Retin-A and Glycolic Acid?

I wasn’t able to apply my 2nd dose of Retin-A last Saturday night because my skin was still red, irritated, and flaking from the Tuesday night application.  My skin is so sensitive that I really have to wait more than a week between applications when I first start using it after a long break, so don’t be discouraged if this happens to you.  You can always start with a retinol cream, which is available OTC.

I really have to listen to my skin.  If you have really sensitive skin, start slowly and you’ll love the results.  Go too fast, and you'll be miserable.  I can only tolerate Retina if I work up slowly; otherwise, I get rosacea, and that is tough to get calmed down.


Because I was starting to break out a bit from not using my glycolic acid chemical peel and it had been almost a week since the Retin-A, I decided to dilute my 50% glycolic acid to make a milder exfoliant to use between Retin-A applications.

In a small glass bowl, I added ¼ teaspoon of 50% glycolic acid to ¼ teaspoon of hyaluronic acid, and I mixed it well.  I applied it and kept it on for about seven minutes, then I rinsed with cool water and moisturized. 

I got a nice exfoliation without any irritation, and I’m ready for my next Retin-A application tomorrow night.

Retin-A Peeling

Retin-A Peeling

Just like most chemical peels, Retin-A (Tretinoin) causes skin flaking and peeling.  When I use glycolic acid, an alpha hydroxy acid, I don’t really flake or peel; however, when I use TCA chemical peel, the skin usually starts peeling or cracking on day three.  These pictures are from Retin-A today:

Retin-A

I applied my first application of Retin-A (in almost six months) on Tuesday night before bed, and this morning (Friday), I am having noticeable flaking and peeling. I'm also a bit red, only in patches.

Acne

The great news about RetinA is that this is one therapy that won’t cause breakouts while building collagen and increasing cell turnover.  Yea!  Can’t say that for TCA chemical peels, although glycolic acid is a wonderful acne treatment that also terminates acne.  Salicylic acid is also great for acne, although it doesn't do much for building collagen since the molecules are large and sit on top of the skin.  

Since I haven't used my glycolic acid in a week, my skin is starting to break out, so the Retin-A should help.  You can see it on the second picture of my chin.

Exfoliating

There really isn’t any downtime with Retin-A because the flaking and peeling can be exfoliated and moisturized so that it’s not very noticeable, but TCA chemical peels aren’t that forgiving.  There really is just no way to hide the cracking and peeling, at least for 1-2 days of it. 

I like to use my Braun toothbrush to gently exfoliate, but I usually do this only on the worst day because too aggressively exfoliating can damage the new skin.  Sometimes, I’ve still had flakes after exfoliating, so I make sure to apply a good layer of moisturizer and let it sit.  If it bothers me, I wipe some of it off after a few minutes, which removes the remaining flakes.

Sunscreen

Just like chemical peels, it’s impossible to wear a normal physical sunscreen during Retin-A therapy because the zinc and/or titanium get caught on the flaking skin and exaggerate it, even after exfoliating because the process lasts for 1-2 days, then it’s time to apply the Retin-A again.  So find a good micro-fine physical sunscreen, or use a chemical alternative, if your skin can tolerate it.  I tend to sting with every chemical sunscreen, and Retin-A only increases my sensitivity to it.  I usually keep my hat with me and avoid the sun as much as possible.

Makeup

As you guessed, makeup creates the same challenge as physical sunscreen when it comes to flaking and peeling skin.  I am able to wear concealer when using Retin-A, but I can’t use powder or foundation since they make the peeling and flaking more pronounced.

Frequency

I will try to apply the Retin-A again tomorrow night (Saturday) so that I start slowly, only twice a week, until my skin adjusts.  I hope to eventually work my way up to nightly, but that will take months (if ever) since I have very sensitive skin that tends to develop rosacea if I am too aggressive.

Retin-A (Tretinoin)

When you see the words chemical peel, you probably don’t think Retin-A (Tretinoin), but it is, in fact, a chemical peel.  Retin-A is a chemical derivative of vitamin A, and it works by increasing the cell turnover of the skin, which causes peeling, and by increasing collagen.  It’s also used to treat and prevent acne.  Sound like a chemical peel? 

I’ve been noticing that my glycolic acid (alpha hydroxy acid) has lost some of its beneficial effect lately, and I read a blog recently that mentioned this phenomenon, called accommodating.  I think a lot of women (and men) can relate to products losing their potency after a few months.  The theory behind this phenomenon is that the skin (or body) acclimates to the medication within 3-4 months and adjusts itself, so with my glycolic acid, the cell turnover has slowed down again.

To counter this effect, I’ve decided to use Retin-A for a couple of months, and then I’ll go back to the glycolic acid.  I still plan to do my TCA peels.  My next one is scheduled for 11/26.

I started Retin-A .01% last night, so I will photograph and post my progress and side effects.  Today there is no noticeable flaking or dryness, but I expect some flaking tomorrow, based on past usage.

Here are a few tricks and tips to avoid or minimize irritation. 

• Use Tretinoin only during the winter months and take a break during the summer months since your skin is more susceptible to sun damage during use.
• Start with a lower dose, and work your way up in strength, since the body will adjust after 3-4 months.
• When you first start using Retin-A, apply it only once or twice a week; if after a couple of weeks, you notice no irritation, you can move to every-other night, then nightly if it works well.  
• If you still have problems using it only once or twice a week, try applying a water-based moisturizer before or after the RetinA.  The side effects are usually the worst in the first 2-5 weeks of application. As your skin adjusts to the medicine, you can apply it more frequently. 
• Apply a pea-size of Retin-A at night on clean skin, about 30-60 minutes after cleansing. A small amount goes a long way.  If you notice irritation, you can wash it off after a couple of hours; this is called short-contact therapy.  My dermatologist suggested this, and I’ve done it in the past.
• In the morning, exfoliate your face with a mild facial scrub or washcloth. This will help remove the noticeable flaking.  I’ve used a sanitized motorized toothbrush for this, and it’s very effective, but be careful not to press while exfoliating.
• After cleansing, apply a water-based moisturizer to make the drying effect of the Tretinoin more tolerable. My favorite is shea butter.
• If noticeable flaking occurs, gently exfoliate and apply more moisturizer, or just apply moisturizer. I usually start to peel about 2 days after each application, and I continue to peel for several days.
• Use sunscreen during the day because Retin-A will make you more susceptible to sun damage, and that will defeat your purpose.
• You may notice some inflammation and redness in some areas. I've found that a green stick or redness corrector works well to neutralize this.
• If the irritation increases, stop using it for a couple of days.  I get a bit of rosacea if I use Retin-A continuously without taking a break.  I can use it once every two weeks without rosacea-type irritation, so don't get discouraged if you can't use it often.  You may also want to try washing it off after a couple of hours to see if that works for you.
• If you still have irritation, and you're using a generic brand, try Renova or Refissa; they're both formulated with emollients. 
• As a last resort, you may want to ditch the Retin-A and go with an OTC retinol (such as ROC), which is a precursor for retinal.  There are other brands, but this one is the least expensive that I've seen.  Since your body won't convert it all to retinal, it will be more tolerable, albeit less effective.

I'll post again tomorrow or Friday with updated photos.

Lifecell Anti-aging Cream

I've been searching for a good cream to use with my glycolic acid peels and TCA chemical peels.  I saw a YouTube ad for Lifecell, but I can't find any real people with posts about this anti-aging cream.

Every before and after picture I see shows the person with a frown in the before and a smile in the after photo.  Of course the person will look different.  It just doesn't seem right. 

Is it just me?  Am I missing something?  Have you seen anything legitimate on Lifecell?  Have you used it?

Botox Covered by Insurance?

I love the results I’m getting from glycolic and TCA chemical peels, but I’ll use all the help I can get, especially if it comes with only a $20 co-pay! 

Have you heard?  On October 16^th, the FDA approved Botox injections for migraine headaches and gave the drug maker Allergan permission to begin marketing the drug to patients with a documented history of migraine headaches.

Unlike chemical peels, there’s absolutely no downtime with botox, so you can see smoother skin in minutes.  Don’t rush to call your dermatologist just yet; the drug is approved for patients who have a documented history of 15 or more days per month of migraine headaches. It is estimated that about 3.2 million people in the U.S. have chronic migraines.  I have been suffering with 15-18 migraines per month since I was 35 years old; that's TWELVE years!  Yes, it’s documented -- I’ve been seeing my doctor since 1998.

If you have been suffering with migraines, call your insurance company first.  I called mine (BCBSIL), and they said that my doctor simply needs to write a referral that states Botox is medically necessary.  For this use, doctors are required to inject patients in the neck or head every 12 weeks to dull future headaches.  Honestly, that doesn’t sound like fun, but I’m still game.

Why did the FDA finally approve Botox for migraines?

The FDA approved this use based on two studies of more than 1,300 patients who received either a Botox injection or a placebo injection (can you imagine getting a shot for nothing). Patients who received Botox reported fewer headache days than patients given the placebo. On average, patients who received Botox reported two fewer headache days per month without headaches than patients who didn't receive the drug.

Botox is also approved to treat spasms in the neck, elbow, wrists, and fingers; eye muscle disorders; and excessive sweating.  Although it’s not approved for cerebral palsy, but it’s often used for that.

Botox is a purified form of botulinum, one of the most toxic substances in the world.  Oh, what we do for beauty!

Update on Saggy, Droopy Eyelids - Halloween Candy is a Drug

I had so many emails from anti-aging warriors about my “How to Eliminate Saggy, Droopy Eyelids” page and post that I had to update with a post-Halloween-candy picture.  I took the picture below this morning, after three days of pillaging my children’s Halloween baskets. 

Here’s a picture of my eyes today, after three days of sugar, something that causes lots of inflammation, a big no-no, according to Dr. Perricone.  And I have to agree that it definitely causes inflammation in me:

Here’s a picture of my eyes when I follow my plan: