COMPLEXION, PART III: Treatments for Mature Skin


Note: The treatments discussed are meant to provide examples of skin care technologies and should not be considered as advertisement for any particular therapy.

Note also that some of the therapies discussed are used “off-label” and NOT approved by the federal Food and Drug Administration (FDA).

Chemical peels are chemical solutions that, when applied to damaged outer layers, leave smoother contours and an overall improved appearance. Chemical peels have many dermatological uses, including the treatment of wrinkles, brown age spots, and scars.

Glycolic Acid/Alpha Hydroxy Acid Peel
Glycolic acid is a member of the alpha hydroxy acid (AHA) family of carboxylic acids. Glycolic acid is ideal for improvement of wrinkles, sun-related damage, uneven pigmentation, and acne.

Once applied, glycolic acid chemically exfoliates the outer layer of skin (epidermis), revealing the underlying new skin and giving your skin an even, dewy texture. In addition, glycolic acid stimulates synthesis of new collagen and elastic fibers that strengthen the skin.

Glycolic acid and other alpha hydroxy acids (AHAs) are the mildest of the chemical peel formulas and produce light, superficial peels. These types of peels provide smoother, brighter-looking skin for people who desire gradual improvement without associated side effects and long recovery periods. Concentration can range from 20 percent to 70 percent. Optimal results are achieved after four to six sessions. Candidates for glycolic acid peels include individuals with superficial lines and fine wrinkles of the face, neck, upper chest, arms, etc.; uneven pigmentation; enlarged facial pores; superficial acne scars; lentigines—age (liver) spots.

Tretinoin Peels
Tretinoin (the same active ingredient used in Retin-A and Renova) is used to fight acne and fine lines. It is applied topically in a peel concentration of from 1 to 5 percent. Tretinoin slowly penetrates the skin to gently slough away sun damage, aging, and melasma.

Tretinoin peels can effectively improve many conditions, including dull, weathered skin, freckling, blotchy pigmentation, fine wrinkles, and shallow acne scars.

While this is a no-downtime procedure, you may experience peeling for several days after the treatment. Multiple cycles of increasing concentration yield the best results. Strict sun protection during treatment is an absolute must.

Acne Targeting Peel/Salicylic Acid Peel
Salicylic acid has been used in cosmetic dermatology for several decades. This type of agent is very safe, and patients generally tolerate the procedure well.

Salicylic acid is lipid-soluble; therefore, it is ideally suited for patients with oily skin. It is also a good peeling agent for comedonal acne, which is characterized by whiteheads and blackheads. The salicylic acid is able to penetrate the comedones better than other acids. The anti-inflammatory and anesthetic effects of the salicylate result are a decrease in the amount of redness and discomfort that generally is associated with chemical peels.

TCA (Trichloroacetic) Peels
Trichloroacetic (TCA) chemical peels have been used for over 30 years to create an even, controlled shedding of several top layers of damaged cells. The process exposes a new, fresh layer of skin with a more even color and a smoother texture. In addition, the peel stimulates cell turnover, new collagen and elastin synthesis, thereby tightening the skin and decreasing wrinkling.

TCA peels have the advantage of creating a fresh, natural-appearing complexion while preserving the normal skin color. For this reason, they are often referred to as “freshening peels.”

TCA peels can effectively improve many conditions, including dull complexion, blotchy pigmentation (including melasma), sun damage (including precancerous lesions), lines and wrinkles, and acne scars.

In some cases, pre-treatment with Retin-A or bleaching agents like hydroquinone may be recommended to prevent skin discoloration following the peel.

Jessner’s Peel
Jessner’s Solution—a deeper peeling solution of resorcinol, lactic, and salicylic acids—is commonly applied after a glycolic peel. The Jessner’s solution is layered on the skin to treat pigmentation (liver spots and melasma, mild to moderate photodamage, acne, acne scarring, and other skin irregularities. Aggressive peeling and occasional crusting form within two to four days of the peel. Redness and swelling may last a week or more. Results are visible with new, clearer skin within 7 to 10 days, but redness or other pigment changes may persist for several weeks.

Various chemical peels can be combined to tailor to your skin’s specific needs.

Next page: laser treatments and skin-tightening technologies

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