A complete facial: what it includes and who it suits

"Skin cleanse", "facial", "face treatment", "hydrafacial", "ritual". The names vary and so does what is done in the treatment room. Some facials are little more than a massage with pleasant creams, and others treat the skin with techniques and concentrations that are not used at home. Both have their place, but it is worth knowing what you are booking.

This article explains what a complete facial usually includes, what each step is for, what the evidence says, who it suits, when it is better to postpone and how often it makes sense to repeat.

What happens in a complete facial, step by step

Each clinic has its own protocols, but a well-done complete facial usually follows this logic.

1. Skin assessment (5 to 10 minutes)

This is the step that separates a "catalogue" facial from a tailored one. It includes questions about your routine, medication, allergies, recent treatments and sun exposure, and examining the skin in good light and, at times, with a magnifier or skin analysis devices. It is also the moment to identify lesions that should be seen by a doctor before any treatment.

2. Cleansing

It removes make-up, sunscreen, sebum and impurities. It is often a double cleanse: first an oily or micellar product, then a gentle gel or foam.

3. Exfoliation

Removes dead cells from the surface and prepares the skin for the next steps. It may be:

• Enzymatic, the gentlest, with plant-derived enzymes.
• Chemical, with low-concentration acids (glycolic, lactic, mandelic, salicylic).
• Mechanical, with an ultrasonic spatula, microdermabrasion or water-based suction devices.

4. Preparation and extractions (when indicated)

Steam or emollient products soften the contents of the pores. Manual extractions remove open comedones (blackheads) and some closed ones (whiteheads). Done with proper technique, gloves and sterile equipment, they are safe; done with excessive force, they can cause inflammation, dark marks and even scars. Inflamed spots and cysts should not be squeezed.

5. Active treatment

It is the step that varies most and that most defines the result. It may include:

• A superficial peel, for texture, tone and acne.
• Serums with antioxidants, depigmenting agents or moisturisers, applied with techniques that improve penetration (iontophoresis, ultrasound, among others).
• LED light.
• Radiofrequency or other technologies that stimulate the dermis.

6. Facial massage and drainage

It relaxes, improves local circulation and reduces puffiness. For many people, it is the most pleasant moment.

7. Mask

Soothing, moisturising, purifying or with specific actives, depending on the skin.

8. Finishing

Serum, moisturiser and sunscreen. A facial that ends without sunscreen, especially after exfoliation, is incomplete.

9. Recommendations for home

A good facial ends with clear instructions: what to do in the following days, what adjustments to make to the routine and when to return.

What the evidence says about facials

There is little scientific research on "facials" as a whole, because each one is different. But there is evidence on the components:

The honest conclusion is that the effect of a single facial is mainly immediate and temporary: the skin is cleaner, smoother and more radiant for days to weeks. Lasting results come from repetition and from combining with a routine at home, above all sunscreen, a retinoid and appropriate cleansing.

That takes nothing away from the value of a facial. For many people, it is also the moment to assess the skin with someone who knows how to look at it, adjust the routine, treat what cannot be treated at home and, no less important, rest. On the actives used at home, see Antioxidants for the skin: vitamin C, E and ferulic acid explained without exaggeration.

Who it suits

What a facial does not replace

• Medical treatment of moderate to severe acne (nodules, cysts, scars): requires a medical consultation.
• Diagnosis of suspicious pigmented lesions.
• Treatment of skin diseases such as rosacea, seborrhoeic dermatitis or eczema, although an adapted facial may be a complement.
• Medical treatments for volume, marked sagging or deep wrinkles.

When to postpone or not do it

Always tell the professional if you are in one of these situations. Some require the facial to be postponed; others only call for the protocol to be adapted.

Adapt:

• Oral isotretinoin (current or recent): the skin becomes very fragile; avoid exfoliation, aggressive extractions and waxing. Gentle protocols, on medical advice.
• Topical retinoids or acids at home: stop a few days before, depending on the planned treatment.
• Pregnancy and breastfeeding: avoid retinoids, some acids at high concentrations and certain technologies.
• Sensitive skin or known allergies: choose fragrance-free products with few ingredients.
• Dark skin or skin prone to dark marks: be careful with aggressive exfoliation and extractions, because of the risk of post-inflammatory hyperpigmentation.
• Anticoagulant medicines: bruise more easily.

A warning

In Portugal, procedures with needles that inject substances into the skin (including so-called needle "mesotherapy", fillers or botulinum toxin) are medical acts. Be wary of facials that include them without a doctor present.

How often, and what to expect afterwards

Frequency

The epidermis renews itself continuously. In young adults, this cycle takes around four weeks; with age it becomes slower (Grove and Kligman, 1983). That is why a frequency of 4 to 6 weeks keeps pace well with the skin and is the most recommended for maintenance.

• Oily skin with comedones: every 4 weeks, at an early stage.
• General maintenance: every 4 to 8 weeks.
• Series with peels or technologies: depending on the protocol, often every 2 to 4 weeks for a few sessions, then maintenance.
• Sensitive skin: space them further apart and prefer calming protocols.

Having facials with exfoliation or extractions too often may irritate the skin and weaken the barrier.

After the facial

• Mild redness is common for a few hours, especially after extractions.
• Small spots in the following days may appear when there are many comedones (purging); they usually resolve within a few days.
• Avoid heavy make-up in the first hours, sauna, swimming pool, intense exercise and direct sun in the first 24 hours; postpone retinoids and acids for 2 to 3 days if there was exfoliation or a peel.
• Sunscreen every day, with special care in the following week.
• Contact the clinic if you have intense redness, persistent stinging, blisters, swelling or signs of infection.

How to choose where to go

• Do they carry out an assessment first, with questions about medication and treatments?
• Do they explain what they will do and why?
• Do they use gloves and sterile equipment for extractions?
• Do they refuse or postpone treatment when there are contraindications?
• Do they refer you to a doctor when they see something that warrants it?
• Do they give instructions for home and not push a long list of products?

At Luxmed, the facial always begins with a skin assessment and is adapted to what we find. We know when to treat, when to postpone and when to refer for medical assessment. You leave with clear instructions for your routine at home.

This article is for information purposes and does not replace a medical consultation. The results of any treatment vary from person to person.

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