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Posts Tagged ‘Acne’

Chemical Peel, Sex in the City
Kim Cattrall’s character Samantha, has a chemical peel in a memorable episode of Sex in The City. Unfortunate timing left her with a dark and peeling face the day of Carries Launch Party. It looks as if she had a medium – deep peel. If she were better informed she could have timed her peel so that she looked as gorgeous as usual for her event or just opted for a more superficial peel. Now in her mid-fifty’s, Kim Cattrall looks amazing, I would not be surprised if she has chemical peels to maintain her skin.

Action and Benefits of Chemical Peels

Chemical peeling is used to improve the skin’s appearance by applying a chemical solution to the skin, causing the top layers of skin to separate and peel off. The new skin is smoother, less wrinkled, more even in color, peels can also be used to improve acne. Chemical peels can be performed at different depths, depending on the layer of correction desired. Deeper peels will cause the skin to peel for a longer period of time and provide more improvements in the skin. There are also a variety of acids and peeling agents that can be used alone or together, depending on skin conditions to be treated.

Chemical exfoliation and peels involve using destructive chemical agents to create a controlled wound.
All peels (whether they are chemical or laser) create a mild burn. They improve skin by the wound healing process, new tissue is created and damaged tissue is quickly replaced. Chemical peels stimulate the fibroblasts wound healing activity, the proliferation of fibroblast activity increases collagen and elastin. The depth of the wound determines the amount and intensity of healing. The body’s response to the burn is what yields the results, a deeper peel will result in more correction.

The terms exfoliation and chemical peel are often used interchangeably, however superficial peels are technically exfoliation not a true peel. True chemical peels are generally performed under medical supervision, and penetrate into the papillary dermis.

Chemical exfoliation and peels are a way to speed up the natural migration process of skin cells. When the bonds between cells are dissolved and epidermal cells begin to shed more rapidly. The shedding skin cells send signals for more cell division, which in turn forces keratinocytes to the top of the stratum corneum. This process helps treat acne, fade skin discoloration and leave the skin with a fresh new layer of skin on the surface.

*Dark skin types are more prone to complications such as hyperpigmentation and should go to a professional that is experienced in treating dark skin.

[ Read: Chemical Peel Do’s and Don’ts ]

Skin Layers

layers of the skin

Layers of skin, chemical peel

Epidermis (Epidermal layers)
Stratum corneum horny layer
Stratum lucidum horny layer – only present on palms of hands, soles of feet
Stratum granulosum horny layer
Stratum spinosum basal layer
Stratum mucosum basal layer
Stratum germinativum / basal layer
Dermis ( Dermal layers)
Papillary dermis
Immediate reticular dermis
upper reticular dermis
mid dermis
lower reticular dermis
Hypodermis/Subcutaneous Tissue
Adipose Tissue ( fatty tissue)

Epidermis
The epidermis is completely cellular, meaning it is in a constant cycle of producing new cells while older dead skin cells are pushed to the surface to exfoliate or slough off. The epidermis is made up of keratinocytes, lymphocytes, melanocytes, Langerhans cells and Merkel cells. Approximately 80% -90% of the cells in the epidermis are keratinocytes, with all others interspersed among them.

Dermis
The dermis is a layer of connective tissue, composed mainly of collagen fibers as well as about 5% elastin. The Dermis is subdivided into the superficial papillary dermis and the reticular dermis. The papillary dermis is a thin layer of connective tissue fibers, the reticular dermis is thicker and contains collagen and elastin fibers.

Collagen constitutes 75% of dry skin weight, giving the skin volume. Fibroblast cells lie among collagen fibers and are known to synthesize (produce) collagen. Fully mature collagen fibers have a low turnover rate. Elastin fibers maintain tension in the skin and provide elasticity ( snap back after being stretched). Metabolic turnover for elastin fibers are very slow and only make up about 2% – 4% of dermal volume. Damage or alterations to the elastin fibers network cause skin to become loose, saggy and wrinkled. Fibroblasts are responsible for producing collagen, elastic fibers, and the ground substance of the dermis. Fibroblasts also control the turnover of connective tissue, unfortunately with age they become smaller and less active.

Understanding the depth of a chemical peel

With chemical peels, the depth is determined by the agent used, concentration of agent, and time applied. {click to view photo’s of peeling}

Very Superficial
Penetrates to Stratum Corneum, Peeling is complete in 0-3 days. Very superficial peels can usually be done as often as once a week. This type of “peel”, generally produces little to no peeling and is ideal for anyone that can’t afford any downtime.

[ Chemical Peels: Superficial Peels Create Little To No Peeling ]

Superficial
Penetrates between the stratum granulsome and stratum germinativum basal layer of epidermis. Peeling is complete in 3-7 days, superficial peels can usually be repeated in 4 weeks. Ideal for most skin types including acne prone skin. This is the most common form of chemical peel performed by estheticians. There isn’t any true “down time” with superficial peels, only what is referred to as “social down time”. You can generally continue normal activities including work, however superficial peels should be done a week before any special events. You can expect to be slightly red or bronzed and have a few days of superficial peeling. On day 1 and 2 skin is slightly red or bronzed, skin starts to peel around day 3 and continues to peel for 2-3 days, may have minimal areas of superficial peeling on day 7. You may be red or pink first few days after peel.

Medium
Penetrates papillary dermis, performed under medical supervision. Peeling is completed in 7-8 days, medium depth peels can be repeated as soon as 6-8 weeks, however it isn’t usually necessary. Peeling skin will be darker and thicker with medium peels vs. superficial peels. Skin will start to darken on day 2 or 3, slight peeling around mouth on day 3, skin will continue to peel until day 7 or 8, starting around mucus membrane ( eyes, nose , mouth) and the forehead usually peels last. Toward end of peel you may just have slight peeling in the hairline. Often times you look okay the first 2 days and last 2 days, it is day 3- 6 that look bad. Exfoliating products and treatment need to be avoided for at least six weeks after a medium depth peel. You can start to see complications at this level, skin should be precondition before peel, especially for darker skin types. Should not be performed on skin with active acne. Follow post treatment instructions to avoid complications. Treats: skin discolorations, epidermal melasma, skin roughness, large pores, fine lines. If peel is medium – deep you may see improvement in stretchable scars and wrinkles. The “Standard Obgai Blue Peel” is a medium depth peel.

Deep
Penatrates to Intermediate Reticular Dermis (IRD). Peeling is completed in 8-10 days. Must be performed under medical supervision. Skin should be preconditioned in advance, and skin should not have any active acne. Following proper post treatment care is important, to prevent complications. This level of peel can be done with phenol, however TCA and lasers have largely replaced phenol peels. This treats: lines, wrinkles, deep melasma, and some scars, The” Designed Blue Peel” is a deep peel. With deep peels the skin will start to darken very quickly and may not start peeling until day 4 or 5, peeling skin will look very dark and thick almost like a thin scab. It is important that you do not assist the peel by picking or pulling skin off, loose peeling skin should be cut of with small sterile scissors to prevent inadvertently removing skin prematurely.

Very Deep
Penetrates upper to mid reticular dermis. Peeling takes up to 3 weeks.
Special training is required, done by a physician. Lasers have largely replaced very deep peels.

Acids and Chemical Peeling Agents

Chemical peels use several types of acid solutions to improve and smooth the texture of skin. Acids come in different strengths and can be used individually, combined or layered. A variety of acid compounds can be used. There are many branded peels, however an experienced esthetician can also create custom peels.

CO2 (cryogen therapy)
Cryotherapy, also called Co2 slush or acne slush, has been used in dermatology for over a quarter of a century. Co2 slush is created at the time of treatment, liquid Co2 is made into a “snow” ball and wrapped in gauze or cheese cloth and then dipped into acetone. The “slush” is the lightly swiped over the treated areas. Cryogenic “slush” can cause mild exfoliation and has antibacterial and anti-inflammatory abilities. Cryogen therapy is added to some superficial peels at the end of treatment
Also known as: Dry ice treatment, acetone slush and slush peel

Glycolic acid
AHA (alpha hydroxy acid), AHA’s are water soluable. Glycolic acid is formulated from sugar cane, and has the smallest AHA molecule, giving it great penetration ability and softening ability. Glycolic acid works by loosening up the horny layer and exfoliating the superficial top layer, also stimulates collagen growth. Needs to be neutralized to stop action, and can cause irritation.

Lactic Acid
AHA, derived from sour milk and bilberries, mild action, often used in conjunction with other acids.

Malic Acid
AHA, derived from apples, mildly invasive peel It can open up the pores, allow the pores to expel their sebum and reduce acne.

Tartaric Acid
AHA, derived from grapes, mildly invasive, similar benefits to other AHA’s

Salicylic acid
BHA (beta hydroxy acid), derived from wintergreen and birch bark. Differs from AHA’s, because it is oil soluble and penetrates the lipid plug in a congested follicle. Salicylic acid is also less irritating than glycolic acid and doesn’t alter skin barrier properties. Has antimicrobial properties.

Retinoic Acid
derived from retinoids; which is denatured vitamin A. It is chemically similar to Retin-A. It is a deeper peel than the Beta Acid peel and is used to remove scars as well as wrinkles and pigmentation problems. It is usually performed in conjunction with other acids to a cause peeling at a deeper level.

Resorcinol
A dihydroxy phenol produced from resins. Used externally resorcinol is an antiseptic and disinfectant, and is used in ointments in the treatment of chronic skin diseases such as psoriasis, and eczema. Resorcinol has been used as a peeling agent as far back as 1800 in strengths up to 30%, the problem with high concentrations of resorcinol is it’s corrosive ability and tenancy to depigment. Currently it is used at low concentrations in chemical peel compounds such as Jessner’s Peels.

TCA (Trichloroacetic acid)
TCA is a chemical cauterant, an agent that coagulates skin proteins. TCA can be used in different strengths and has the ability to penetrate past the papillary dermis and should be used with caution. TCA in concentrations less than 25% can be used in superficial peels. Medium depth peels are achieved with 30-40% TCA, and 50% TCA should only be used by a physician to achieve a deep peel and has greater chance for complication. TCA is used in the Obagi Blu Peels.

Phenol
Phenol is a very strong and toxic chemical, phenol peels require general anesthetic and heart monitoring. Lasers and TCA have largely replaced deep phenol peels, however low concentrations are often added to superficial and medium depth peels.

The Medical Estheticians at Shapiro Plastic Surgery, Paradise Valley Skin Klinic are experienced with chemical peels at all levels.
Call to schedule a treatment or consultation.
480 421-1701
www.shapiroplasticsurgery.com
You can follow Paradise Valley Skin Klinic on facebook

Thank you for visiting Best of Both Worlds Az.
You can follow us on facebook, twitter and on our blog site.
www.bestofbothworldsaz.com

Read MoreSeptember 20, 2010 2:15 am - Posted by Kristy

Hollywood Secret

Anti Aging – Anti Acneic – Brighten / Active Serum, fans are said to include Halle Berry and Charlezie Theron

Active Serum is in the top 5 of my favorite skin products, and I have tried a lot of products!
I’m not alone, all of the Estheticians I know love it and I can’t remember ever having a client say they didn’t like it.

I will sometimes incorperate Active Serum into my Obagi Protocol by mixing it with Exfoderm, or put it directly on my skin before tretinoin ( Retin-A). If I am not using Retin-A, I use Active Serum AM and PM before other creams.

Originally designed as an anti- acne formula, this product contains a combination of ingredients that target other concerns such as aging and pigmentation. Active Serum is appropriate for most skin types and can be incorporated into other skin regimens. Although is Clinical Active serum contains active exfoliates it will not cause skin peeling.

Active serum is applied in the evening after cleansing, and before any creams. Active Serum is contraindicated after chemical peels and many laser treatments, it may also cause irritation when used with some acne products. Be sure to consult with your Esthetician before using this product.

Active Ingredients and Benefits

Glycolic Acid 8.0% – Excellerates natural exfoliation processes, unclogs pores.

Lactic Acid 2.0% – Moisturizing and light exfoliation

Salicylic Acid 0.4% – Exfoliation, reduce sebum (oil) blockage,
anti-inflammatory, antimicrobial

Arbutin 1.0% – Lightens irregular pigmentation

Kojic Acid 0.5% – Lightens irregular pigmentation, some antibacterial effects

Menthol 0.5% – Antibacterial, antiviral action and cooling

Specifications

You can find is Clinical Products at Paradise Valley Skin Klinic.


Shapiro Plastic Surgery, Paradise Valley Skin Klinic
5410 N. Scottsdale Rd., ste F-100
Paradise Valley, AZ 85253
480 421-1701
www.shapiroplasticsurgery.com

Thank you for visiting Best of Both Worlds Az.
You can follow us on facebook, twitter and on our blog site.
www.bestofbothworldsaz.com

Read MoreSeptember 3, 2010 11:54 am - Posted by Kristy

Isotrex: This drug is NOT FDA APPROVED!

The FDA has sent out warning letters to company’s that are selling Isotretinoin drugs online.

Isotrex is a topical Isotretinoin drug used to treat acne. There are not any topical Isotretinoin drugs that are currently approved in the US. The only form of Isotretinoin that is FDA approved is Oral Isotretinoin (Accutane), and it is very regulated. Isotrex is a category X drug, in comparison to Percocet and Tretinoin ( Retin-A) that are category C drugs. Do not confuse Isotretinoin with Tretinoin, although they are both Vitamin A derivatives, Isotretinoin can have severe side effects and is a category X drug.

About Isotretinoin

I worked for a doctor that prescribed Isotretinoin ( Accutane) and I was the i Pledge designee for the clinic. Every month I had to schedule patients for lab work, doctor’s visits, and register patients with i Pledge. I can tell you it is a lot of work.

Special Prescribing Requirements for Isotretinoin
Because of isotretinoin�s teratogenicity and to minimize fetal exposure, isotretinoin is approved for marketing only under a special restricted distribution program approved by the Food and Drug Administration. This program is called iPLEDGE™. Isotretinoin must only be prescribed by prescribers who are registered and activated with the iPLEDGE program. Isotretinoin must only be dispensed by a pharmacy registered and activated with iPLEDGE, and must only be dispensed to patients who are registered and meet all the requirements of iPLEDGE.

Isotretinoin is only dispensed one month at a time, so every months patients will need to return to their doctor to have a pregnancy test, and blood work done before you physician can register you for that month. Patients must also go to the i Pledge website and answer a series of questions and reregister every month. After you have met all of the i Pledge requirements you have 7 days from the date on the prescription to get your prescription filled at an approved pharmacy. If you do not fill your prescription within 7 days you are not eligible for another month. You will repeat this entire process every month for up to five months.

Many insurance company’s do not cover Isotretinoin, and the cost ranges from $500 – $900 a month depending on the brand. Patients may also be responsible for covering the costs of monthly lab work and doctor’s fees. You should check with your insurance company to see what they cover.

With all that said:
I believe that Isotretinoin is a good idea for some patients. If someone is suffering from severe or cystic acne and has exhausted all other options, they may want to consider Isotretinoin. There are many acne treatments available, if you are compliant and patient they are very successful. You should discuss options with your doctor.

Brand names for oral Isotretinoin:
Accutane, Claravis, Amnesteem, Stret

Brand names for topical Isotretinoin :
Isotrex, Isotrexin ( not approved in US)

If you suffer from acne, call Paradise Valley Skin Klinic to schedule a free consultation.

Shapiro Plastic Surgery, Paradise Valley Skin Klinic
480 421-1701
www.shapiroplasticsurgery.com

Thank you for visiting Best of Both Worlds Az.
You can follow us on facebook, twitter and on our blog site.
www.bestofbothworldsaz.com

Read MoreSeptember 1, 2010 4:17 pm - Posted by Kristy

My teenage son actually asked me to buy him Proactive to treat his breakouts. I almost, fell over. I reminded him of my profession and pointed out that I have access to the best skin care products available. Why did he want Proactive? Marketing: with endorsements like P-Diddy and Jessica Simpson, it’s no surprise that people would be influenced to try it. So, I asked him if he would rather use a medical product that was dispensed by a physician or something sold in a vending machine in the mall. For a teenager that is better reasoning than any scientific explanation.

Obagi Clenziderm M.D. is a 3- step physician dispensed acne treatment. Step #1 is a Foaming cleanser with 2% salicylic acid, to remove excess sebum and cleans skin. Step #2 is Pore Therapy with 2% salicylic acid to help unclog pores, and menthol to remove surface bacteria. Step #3 Serum gel is a 5% solubilized benzoyl peroxide to reduce P. acne bacteria.

Obagi Clenziderm M.D. is unique because it is the only prescription strength acne treatment that contains a patented solubilized form of 5% benzoyl peroxide BPO, to penetrate deep into follicle and treat acne deep where it start. The BPO in the Clenziderm M.D. system is in a liquid form with macro-sized BPO crystals size that is one tenth the size of other BPO products. Average size of BPO crystals are larger than the size of the skin follicle, so they sit on skins surface.

Clenziderm M.D. Before and After 4 weeks

It is important to see a physician or medical esthetician to set up a treatment protocol. For some patients additional products and treatments may be recommended to enhance results. There are also skin care products,medications and treatments that can be contraindicated with this acne therapy. As with any skin treatment, compliance is key. You can schedule a free consultation at Paradise Valley Skin Klinic, Shapiro Plastic
Surgery.

Paradise Valley Skin Klinic offers a wide variety acne treatments and carries Obagi Products .
Call to schedule a treatment or consultation. 480 421-1701
www.shapiroplasticsurgery.com

You can follow Paradise Valley Skin Klinic on facebook.

Thank you for visiting Best of Both Worlds Az.
You can follow us on facebook, twitter and on our blog site.
www.bestofbothworldsaz.com

Read MoreJuly 12, 2010 11:26 am - Posted by Kristy