How Do Dermatologists Decide Which Facial Treatment Is Right for You?

You're thinking about getting a facial but feel confused about which one to choose. If you need the best facial, a skincare professional can help you select the one that works best for your skin concerns.

A dermatologist selects the most appropriate facial treatment not based on what’s trending or a person’s age, but rather on a thorough facial skin assessment, the identified concerns, and an understanding of medical and skincare history.

The facial is tailored to the patient's underlying cause, skin condition, skin type, lifestyle, medical history, skincare routine, and treatment goals, shares Dr. Niti Gaur, senior dermatologist in Gurgaon and founder of Citrine Clinic. It aims to safely and effectively address skin issues and promote long-lasting healthy skin. 

Quick Summary

• A dermatologist first assesses your primary skin concern, skin tone, skin type, sensitivity, and the extent of aging, acne, or inflammation before recommending a facial treatment.
• Medical and skincare history, existing skincare routine, treatment expectations, and previous cosmetic treatments may also affect the facial choice.
• Facial treatment is decided based on concerns like acne and its scarring, pigmentation, fine lines, wrinkles, melasma, dullness, enlarged pores, uneven texture, and loss of skin firmness.
• Dermatologists choose one or a combination of facial treatments based on the specific concerns.

Why a Single Facial Treatment Can’t Work for Everyone

Every person possesses unique skin- the condition, type, and severity of concerns. Though facial skin concerns look similar in two people, their cause may differ. That is why a dermatologist’s skin assessment should come before treatment.

A dermatologist will not simply choose the most expensive, advanced, or popular procedure, as it could be inappropriate and worsen your skin condition instead of improving it.

How Do Dermatologists Decide Which Facial Treatment is Right for You?

Here are the factors that dermatologists consider before choosing facial treatment:

1. The Primary Skin Concern: Dermatologists first ask the patient what they are struggling to improve- acne, scars, uneven texture, pigmentation, volume loss, laxity, or other skin concerns, as every skin concern needs a different treatment approach. If more than one concern is bothering the patient, a dermatologist plans a combination of treatments.
2. The Skin Type: The dermatologist identifies the patient’s skin type: oily, combination, dry, normal, sensitive, or acne-prone. Some treatments must be tailored to skin type, or complications can occur.
3. Skin Tone: Certain energy-based procedures and lasers must be customized to skin tone. For darker-skinned people, appropriate selection of device and treatment settings minimizes the risk of inflammation and pigmentation.
4. The Cause and Severity of Skin Concern: A dermatologist closely examines the skin, possibly with specialized tools like dermoscopy. Based on the level of collagen, volume loss, acne severity, pore size, scar depth, pigment distribution, skin texture, and skin laxity, and their severity and cause, the dermatologist determines the type and intensity of the treatment.
5. The Skin’s Sensitivity: For those with a compromised skin barrier or skin that easily turns red, itchy, burning, or irritated, the dermatologist recommends gentle treatment initially, with a gradual increase in intensity.
6. The Age: Younger people are most likely to have acne, pigmentation, acne marks, or enlarged pores, while older people experience aging concerns like fine lines, wrinkles, dehydrated skin, skin laxity, loss of volume, and uneven texture. Based on the concerns, not just the age, the dermatologist decides on the treatment.
7. The Lifestyle Factors: A dermatologist may ask about your daily routine, stress, sun exposure, sleep schedule, water intake, skincare, makeup use, smoking habits, exercise, travel frequency, and upcoming events to select the right facial treatment.
8. Medical History and Current Medications: Dermatologists may ask about previous and current skin conditions, allergies, medication use, acne treatments, previous cosmetic treatments, a history of keloid scarring, pregnancy and breastfeeding status, and reactions to previously used topicals or procedures to determine a suitable treatment or make necessary adjustments to previous treatment.  
9. Downtime Preference: Dermatologists may determine the practical suitability for a facial by knowing its downtime.
10. Expectations- Dermatologists help select a treatment that matches patient expectations for results.
11. The Budget- By knowing the patient’s budget, dermatologists create a realistic facial treatment plan.

Which Facial Treatment Do Dermatologists Recommend for Different Skin Concerns?

Here is what one can choose based on their concern:

1. For Dull, Dehydrated Skin: Gentler treatments like medical-grade skincare, HydraFacial, and superficial chemical peels that encourage exfoliation, hydration, and better skin appearance. 
2. For Acne-Prone Skin: For active acne, medical treatments are prescribed before cosmetic procedures. Depending on acne severity, a dermatologist may recommend products containing azelaic acid, retinoids, salicylic acid, or benzoyl peroxide, prescription medicines, or chemical peels/laser treatment.
3. For Acne Scars: For rolling scars, microneedling, subcision, or laser resurfacing is recommended, while boxcar scars are treated with microneedling, fractional laser, or TCA-based treatment. Ice pick scars are treated through punch techniques or TCA cross.
4. For Pigmentation and Uneven Skin Tone- Depending on the extent of pigmentation, a dermatologist may recommend skin-brightening/lightening treatments like Vitamin C or azelaic acid-based topicals, laser treatments, sun damage treatment, or chemical peels.
5. For Early Signs of Aging- Dermatologists may recommend collagen-stimulating procedures like chemical peels, microneedling, laser resurfacing, radiofrequency, or skin boosters to improve skin texture, hydration, and quality.
6. For Deeper Wrinkles and Volume Loss- Dermatologists use anti-wrinkle injections for dynamic wrinkles and dermal fillers to address volume loss.
7. For Skin Laxity- Dermatologists recommend radiofrequency treatment and ultrasound-based treatment to address mild skin laxity.