A common question that is asked is "Does retin-A thin the skin?" The answer is: no, it does not thin the skin. The source of the confusion has to do with what it does. Retinoids such as retin-A, differin, and tazorac are derivatives of vitamin A and have multiple effects on the skin. They stimulate cell turnover in the very outer layer of the skin , removing the dead skin cells on the surface which give an uneven texture and a dull appearance and clog pores. For this reason they work well for anti-aging and acne. This is the very outer layer of the skin called the stratum corneum (which is part of the epidermis) and is approximately one hundredth of a millimeter in thickness. The other action of retinoids is deeper in the skin, where they stimulate the production of collagen which provides the structural stability to the skin. This increases the thickness of the deeper layer of the skin called the dermis (which is approximately a full millimeter in thickness), leading to improvements in fine lines, wrinkles, and laxity as well as reduction in pore sizes. Since it thins the very outer layer of skin but thickens the deeper layer of the skin which is one hundred times thicker than the very outer layer, the overall result is a thickening of the skin. Retinoids can cause irritation and starting on a low dose and using them on alternate nights reduces this irritation. They also increase the sensitivity to the sun, so broad spectrum sunscreen with SPF of at least 30 must be used every day. Retinoids do not work overnight and it is important to be patient and use them for a few months to see results. Be sure to take high quality before and after pictures to be able to notice the difference. Women who are pregnant or breast feeding should not use retinoids.
Sunday, June 17, 2012
A light- to medium-depth chemical peel is a simple procedure performed in the office that can give outstanding results. Carefully following these aftercare instructions will prevent side effects such as scarring or discoloration.
Avoid heat, alcohol consumption, and strenuous exercise for 24 hours. Heat refers to a hot environment outdoors or other hot environment such as a hot bath, sauna, or steam room. Heat also refers to hot or spicy food and drinks such as coffee or tea. Any of these things will draw blood to the skin and may lead to scarring or discoloration.
Beginning the second day after the treatment, apply a thin layer of Aquaphor®, Vaseline, or other ointment two to eight times per day. Mixing it with a small amount of water makes application easier. Continue this until the seventh day after the treatment. This will accelerate the healing process.
Flaking and peeling usually begins two to three days after the treatment and lasts up to seven days. Some people do not peel. Do not be alarmed if you do not peel. The goal is not to peel, the goal is to get results. People who do not get visible peeling still peel, but it is microscopic so it is not seen. Do not remove flaked skin by pulling, picking, or rubbing. This can cause discoloration and scarring. Small scissors may be used to cut off the excess skin.
Wash your face with a gentle cleanser daily. Do not use wash cloths, mechanical scrubs, glycolic acid, salicylic acid, retinoids, skin lighteners, wax, or strong astringents for seven days. Do not get electrolysis, collagen injections, Botox, depilatories and facial waxing for seven days.
Do not apply makeup for 24 hours after the procedure. For the subsequent six days of the week, makeup avoidance is recommended, but mineral makeup is acceptable.
Avoid exposure to the sun as much as possible for the next seven days, especially between 10 AM and 4 PM. Protective hats and sunglasses are recommended. Use a sunscreen every day, even if you avoid the sun. Recommended sunscreens have SPF of at least 30 and provide UVA and UVB protection.
Do not tan for at least one month after the procedure.
Posted by Alex Eshaghian, MD, PhD at 8:39 AM
Sunday, June 10, 2012
As we age, our skin changes. One of the most notable signs is dry skin. This occurs for several reasons. First the skin produces less oils which naturally moisturize the skin. At the same time, the barrier protection of the skin weakens with age, so more water is lost. Additionally, the slowing of the cell turnover rate and the accumulation of sun damage over years leads to dryness. To make matters worse, dry skin can be induced or exacerbated in arid climates. There are a number of things we can do to prevent dryness. Using plenty of moisturizer is the most obvious one. Moisturizers work best when applied on damp skin immediately after cleansing. In addition, drink plenty of water and use products such as hyaluronic acid to make sure the skin is hydrated. Avoid prolonged hot showers or baths, using excess soap, and wearing perfumes, all of which can irritate the skin and contribute to the dryness. Other measures include using sunscreens and antioxidants to prevent further damage from the sun. Placing a humidifier in your bedroom can provide the much-needed moisture to the skin. Finally, maintain a healthy lifestyle by eating healthy foods, exercising regularly, getting enough sleep every night, and avoiding harmful behaviors such as suntanning and smoking to keep the skin healthy.
Posted by Alex Eshaghian, MD, PhD at 5:06 PM
Sunday, June 3, 2012
As we age, our skin changes. In the deeper layer of the skin the production of proteins responsible for maintaining the structure of the skin slows down. At the same time it is broken down by the body. These proteins include collagen, elastin, and glycosmaminoglycans such as hyaluronic acid. Collagen and elastin give the skin its firmness and plumpness. Hyaluronic acid binds 1,000 times its weight in water, providing hydration to the skin. Over time, reduced levels of these proteins leads to fine lines, wrinkles, dehydration, and laxity giving a leathery appearance to the skin. A good skin care regimen is essential for maintaining healthy skin. Retinoids such as retin-A stimulate collagen synthesis. Vitamin C is an antioxidant which neutralizes harmful free radicals that are formed from sun damage, chemicals, pollutants, and anything in the diet. At the same time it is required for collagen production. Sunscreen is important to prevent further damage to the skin. Finally moisturizers should be used to prevent water loss from the skin and maintain hydration. Make sure you add these products to your regimen in order to both reverse these age-related changes in the skin and prevent further damage.
Posted by Alex Eshaghian, MD, PhD at 1:18 PM