How To Exfoliate Your Underarms (A Dermatologist’s Guide)

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How To Exfoliate Your Underarms (A Dermatologist’s Guide)

One of the most forgotten areas on your body are your armpits, also know as underarms or axilla. In fact, they need just as much care as the skin on the rest of your body.

You must cleanse, moisturize and exfoliate underarms to keep them looking good and healthy. They are often ignored which can lead to consequences.

This article will discuss the proper hygiene of the underarms as well as how to exfoliate underarms and why you should exfoliate armpits.

Why is the armpit skin different?

The underarms have thin delicate skin which is easily irritated with improper care. The skin here, just like the rest of the body, consists of 3 layers: the epidermis (top), dermis (middle), and fat (bottom) (1). These layers are just thinner overall, which makes the skin delicate.

It is also unique in that it possesses 2 types of sweat glands: eccrine and apocrine glands (2). Eccrine glands are necessary to help regulate body temperature. When it is hot outside, you sweat because your eccrine glands secrete water to cool the skin.

Apocrine glands, on the other hand, are scent glands that secrete fats and proteins during emotional stress as well. These odorless fats are broken down by bacteria on the skin which is the root cause of body odor. Apocrine glands are located only in the scalp, armpits, and groin, whereas eccrine glands are all over the body.

The underarms are also one of the warmest, wettest places on your body. This leads to a microbiome with more bacteria and other microbes than other places on the body. The pH is also more alkaline than other parts of the body, which allows more growth of microbes (3-5). These bacteria break down sweat products which cause body odor to form (6).

Why do underarms get darker and rough?

There are several reasons why armpit skin gets darker and rougher.

1. Irritation from chemicals

There are several common chemicals in deodorants that can irritate and darken delicate underarm skin (7). These include alcohol, parabens, fragrances, and aluminum. Long-term constant irritation from these will darken skin and make it rougher. The darkening or hyperpigmentation is caused by an increase in the pigment melanin that appears as a result of the healing process.

2. Abrasions and irritation from shaving

Just like irritation from chemicals, physical irritation will lead to rougher darker skin (7). It is also caused by an increase in melanin as a result of the healing process. Oftentimes, disposable razors or dull razors will cause this. Dull razors also lead to ingrown hairs, which will irritate the skin as well. Abrasions from dull razors can also lead to infections and scarring.

3. Build-up of dead skin cells and products

Just like on your face, if you do not exfoliate the dead skin cells, they will collect, causing dark, rough skin (8, 9). It can also lead to clogged pores and folliculitis, which is similar to the acne pustules on the face.

4. Friction from excess weight or tight clothing

Friction is a form of physical irritation which will lead to dark rough skin in the armpits (2). Tight clothing also restricts airflow to the underarms, which will make it a good breeding ground for infection from yeast and bacteria.

5. Underlying medical conditions

There are certain medical conditions, such as Addison’s disease and acanthosis nigricans, which lead to darkened armpits (2). These medical conditions require medical attention to treat. Addison’s disease is a problem with the adrenal glands that produce certain hormones. These hormones stimulate the body to produce more melanin which darkens the skin. Acanthosis nigricans can result from diabetes or hormone imbalances. Much the same as Addison’s, diabetes causes the release of hormones that stimulate melanin production to darken the skin.

6. Infections

Infection from bacteria, fungi, or yeast is common in this area and can cause darkening of the skin through the same mechanisms as irritation (2). Fungi and yeast love to grow in warm, dark, moist places, so the armpits are ideal for them to thrive. Bacteria also love moist warm places to grow.

7. Genetics

Some people are genetically determined to have more pigment in their skin, making them more prone to develop darkening in the underarm areas (2).

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What can I do to prevent or treat my dark underarms?

Taking care of the underarm area is very similar to taking care of your face. There are basic hygiene steps as well as more advanced ones when needed.

Cleansing

It is important to clean your underarms twice a day with a gentle cleanser, not soap. Soap is too drying and irritating for this delicate skin. You need a pH-balanced cleanser that is gentle and moisturizing without dyes and fragrances (10, 11). You can use a clean, gentle wash cloth or your clean fingers to apply and massage in the cleanser. Use lukewarm water, not hot as that could irritate your skin and lead to further moisture loss.

Just like with your face, cleansing twice daily is important to remove the dirt and bacteria that have accumulated either throughout the day or while sleeping. Removing the bacteria will lead to less body odor since the bacterial breakdown of sweat gland products is what causes odor.

There are many gentle cleansers that can be used in the underarm areas. Cetaphil Gentle Cleanser or Dove Cleanser for Sensitive Skin. They both are pH-balanced cleansers that work gently to remove dirt while moisturizing the skin.

Moisturizing

Using a moisturizer in your armpits is just as important as on your face and the rest of your body. It is skin just like anywhere else on your body and needs moisture to keep it functioning properly. A pH-balanced moisturizer will keep it protected and lubricated, so there is no friction (11, 12).

It also prevents moisture loss and drying of the area. Dryness irritates the area. If the area dries out severely and cracks open, that can lead to microbe invasion and infection.

Stick to gentle, dye and fragrance-free moisturizers that will not irritate the skin. You should apply it twice a day to clean your skin.

Cetaphil Moisturizing Cream or Cerave Moisturizing cream are both pH balanced, and free of dyes or fragrances, which can irritate the skin. They also hydrate the skin well without leaving a greasy residue.

Shaving

It is best to shave your armpits at night so they have time to recover while you are sleeping. Even when you apply serums to your face, they are better absorbed at night because your skin has the time to regenerate at night. Skin is too busy during the day fending off assaults to repair itself.

Always use warm water to soften the hairs before shaving. It is best if you can use a cream or gel-based shaving product as this facilitates gentle gliding of the razor over the skin leading to fewer abrasions. Massage the shaving cream or gel into the armpit skin. Then gently glide the razor over your skin without exerting too much pressure as this could lead to abrasions. Always shave in the direction of hair growth to prevent ingrown hairs. Never dry shave because this causes irritation, abrasions, and more ingrown hairs.

Always use a clean sharp razor that you store in a dry location. You should clean your razor after every use with alcohol. Store in a dry place so microbes cannot grow on it. Usually, 5 uses are the max for a razor after which time it will become dull and you can get cut or develop more ingrown hairs. Never share razors with anyone. Also, only shave when it is necessary. Excessive shaving can irritate the skin.

Some people cannot tolerate shaving at all. Depilatory creams are an effective alternative but the chemicals can be irritating as well, so try to avoid using them. Waxing is another alternative if you can tolerate discomfort and irritation. Finally, electrolysis or laser treatments can give a longer-lasting result with the least irritation.

Vanicream Shave Cream contains aloe and stearic acid to hydrate and soothes the skin while shaving (8, 9). Aveeno Positively Smooth Shave Gel contains sunflower oil, allantoin, and glycerin to hydrate and soothe the skin while shaving (8).

Exfoliating

Exfoliation is important to remove dead skin cells which can accumulate on top of the skin causing the skin to get rough and dark (8). These dead skin cells can harbor bacteria and microbes. This will smooth and soften the skin while unclogging pores.

There are 2 types of exfoliating treatments: chemical and physical. Chemical exfoliants break down the bonds between the dead skin cells so they can be washed away easily. These include alpha (glycolic acid, lactic acid), beta (salicylic acid), and poly hydroxy acids (8). Because the skin in the area is delicate, you want to choose the lowest strength possible to avoid irritation.

Physical exfoliants include beads, washcloths, or sponges. Care should be exercised to avoid overusing them and further irritating the area. Loofahs may be too abrasive. Also, be careful with armpit scrubs, as some contain large jagged beads that can abrade the skin. Physical exfoliants should be reserved for experienced users.

You should not exfoliate more than 1-2 times a week, as it could irritate the delicate underarm skin.

The ZELEN Life Exfoliator combines sugar powder with jojoba oil and sunflower oil to gently and effectively exfoliate underarms to remove dead skin cells and unclog pores while hydrating and reducing inflammation. Sugar powder is a gentle exfoliator that removes dead skin cells without irritation. Jojoba oil helps regulate oil production while moisturizing the skin (8). Finally, sunflower oil is an effective anti-inflammatory and moisturizing agent.

Deodorants

Deodorants can cause darkening of the skin in 2 ways. They can build up on the skin and cause discoloration of the skin. Proper cleansing and exfoliating can help remove the build-up. Also, the chemicals in some deodorants can irritate the skin which will lead to darkening (13, 14). It is best to avoid deodorants with fragrances or certain chemicals like alcohol, parabens, aluminum, and sulfates. These are known skin irritants and should be avoided especially if you have sensitive skin.

There are natural alternatives that are usually less irritating, such as Tom’s of Maine which does not contain aluminum. Tom’s contains coconut oil, glycerin, chamomile, and aloe to name a few. This deodorant helps to control sweat while soothing and hydrating the skin (8).

Some even make their own homemade deodorants from coconut oil or tea tree oil.

Peels

Hydroxy acids, mentioned above, are a great choice for at-home and professional underarm peeling to help lighten dark skin, to remove dead skin, and to smooth out rough skin (8). They are not meant for daily use because they can irritate the skin if used too often or combined with the wrong products. You should consult with your dermatologist before using them. Professionally armpit peeling treatments are stronger so you will see results faster.

Bleaching cream

There are prescription and over-the-counter options. Hydroquinone, kojic acid, vitamin C, niacinamide, arbutin, and licorice are the ingredients found in many bleaching creams (8). However, some may be too irritating for the underarms areas, such as vitamin C and hydroquinone, especially if you have sensitive skin. You should always try a test spot first to see if it will irritate the skin. Also, you may not be able to use them every day. It is best to talk to your dermatologist about these creams before using them.

Professional treatments

When all else fails or you want a quicker treatment option, dermatologists have a variety of options for you in addition to professional peels, such as lasers, dermabrasion, and microdermabrasion to lighten the dark areas and smooth the skin (15-17). They can even use Botox to help reduce sweating.

Conclusion

The underarm area is an important part of your body that is often underappreciated and overlooked when it comes to skincare. It requires the same basic hygiene that the rest of the skin receives, such as gentle cleansing, moisturizing and exfoliating.

These basic steps can help with darkening and rough skin that can develop in those areas for various reasons. It is also important to prevent infections that could develop.

Proper shaving tools and techniques as well as deodorants can play a role in keeping the skin in this area light and soft. There are also professional treatments and products that can help even the most difficult cases.

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References

1. Montagna W, Parakkal P. 1974. Structure and Function of the Skin. Elsevier Inc, NY.

2. Bolognia J. 2012. Dermatology. Elsevier Inc, NY.

3. Williams S, Davids M, Reuther T, Kraus D, Kerscher M. Gender differences of in vivo skin surface pH in the axilla and the effect of a standardized washing procedure with tap water. Skin Pharmacol Appl Skin Physiol. 2005; 18: 247-252.

4. Stenzaly-Achtert S, Schölermann A, Schreiber J, Diec KH, Rippke F, Bielfeldt S. Axillary pH and influence of deodorants. Skin Res Technol. 2000 May;6(2):87-91.

5. Wang S, Zhang G, Meng H, Li L. Effect of Exercise-induced Sweating on facial sebum, stratum corneum hydration, and skin surface pH in normal population. Skin Res Technol. 2013 Feb;19(1):e312-7.

6. Natsch A. What Makes Us Smell: The Biochemistry of Body Odour and the Design of New Deodorant Ingredients. Chimia (Aarau). 2015;69(7-8):414-20. doi: 10.2533/chimia.2015.414. PMID: 26507593.

7. Evans RL, Marriott RE, Harker M. Axillary skin: biology and care. Int J Cosmet Sci. 2012 Oct;34(5):389-95. doi: 10.1111/j.1468-2494.2012.00729.x. Epub 2012 Jun 27. PMID: 22612735.

8. Baumann L (ed) 2015. Cosmeceuticals and Cosmetic Ingredients. McGraw-Hill Education, NY.

9. Draelos ZD (ed) 2005. Cosmeceuticals. Elsevier Inc, NY.

10. Blaak J, Staib P. The Relation of pH and Skin Cleansing. Curr Probl Dermatol. 2018;54:132-142.

11. Wohlrab J, Gebert A. pH and Buffer Capacity of Topical Formulations. Curr Probl Dermatol. 2018;54:123-131.

12. Elias PM, Wakefield JS, Man MQ. Moisturizers Versus Current and Next Generation Barrier Repair Therapy for the Management of Atopic Dermatitis. Skin Pharmacol Physiol. 2019; 32: 1-7.

13. Erdmann SM, Merk HF. Kontaktsensibilisierungen auf Externa [Contact sensitization to external agents]. Hautarzt. 2003 Apr;54(4):331-7. German. doi: 10.1007/s00105-003-0517-2. Epub 2003 Mar 11. PMID: 12669204.

14. Orton DI, Wilkinson JD. Cosmetic allergy: incidence, diagnosis, and management. Am J Clin Dermatol. 2004;5(5):327-37. doi: 10.2165/00128071-200405050-00006. PMID: 15554734.

15. Ogunbiyi A. Pseudofolliculitis barbae; current treatment options. Clin Cosmet Investig Dermatol. 2019 Apr 16;12:241-247. doi: 10.2147/CCID.S149250. PMID: 31354326; PMCID: PMC6585396.

16. Das A, Datta D, Kassir M, Wollina U, Galadari H, Lotti T, Jafferany M, Grabbe S, Goldust M. Acanthosis nigricans: A review. J Cosmet Dermatol. 2020 Aug;19(8):1857-1865. doi: 10.1111/jocd.13544. PMID: 32516476.

17. Scheinfeld N. Hidradenitis suppurativa: A practical review of possible medical treatments based on over 350 hidradenitis patients. Dermatol Online J. 2013 Apr 15;19(4):1. PMID: 24021361.

About The Author

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Board-Certified Dermatologist

BS-MD (University of Miami)

United States

Dr. Trent completed a 6 year combined BS-MD at the University of Miami with an undergraduate major in biology and a minor in chemistry. She completed her internship in Internal Medicine and her residency in Dermatology and Cutaneous Surgery at the University of Miami/Jackson Memorial Hospital. Dr. Trent is a world recognized dermatologist, who has published over 40 articles in peer-reviewed journals. She also co-authored a textbook on dermatologic diseases and therapy, which was published by McGraw-Hill Co, Inc. She has had the opportunity to present her clinical research several times at national medical meetings. Dr. Trent has been the recipient of several awards for research, teaching and clinical practice, including the prestigious Young Investigators award for research from the American Academy of Dermatology as well as the coveted Castle Connelly Top Doctor award.

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