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What is a Comedone and what causes them?

Hereditary oiliness, as well as, retentention hyperkeratosis are contributing factors to to the formation of open comedones. Retention hyperkeratosis is the technical term for the hereditary tendency of oily , acne prone skin to not shed cells. The cells build up inside the follicles, contributing to the congestion of the follicle, resulting in clogged pores and black heads. Open comedones are also known as blackheads that occur in oily skin areas. Blackheads are caused by a build up of dead cells and a mixture of sebum (oil) secreted by the sebaceous glands. The darkening of the tip of the blackhead is caused by oxidation. The follicle is dilated to the point where the sebum oxidizes, forming a dark “head” on the surface from exposure to the air.

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Are the tiny clogged pores I get on my nose the same as open comedones?

No, these tiny clogged follicles are called sebaceous filaments. Sebaceous filaments are similar to open comedones, but they are much smaller and contain mostly solidified, hardened sebum and little cell build up. The blackhead of the lesion is also caused by oxidation of the sebum exposed to the atmosphere at the top of the follicle.

How can comedones and sebaceous filaments be treated?

Chemical exfoliation through fruit enzymes, salacylic acid, glycolic acid or lactid acid effectively breakdown the natural sebum that fills the pores with sebaceous filament. Microdermabrasion is another great exfoliating method of treating sebaceous filaments as well. Chemical peels, professional extraction, deep cleansing, and hydra facials are also good methods for treating comedones.

Skin Life Cycle

Is the outside of the skin really dead?

Technically, yes, at least for the outermost layer of the skin. The outermost layer of the skin is the epidermis and is the first line of defense against dehydration, bacterial invasion, and irritant penetration. This is the layer that is addressed when we are using a skincare program. The cells in the epidermis go through many biochemical changes, and there many functions of this layer even though most of it is technically dead. There are three types of active cells in the epidermis which include basal cells, melanocytes, and Langerhans cells. Melanocytes are pigment producing cells that are found in both the lower epidermis and the dermis. Melanocytes give skin its color and are responsible for tanning. The Langerhans cells are immune function cells that patrol the epidermis to detect foreign invaders and pathogens. The basal cells are the cells that make new skin cells in the epidermis.

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How does the skin renew itself?

The cells in the outer layer of the skin, the epidermis, begin as live cells in the lowest layer of the epidermis known as the basal layer. The basal cells divide in a biological process called mitotic division forming new cells. The cells are pushed upward. As they approach the surface the cells go through a process called keratinization. During this process the cell are filled with a protein called keratin. Keratin’s main structure in the skin is to make the skin surface more resilient and resistant to invasion of foreign substances such as bacteria. It also helps to keep the skin from becoming dry and dehydrated.

Is any part of the skin alive?

Yes! We have just discussed the epidermis, containing mostly dead and dying cells. However, we have also learned how active this layer is biologically. The skin is actually the largest organ in the body. The dermis is the layer under the epidermis and is very much alive. The live layer contains blood and blood vessels and the epidermis does not. The epidermis sheds and renews itself constantly. The dermis does not shed or have a renewal cycle, but does contain blood vessels that nourish many active and different living cells in this area.



What are the different types of Peels?

There three basic levels of peels. There are Deep Peels, Medium Depth Peels, and Superficial Peels. Deep Peels are sometimes called surgical peels and should only be performed by a dermatologist or a plastic surgeon. This type of peel requires sedation and anesthesia and also requires pain medication during recovery. This peel treats severely sun damaged skin and very deep and widespread wrinkling. It takes up to 6-8 weeks to heal and can takes several additional months before the redness from the peel subsides. Medium depth peels are performed using trichloroacetic acid (TCA). This peel should also be performed by a dermatologist or plastic surgeon as it removes the entire epidermis and some dermal tissue. Superficial peels are light peels that only remove corneum cells from the epidermis. Mild acids or enzymes are utilized to remove or dissolve the surface keratinocytes. Superficial peels do not cause blistering or bleeding.

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How can peels help aging skin?

Superficial peels can make the skin look a lot smoother, helping to improve rough textures and reduces the depth of surface lines and wrinkles. It is especially effective for fine lines around the eyes. It also helps to fade splotchiness and improve hyper-pigmentation. The most common type of superficial peel administered is the alpha hydroxy acid peel. These AHA treatments used by estheticians are about three times the concentration of home care AHA’s. This can be performed safely 2-3 times a year. Salicylic acid peels are also sometimes used by estheticians. These are slightly stronger than most AHA peels and are administered less often. Jessner’s peels are a chemical combination of salicylic acid, resorcinol, and lactic acid. This is the strongest peel an esthetician can perform without medical supervision. It is best to address your concerns with your facial specialist (esthetician) so that they can determine what the best course of treatment is for you.



What are peptides and how do they help the skin?

Peptides are chains of amino acids. Peptides are thought to send signals or stimulate the skin to behave in a different way. It is believed that certain sequences of amino acids produce different effects when exposed to the skin.  Probably the most well known in skin care products is a peptide called palmitoyl pentapeptide-3, commercially know as Matrixyl. This peptide helps to improve the firmness of the skin. Based on documented research, this peptide stimulates collagen production in the skin and also increases the amount of water-binding substances in the dermis. Regular use of this product can improve the appearance of fine lines, wrinkles, firmness, and elasticity.

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Another well known peptide is acetyl hexapeptide-3, commercially known as Argireline. This product has anti-wrinkle properties  and is often promoted and used to treat expression lines, but it can be used on any type of wrinkles. The peptide works by inhibiting certain binding proteins that create the tension that causes wrinkling. There are other types of peptides now available in skin care products that can help with elasticity, puffiness, fluid retention, and other esthetic problems. Peptides are being used in serums, moisturizers, eye creams, and other types of products. To have a real lasting effect on the skin, peptide products must be used consistently, solid results can not be expected from periodic use. Peptides can be used in conjunction with other products to minimize the appearance of aging, including sunscreens, AHA products, antioxidants, lipid-based products, and moisturizers. A combination of all these ingredient types in a planned program for daily application can produce substantial improvement in appearance of age or sun damage related wrinkling, elastosis, puffiness, and other visible signs of aging.

Exfoliation and Aging Skin

What effect does daily chemical exfoliation have on Aging Skin ?

Chemical exfoliation is the use of a product that dissolves or loosens dead skin cell build up. Mechanical exfoliation removes surface cells by physically bumping them off the skin. A scrub is an example of a mechanical exfoliator. Using a daily chemical exfoliant such as alpha hydroxy acid can make a huge difference in skin that already has aging symptoms, and it can actually help maintain younger looking skin. Mechanical exfoliators are good for helping make the skin look smoother and clearer but, does not have the same long range effects as daily use chemical exfoliants. Alpha Hydroxy Acids include glycolic, lactic, mandelic, malic, and tartaric acids. Beta Hydroxy Acids include salicylic acid and citric acid.

By loosening and removing dead surface cells chemical exfoliants accomplish the following :

  • Removal of dead cell build up on the skin’s surface immediately causing a smoothing effect on the skin, reflecting light more evenly and making wrinkles look less deep.
  • Fine lines are significantly lessened, often to the point where they are no longer visible.
  • Daily use of AHAs speeds up the epidermal cell renewal, significantly improving hydration, helping to plump the skin surface cells, and improving smoothness and texture.
  • With daily use of AHAs the barrier function is improved due to the acceleration of the cell renewal cycle.
  • Routine use of daily AHAs stimulates the production of new collagen in the skin.
  • It also removes stained or hyper-pigmented dead cells, improving the appearance of dark spots, sun related freckles, and splothchiness.

How do I know which type of Alpha Hydroxy home care product is right for my skin?

Alpha Hydroxy acid products are available in cream, lotion, serum, and gel forms. They are worn on the skin usually under a moisturizer or sunscreen. Creams are most often intended for dry skin and gels are best for oily or combination skin. Serums can often be used on several skin types. The percentage of alpha hydroxy acid content is important. Make sure the product contains 8-10% alpha hydroxy acid. Products with more than 10% AHA can cause inflammation and visible peeling of the skin, which is not necessary to see results with an AHA product. An AHA product should have a PH of about 3.5 and an AHA concentration of 8-10%. Products with a PH lower than 3.5 , when used daily can cause inflammation and irritation. Also, rinse off products do not have the same improvement effects on the skin as a product that is worn. Sunscreen use is imperative when using alpha hydroxy acid products. Because the skin is being routinely exfoliated, the skin must be protected from UV exposure.