Chemical Peels: How Often?

How often I do a chemical peel depends on my purpose:

Reverse damage: This calls for a more rigorous solution of .05-1.5 pH level working up from 12.5% to 25% TCA peel solution during the winter months, with daily sunscreen use. This low pH level will cause peeling of the skin, which will kick start my body's healing mechanism to produce more collagen. Frequency depends on my skin condition; I try to fit in 3-5 peels during the winter, but we have long winters! If I do only 3 peels, I try to squeeze in a spot treatment as well.

Maintain results: I opt for a higher pH level of 1.6-2.4 for mild exfoliation (the lower the pH, the more exfoliation), with chemical peel percentages of 20-35% glycolic or lactic acid chemical peel solution (depending upon skin type: glycolic for oily, lactic for dry, or glyco-lac for combination). Frequency depends on percentage, to 35% glycolic acid or a combination Glyco-Lac peel of this strength,  I will use only 1-2 times per month, with daily sunscreen use. I like to use this type of peel during the spring and fall.

Prevent and/or anti-aging: I use a higher pH level product (to reduce irritation), with about 5-15% active solution, which could be  10% glycolic acid, lactic acid, or salicylic acid. I may be able to use it 2-3 times per week (depending upon skin type: glycolic for oily, lactic for dry, and salicylic for acne-prone) or even daily if my skin isn't too sensitive and the pH level isn't too low. I also like to add in a vitamin C solution, but I'll post separately about vitamin C, since it's fairly complicated and can really cause damage if not used properly.

Somewhere between: If I am unable to have any downtime but still want a fairly aggressive product that stimulates collagen, I can also opt for a tretinoin or tri-retinol product. Tretinoin (Retin-A) requires a prescription and some forms are associated with redness, flaking, and other irritation, but clinical studies show that tri-retinol products are just as effective but without the irritation. These are usually labeled as retinol-complex or tri-retinol complex serums or creams. Remember to use retinol products at night; and these take time, so I consider them as products that achieve a purpose somewhere between the three above.


Some of these schedules can be mixed; for example, I reverse damage during the winter, maintain during spring and fall, and prevent during the summer, depending upon my sun exposure.

(More on pH level and why it’s important)

Why Didn't my Chemical Peel Frost?

Ever wonder why that 25% TCA didn't frost or result in peeling of the skin? Its pH level may have been too high, although the percentage was listed as 25%.  pH levels and percentages may be confusing, but they are quite different and have important distinctions, depending upon desired outcome.

Shopping for Chemical Peels

I have to decide what the purpose is for my peel: if I want a medium or deep peel, which causes peeling of the skin and induces collagen production more quickly, I shop for chemical peel agents with a pH level between .05 - 1.0. If I want a superficial peel to deal with acne or moisture, which will not necessarily cause necrosis (death of most or all cells due to damage), I usually shop for a higher pH level product, something I can use more often.

But there's an important caveat: even higher pH level chemical peels can be effective at inducing collagen synthesis--it just takes longer. If my skin is sensitive, I may also want a higher pH product, which is effective, but it may not irritate my skin as much or cause apparent tissue damage. Here's a quote from a clinical study that compared the efficacy of acids with different pH levels: "When using a 70% glycolic acid solution, the lower pH products (below pH 2) create more necrosis than the partially neutralized products with a pH above 2. At this time there is no evidence that creating necrosis leads to a more favorable result of the peel. Therefore, the use of partially neutralized glycolic acid solutions seems prudent, since they have a better safety profile than low pH solutions, which contain only free glycolic acid."

Remember, peeling the outer layers of skin is not the real purpose of a medium or deep peel, although it does kick start the body's healing process faster. I will admit that there's some satisfaction in peeling; the real purpose is to induce collagen production. So, if I bought a 25% TCA chemical peel that never frosted, it may have still been beneficial! Now, more about the pH scale...

The pH scale measures the acid or alkaline level of chemical peels (and any other substance that is measurable), and it ranges from 0 to 14. As a reference, here’s the pH level of some commonly known items:



pH Levels

Technically speaking, pH is a logarithmic measure of hydrogen ion concentration, but that doesn't really matter to me. pH levels are important to me because I use chemical peel acids, and when the skin's proteins react with an acid of low pH, the acidic environment destroys the existing tissues, and the body's repair system works to replace the destroyed tissue with new structures. The lower the pH, the stronger the chemical peel. Don't confuse pH with percentage; this is completely different. pH levels in products purchased can be altered--up or down; this is called buffering, but when the percentage is changed, we easily understand what that means: how much of the entire product is actually active vs. inert.

Testing pH Levels

To test my solutions, I use pH strips that measure 0.0 - 14.0 because they are more accurate (show pH level in increments of .02, which is good for testing products) than the pH strips that measure the body's pH level, which usually show pH levels between 4.0 - 8.0.


Buffering

Anytime the natural pH level of an ingredient or product is altered, it’s called buffering. Buffering can either increase or decrease a pH level. Buffered and non-buffered products can carry the same percentage of an active ingredient, but the pH level is not in its original range.

When I dilute my 50% TCA with distilled water, I am lowering the percentage, not the pH since water is neutral. If I mix my 50% TCA with ammonium hydroxide (ammonia), lye, calcium carbonate, or another highly alkaline base, it will increase the pH and drastically reduce its strength, although the percentage of TCA may be the same as the one I mixed with water.

Imagine two different products with the same percentage of TCA (let's say 25%), but with different pH levels: one has a pH level of 1.3 and the other has a pH level of 0.5. Which is going to create a frost or create a frost faster?

Let's take a different approach at understanding pH; for example, this 30% glycolic acid has a pH level of 2.1; it has been chemically altered to give it a higher pH level so that the inexperienced at-home user has a safer peel; interestingly, their 50% glycolic acid also has a pH of 2.1, which means that the percentage of acid to other ingredients is higher than in the 30% product—but not the pH. What do you think the outcome of using the first product would be compared to the second?

Here's a final example: their 70% glycolic acid peel has a pH of 0.6 – its pH has been chemically altered to be lower. Why do you think that is? The difference on the scale may not seem like much, but it makes a big difference.

A leave-on product, such as this 15% Glycolic and Hyaluronic acid serum has a pH level of 3.4, which  allows me to keep this on my skin without feeling that constant stinging, while still benefiting from the acid, although it will take more applications over time to achieve the same results, but there's no down time!

Free Acid Values and Compounds

Free acid values and compounds are an important concept; this is an area where a product's concentrations may be misleading. A compound is a mixture of ingredients that contain not only the acid(s) but also water, alcohols, preservatives, etc., which all make up a portion of the compound, so a 30% glycolic compound is not really 30% glycolic acid. I can only guess what the actual amount of acid is in that compound, but legally, a company can state that this compounded product is 30%, so I always ask to make sure.


Chemical Peels and Air Pollution

Anyone who's done a chemical peel will admit that the peeling is a bit unsettling, from the way it feels to the way it looks, but do we ever consider those flakes of skin after they leave our bodies?

Flakes of skin that people normally shed (about 500 million cells every day when we're not doing a chemical peel) are not really a nuisance: they can actually be beneficial. Yep, it seems a bit gross, but it's true.

A new study, published in the American Chemical Society's journal, Environmental Science & Technology, concludes that oil in skin cells makes a small contribution to reducing indoor air pollution.  So, peel on.

Weschler and colleagues explained that humans shed their entire outer layer of skin every 2-4 weeks (and for those of us doing chemical peels, well...it's more often). Those flakes contain skin oils, including cholesterol and "squalene," and are a major constituent of the dust that accumulates on tables and other surfaces in homes and offices.

If you really want to feel disgusted the next time you fly, consider this: past research suggested that squalene from passengers' skin had a role in reducing levels of ozone--a pollutant that can irritate the eyes, nose and throat and worsen asthma symptoms--from the air in airplane cabins.

"It is only within the last five years that we've grown to appreciate the central role that squalene (from human skin oil) plays in oxidation chemistry within indoor environments," the report notes. "More than half of the ozone removal measured in a simulated aircraft cabin was found to be a consequence of ozone reacting with exposed, skin, hair, and clothing of passengers."

In the new study, the scientists set out to make the first extensive determinations of cholesterol and squalene in dust in homes and daycare centers and to figure out how these substances affect indoor air pollution. The scientists analyzed dust samples collected from 500 bedrooms of children aged 3-5 and the 151 daycare centers the children attended in the city of Odense, Denmark and its surroundings as part of the Danish Indoor Environment and Children's Health Study.

Among their findings: "Squalene in settled dust ... contributes, in a small way, to the indoor removal of ozone," reducing indoor ozone levels roughly 2 to 15 percent.

So the next time you're dreading all those flakes after your chemical peel, know that you'll breathe easier because of it.


Source:
American Chemical Society

Transform Favorite Moisturizer into Sunscreen

For many of us with sensitive or acne-prone skin, finding the right moisturizer is hard enough, but finding a sunscreen that doesn't irritate, clog pores, or sting can be next to impossible.

I've been experimenting with making my own sunscreen, and I've found that my favorite moisturizer is an excellent base for a zinc oxide sunscreen or sunblock. Although I do love Keys Solar Rx, it still leaves much to be desired since it can feel a bit too greasy during the summer.

Making my own sunscreen has been much easier than I thought! I don't make it in batches, so I really don't need any special equipment or containers. Here's what I do:

Favorite moisturizer now a sunscreen!

1. Squirt out the moisturizer on my fingers; in this case it's CeraVe PM lotion,
2. Dab one of my fingers into my zinc oxide powder,
3. Rub my fingers together to mix it, and apply.

Or, you can make your own lotion with only THREE ingredients. Here's the recipe and the steps.

To add a tint, see this post.

My favorite moisturizer is now my favorite sunscreen too! I haven't tested the SPF yet, but I know it's higher than wearing nothing.

There are several features about this sunscreen that I love:
  • It's physical-based sunscreen, so it never stings, even after a peel;
  • Zinc oxide has been shown to accelerate healing and it calms irritated skin, so it's a good additive;
  • already know the base moisturizer doesn't break me out;
  • don't have to talk myself into wearing sunscreen now;
  • I'm skipping the expense of buying an additional product that may or may not work with my sensitive skin;
  • I can adjust it by adding more or less zinc oxide or moisturizer;
  • I know what's in it.
Using zinc oxide powder can be potentially harmful if inhaled, so I am very careful not to breathe in the powder or use it in an area that has air movement that would disrupt the powder. I also do not pour it; I gently spoon the powder from the bag. I’ve also read several studies on the safety of micronized particles, so I feel very comfortable using them.

Clinical Study: Peeling and Needling Acne Scars

A clinical study reported last month (March 2012) compared two acne scar treatments: deep peeling using phenol and PCI (Percutaneous Collagen Induction, also known as micro needling or rolling) combined with 20% trichloroacetic acid (TCA).

One group (let's call them Group A) of subjects had one (1) phenol peel; the other group (Group B) had four (4) sessions of PCI (micro needling) combined with a 20% TCA peel. After the study, the patients rated their own scar improvement with a percentage.

Group A with the single phenol peel believed that their scars improved by just over 75% whereas Group B with the four TCA peels combined with needling believed their scars improved by just under 70%.

Although it seems clear that both of these acne scar treatments were highly effective to the participants, it appears to me that one phenol peel would be much easier than four sessions of rolling combined with 20% TCA peels. Sigh

I’ve never seen phenol acid available for purchase to non-licensed individuals, and that’s probably for a good reason. Fortunately, similar results (as found in the study) can be achieved with rolling and 20% TCA peels.

In addition, microneedle devices used for needling may also help deliver more of the active ingredients in serums, according to this clinical study. Needling is nothing new; people have been doing this for years now, but it's nice to see studies that corroborate what we read on product advertisements.

Boost Healing and Protection after Peels

I spend countless days prepping, peeling, and healing my skin, so it stands to reason that protecting that newly exposed skin is very important to me. Wearing my 30 SPF sunscreen just isn't enough during the summer. I've found a way to increase antioxidants, antibacterial action, and wound healing just by adding two ingredients: zinc and turmeric.

I love Keys Solar RX sunscreen, but during the summer, I need more than 30 SPF. I’ve found a way to boost the SPF in my sunscreen by adding zinc oxide powder. Uncoated zinc oxide powder is a natural healing element (think diaper rash ointment), and of course it reflects harmful UV rays.

There are two ways that I’ve boosted the SPF and healing properties of my sunscreen:
1.    Mixing the zinc powder with my zinc-based sunscreen, which makes it a bit thicker
2.    Using the zinc as a powder and brushing it on after I apply my sunscreen--this doubles as my finishing powder!!!

I really like #2 better, not only because I’m boosting the SPF and healing properties, but also because I’m using a product that doesn’t include many chemicals and preservatives (like the finishing powder I used to buy). The problem with #2 is that it tends to look just a bit white, especially during the summer, even though I have fair skin.

I’ve found a remedy that actually adds even more healing and protective power to my skin, before and after chemical peels.  Using my mortar and pestle, I grind just a pinch of Turmeric (also called curcumin; species is C. Longa or Curcuma Longa) with the zinc, and this gives it a light beige color (can be adjusted to vary the color). 

My skin's undertone is slightly yellow, so turmeric works really well to achieve a natural color for me, but if I had an olive or darker undertone, 100% cocoa powder would be perfect as a replacement for turmeric. Cocoa powder (100%, as in the product linked) provides an incredible array of benefits for the skin! I also use this cocoa powder in my smoothies!


Turmeric benefits the skin too, so just like my uncoated zinc oxide, it acts as an antibacterial agent. In addition, it has been shown to have UV photoprotective properties (which is boosting the SPF even more) and the ability to help wounds heal better. Turmeric is also a very strong antioxidant, so it will neutralize free radicals on the skin, which will protect against further damage. Turmeric has numerous benefits; I could devote an entire post to it, so any time I can incorporate it with my routine, I will.

Protecting skin that has been treated with chemical peels is very important because the new skin is even more vulnerable to UV damage, which causes brown spots, age spots, hyperpigmentation, even melanoma. UV rays also damage the underlying structure of skin, which causes wrinkles! I don't mean to be cliché, but an ounce of prevention truly is worth a pound of cure.

Using zinc oxide powder can be potentially harmful if inhaled, so I am very careful not to breathe in the powder or use it in an area that has air movement that would disrupt the powder. I also do not pour it; I gently spoon the powder from the bag. I’ve also read several studies on the safety of micronized particles, so I feel very comfortable using them.

Being a DIY'r, I love making and using products for myself because I know exactly what's in them--and it's so much less expensive than buying products that often don't live up to my expectations. My next DIY adventure will be to make sunscreen or sunblock using zinc oxide powder, my favorite oils, and beeswax. I will also test it this summer, along side my Solar Rx to see how it performs.

Clinical Study Finds Herb to Treat Acne

Topical tinctures including the herb thyme could be more effective for acne than prescription creams, according to research presented at the Society for General Microbiology's Spring Conference in Dublin (March 2012).


Researchers from Leeds Metropolitan University tested the effect of several herbs, including thyme, marigold, and myrrh on the bacterium that causes acne.


“The group found that while all the preparations were able to kill the bacterium after five minutes exposure, thyme was the most effective of the three. What's more, they discovered that thyme tincture had a greater antibacterial effect than standard concentrations of benzoyl peroxide, the active ingredient in most anti-acne creams or washes.”

Wondering if you can make something like this at home? I found an organic thyme tincture for only $9.28, but if you're a DIYer, the plant material is steeped in alcohol (for days to weeks) to prepare a tincture. This procedure pulls out the active compounds from the plant. In the study, the effects of the tinctures were measured against an alcohol control, proving their antibacterial action was not simply due to the sterilizing effect of the alcohol in which they were prepared.

Most of us would agree that an herbal treatment for acne would be a welcome change, particularly for those of us who suffer from acne and are also plagued with skin sensitivity. Herbal preparations are less harsh on the skin due to their anti-inflammatory properties.

Organic Thyme Tincture 3.52oz $9.28

Reference
Society for General Microbiology. "Acne Medications May Soon Include Thyme." Medical News Today. MediLexicon, Intl., 28 Mar. 2012.

TCA Chest Peel

My 30% TCA chest peel is nearly complete. I decided to peel this area without prepping it; the results confirmed what I’ve read numerous times: skin that is not prepped with a peeling agent for about a month prior to a TCA peel may produce uneven results.

On March 25, I started with an alcohol wipe to remove all oils from the area. Then I applied the TCA peel solution evenly, using strokes that I counted. I applied three layers. Although I applied it evenly, some areas frosted while others did not.

I neutralized the areas that frosted early, but those areas still seemed to have a deeper peel compared to the remaining areas, which seemed to be more of a medium to light peel.


The deeply affected areas required antimicrobial ointment for several days because they became red and irritated—much more than a normal peel produces. It kind of scared me.

After applying the ointment for several days, the redness subsided as well as the pain. Those areas became a deep brown color. You can see the areas toward the top and then the bottom center:

Following that first week, after the inflammation was reduced, I was able to apply my CU3 Intensive Tissue Repair Creme nightly.

It’s been two weeks since I applied this peel, and it's peeling all over, the deeper and lighter areas.