Skin and Cosmetics

The facial: eight steps, one result

A classic deep-cleansing facial takes 60 to 90 minutes and runs through 8 steps in a fixed order: cleanse, analyse, exfoliate, soften, extract, calm, massage, then mask and sun protection. Its value sits in steps 3 to 5, where the outer skin is loosened and blocked pores are emptied by hand under a magnifying lamp instead of in front of your own mirror. The visible result lasts weeks, not months, which is why an interval of 4 to 6 weeks follows the epidermis and its renewal cycle of roughly 4 weeks.

Cleanse, analyse, exfoliate, soften

The first 4 steps prepare the skin, and how carefully they are done decides how well step 5 goes. Cleansing comes in two passes: the first lifts make-up and sunscreen, the second cleans the skin itself, with lukewarm water, fingertips or a soft sponge and no scrubbing, the same rules dermatologists give for washing your face at home. Then the analysis. Under a magnifying lamp (a 5 dioptre lens shows the skin at roughly twice its size) the practitioner reads oil flow, pore size, dryness, broken capillaries and inflamed spots, and decides which exfoliant, which mask and how much extraction the skin can take today. If this step is skipped, you are getting the standard programme whatever your skin needs. The Skin Type Finder gives you a first reading before you book.

Exfoliation loosens the stratum corneum, the outermost layer of 20 to 30 flattened cell layers. There are two routes: mechanical (a fine scrub, a brush or a pad) and chemical (alpha and beta hydroxy acids, or fruit enzymes as the gentlest option). The American Academy of Dermatology puts it plainly: dry, sensitive and acne-prone skin does better with a mild chemical exfoliant, oily and thicker skin tolerates stronger acids or a mechanical method, and darker skin tones should avoid aggressive exfoliation because it can leave dark marks. Softening follows, 5 to 10 minutes of warm steam at 30 to 45 centimetres from the face, or warm compresses changed 2 or 3 times. This is not a spa flourish. A warm, hydrated corneum releases its plugs with far less pressure, and less pressure means less redness afterwards.

Extraction is what you are paying for

Now the practitioner spends 15 to 20 minutes emptying comedones, the open ones (blackheads) and the closed ones (whiteheads). Two facts from DermNet frame the step. First, a blackhead is dark because of melanin at the surface of the plug, not because of dirt, which is why no amount of scrubbing removes it and why extraction is a matter of pressure, not soap. Second, squeezing that ruptures the follicle wall pushes its contents into the surrounding skin and turns a 1 millimetre plug into an inflamed papule that lasts 1 to 2 weeks. A trained pair of hands works with two fingers wrapped in gauze or with a looped extractor, at a shallow angle, with the light and the magnification a bathroom mirror never gives you. Anything larger than 2 to 3 millimetres (a macrocomedone), anything inflamed, and anything that does not move on the second attempt is left alone.

Step 6 is the calm-down: a soothing concentrate, often with panthenol, allantoin, niacinamide or centella, sometimes a cold globe or a cool compress for 2 to 3 minutes. Redness after extraction is normal and fades within 30 to 60 minutes on tougher skin, within 24 hours on sensitive or rosacea-prone skin. Some studios add a mild antiseptic or run a high-frequency wand over the area for 1 to 2 minutes; the antiseptic is sensible, the evidence for the wand is thin, and it should be skipped by anyone with a pacemaker or other implanted electrical device, and in pregnancy, because the current can interfere with the electronics. If your skin is oily and congested, this middle section is where you want most of the time. If it is dry and clear, a 5 minute check is enough and the minutes belong to steps 7 and 8.

Massage, mask and the last layer

Massage is the step people remember and the one with the least lasting effect. It does do something, and it can be measured. In a 2018 study in Complementary Therapies in Medicine, 5 minutes of massage with a roller on one cheek raised skin blood flow in that cheek, and only that cheek, for at least 10 minutes afterwards in 12 volunteers; 14 others who used the roller daily for 5 weeks showed a stronger vasodilation response to warmth at the end of it. Read that as it stands: a temporary flush, a slightly better-trained microcirculation with regular use, no change to collagen. In a facial the massage runs 10 to 15 minutes with an oil or a cream, in upward and outward strokes, and its practical job is to work the concentrate in and let the skin settle after extraction. The facial massage guide covers the strokes.

Step 8 is the mask, 10 to 15 minutes, chosen at the analysis stage: clay or kaolin for oily and freshly extracted skin, a gel or sheet mask with hyaluronic acid for dehydrated skin, a cream mask for dry skin (the guide to face masks explains the types). Then the finish that decides whether the session helped: a light moisturiser and, in daytime, a sunscreen of at least SPF 30, because exfoliated and extracted skin has lost part of its shield for about 48 hours. A facial that ends with a full make-up application has undone step 5. A good studio sends you out with bare, protected skin and a written aftercare note.

What a facial does, and what it cannot do

The benefits are modest and real. Pores look finer for 2 to 4 weeks because they are empty, not smaller. Skin feels smoother for 1 to 2 weeks because the loosened corneum has been lifted. Products penetrate a little better for a few days for the same reason. Then the epidermis does what it always does and renews itself in roughly 4 weeks, which is the basis for the 4 to 6 week interval most practitioners recommend. Weekly facials do not add up; they mostly add irritation. As a guide to cost, a 60 to 90 minute facial in a mid-range studio in Western Europe runs 60 to 150 EUR, in the United States 80 to 200 USD, and a 30 minute express version at half the price usually drops steps 4 and 5, the two that are worth paying for.

What a facial cannot do: it does not soften wrinkles for longer than the mask is on, it does not treat acne (a medical condition with its own plan, see acne: four causes, one plan), and it does not remove pigmentation. Anything that changes the structure of the skin works below the epidermis, in the dermis, which means microneedling, medium-depth chemical peels, lasers or radiofrequency, each with 3 to 6 sessions and days of downtime. A facial is skilled care with zero downtime, and either it is honest about that or it is being sold wrongly.

Before you book, and the 48 hours after

Three questions save disappointment. Is there an analysis, or a fixed menu? What is inside the 60 or 75 minutes, because 60 minutes with a 25 minute massage is a different product from 60 minutes with 20 minutes of extraction? And what am I to do afterwards? Then the exclusions. If you take isotretinoin, the NHS advice is no waxing, no laser hair removal, no microdermabrasion and no chemical peels for the whole course (usually about 3 months), and most practitioners extend that to extraction and to the 6 months after the last capsule, because skin repair is slowed. If you use a prescription retinoid or benzoyl peroxide, the AAD advises against exfoliating on top of them; pause them 3 to 5 days before the appointment and tell the practitioner. An active cold sore, sunburn, open spots and a fresh course of acne antibiotics are reasons to move the date.

Afterwards: no make-up for 24 hours on freshly extracted skin, no sauna, steam room, swimming pool or hard training for 48 hours, no acids, retinoids or scrubs for 2 to 3 days, and SPF 30 every morning for at least a week. Do not book the facial for the day before a wedding, a shoot or an interview; 3 to 4 days before is the safe distance, because sensitive skin can stay pink for 24 hours and a small extraction site can take 2 to 3 days to close. Drink normally, sleep normally and leave the skin alone. The work has been done under a lamp; the result now depends on what you do not put on top of it.

Five questions to ask before you book

Frequently asked

How long does a facial take?

A classic deep-cleansing facial takes 60 to 90 minutes. What matters is how the time is split: extraction needs 15 to 20 minutes, and a 30 minute express facial usually drops it altogether.

How often should I have a facial?

Every 4 to 6 weeks. The epidermis renews itself in roughly 4 weeks, so that interval follows the skin's own cycle; more often adds irritation rather than results.

Will my skin be red afterwards?

Usually for 30 to 60 minutes, on sensitive skin for up to 24 hours. Plan the appointment 3 to 4 days before an important occasion, not the evening before.

What should I avoid after a facial?

No make-up for 24 hours, no sauna, pool or hard training for 48 hours, no acids or retinoids for 2 to 3 days, and SPF 30 every morning for at least a week.

Does a facial help against wrinkles or acne?

Not in a lasting way. It cleans and cares for the surface but does not rebuild collagen or treat the causes of acne; for structural change you need microneedling, medium-depth peels or laser, for acne a medical plan.

Can I have a facial while taking isotretinoin?

Not the full version. The NHS advises against waxing, laser, microdermabrasion and chemical peels during the course, and most practitioners also skip extraction until 6 months after the last capsule. A gentle cleanse, mask and moisturiser are fine.

Sources

• American Academy of Dermatology: How to safely exfoliate at home · mechanical versus chemical exfoliation, which skin types tolerate what, no exfoliation on top of retinoids or benzoyl peroxide, moisturiser straight after
• DermNet: Comedonal acne · blackheads are dark from melanin rather than dirt, macrocomedones over 2 to 3 mm, follicle rupture from squeezing, comedolytic agents need weeks to months
• Miyaji A, Sugimori K, Hayashi N, Short- and long-term effects of using a facial massage roller on facial skin blood flow and vascular reactivity, Complementary Therapies in Medicine 2018 · 5 minutes of massage raised cheek skin blood flow for at least 10 minutes in 12 subjects; 5 weeks of daily use improved the vasodilation response in 14 subjects
• NHS: Isotretinoin capsules · no waxing or laser hair removal, no microdermabrasion or chemical peels during the course; course usually about 3 months; sunscreen SPF 30 or higher

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This guide is for general information. It does not replace medical or professional cosmetic advice or an examination.