Physician's Advice: Chemical Exfoliators, the acids
There are 2 types of exfoliation, chemical and physical. Today we will discuss chemical exfoliaters and how they impact acne and anti-aging. There are several different types and are composed of acids. The way acids exfoliate the skin will depend on their affinity for different aspects of the skin. To better understand this, we need to look at a skin cell with microscopic eyes.The individual skin cells start at the bottom of the epidermis at a place called the basement cell layer. They will then mature and ascend upwards over the next 90 to 120 days to eventually be shed. The cells are all attached to each other as if each cell is holding multiple hands with the other skin cells. These tiny hand holding attachments are called desmosomes. Interspersed throughout the epidermis are tiny tubes composed of modified hair follicles that have evolved to produce oil rather than grow hair. That is what your skin looks like with microscopic eyes.
As they age, skin cells will clump together and adhere to the oil glands. Acids help weaken this clumping action through various ways. The weakest acids used in dermatology are Vitamin C acids. This acid has anti-inflammatory and anti-oxidant properties and is useful for Rosacia or sensitive skin states. The next strongest acid is Salicylic acid. This is the same acid that aspirin is made of. Its mechanism of action is similar to vitamin C acid in that it weakens certain hand holding desmosomes between the skin cells and the cells will fall off. This property makes it useful in anti-aging applications and acne to a lesser extent. Glycolic acids are made from fruit acid and are the next strongest strength. They will have an affinity for the pore itself and as such are ideal for acne situations. The next strength moves to the vitamin A acids, many of which are prescriptions. These are unique in that they detach desmosomes, clear the pore and send a unique signal to the cell to operate more efficiently. Oil production is decreased, skin cells fall off at about 45 days and the remaining cells function to their capacity. These acids are most ideal for acne and anti-aging. Prescription Retin A is the prototype of this vitamin, although there are several chemical modifications of this drug that are weaker or stronger depending on what your Dermatologist recommends. Chemical exfoliation is most effective when combined with physical exfoliation. The acids will loosen the old cells attachment and the physical exfoliation will sweep them away!
These acids are in a great deal of products for acne and anti-aging uses. Any label that says anti-aging on a creme probably has an acid in it. Important to know, if you have sensitive skin. Knowing the mechanism of action may help you decide which over the counter product may be useful to you. Some caveats are in order. Salicylic acid strengths are regulated as medications and should not be used during pregnancy. Glycolic acids are considered foods and are not regulated. They are often sold in different strengths. People have the erroneous perception that larger numbers are stronger and perhaps better. Higher strengths may have deeper penetration but the manufacturer does not wish to incur additional liability for possible burns so they will “buffer” the acid. Meaning they will add a base to the acid resulting in a higher pH that reduces the efficacy of the product. Be aware when comparing different product lines based on concentration and be sure to ask if it is buffered. Un-buffered glycolic acids over 20% are unpredictable, so use with caution. Any of these acids will assist in keeping fresher more rounded cells at the bodies surface. These are useful for acne and for combating fine lines and wrinkles.
Acids can be unpredictable and can result in burns if used indiscriminately or too often. While many are safe, they are best used under the direction of your Dermatologist. This guide is for informational use only. It is not meant to take the place of your health care provider recommendation and no doctor patient relationship is implied. If you are curious if these types of cremes are for you, please come see us for an appointment.