Chemical Peels and RetinoidsChemical peels and retinoid products are used for the purpose of skin exfoliation, and are not to be used for rosacea. The skin needs to be 'intact' and not to be further aggravated by any chemical or mechanical peels of the below listed means. The objective is to help your body get rid of dead skin cells and to make your body build new skin quicker. Various products available today such as Retin-A, Alpha Hydroxy Acid (AHA), Beta Hydroxy Acid (BHA), and glycolic acid are all designed to burn dead skin cells off. The active agent in all these products is fruit acids. The problem with using fruit acids such as AHA and BHA is that either you get acids that are very weak that do not remove many dead skin cells and therefore you see little results, or they increase the strength of the acid, and once the acid has burned through the dead cells, it continues on and begins to attack your living skin. If this happens you may experience one or more of the following; burning, redness, irritation and light sensitivity. Another problem with using acids is that the dead cells do not come off immediately; your skin gets white, flaky, and tight as the dead cells fall off over the course of a few days. Using acids is not only uncomfortable; but it can at times do more damage than good. Alpha hydroxy acids and beta hydroxy acids are simple organic fruit acids found in nature or synthesized in the laboratory. Beta Hydroxy acids are somewhat different from alpha hydroxy acids in their structure and mode of action. Salicylic acid, a common beta hydroxy acid, has been used for treating acne for decades. In fact, acne treatment remains the primary use for beta hydroxy acids. There are no studies showing that beta hydroxy acids are superior or even equal to alpha hydroxy acids in skin exfoliation or reducing fine wrinkles however for acne, beta hydroxy acids are clearly superior to alpha hydroxy acids. Over the last decade, alpha hydroxy acids (AHAs) have increasingly appeared as ingredients in cosmetics intended to reduce the signs of aging in the skin. More recently, beta hydroxy acids (BHAs), or a combination of AHAs and BHAs, have appeared as ingredients in these skin care products. While both AHAs and BHAs act as exfoliants, it has been claimed that BHAs are effective in reducing the appearance of fine lines and wrinkles, and improving overall skin texture, without the occasional irritation associated with the use of AHAs.
BETA HYDROXY ACIDS Beta Hydroxy Acid or BHA is a derivative of aspirin and is often used in skin care products to accelerate skin cell turnover and help clear pores. It can penetrate more deeply than Alpha Hydroxy Acid and is gentler. Beta Hydroxy Acid is salicylic acid. This occurs in nature in sweet birch and in wintergreen leaves. Its effect on the epidermis and upper dermis are similar to those of Retin-A, but with less irritation. It is soluble in oil and can exfoliate oily skin areas, even within oil-rich pores. Therefore, it has a beneficial effect on acne, pigmentary disturbances, and sun damaged skin. Because it does exfoliate, use of sun protection is needed. BHA ingredients may be listed on packaging inserts as:
Currently, the most commonly used BHA in cosmetics is salicylic acid. On rare occasions, citric acid is also listed as a BHA in cosmetic formulations; although, citric acid is more commonly considered to be an AHA. The long-term safety of salicylic acid in cosmetics is being evaluated in studies initiated by FDA and sponsored by the National Toxicology Program. These U.S. government-sponsored studies are examining the long-term effects of both glycolic acid (an AHA) and salicylic acid on the skin's response to ultraviolet (UV) light. These studies have determined that applying glycolic acid to the skin can make people more susceptible to the damaging effects of the sun, including sunburn. Until these safety assessments are completed, FDA advises that similar precautions be taken for the use of cosmetics containing AHAs and BHAs. These precautions are: Test any product that contains a BHA on a small area of skin before applying it to a large area. If you use cosmetics with BHAs and experience skin irritation or prolonged stinging, stop using the product and consult your physician. Follow the use instructions on the label. Do not exceed the recommended applications. Avoid using BHA-containing products on infants and children. Use sun protection if you use a BHA product.
ALPHA HYDROXY ACIDS Alpha-Hydroxy Acids or AHA is a compound found naturally in many common fruits and other foods. The principal AHA is glycolic acid which is found in sugar cane and sugar beets. Other AHAs include lactic acid from dairy products and malic acid from fruit. Glycolic acid is the most skin-active AHA; and its primary action is to accelerate shedding of abnormal cells in the topmost layers of the skin by decreasing their cohesiveness. Continued use of glycolic-acid-based products may result in a normalized, more compact top layer of the epidermis. This makes the skin smoother. Additionally, it helps to remove comedones (blackheads); and, like retinol, it helps to restore the barrier function of the skin, thereby helping naturally to increase its own moisture content. It also leads to increased collagen production in the upper dermis, resulting in reduction of fine lines. Glycolic acid also has an anti-inflammatory effect and is able to enhance the effects of other topical agents, such as hydroquinone and salicylic acid. It is well-tolerated by many people, but it can cause irritation and stinging in some. It can make the skin more sensitive to the effects of the sun’s UV rays; therefore use of effective sunscreen is essential. The main benefits of alpha hydroxy acids come from its ability to exfoliate skin. Removal of the outermost layer of the skin stimulates the cells in lower layers to grow and divide, causing the skin to thicken and thus diminishing visible signs of aging. The more you exfoliate, the more cell divisions you have occurring in the lower skin layers. There is one problem though. Normal human cells cannot divide indefinitely. Fibroblasts (a key type of cells in the skin) will divide about fifty times and then enter a so-called stage of senescence. This is a state in which cell division becomes sluggish, inefficient and unresponsive to various signals from the body and unable to divide. This is similar to how a plant will slow its leaf and bloom production at the end of its growth cycle. Skin with many senescent cells is usually fragile, blotchy and easily wrinkled. This limit of about fifty cell divisions is called the Hayflick limit (after its discoverer, Dr. Leonard Hayflick). Exfoliation remains a valuable cosmetic tool but if you overuse it, your skin may "hit the Hayflick limit" earlier than it should. In recent years, researchers have discovered the molecular mechanism of the Hayflick limit. (It has to do with the areas at the tips of chromosomes called telomeres). Medical technologies to eliminate the Hayflick limit may appear at a point in the future, although these advances in technology are likely to work only for those cells whose Hayflick limit has not yet been reached. The most important precaution to take when using alpha hydroxy acids is to know the percent and pH level of the product. The ideal pH is 3.0-3.5, any lower and the product may be too acidic; any higher and the product's exfoliating benefits may be nullified. Even at lower levels, though, some alpha hydroxy acids can be irritating, depending on how sensitive your skin is. Mandelic acid is the recommended AHA for those with sensitive skin since it is the most non-irritating. Also, darker skin types should avoid most alpha hydroxy acids due to the risk of hyperpigmentation. Hyperpigmentation will occur in darker skin if it becomes irritated or inflamed. Those with a skin type which tans easily or rarely burns through skin types which always tan or never burn, should be especially careful and avoid possibly irritating products. Because alpha hydroxy acids peel away the tough outer layers of the skin, the newer and younger skin is more susceptible to the suns UV rays. CHEMICAL PEELS Having acid applied to your face probably doesn’t sound like something you’d want done, but it is the foundation of a very popular cosmetic procedure known as the chemical peel. Chemical peels can give your skin a healthy, “just refreshed” look, or can be aggressive, taking years off of your appearance. Just like other cosmetic procedures, there is a wide range of varying chemicals used and techniques that can be overwhelming if you have to decide which is best for you. Fortunately, this is one area where the physician will often guide the patient to the chemical peel most appropriate for their condition as well as the patient’s skin type. Listed below are some of the realistic vs. unrealistic goals of chemical peels. This may be helpful if you are trying to decide if this procedure is right for you. Realistic Goals of Chemical Peels:
Unrealistic Goals of Chemical Peels:
There are a variety of different chemicals used for the purpose of rejuvenating the skin in what are called “chemical peels”. If the skin condition is predominantly superficial, then a milder, less caustic ingredient is selected. If deeply placed conditions exist, then far stronger products with matching levels of potential complications may be necessary. Chemical peeling agents that perform mild or moderate peels typically provide a safer peel that has less associated long-term side effects. These peels work on the epidermis and possibly the most superficial portion of the dermis (known as the papillary dermis). Deeper peels go midway into the dermal layer (into the reticular dermis), almost invariably leaving a permanently lighter skin tone. Instead of being able to tan as in the past, this lighter skin often freckles instead. These deeper peels should not be undertaken lightly, and you need to make sure in advance that the peel technique will be feathered into the scalp line and performed down the neck, possibly even the décolletage, or you may find that you have a highly noticeable line marking the difference in your original skin tone and the new one that is on the face. The glycolic acid peels (ranging from 70%-99% glycolic acid compound) and the beta-hydroxy acid (salicylic acid) peels (ranging from 20%-30% salicylic acid in a microsponge delivery system) are among the most effective chemical peels. Glycolic acid peels work by diminishing the cohesion of the skin cells (corneocytes) at the innermost levels of the surface layer of the skin (stratum corneum), by stimulating this layer of skin in its renewal process, increasing skin thickness, and promoting the formation of new epidermis and new dermal collagen. This process will result in skin shrinkage, reduction of wrinkling and "crepe-paper-like" skin, softening of "crow’s feet," and often helping to lighten hyperpigmentation. The salicylic acid peels or Beta-Lift peels are effective in lifting the topmost layer of skin by dissolving the "glue" (desmosomes) which binds it to the underlying epidermis, triggering a "burst" of cell division which accelerates skin cell production and shedding. Its developer, Douglas Kligman, M.D., Ph.D.(who is the son of Albert Kligman, M.D., Ph.D., the founder of Retin-A), developed it for the cosmetic treatment of sun-damaged skin, hyperpigmentation (including melasma, "liver" or "age" spots, and freckles), superficial lines, and "weathered" or rough skin. The salicylic acid peels are often more intense than the glycolic acid peels. If you are currently taking or have taken Accutane within the past six months, you are not a candidate for chemical peels. Patients with healing wounds from recent surgery, patients with active herpes simplex (fever blisters or cold sores) on their face, patients who have had radiation therapy to their face (or to the area which they wish to have peeled), or patients who have had cryotherapy in the past month should not have a chemical peel. A tendency toward hypertrophic or keloidal scarring may also make you not a good candidate for a peel. It is essential that you use very effective photoprotection after a peel; thus, if you are unwilling or unable to do so, you should not consider having a chemical peel. We continually update this site to keep you informed of the latest scientific findings about rosacea. Click below to access another page within the INTERNATIONAL ROSACEA FOUNDATION site, or a related website. [Symptoms of Rosacea] [Ocular Rosacea] [Acne Factor] [Dermatitis Factor] [Lifestyle Recommendations] [Oral & Topical Antibiotics] [Non-Prescription Treatments] [Prescription Treatments] [Topical Steroids] [Chemical Peels & Retinoids] [Laser Treatments] [Glossary] [Summary] [Citations] [International Rosacea Foundation Home] [Clinical Trials Resource Center] |