Skin Care Triage: What to Fix First When Everything Feels Off

When skin is dull, tight, or breaking out, the answer isn’t “buy more products.” Start with a short triage that protects your barrier, keeps inflammation down, and sets you up for steady wins across all skin tones.

Step 1 – Stabilize your barrier

  • Switch to a gentle, low-foam cleanser and a plain moisturizer you’ll use twice daily.
  • Look for ceramides or similar barrier-supporting lipids; studies show ceramide-containing moisturizers help barrier recovery and symptom improvement in compromised skin.

Step 2 – Lock in daily photoprotection

  • Daily, broad-spectrum SPF (face, neck, ears). Aim for SPF 30+; reapply with exposure.
  • This is non-negotiable for every shade of skin to curb photoaging, reduce cancer risk, and limit dark-mark “stickiness.” The AAD and FDA both back this guidance. 

Step 3 – Pick one targeted active (not five)

Choose based on your top concern; add slowly, patch test, and keep the rest of your routine boring.

  • Breakouts (comedones or inflamed acne):
     Start with benzoyl peroxide (AM or PM, low strength) or salicylic acid wash; pair with a topical retinoid at night once or twice a week, then build. Current dermatology guidelines list benzoyl peroxide and topical retinoids as first-line, cornerstone therapies.
  • Uneven tone / post-inflammatory hyperpigmentation (PIH):
    Daily SPF + gentle moisturizer first. Add azelaic acid or a retinoid a few nights a week. Evidence supports these agents for PIH across skin tones; slow and steady limits irritation that can worsen discoloration.
  • Texture / fine lines:
     Ease in with retinoid nights (buffer with moisturizer if needed). Retinoids have long-standing data for photoaging and cell-turnover support.

Step 4 – Set expectations by the calendar

  • Give a new routine 4–8 weeks before judging results, unless you’re reacting.
  • Keep a simple log: products used, nights applied, any irritation. Consistency beats intensity.

Step 5 – Add procedures only when the foundation is steady

Once the routine is calm and predictable, in-clinic options can amplify results:

  • Chemical peels: Effective for tone and texture when matched to skin type and concern. People with darker skin can have peels safely with experienced providers and peel choices that lower PIH risk (e.g., salicylic or mandelic blends rather than strong high-% glycolic in many cases).
  • Microneedling: Useful for acne scarring and texture, with low PIH risk when performed correctly; evidence supports benefit as monotherapy and in some studies combined with gentle peels.

Step 6 – Inclusivity matters in the plan

  • PIH risk is higher in many deeper skin tones; minimize irritation, introduce actives slowly, and bias toward agents with a lower irritation profile.
  • Sunscreen selection should fit complexion and preference (tint options, mineral or chemical); the “best” sunscreen is the one you’ll actually wear daily.

Step 7 – Know when to get help

  • Swift worsening, painful cysts, or strong reactions deserve a clinician’s eye.
  • If you’re stacking more than two actives, get a plan before you mix.

If you’d like a human to map this to your real life and calendar, Delicia offers short planning appointments at Brampton Cosmetic – simple routine, clear cadence, and options that respect your skin and schedule.

About Dr. Robert Sleightholm

Dr. Robert Sleightholm is one of the founders of the Brampton Cosmetic Surgery Center and Medical Spa. He is the clinic’s Director of Surgery and, since its opening in 1994, has safely and successfully completed more than 200 cosmetic surgery procedures each year. An Ontario plastic surgery veteran, he is a board-certified Fellow of the Royal College of Surgeons of Canada (FRCSC).

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