Chemical Peels and Retinoids
ALPHA HYDROXY ACIDS
Alpha-Hydroxy Acids (AHA) is a glycolic acid compound occurring naturally in fruits, vegetables and dairy. AHA is occurs in sugar cane, sugar beets, lactic acid from dairy products and malic acid from fruit. Glycolic acid accelerates the shedding of skin cells in the topmost layers of the skin by reducing their cohesiveness. With regular use glycolic-acid-based products may result in a more compact top layer of the epidermis causing the skin to feel smoother. It helps to remove blackheads and helps to restore the barrier function of the skin increasing its moisture content. It also leads to increased collagen production in the upper dermis, resulting in reduction of fine lines. Glycolic acid has an anti-inflammatory effect but may cause skin redness, irritation and stinging.
Alpha hydroxy acids exfoliate the skin removing of the top layer of the skin stimulates the cells in lower layers to grow and divide, resulting in a thickening of the skin and reducing the visible signs of aging. The more you exfoliate, the more cell divisions there are taking place, BUT normal, healthy human cells do not divide indefinitely. A key type of cells in the skin called Fibroblasts will divide about fifty times before entering a state of a gradual deterioration of function. At this point cell division slows, becomes sluggish, inefficient and unresponsive to the process of cell division and regrowth. The skin cells become fragile, wrinkle easily and the skin tone is blotchy. This limit of about fifty cell divisions is named the Hayflick limit after Dr. Leonard Hayflick who first discovered the limitation of skin cell division.
Chemical peels and retinoids as rosacea treatments should not be used to remove skin. The sensitive rosacea skin does not need further aggravation but needs to heal.
VITAMIN C
VITAMIN C is an anti-oxidant which is applied topically to protect from the skin cells from environmental pollution caused by free-radicals. It has mild sunscreen properties but a sunscreen containing a high SPF is still recommended for adequate protection. To work effectively, the Vitamin C treatment needs to have an acidic pH containing a minimum of 10% L-ascorbic acid. Application of Vitamin C products commonly result in skin irritation and stinging.
ORAL RETINOIDS
Oral Retinoids are vitamin A derivatives marketed under the brand names Acitretin and Soriatane for use in treating severe episodes of pustular and erythrodermic psoriasis. It may also be prescribed in a combination therapy with UVB and PUVA. Isotretinoin or Accutane have been prescribed for severe cystic acne.
Due to the severity of the risks and side effects associated with these drugs, patients are now required to sign a consent form acknowledging that they have been fully informed of the risks and dangers of these medications.