choosing a care program for combination skin. The issue should be resolved individually with each patient. If a patient with a combination skin type has pronounced dryness of the lateral surfaces of the face, then cosmetics for oily skin are applied to the forehead, nose and chin, and for normal or dry skin to the cheek area. All procedures should begin with removing makeup from the skin around the eyes and lips (using cosmetics specially designed for this purpose) and cleansing the skin of the face and neck. All manipulations in the face and neck area are carried out along the lines of least skin tension. In a cosmetology office, patients with combination and oily skin undergo peeling and skin cleansing procedures, and use masks (easily removed from the skin surface - anti-inflammatory, drying, cleansing and moisturizing). The question of the appointment and choice of the type of peeling is decided for each patient individually. In the absence of inflammatory elements, preference should be given to ultrasonic peeling, mechanical peeling for oily and combination skin, as well as glycopeeling. In rare cases, the use of soft brushes on peeling cream is allowed.

In case of decreased skin turgor, secondary pigmented spots, and scars, glycopiling procedures (with 25 and 50% solutions) are indicated. For the first glycopiling procedure in a cosmetology office, preliminary home preparation is required. Patients are recommended to apply creams containing fruit acids (up to 15%) to the skin of the face and neck 1-2 times a day for 2 weeks. Immediately before the glycopiling procedure, the skin of the face and neck should be thoroughly cleaned with cosmetic milk. Tonic liquids are usually not used. In some cases, before applying glycopiling, the skin is treated with a special pre-peeling solution. Glycopeeling is applied with cotton swabs in the following sequence: to the forehead, nose, chin, above the upper lip, cheeks, eyelid skin, neck, and décolleté. The exposure time is strictly individual (1-3-5-10 min).

Glycopeeling is removed from the skin surface using sponges and a large amount of cool water. The glycopeling procedure is carried out every other day, for a course of 7-10 procedures. The effect after these procedures lasts for 1.5-2 months. It is not recommended to carry out the glycopeling procedure in severe frosts and during active insolation.

In some cases, patients with oily and combination skin may be recommended mechanical facial cleansing. Currently, special gels are used to prepare the skin for this procedure. Vaporization of the skin before mechanical cleansing is currently considered undesirable for this category of patients. Mechanical cleansing is performed manually or with special instruments (loops, spoons, etc.). Open comedones, milia (horny cysts) and single pustular elements, opened with a sterile needle, are subject to removal, followed by treatment with alcohol solutions of salicylic, boric acid or other antiseptics. Mechanical cleansing is not recommended during menstruation and in case of severe somatic pathology.