Glycolic Acid a Miracle for Acne-prone Skin



Two days ago, I had a fairly common reaction I get when I go without using glycolic acid once a week: acne and red, splotchy skin. I was out of glycolic acid and had been for a couple of weeks before I ordered more, so it I went about three weeks without a peel, and here's how I looked:



Before Glycolic Acid Peel

I received my glycolic acid that evening and immediately applied it. The next day, it was much better, but the following day, it was as if I'd never been without it. See below for my AFTER picture.

Why Is Glycolic Acid Better than Other AHAs?
Glycolic acid has the smallest molecule in the AHA (alphahydroxy acid) family, so it is the most bio-available AHA, which means it is able to penetrate the pores easier than any of the others. I use this 40% gel; I've found lower percentage ineffective for me, but they work for others.

AHAs with greater bioavailability appear to have deeper dermal effects. Glycolic acid (GA) with topical application to photodamaged skin, has been shown to produce increased amounts of mucopolysaccharides and collagen, resulting in increased skin thickness without detectable inflammation, as monitored by skin biopsies.
<Ditre CM, Griffin TD, Murphy GF, Vasn Scott EJ: Improvement of photodamaged skin with alpha-hydroxy acid (AHA): A clinical, histological, and ultra-structural study. Dermatology 2000 Congress. Vienna, Austria. May 18–21, 1993:175.>

Once applied, glycolic acid reacts with the upper layer of the epidermis, weakening the binding properties of the lipids that hold the dead skin cells together. This allows the stratum corneum to be exfoliated, exposing live skin cells. 

Which One Should I Buy?

In addition to concentration, pH also plays an important role. Physician-strength peels can have a pH as low as 0.6 (strong enough to completely keratolyze the epidermis), while the acidity level for home peels can be as high as 2.5. My glycolic acid's pH is 1.5.

It really depends on skin type, sensitivity, and goals. The first time I used glycolic acid, I bought a 30% 1.5 pH product. Since my goals also include improving hyperpigmentation and fine wrinkles, I've moved up to 40%, although I've seen 70% on Amazon, but this is unbuffered and listed for body only; since I don't see a pH level listed, I'm not sure I'd use this on my face, but I think it would do miracles for my feet! 

I used this nightly glycolic acid cream before turning to weekly peels, and I loved it, but weekly was easier for me. I always read the reviews to make sure a product has made a similar difference for someone else.

What it Can Improve
Glycolic acid is used to improve the skin's appearance and texture. It may reduce wrinkles, acne scarring, hyperpigmentation and improve many other skin conditions, including actinic keratosis, hyperkeratosis, and seborrheic keratosis.

Although a single application of GA will produce beneficial results, multiple treatments every 2 to 4 weeks are required for optimal results.
<What Is Glycolic Acid All About? By Peter T. Pacik, M.D., F.A.C.S.>

My AFTER Photos:
Day 2 after Glycolic Acid


Day 2 after Glycolic Acid

Acne and Rosacea Caused by Mites?


Not science fiction at all, I found after doing a little research (see below). I am definitely a bug-phobe, so when a friend at the gym said, “Your acne may be caused by mites that live on your face,” I had a little shudder, and then she went on to tell me that the bugs crawl around on my face, coming out of my pores to mate at night while I sleep. OMG! I started itching right away. Of course my itching was psychosomatic, but many people on forums I read say that they have tingling or itching that precedes acne or rosacea flares.

What preempted that friend’s comment? Here’s a picture of my face, having gone three weeks without my weekly glycolic acid peel:

Other side and chin look the same


My work-out buddy was surprised to see my face in this condition, although I certainly was not and knew that I needed a peel, but I had let mine run out and was waiting for it to arrive in the mail. Okay, on to the research.

What the Research Shows

I did a Google Scholar search for mites and acne, and I learned that, in fact, a type of mite lives on our skin and is associated with both acne and rosacea. In the  scientific study "A Meta-analysis of the Association between Acne Vulgaris and Demodex Infestation," the scientists concluded that “…acne vulgaris is associated with demodex infestation.” The demodex mite burrows into and lives in our pores or hair follicles and comes out at night to mate.  < Journal of Zhejiang University SCIENCE B, March 2012, Volume 13, Issue 3, pp 192-202.>

This is what the Demodex Mite looks like:
Adult Demodex Mite


According to the article, "Association of Demodex Folliculorum in Acne/Rosacea and Folliculitis and the Efficacy of Combined Therapy (Metronidazole and Benzyl Benzoate)," “84% of patients [with acne/rosacea and/or folliculitis] had positive results for Demodex folliculorum.”  The aim of the study was the evaluation of the role of Demodex infestation in acne/rosacea, folliculitis, perioral dermatitis.
In this clinical study, "148 outpatients were enrolled and the direct microscopic examination of the lesions was done.... Conclusion: Demodex folliculorum infestation has to be considered in resistant acne/folliculitis..."

Demodex was first identified over 150 years ago, but only recently has it attracted wider interest as a contributor to chronic diseases such as acne rosacea or marginal blepharitis.

Eyelash Infestation

Yes, they also live in the eyelash hair follicles. On EyeWorld, I found an article and photos about eyelash infestation (called demodex blepharitis), which can accompany acne and rosacea--or occur alone. According to the Dr. Tseng, "The Demodex lay their eggs on oil, they eat oil, and they live on oil." Here's a picture of what they look like:
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They also live on our heads and may be associated with hair loss and dandruff.

Treatment
Dr. Tseng says that Tea Tree Oil is considered "the go-to treatment." He says, "It can kill mites and and also has other antimicrobial activity." Use extreme caution if with tea tree oil near the eyes--it can cause blindness. For patients with demodex blepharitis (mites on eyelashes), Dr. Tseng recommends Cliradex, which contains the active ingredient in Tea Tree Oil, 4-Terpineol, also called terpinen-4-ol. Reviews on this product say that they're strong and should be used just before bed when the eyes can be kept shut to avoid stinging and tearing.

For recurring acne that has been resistant to normal treatment, this may be something to investigate. Mine is under control with weekly glycolic acid peels, but in doing this research, I read many dermatological papers on the efficacy of using tea tree oil (TTO), for those of us who prefer self-treatment. Some say that the solution can be as low as 10-20% TTO (mixed with a carrier oil or moisturizer, but not water) and should be applied nightly just before going to bed, since that’s when the mites are most active.  Some people on forums say that a mask of 50% TTO once a week is also effective, but I would treat this high percentage as a chemical peel and test first on sensitive skin inside the elbow or wrist! I have used TTO at this percentage mixed with rosehip oil, but it is strong. I may try the 10-20% nightly, mixed with my moisturizer to see if I have any results, without using my glycolic acid peels.

I am always careful handling 100% Tea Tree Oil, especially around the eyes. I’ve read that we should never apply 100% TTO to the skin, but I have used it at the percentage as a spot treatment, but it causes redness, drying, and subsequent peeling—so treat as a strong chemical peel at this percentage.

Is Needle Rolling Effective?


According to JAMA Dermatology, "Needling devices that prick the skin with 1mm or 2mm needles on a roller improved acne scars in a recent trial."

I have this derma roller, and I use it because I believe that it also helps wrinkles--and I have a few small acne scars on chin.

I think this is a great treatment between chemical peels because there's practically no downtime: my skin is red for only a couple of hours. There is some micro swelling, which sort of plumps up the skin a bit, so this may also be good option when I want nice glow with fewer wrinkles for a special event ;)

Image Courtesy of dermarollers.com

Dermatologists, blinded to treatment procedures, reported a "significant improvement in scars treated with these devices," researchers said. "For each of the patients in the trial, half the face was randomly assigned to needling; the other half of the face received no treatment. Patients underwent three treatments, each spaced two weeks apart. Three and six months later, two dermatologists rated the scars of both the treated and untreated sides of the patients' faces.

Although patients can have this done at a doctor's office for less than the cost or downtime of lasers, these simple rollers can be purchased for less than $15! 


How I Use my Derma Roller

After cleansing my face, I roll mine about 5 times in one direction, change directions, and repeat until I can't tolerate it anymore.

I may see one or two tiny spots of blood, but not always; it is red afterward though, and it hurts but not terribly. I immediately apply actives, such as DIY vit C and EGF (epidermal growth factor), followed by rosehip seed oil to moisturize.

I immediately spray the roller with alcohol and store it back in the plastic case to keep it clean.

I do not use mine as aggressively as I've seen others in videos. I use it once or twice a month.


Compared to Other Treatments

The trial didn't include other treatments, so they didn't compare needling to other methods, but the study did show a benefit, researchers say.

Compared to the scars at the start of the study, those treated with needling had improved significantly at six months (p=0.03) and not quite significantly at three months, as assessed by the global scarring grading system developed by Dr. Greg Goodman at the Skin and Cancer Foundation of Victoria, in Victoria, Australia.

Comparing microneedlers to lasers is tricky now without much data, but at least one trial is underway to compare the two. In the meantime, Dr. Alam guesses that a fractional non-ablative laser is probably more effective.

"On the other hand, needling is easy and cheap," Dr. Alam says.

Costs

I don't have costs for professional needling, but mine cost around $13. I've replaced mine twice (every 6 months) because I've read that it becomes dull after about 15 uses and should be replaced.

"Needling is so easy to undergo, and potentially so inexpensive, that even a modest benefit may be sufficient to make this a worthwhile treatment for some patients with limited budgets," reported Dr. Murad Alam of Northwestern University in Chicago, who led the study.




SOURCE: http://bit.ly/1qeqbzq

TCA - Is Percentage % or pH More Important?


First, what's the difference between % and pH
Percentage simply tells us how much of the entire product is actually active vs. inert (inactive). A product that is 50% TCA has been watered down (diluted) with about half of the contents being inert and half being the active acid.

pH, on the other hand, is a method of measuring the acidity or alkalinity of substances. 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 visible peeling action

Example:
When I dilute my 50% TCA chemical peel with distilled water, I am lowering the percentage, not the pH since water is neutral. If I mix a separate container of my 50% TCA with ammonium hydroxide (ammonia), lye, calcium carbonate, or another highly alkaline base, it will increase the pH and drastically reduce its acidity or ability to cause visible peeling, although the percentage of TCA may be the same as the one I mixed with water. These two solutions will cause completely different reactions in my skin!

Should I buy a high or low Percentage?
I personally like to buy higher percentage products because I feel like it's a better bargain because I can dilute or buffer the product to meet different goals without having to buy several different products.

So, both percentage and pH are important, but it depends on my goals:

When buying a chemical peel, pH is very important, but so is percentage (%), but really, it depends on my goals. One rule I use above all: if a product does not state the pH level, and no one can tell me what it is, I wouldn’t buy it since I won’t know if it’s going to meet my needs.

Which pH do I buy?
If I want a medium or deep peel, which causes obvious 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 lighter peel to deal with hyperpigmentation, acne, spots, or moisture retention, which will not necessarily cause detectible peeling, I shop for a higher pH level product, something I can use more often, with a pH level above 1.5 or 2.

Higher pH level chemical peels are 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.

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.
How can I measure my Chemical Peel if pH is not Listed?
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 are the pH levels of some common substances:


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 acidity or ability to cause visible peeling, although the percentage of TCA may be the same as the one I mixed with water.
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?
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!