With so many exfoliating treatments on the market, how should you go about choosing one? The answer depends on a variety of factors—particularly your skin type. Although the number of products is endless, most of them fall into one of three categories. Let’s start with a look at the pros and cons of the hands-on approach: Manual or Mechanical Exfoliation For routine exfoliation, I recommend a gentle daily cleanser with a mild exfoliant such as white willow bark. A natural alternative to salicylic acid—an ingredient in many acne medications—this powerful but safe botanical extract is also an anti-inflammatory that stimulates and purifies the skin while also calming irritation. You can use your fingers to massage your cleanser into the skin. If your complexion is very robust, you may want to use a washcloth or sponge to increase the exfoliating effect. But remember to be gentle—the last thing you want to do it over-abrade your skin. And remember to wash your washcloth or sponge with hot, soapy water after each use. Stay away from stiff complexion brushes or loofahs—which are not only too rough, but also tend to trap bacteria and product residue that can cause breakouts and infections. At the high-tech end of this approach, there are a number of vibrating complexion brushes. These vary in quality and can be as expensive as $200. The best ones can help keep a healthy complexion glowing, but individuals with acne, rosacea, or fragile skin with broken capillaries, should steer clear of this type of device. Your complexion should be handled with the utmost care. What about facial scrubs? First of all, check out the ingredients. The good, the bad, and the ugly sides of exfoliation ultimately reside in the various type of scrubbing grains used in these products. Many types of granules are so large and jagged that they can cause microscopic lacerations on the skin surface. Surprisingly, the grains used in some types of all-natural scrubs are the worst offenders. Ground apricot pits as well as crushed nutshells, for instance have been cited by the Environmental Working Group  as potential skin-health hazards. As a natural alternative, finely ground nutmeats such as almonds or walnuts combine gentleness and safety with the restorative benefits of antioxidants. To supplement these daily and weekly methods of hands-on exfoliation as you're preparing your skin for winter, you might want to try a course of professional microdermabrasion treatments. Performed by an experienced professional with state-of-the-art equipment, microdermabrasion is far safer and more effective than at-home methods. A good esthetician understands exfoliation is not an end in itself—the delicate layer of new skin that’s revealed needs to be soothed, moisturized, and replenished with nutrients. And don’t forget to protect your baby-fresh skin! A good sunscreen with at least SPF 15 will help keep your complexion rosy instead of red. Here's a great video from Dr. Schultz's Dermtv.com on how often you should exfoliate. Enjoy.