Photo-Illustration: by The Cut; Photo: Getty Images
Q: Does our skin get “used to” products so they stop being effective? Does it ever make sense to switch things
A: All I can say is I hope not. I’ve been using the same skin-care routine for around 20 years: a prescription retinoid in the evening and a drugstore moisturizer with sunscreen during the day. But dermatologist Laurel Geraghty, MD, adds a few illuminating observations.
There are actually a few things to consider about this great question, she said. “One is about efficacy, meaning: Does the product still work as well if I use it consistently over the long term? The answer is usually yes, but with some medications, sometimes no. Another issue concerns side effects, meaning: Are the side effects reduced if I use a product consistently, while the benefits remain? The answer is almost always yes.”
To start with those medications that can lose efficacy: “Your skin can and does get used to certain products when they’re applied consistently for weeks to months,” said Geraghty. “The medical term for this phenomenon is tachyphylaxis. It’s classically true for steroid creams — hydrocortisone, for example — which can be used to calm rashes, such as eczema or psoriasis. When it’s applied to the skin consistently, twice a day, over weeks or months, the medication can gradually stop having the same beneficial effect.” It just doesn’t work as well anymore. But it’s pretty simple to avoid this: Take weekends off, and use a different type of medication, or plain moisturizer, instead. (This works the same way it might with our morning coffee, said Geraghty. If we chug a double espresso day after day, it’s not going to give us the same happy jolt anymore. But take the weekend off, chances are that double espresso will give us a nice bounce again on Monday morning.)
Other medications, like the prescription antibiotic gel or lotion clindamycin for acne, can lose their effect over time due to antibiotic resistance on the skin’s surface, said Geraghty. So if you’re using clindamycin repeatedly over time to control breakouts — without the addition of another antibiotic like benzoyl peroxide — the germ linked to acne can gradually outsmart and circumvent the medication, she said.
As for those treatments whose efficacy persists: Many other topical medications and creams do not seem to cause tachyphylaxis and seem to keep working well over the long term, even when we use them consistently. As an example, Geraghty points to the vitamin-C serum she uses, along with peptides, glycolic acid, and a topical retinoid lotion, all of which keep paying off, month after month, year after year, with mounting benefits the longer she uses them. She points out that because any side effects of these products have been reduced with consistent use, that might make it feel like they’re not as effective. But they are! “When side effects subside, that means your skin has gotten used to products in the best possible way, as the benefits remain. It is the skin-care happy place,” said Geraghty.
And about switching things up. The popular idea of skin cycling — rotating through different products to get the advantages of all of them with less irritation — might be one way to avoid tachyphylaxis. The irritation caused by some ingredients, like topical retinoids, can make them difficult to tolerate all the time. So taking a break is fine. The problem is that throwing too many different products at our skin can cause other issues. If you use an excess of certain active ingredients in a short period of time, it can trigger redness, flaking, irritation, itching, or an annoying, bumpy rash around the mouth, nose, and eyes (periorificial dermatitis), Geraghty said. It’s a good idea to remember that skin care is a long game. For example, it usually takes at least three to six months to see the effects of a prescription retinoid. It’s not about how much or how often we blast our face with one trendy product or another.
There is a product that never stops offering a benefit, no matter how long and consistently you apply it. In fact, the more consistently you apply it, the healthier your skin will be. That would be sunscreen, and there is never an upside to switching it out or skipping it, said Geraghty.