By Anthony L. Komaroff, M.D.

DEAR DOCTOR K:

I wash my face very little because I've heard that soaps, even mild ones, dry out the skin. What do you think?

DEAR READER:

Most facial skin is quite sturdy. It has many pores and heals quickly.

But as you get older, you start to see the effects on your face of chronic exposure to the environment. The skin thins and becomes less elastic. It develops more pores, fine lines and wrinkles, and more prominent freckles.

Excessive cleansing of the skin with soap and water or solvents can lead to redness and dryness. However, this problem usually affects the hands, not the face. Washing your face, even if you do it fairly often, shouldn't cause a problem unless you have an underlying disorder, such as eczema. How often is too often? I don't think it's ever been carefully studied in a large number of people.

Obviously, the time to wash your face is when it gets dirty, as in following a meal, or if you are working outside in the dirt and sun and getting sweaty. But for someone who is indoors most of the time, in cool air, it's hard to imagine why washing the face more often than a few times a day would be necessary.

It's a good idea, however, to be careful about what you wash your face with. Washing with just water is usually not sufficient because dirt sticks to the skin. Besides, many people need some type of cleanser because they have oily skin.

Using regular soap is fine in many cases. But soap is alkaline, so it can be irritating even to normal skin, which tends to be slightly acidic.

Synthetic soaps -- often identified on the package as being "soap-free" -- are a better choice for some. That's because their pH is closer to that of normal skin. The synthetic products are definitely worth a try if your skin is reacting badly to regular soap.

Facial scrubs that clean and remove the outer layer of skin are OK, but I've seen many patients who use them so enthusiastically that their skin gets irritated. The same is true of rough washcloths and loofahs.

I had a patient who scrubbed the skin of her face so forcefully, and so often, that she got nearly as red as an apple. She told me she was doing it so that the old, tired skin cells would be stripped away and replaced by "young" skin cells.

There's a measure of truth to that: Many effective "skin rejuvenation" creams work on that principle. But don't get carried away. If you badly irritate the skin of your face, you've gone too far.

Regardless of the type of soap you use, or how you use it, it's best to use warm, not hot, water. Hot water can leach protective oils out of your skin and is no better at removing dirt. Too much of a good thing can be bad.

We have more information on caring for your skin in our Special Health Report, "Skin Care and Repair." You can find out more about it at my website.

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.)

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