The eyes, the proclaimed windows to the soul, give insight into people’s deepest emotions. Yet, on the outside, they tell a very different story. Comprised of the most delicate skin on the face, the eye area’s susceptibility to environmental stressors reveals the first signs of aging and reflects how much attention is given in this fragile area.

Vulnerable to the same aggressors as the rest of skin, the eye area experiences fine lines and wrinkles, dark circles, dryness, uneven texture, puffiness, and loss of firmness to a greater degree. Repeated exposure to ultraviolet rays damages collagen and elastin, thinning skin further and resulting in fine lines and dark, hollowed areas beneath the eyes. Skin degradation is further progressed through hereditary factors and daily lifestyle habits, such as smoking, lack of sleep, smiling, frowning, and repetitive squinting.

Perhaps you’ve heard of or even received the heralded “Hollywood Facial,” also marketed as the “Porcelain Doll Facial.” Regardless of its title, these treatments are all cut from the same cloth: the carbon peel facial. Delicate enough for all skin types, this nonablative treatment promises a porcelain-smooth complexion while boasting a host of other antiaging benefits. Touting a low-pain factor, minimal downtime, and a cost-effective price margin, the carbon facial has become a staple procedure in the aesthetics industry.

CARBON PEEL FACIAL

Improving the look of enlarged and clogged pores, addressing pigmentation issues due to acne scarring and melasma, and reducing the prominence of fine lines and wrinkles are among its list of achievements. The carbon peel facial exfoliates skin deeply, stimulates collagen remodeling, targets photoaging, and leaves skin looking firmer and feeling more hydrated. Not reserved for the face alone, this treatment can improve the neck and chest area, as well as the back of the hands. Ideal candidates for this treatment include those with sensitive skin types that are prone to bouts of acne, rosacea, and eczema.

The main difference between the carbon facial and traditional chemical peels lies in how these results are achieved. Using a significantly gentler approach than a traditional chemical peel, the carbon facial rejuvenates skin by harnessing the power of controlled heat delivery by way of a laser. This approach draws out impurities, causing a peeling effect without damaging the outer layers of skin, as opposed to a chemical reaction which employs a fine acid composite to cause rapid skin proliferation. Results are visible immediately, all while remaining noninvasive, pain-free, and with minimal recovery time.

With over a decade of experience in aesthetics, Suzanne Whigham has immersed herself in exploring the most challenging aspects of skin care and conditions. As a regular contributor to DERMASCOPE magazine, she has a passion for writing and passes that knowledge on to her clients at her clinic, Epiderme Aesthetics, where she encourages a whole-body approach to skin health and wellness.

The summer of 2020 was one marked by unprecedented change in the lives and habits of people worldwide. Months of being confined to homes brought about the do-it-yourselfer in many. People sought alternatives to maintain their skin care and health. And while more complicated cosmetic practices such as injectables had to be put on the back burner, procedures like dermaplaning quickly found their way into the hands of savvy consumers. 

Adhering to a pro-active recipe for antiaging is a multi-faceted approach that is inclusive of several factors which all play an integral role in contributing to skin health as a whole. The wealth of products that make up a skin care arsenal include diet, exercise, and general health, sun protection, environmental exposures, and physical factors, such as how one positions skin while sleeping. These are all important factors that comprehensively determine how well a person’s age.

So, how great of a role does sleeping on a silk pillowcase play in this great skin equation? Also, how does it compare to the use of traditional cotton fabrics? While sleeping on one’s back is the ideal position to mitigate facial wrinkling that results from placing too much pressure on either side of the face, it is not always comfortable or even possible due to underlying health conditions. Sleeping on one’s side compresses the skin up towards the mid-line of the face, which creates a tugging and pulling of the skin that forms temporary folds and creases. As skin ages, there is an inevitable loss of elasticity, which further exacerbates its susceptibility to folding and wrinkling that may become more prominent and even permanent over time. These long-term effects may be mitigated by limiting the amount of friction through sleep positioning and the use of gentler fabrics for those areas of exposure.

Far inferior in form and function to its more expensive counterpart, traditional cotton is one of the most absorbent materials. Due to its molecular structure and hydrophilic nature, the fibers in cotton are capable of drawing in and trapping a staggering amount of moisture, as well as product from the skin while one sleeps. Cotton can also absorb hair product into the pillowcase, which can then transfer onto the skin, leading to unwanted breakouts and irritation.

Silk, on the other hand, provides an exponentially smoother surface which causes minimal friction and dragging of delicate facial skin. It is especially beneficial to those with drier skin, as the smoothness of silk makes it less apt to absorb moisture, leaving the skin hydrated. And while a faux silk pillowcase made of polyester is an affordable and durable alternative that will deliver ample benefits, opt for a higher-quality case comprised of mulberry silk with a high momme, or fabric weight of 22 or more to capitalize on these skin benefits.

There are several companies that have taken these preventive measures a step further by incorporating the added benefit of shape design. Most often shaped like a half-moon to accommodate the natural curves of the face, these pillows are specially fabricated to limit the compressive effect on the cheeks, thereby reducing the formation of sleep lines.

While silk pillowcases cannot single-handedly prevent all facial wrinkling, they add a tangible layer of prevention. And what better way to optimize beauty sleep than to incorporate the luxury of silk, all while minimizing skin damage and facilitating the vital recovery and renewal process that occurs in the skin while snoozing.

The summer of 2020 was one marked by unprecedented change in the lives and habits of people worldwide. Months of being confined to homes brought about the do-it-yourselfer in many. People sought alternatives to maintain their skin care and health. And while more complicated cosmetic practices such as injectables had to be put on the back burner, procedures like dermaplaning quickly found their way into the hands of savvy consumers.

Skin that has been exposed to trauma stemming from surgery, infection, injury, or even severe acne and cancer must be approached with a thoughtful and educated approach tailored to the individual’s specific needs. With a rise in clients who are more receptive to treatment plans designed not only to beautify, but more specifically to treat and heal, professionals in the skin care industry are responding to this need by acquiring the advanced training necessary to accommodate the challenges involved with rejuvenating compromised skin.

After enduring the long gray cast of winter, there is no question that feeling the sun’s warm embrace on bare skin induces a therapeutic pleasure response. It makes sense scientifically, since the body’s ability to produce serotonin, also known as the happy hormone, is directly affected by sunlight. Lack of sunlight can actually lead to a condition known as seasonal affective disorder, in which patients individualsdisplay symptoms of depression associated with a drop in serotonin levels experienced during months with reduced sunlight.

However, despite the feelings of well-being sunlight exudes, indulging in it has a dark side. Exposure to ultraviolet rays accounts for a staggering 80% to 90% of the visible effects of aging. The sun emits two basic types of ultraviolet rays that reach skin: long-wave UVA and short-wave UVB. Both wavelengths create free radicals that impair cellular function, altering genetic material, and damaging the collagen and elastin fibers found within the skin. Accounting for 95% of the ultraviolet light that reaches skin, UVA rays penetrate far beyond the dermis, wreaking havoc on each layer of the skin, and is responsible for wrinkles and visible aging. UVA rays are also a major contributor to skin cancers. UVB rays are shorter waves, directly responsible for sunburns, which can lead to skin cancers later in life. When choosing a sun protection factor sunscreen, it is important to select a product that offers both UVA and UVB broad-spectrum coverage to ensure adequate protection.

BREAKING DOWN SPF 

When choosing a sunscreen, look for a broad-spectrum UVA and UVB formula with a sun protection factor of 30 or above. SPF (sun protection factor) denotes the amount of time skin is protected. Multiply the SPF by the amount of time it takes skin to burn without protection, and this will give the amount of time in minutes the sunscreen will protect skin. Keep in mind that a SPF of 30 blocks out 97% of UVB rays, so as the sun protection factor increases, the amount of increased protection is negligible. Be sure to apply sunscreen at least 20 minutes before sun exposure and reapply every two hours or more often if sweating or swimming.

CHEMICAL OR PHYSICAL 

With so many formulations available to clients, there are sunscreen options for every skin type and preference. The key to selecting the right product is understanding how each works and which will better suit a client’s needs.

Chemical Sunscreen 

What differentiates physical from chemical sunscreens are the ingredients found in each and the way they offer protection. Chemical sunscreens are comprised of active ingredients which are non-natural, chemical compounds and work by absorbing the sun’s ultraviolet rays by way of a chemical reaction that transforms ultraviolet rays into heat. Ultraviolet rays are then forced to dissipate and the skin is protected. Since skin absorbs chemical sunscreens, trace amounts might seep into the bloodstream, presenting an opportunity for irritation, discomfort, or allergic reactions. After applying chemical sunscreens, wait at least 20 minutes before sun exposure to ensure maximum effectiveness.Common ingredients found in chemical sunscreens includeoxybenzone octisalate, avobenzone octocrylene, and octinoxate homosalate.

Physical Sunscreens 

In contrast to chemical sunscreens which penetrate the skin, physical or mineral sunscreens work by providing a physical barrier between the sun’s rays and the skin. Physical sunscreens offer sun protection at the moment of application and are less likely to clog pores. Damaging ultraviolet rays are deflected and scattered away from the skin. The most common ingredients in physical sunscreens are titanium dioxide and zinc oxide, with zinc oxide offering slightly better coverage against UVA and UVB rays. Zinc oxide is also antimicrobial and noncomedogenic, making it ideal for acneic skin. Also noncomedogenic and gentle on the skin, titanium dioxide is a natural mineral used as a thickening, whitening, and lubricating agent in sunscreens and cosmetics. Titanium dioxide is a great choice for sensitive skin that is prone to redness; however,it is better suited for casual sun exposure since its ultraviolet absorption spectrum is not as broad as zinc oxide.

While dry skin will benefit from using a daily moisturizer that incorporates sunscreen, those with oily or combination skin should select light creams, fluids, or gels labeled noncomedogenic to avoid excess clogging of pores. Oil-free products provide a non-greasy finish without contributing excess shine to the complexion. Those with sensitive or sensitized skin should opt for fragrance-free, hypoallergenic formulas to minimize the chance of irritation. Lightweight and long-wearing, chemical-free, mineral sunscreens are well-tolerated by sensitive skin types.

SUN PROTECTION AND ACNE 

A common misconception touting the benefits of sunlight is the belief that basking in the sun will effectively remedy a bout of acne. While blemishes appear to diminish following sun exposure, the effect is as misleading as it is fleeting. In response to sunlight, the body dispatches melanin, which gives the skin its color, to absorb ultraviolet light and protect the skin from further damage. While this bronzing effect temporarilymasks redness associated with acne, the potential damage being caused by exposure to the sun’s rays far outweighs its short-lived benefits. The underlying causes of the acne breakouts should rather be addressed and paired with the appropriate treatment and sun protection to maintain a smooth, healthy complexion.

In fact, too much exposure to the sun’s rays can actually worsen acne by exacerbating dryness due to the overstimulation of the sebaceous glands. This leads to an excess of sebum production, referred to as seborrhea, and the formation of blemishes. Excessive drying of surface skin cells can cause them to harden, a response is known as keratinization. This process interferes with the skin’s natural shedding process, preventing the release of sebum out of the pores and resulting in the formation of comedones. Cumulative sun damage also leads to an inconsistency in the thicknessof various areas of the skin. This can result in the emergence of acne lesions as sebum and P.acnes bacteria combine with dead skin cells to clog pores due to the improper sloughing of these excess layers of skin. Not only does ultraviolet radiation cause an increase in inflammation and redness in the skin, the potential for discoloration, (especially in clients suffering from acne marks,) is heightened. Post-inflammatory hyperpigmentation is a bothersome condition which can persist for months or even years.

It is especially important to be diligent with sun protection when using oral or topical acne medications, as certain active ingredients can heighten skin sensitivity to UVA and UVB rays. These medications can cause excessive drying of the sebaceous glands, depleting the skin’s natural moisture barrier and triggering a rapid rate of cell growth and exfoliation. This process leaves the skin exposed and more vulnerable to the damaging effects of ultraviolet rays. Some of the more common ingredients used in the treatment of acne include glycolic acid, retinoids, salicylic acid, and benzoyl peroxide. Isotretinoin and doxycycline are more aggressive forms of acne management that have the propensity to cause rapid sunburn and should be taken with extreme caution and diligent sun protection.

A safe alternative for treating mild to moderate acne breakouts that is easy to use and backed by scientific research is phototherapy. The light emitted by these devices does not generate the same cancer-causing wavelengths as the sun’s rays. FDA-approved for acne, blue light therapy works by penetrating deep into the pores to kill the bacteria P.acnes on the skin. Red light can penetrate deep into the skin to activate hemoglobin, cutting off the blood supply of sebaceous glands, so the pores arenot able to secrete as much sebum. The best results can be seen when red and blue light are used together.

When used consistently, sun protection can help to prevent, slow down, or even reverse the signs of sun damage. It is important to avoid the peak hours of sun exposure between the hours of 10 A.M.to 4 P.M. when the sun’s rays are strongest. Opt for tightly woven, loose-fitting clothing, a broad-brimmed hat, and sunglasses that offer UVA and UVB protection. Be diligent about wearing sunscreen every day of the year, including cloudy days.

BREAKING DOWN SUN PROTECTION FACTOR 

When choosing a sunscreen, look for a broad-spectrum UVA and UVB formula with a sun protection factor of 30 or above. Sun protection factor denotes the amount of time skin is protected. Multiply the sun protection factor by the amount of time it takes skin to burn without protection, and this will give the amount of time in minutes the sunscreen will protect skin. Keep in mind that a sun protection factor of 30 blocks out 97% of UVB rays, so as the sun protection factor increases, the amount of increased protection is negligible. Be sure to apply sunscreen at least 20 minutes before sun exposure, and reapply every two hours or more often if sweating or swimming.

With so many formulations available to clients, there are sunscreen options for every skin type and preference. The key to selecting the right product is understanding how each works and which will better suit a client’s needs.

Chemical Sunscreen 

What differentiates physical from chemical sunscreens are the ingredients found in each and the manner in which they offer protection. Chemical sunscreens are comprised of active ingredients which are non-natural, chemical compounds, and work by absorbing the sun’s ultraviolet rays by way of a chemical reaction that transforms ultraviolet rays into heat. Ultraviolet rays are then forced to dissipate and the skin is protected. Since skin absorbs chemical sunscreens, trace amounts might seep into the bloodstream, presenting an opportunity for irritation, discomfort, or allergic reactions. After applying chemical sunscreens, wait at least 20 minutes before sun exposure to ensure maximum effectiveness.Common ingredients found in chemical sunscreens includeoxybenzone octisalate, avobenzone octocrylene, andoctinoxate homosalate.

Physical Sunscreens 

In contrast to chemical sunscreens which penetrate the skin, physical or mineral sunscreens work by providing a physical barrier between the sun’s rays and the skin. Mineral sunscreens offer sun protection at the moment of application and are less likely to clog pores. Damaging ultraviolet rays are deflected and scattered away from the skin. The most common ingredients in mineral sunscreens are titanium dioxide and zinc oxide, with zinc oxide offering slightly better coverage against UVA and UVB rays. Zinc oxide is also antimicrobial and non-comedogenic, making it ideal for acneic skin. Also, non-comedogenic and gentle on the skin, titanium dioxide is a natural mineral used as a thickening, whitening, and lubricating agent in sunscreens and cosmetics. Titanium dioxide is a great choice for sensitive skin that is prone to redness; however, it is better suited for casual sun exposure since its ultraviolet absorption spectrum is not as broad as zinc oxide.

While dry skin will benefit from using a daily moisturizer that incorporates sun protection factor, those with oily or combination skin should select light creams, fluids, or gels labeled non-comedogenic to avoid excess clogging of pores. Oil-free products provide a non-greasy finish without contributing excess shine to the complexion. Those with sensitive or sensitized skin should opt for fragrance-free, hypoallergenic formulas to minimize the chance of irritation. Lightweight and long-wearing, chemical-free, mineral sunscreens are well-tolerated by sensitive skin types.

While wearing sunscreen regularly will provide ample prevention from future injury to the skin from exposure to ultraviolet light, learning to identify and promptly treat present sun damage can turn back the hands of time and provide an opportunity to detect malformations of the skin that could possibly lead to skin cancer. Common signs of sun damage includeskin discoloration and hyperpigmentation,loss of elasticity and drooping, broken capillaries and spider veins,fine lines and wrinkles, and atypical moles, reddish-brown patches, and raised scaly growths. Other signs of sun damage can includethinner, more translucent skin,loose, sagging skin on the neck area resulting from a breakdown in collagen,broken capillaries,dry, rough, leathery skin,large freckles, age spots or liver spots,blotchy or ruddy complexion,and chronically chapped, dry lips due to sun exposure, as lips are often overlooked when applying sun protection factor but are just as prone to sunburn.

Always consult a Dermatologist to diagnose, monitor, and rule out skin cancers.

SUN CARE AND AGING 

There is a multitude of ways to treat the various signs of existing sun damage. Fine lines and wrinkles can be minimized by implementing a daily regimen of results-driven correctives and serums which contain age-fighting ingredients such as vitamin C, which work to repair existing damage and neutralize free radicals; prescription retinoids which stimulate collagen production; and alpha hydroxy acids for increased cellular turnover. For deep-set wrinkles, injectable fillers can provide an instant plumping and smoothing effect, while the injection of neurotoxins can be utilized to minimize the movement and depth of expression lines.

Age spots, discoloration, and hyperpigmentation can be addressed through the use of skin-lightening ingredients such as kojic acid, glycolic and lactic acids, arbutin, niacinamide, and azelaic acid, as well as stronger, prescription topicals such as hydroquinone and corticosteroids. A series of chemical peels which toremove the topmost layer of skin to reveal new, smoother skin is beneficial for a host of skin concerns. In order to prevent recurrent hyperpigmentation or discoloration triggered by this procedure, it is important to prime the skin using depigmenting agents, such as hydroquinone, beforehand. Laser and intense pulsed light therapies work by destroying melanocytes which thatproduce melanin without damaging the skin’s surface. For isolated spots, cryotherapy may prove beneficial at precisely lightening a specific small area. Intensive fractional resurfacing treatments can improve tone and texture by stimulating the growth of healthy new tissue by delivering microbeams of light into the lower layers of skin, which creates deep, narrow columns of tissue coagulation. This procedure is ideal for the face, neck, chest, and arms and is an excellent choice for correcting a multitude of sun damage, including fine lines and wrinkles, sagging skin, hyperpigmentation, and age spots.

When applying sunscreen, always be mindful to extend the application down the neck and across the décolleté. The skin on the neck is much more delicate and thinner than the skin on the face and has few oil-producing glands, making it more susceptible to visible aging. Over time and with continued exposure to the sun’s rays, the neck can develop irregular pigmentation, looseness, sagging, and broken capillaries. A combination of hydrating topicals, prescription retinoids, growth factors, and peptides are beneficial in the treatment of loose skin; however, more impressive results can be achieved through the use of non-invasive radio frequency, ultrasound, and intense pulsed light treatments to combat loose skin and stimulate collagen and elastin production.

SIGNS OF SUN DAMAGE 

While wearing sunscreen regularly will provide ample prevention from future injury to the skin from exposure to ultraviolet light, learning to identify and promptly treat present sun damage can turn back the hands of time and provide an opportunity to detect malformations of the skin that could possibly lead to skin cancer. Common signs of sun damage includeskin discoloration and hyperpigmentation; loss of elasticity and drooping, broken capillaries and spider veins; fine lines and wrinkles; and atypical moles, reddish-brown patches, and raised, scaly growths. Other signs of sun damage can include thinner, more translucent skin; loose, sagging skin on the neck area resulting from a breakdown in collagen; broken capillaries; dry, rough, leathery skin; large freckles, age spots or liver spots; blotchy or ruddy complexion; and chronically chapped, dry lips due to sun exposure, as lips are often overlooked when applying sunscreen but are just as prone to sunburn.

Always consult a dermatologist to diagnose, monitor, and rule out skin cancers.

SKIN CANCER 

The most alarming form of sun damage resulting from overexposure to sunlight are skin cancers. Skin cancer is an uncontrolled growth of abnormal skin cells, which can result in tumors that may be malignant or benign. There are three types of skin cancers, and it is imperative that professionals familiarize themselves with the characteristics of each to be able to serve as the client’s first line of defense in identifying possible cancers and precancerous lesions.

Basal cell carcinoma is a skin cancer that originates in the basal cells, which make up the outermost layer of the skin and are thought to be caused by long-term exposure to ultraviolet light. While commonly occurring on parts of the body exposed to the sun, basal cell carcinomas can develop anywhere. These can appear as a translucent, pearly white, or flesh-colored bump, often seen on the face and ears or as darker lesions with slightly raised, translucent borders. Basal cell carcinomas can also appear as flat and red scaly patches or white, waxy lesions with no clearly defined borders. Encouraging regular skin checks will ensure clients become familiar with their skin, so they will recognize any unusual or changing areas that require further examination.

Squamous cell carcinoma is a common type of skin cancer, often resulting from prolonged exposure to ultraviolet radiation from sunlight or commercial tanning beds. This type of slow-growing cancer develops in the squamous cells that comprise the middle and outer layers of the skin and, if left untreated, can spread to the tissue, lymph nodes, and bones. A red, scaly sore or scab that does not heal in a reasonable amount of time or an unusual flat patch of rough skin should be examined by a physician to rule out the possibility of skin cancer. 

Melanoma, the deadliest form of skin cancer, develops when DNA damage from sun exposure to skin cells triggers mutations, leading to rapid multiplication of skin cells that form malignant tumors. Melanoma can occur on any part of the body, developing from exposure to ultraviolet rays from sunlight, tanning lamps, or even resulting from intense sun exposure or sunburns occurring in early childhood. Early detection is vital in preventing the spread of this aggressive cancer.

While there is a solution or modality to remedy every form of sun damage, the best prescription is sun prevention. Implementation of a results-driven skin care regimen that addresses skin concerns should be complemented with a daily, broad-spectrum coverage sunscreen to not only protect the skin,but prevent the introduction of future damage or compounding current sun damage. There is little room needed for evidence substantiating the sun’s detrimental effects on the health of the skin. Help clients aim for consistency in making sun protection a daily affair andremind them to schedule an annual checkup with a professional to note and monitor changes in the skin since early detection could be monumental.

A graduate of Aveda Institute of Lafayette, Suzanne Whigham has served as a licensed aesthetician for nine years with extensive training in various treatment modalities and techniques. She especially enjoys educating others through in-depth consultation, encouraging a whole mind-body approach to skin care. 

Thanks to modern marvels in health and beauty, great skin is not only easily attainable, but may even be as close as a salad plate. The benefits of this nutritious superfood extend far beyond its internal merits. Not to be cast aside as yet another passing trend, kale is making its mark in skin care, possibly solidifying its place in a skin care array.

Long-term exposure to environmental pollutants inherently leads to skin damage. Continuous subjection to free radicals induces inflammation, premature aging, and negative skin responses, such as acneic conditions and dryness. Incorporating products comprised of kale topically through the application of cleansers, serums, and masks provides instant hydration, tightening, and brightening. Rich in detoxifying chlorophyll, this nutrient-dense vegetable has the potential to heal the skin, while decreasing the appearance of fine lines and wrinkles. Skin suppleness is visibly improved, effectively slowing the aging process.

An absolute powerhouse of antioxidants, kale boasts a healthy dose of vitamins A, C, and K, in addition to quercetin and kaempferol, and the carotenoids lutein and zeaxanthin. Infused with iron and copper, kale has been shown to decrease inflammation, promote collagen production, and aid in wound healing. This leafy cabbage packs an impressive amount of beta-carotene, a precursor of vitamin A, which has long been recognized for its proven antiaging benefits. On the surface, vitamin A increases cellular turnover, rebuilds collagen, and promotes healthy cell growth in both the dermis and the epidermis. Vitamin C aids in the production of healthy and robust collagen, which is necessary for skin strength. It also works to brighten skin tone, repair sun damage, and lessen the appearance of dark spots. Kale is a premiere source of vitamin K, a nutrient well known for its capability to reduce the bruising, swelling, and scarring commonly associated with surgical procedures. It is ideal for use around the delicate eye area, effectively reducing the look of dark, under eye circles.

With such an impressive catalog of antioxidants, kale is a nourishing multitasker that has the potential to lend itself a powerful addition to an antiaging arsenal. However, as with all new ingredients, further research is warranted to ensure the capability of these ingredients to penetrate the surface layers of the skin and deliver consistent and effective results in the long-term.

Like it or not, clients performing their own skin care treatments at home is an all too common reality for most professionals. In some cases, these homecare efforts can complement professional treatments and help maintain results between appointments. However, in other instances, these attempts can lead to undesired outcomes and even serious damage. When it comes to chemical exfoliation, while there are some peels that can be safely performed at home, others are best left to the professional. Communicating the difference to clients is vital.

Entrenching itself as a cornerstone of effectual skin care, exfoliation is one of the most effective therapeutic skin treatments an individual can implement to achieve younger, healthy-looking skin. But, unless harnessing the genes of the goddess Athena herself, achieving a coveted glass-like complexion requires a bit of diligence. Through the process of exfoliation, dead skin cells that have accumulated on the skin’s surface, giving the skin a dull appearance, are removed through physical or chemical means. And, while both methods essentially provide a smooth and polished result, the difference lies in the manner in which dead skin cells are loosened, as well as the range of benefits each can provide. Regardless of age, exfoliation is a necessary step that should become a staple of any skin care regimen.

BENEFITS OF EXFOLIATION

Contrary to physical methods, which utilize an array of scrubs or manual tools to polish away dead skin cells through friction, chemical peels employ a variety of acids which work to loosen and chemically dissolve the intercellular glue that holds keratinized skin cells together. This process creates a controlled wound which allows the skin to regenerate itself.

Introduced in the late 1980s, earlier acids were considered unstable and presented a cause of concern to clients. Today’s formulas, however, are much safer and the chemical peel is in many ways considered a gentler option than some of its physical counterparts. And, with such a broad range of acids available, a professional is able to devise a tailored approach consistent with the client’s skin type, condition, and expectations.

EDUCATION

While chemical exfoliation can result in discernible improvement in the skin, it is imperative that the client has an understanding of not only their own skin type and needs, but also which chemicals are safe for use at home and which should only be performed in a medical setting by a licensed skin care professional. Generally speaking, the type of chemical peel, along with its strength and pH, will determine its level of user-friendliness. In any case, professionals should discuss safe at-home practices with their clients to ensure they gain a working knowledge of products, safety precautions, and post-care, which is necessary to avoid causing serious damage to the skin. The goal is to integrate chemical exfoliation into a skin care regimen in a way that allows for effective, consistent results, while providing for client safety and avoiding overuse, which can lead to unnecessary irritation and unwanted side effects.

TYPES OF PEELS AND WHICH CAN BE USED AT HOME

The safest at-home approach to chemical exfoliation comes in the form of enzyme peels. Fruit enzymes, such as papain (papaya), bromelain (pineapple), and protease enzymes, break down the keratin in skin by decomposing proteins into smaller fragments, which induces a sloughing of dead skin only. This process causes no injury to live tissue, making enzyme peels a suitable choice for those clients with sensitive skin or clients looking to achieve softer skin and refined pores with no downtime.

Enzymes aside, acid-based chemical exfoliants normalize cell turnover in the epidermis and stimulate healthy skin formation resulting in a more youthful appearance. These acids generally fall into two categories: alpha hydroxy acids, including lactic, glycolic, citric, malic, and tartaric acid, which are the mildest of all chemical peels; and beta hydroxy acids, which include salicylic acid. While beta hydroxy acids effectively break down the bonds between cells, alpha hydroxy acids primarily affect the skin by normalizing skin cell turnover in the epidermis, thereby causing the cells themselves to detach. Because they are water-soluble, alpha hydroxy acids cannot penetrate deep into pores, making them less effective than beta hydroxy acids, which reach deeper into the skin and pores. Both fall under the category of superficial peels, while Jessner and TCA peels are considered medium deep peels. Phenol peels are the deepest type of chemical peel and should always be administered by a physician.

Alpha Hydroxy Acids

A gentle, lightweight peel to begin with is a lactic acid peel. Made from sour milk, lactic acid is an excellent peel for at-home use because it provides hydration to chronically dry skin, improves minor wrinkles, and directly inhibits tyrosinase activity which aids in the improvement of pigmentation, all with little to no visible peeling.

A second alpha hydroxy acid, glycolic acid, is derived from sugar cane and has the smallest molecular structure of the alpha hydroxy acids, allowing it to penetrate into the deeper layers of the skin. Glycolic acid peels diminish the appearance of fine lines and wrinkles, stimulate the production of collagen, refine skin texture and post-acne indentation, brighten skin, and combat hyperpigmentation. The results of a glycolic acid peel are cumulative and, with consistent use, will deliver excellent results. Safe to use during pregnancy, glycolic acid is a user-friendly, at-home method of exfoliation, so long as the client is mindful of the warning signs of overuse, such as excessive dryness and irritation. Ideally, the client should use a glycolic peel with a pH between two to three and a concentration of 30 to 50 percent, never exceeding 70 percent. As a precaution, at-home peels are usually buffered with slightly higher pH levels, providing extra time as a measurement of safety for the client.

Mandelic acid, an alpha hydroxy acid derived from bitter almonds, is a gentle, yet effective exfoliator that improves skin texture, refines skin tone, reduces acne, and improves fine lines and discoloration. And, since its molecular structure is larger than that of other alpha hydroxy acids, mandelic acid penetrates the epidermis slowly and more consistently, making it less likely to cause irritation and inflammation. It is a great peel for all skin types that can be used weekly. The mandelic acid can be applied at a 20 to 25 percent concentration, leaving higher percentages to licensed professionals.

Beta Hydroxy Acids

Unlike alpha hydroxy acids which are water-soluble, salicylic acid is an oil-soluble beta hydroxy acid which penetrates and exfoliates the pores deeper, effectively dissolving congestion and debris, which makes it an excellent peel for the treatment of acne. Salicylic acid has anti-inflammatory properties and does not increase sun sensitivity, or erythema, as does glycolic acid, and is great for treating photodamage, skin discoloration, and the buildup of dead skin. This peel is contraindicated for clients with a sensitivity to aspirin products.

Jessner

With versatility of depth as a superficial, medium, or deep application, the Jessner peel is comprised of equal parts lactic acid and salicylic acid, with or without resorcinol, in a 95 percent ethanol solution. It is available in one strength, with the level of depth determined by the amount of layers of the solution that are applied. This alpha and beta peel is an excellent choice for clients with oily or acneic skin looking to improve cystic acne, as well as clients hoping to diminish the effects of photoaging, melasma, and post-inflammatory hyperpigmentation. Clients may experience frosting, an effect in which areas of the skin turn white due to the skin’s surface being exfoliated away by the acidic solution. Downtime from this application can range anywhere from a few days up to a week.

TCA

The trichloracetic acid (TCA) peel is a highly versatile, professional-strength acid classified as a medium-deep peel according to the strength and percentage being used. While TCA peels are generally well tolerated by most skin tones, the risk of pigment change in darker skin tones warrants a cause for strong precaution. TCA peels effectively treat advanced pigment irregularities, deeper wrinkles, skin laxity, acne scars, rough skin texture, and photodamage. As a superficial peel, it can be used in conjunction with salicylic acid or other acids. It is recommended that clients initially administer this peel at a lower percentage of 15 percent and seek the consultation of a physician for percentages above 20. TCA peels are the strongest among the medium-deep peel category with an accompanying downtime of 7 to 10 days.

Phenol

Phenol (carbolic acid) peels are the strongest chemical peel solutions which penetrate the lower dermal layer and result in dramatic facial rejuvenation with long-lasting results. Always administered by a physician, this aggressive peel addresses more serious skin concerns such as deep, coarse wrinkles and imperfections such as blotchiness, acne scars, and pre-cancerous growths. A pre-treatment course of products carefully selected by a physician, usually a retinoic acid, should be adhered to for several weeks to prepare the skin to allow for deeper and more even penetration of the chemical solution. Before the peel, the client will be administered a local anesthetic or sedative to manage discomfort during the procedure. Recovery is lengthy and uncomfortable compared to other peels and is generally performed only once or twice in a lifetime.

UNDERSTANDING RISKS

When the depth and intensity of a peel is increased, so are the results. There is also a rise in downtime, peeling, inflammation, healing, and the risk of complications. For the client looking to administer chemical peels in the comfort of their home, the safest approach is to begin with superficial peels, applying the product at the lowest strength to gauge sensitivity, increasing the percentage and the time of application accordingly. It is imperative that the peel is purchased from a reputable source and attention should be paid to the expiration date, as product strength and effectiveness will change over time. The client should have a general working knowledge of the product’s pH and acid content, because in the hands of an untrained person, an acid having a pH of 3.0 or below could injure the skin and result in permanent scarring. Also, the client must be aware of the various complications that may occur during and after a chemical peel, as well as the important of practicing diligent pre- and post-treatment care. Immediate complications will occur within minutes to hours of performing a chemical peel and include pruritus, erythema that does not subside, edema, burns, and irritation. Delayed complications may present within days up to weeks post-treatment and may include allergic reactions, scarring, milia, hyper- or hypopigmentation, and infection. The risk of complications increases with the depth of the peel and is more prevalent in clients with darker skin tones.

DOS AND DONT’S

With the health and safety of the skin being of optimal importance, there are some guidelines the client should follow in regards to what not to do before, during, and after administering a chemical peel at home.

Clients with darker skin tones or who notice dark spots after acne breakouts from bug bites should not perform chemical peels. Clients should not perform a chemical peel if they have open cuts, wounds, or a sunburn. Clients with cancer or an autoimmune disease should not do at-home chemical peels. Teach clients no to pick, peel, scratch, or scrub their skin. Also, they should not exercise or sweat for a few days following a chemical peel. Clients should not perform a chemical peel if prone to cold sores. They must not use electronic exfoliation devices after a chemical peel until the skin is healed. Teach them not to perform a chemical peel if they have been off Accutane less than six months. Educate them on not waxing or bleaching the area at least three days before administering a chemical peel. Clients should not skimp on the sunscreen. It is especially important after exfoliation of any kind. Lastly, they should not use chemical exfoliants such as alpha hydroxy acids or beta hydroxy acids, ascorbic acid, or prescription retinoids for at least 10 days following a peel.

To maximize the benefits of a chemical peel, the client should practice vigilant post-care by incorporating hydrating products into their regimen that promote wound healing. Skin-identical ingredients such as hyaluronic acid, ceramides, and peptides work to repair damage and strengthen the skin’s natural moisture barrier. Performing a patch test will help a client determine skin sensitivity prior to administering a product and thus avoiding an allergic reaction. It is crucial that the client follow the instructions on the product carefully and discontinue use should the skin exhibit excessive redness or swelling, burning, oozing, blistering, or pain. Immediately after application, a broad-spectrum sunscreen should be applied, as well as during the healing period and afterwards to avoid pigmentation issues. Administering the peel at night is ideal because the active ingredients in the peel will encourage skin repair.

Gentle enzyme peels and superficial chemical peels such as alpha hydroxy acids or beta hydroxy acids are considerably safe for at-home use, considering the client follows the instructions on the product carefully and practices conscientious post-care. And, while it is advised to practice extreme caution when self-administering medium-strength peels such as Jessner peels, these are best performed under the guidance of a licensed professional. Deep peels, such as phenol chemical peels, penetrate the middle layer of skin very deeply and should never be practiced at home.

As licensed professionals, it is important to counsel clients on the possible complications that can be anticipated both during and following a peel, as well as discussing preventative techniques to ensure a safe and pleasant experience. The importance of adequately priming the skin before administering a chemical peel, as well as post-care and the benefits of each should be explained. Take the opportunity to identify clients who may be at risk of increased complications through proper consultation. Those factors that may affect the type of peel the client receives and contraindications to receiving treatment may include past medical conditions, allergies, products the client currently uses, occupation, history of photosensitivity or post-inflammatory hyperpigmentation, history of keloids, and photosensitizing medications. Educate the client on the benefits of having professional level chemical peels done in-office, while providing guidance in product selection should an at-home peel be considered. Encourage a conservative approach, as results are cumulative and advancing to more aggressive peels initially will not bring the desired results faster. In fact, this may cause skin damage and become a major setback in the quest for skin rejuvenation. While peels developed for application at home can provide mild peeling and are effective at maintaining an even-toned, healthy complexion, a chemical peel performed by a licensed professional will benefit from a lower pH, which allows for deeper penetration and substantially better results. During a professional service, a client is also continuously being monitored for signs of unusual skin reactions such as swelling, frosting, and erythema, while at home, a client is left to his or her own discretion.

Working together to develop an effective at-home regimen will complement and maintain the results of a professional chemical peel. A mutual plan of action pairing the client’s expectations with the appropriate professional and at-home treatments should be discussed to ensure compatibility and client satisfaction. Great skin care should involve a well-balanced approach pairing a series of chemical peels with supportive antioxidant nutritives, as well as a personal dose of responsibility in knowing a professional’s product, understanding skin and its limits, and practicing due diligence by seeking professional consult and applying that knowledge at home.

Growing up, Whigham lost herself in books, but more so she was drawn to beauty magazines. The aesthetics of the human body, especially the face, and more specifically the skin intrigued her. Soon after her fifth daughter was born, she graduated from the Aveda Institute of Lafayette where she studied esthiology. Whigham continued her skin care training by pursuing certifications in various modalities and treatments, and subsequently started Fountain of You Aesthetics. After a suspicious mole on her thigh returned a diagnosis of melanoma, her love of skin care took a more defined turn towards educating clients on the importance of sun protection and early detection. Whighham’s hope is to continue learning, writing, and growing as an aesthetician and increasing awareness of skin cancer prevention.