It's Time to Prep for Your Chemical Peel Series

If you're planning to start your chemical peel series this fall, it's time to start the prepping process. Your skin needs to be prepped to achieve the best results from your chemical peels.

I started my prep this week with my first Retin-A application in months. Although I've been using glycolic acid weekly throughout the summer, I do not use any other peeling agents--to prevent sun damage to newly peeled skin.

Most people should complete 4-6 weeks of a skin prep before doing chemical peels, and I'm no exception. I will apply Retin-A twice a week for 4-6 weeks before I do my first chemical peel.

I'm really ready for this: I feel like my skin needs a good peel. What are you using to prep your skin?

Low-carb Diet Improves Acne

August 8, 2011 — Low-carb eating plans may do more than promote weight loss. These diets may also improve acne.

Although the few studies conducted on this topic have yielded mixed results, “theoretically, people with acne may have hyperinsulinemia and foods that are low in the glycemic index (GI) may contribute to the hormonal control of acne,” says Alan R. Shalita, MD, the distinguished teaching professor and chairman of the department of dermatology at SUNY Downstate Medical Center in New York.

Hyperinsulinemia is characterized by excess levels of the hormone insulin in the blood, and foods with a low glycemic index that are favored by low-carb eating plans can help control blood sugar (glucose) levels.
“I would encourage patients with acne to moderate the amount of carbs that they eat and not to overdo dairy,” he says. There is some suggestion that dairy products may contribute to acne, he says.
Shalita spoke on the relationship between diet and acne at the American Academy of Dermatology Summer meeting in New York.

Much of the information circulating about how certain foods cause or cure break-outs are myths, he says.
For example, there is no evidence that chocolate causes acne, he says. “One study that compared Hershey chocolate bars with carob bars found no difference in acne risk,” Shalita says. “There is sugar and fat in both, so for people that do react to chocolate, it has more to do with the sugar than the cocoa.”

Acne Treatment Update
The good news on the acne front has to do with treatments; Shalita says. Over-the-counter (OTC) products are the best place to start for mild-to-moderate acne. Shalita suggests a salicylic acid cleanser followed by a benzoyl peroxide leave-on product to help dry the skin for people with mild-to-moderate acne.
“If you don’t respond, see a dermatologist,” he says.

For severe, scarring acne, the gold standard is still isotretinoin, a form of vitamin A. This drug was formerly known by the brand name Accutane. It can cause severe birth defects and can have other side effects, including depression, hallucinations, and suicidal behavior.

So now people are looking for alternative acne treatments, says Amy Forman Taub, MD, the medical director of Advanced Dermatology and an assistant clinical professor of dermatology at Northwestern University Medical School both in Chicago.

Certain laser treatments can help with acne and acne scars, and for teenagers and people with severe acne, blue light Levulan photodynamic therapy can be an option, she says.

Levulan is a liquid that is applied to the skin and absorbed by the oil glands; blue light treatment activates the medicine in the glands and shrinks them. This treatment also kills acne-causing bacteria, she says.
Other acne treatment options include certain oral contraceptives and oral or topical antibiotics.

“If you have mild acne and can get away with using OTC salicylic acid cleansers and benzoyl peroxide, these are still very viable treatments,” Taub says. But “if your acne is severe, don’t mess with this as a first step as you may be flirting with acne scars."

SOURCES:
Amy Forman Taub, MD, medical director, Advanced Dermatology; assistant clinical professor of dermatology, Northwestern University Medical School, Chicago.
American Academy of Dermatology’s Summer Academy Meeting 2011, New York, Aug. 3-7, 2011.

No Downtime Peels: Cornerstone of Skin Rejuvenation


If looking your age doesn't sound appealing to you, a chemical peel could be your secret weapon in erasing the tell-tale signs that go hand in hand with growing older. Whether you opt for a superficial chemical peel or a deep peel that penetrates several layers of the skin, peeling agents are giving people more options than ever to treat fine lines, sun damage, mild scarring, and even some forms of acne and pigmentation disorders safely and effectively.

At the American Academy of Dermatology's summer scientific session in New York, dermatologist Neil S. Sadick, M.D., a clinical professor of dermatology at the Weill Medical College of Cornell University in New York, N.Y., addressed the benefits of chemical peels in rejuvenating the skin.

"Superficial chemical peels, often referred to as lunchtime peels, remain the cornerstone of any skin rejuvenation program because they require virtually no downtime and produce good results for signs of aging," said Dr. Sadick. "Patients with fine lines or some mild areas of uneven skin pigmentation caused by sun damage are ideal candidates for this procedure."

Alpha hydroxyl acids used as chemical peeling agents, including beta and polyhydroxy acids, have been shown to help in the treatment of acne by reducing the amount of sebum (oil) trapped in the tiny hair follicles of the skin that produce acne.

If a patient has more noticeable wrinkles or dispersed areas of irregular pigmentation, dermatologists may recommend using an intermediate or medium depth peel to penetrate beyond the outermost layer of the skin. A chemical peeling agent with a higher concentration, such as trichloroacetic acid (TCA) or a combination of solutions, produces more noticeable results. In addition to softening wrinkles and improving the skin's overall texture, Dr. Sadick noted that these peels can tighten the skin, reduce pore size, and diminish mild acne scarring. Side effects are normally temporary and include post-peel hyper-pigmentation (or loss of skin pigment) and redness.

For more severe skin damage, deeper peeling agents are used and applied either openly to the skin or sealed under surgical bandages to further strengthen the effect. While deeper chemical peels produce the most dramatic results, the procedure can be painful due to the higher concentration of peeling agents used and require a longer healing period than other peels--usually two to three weeks. These types of chemical peels should be administered only by physicians since occasionally, patients experience serious side effects, such as persistent post-peel hyperpigmentation or even scarring or infection.