Discovery of the rejuvenating effects of lactic acid on skin predates modern medicine. Chemical peels were not created in laboratories after years of research. They were developed in boudoirs and salons, and were embraced by dermatologists and plastic surgeons much later. Fortunately, we are now seeing more clinical trials using these well-known acids, and scientists are beginning to understand more about how chemexfoliation agents stimulate skin rejuvenation.
“About 10 years ago lasers began to take over as the resurfacing tools of choice,” says Mamad Bagheri, MD, a dermatologist in Hemet, California. “Lasers offer good results, but many of my patients like the more affordable results they get with today’s chemical peels. And the word is spreading. Newer peels are easier for doctors to master, and adding them to their practices costs less and requires little space.”
Today’s chemical peel preparations still rely on familiar acids like glycolic, salicylic, lactic and trichloroacetic (TCA). The formulations, however, are very different. Here are five trends currently affecting the formulation and use of these important aesthetic tools.
Blending of acids with additional ingredients
“Older formulations combined acids with water,” says chemist John Kulesza, founder and president of Young Pharmaceuticals (www.youngpharm.com). “When acids dissolve in water, the chemical reaction creates free protons that are looking for electrons on other molecules. When they find them, energy—such as heat—is created that can burn and damage the skin. When an acid breaks the chemical bonds that hold proteins together, the proteins unfold—or denature—and reflect light differently. This is the ‘frosting’ you see with most escharotic chemical peels. Some newer formulations use solvents such as glycerine, propylene glycol or alcohol instead of water. The absence of water makes acids less keen on donating their protons, causing less injury and thus less pain and downtime. Some physicians still believe you need an escharotic peel for effectiveness. I argue you can achieve similar results by signaling fibroblasts that it’s time to make new skin, as you do with retinoids. The new anhydrous formulations don’t usually cause an escharotic injury. They do, however, break down the ‘glue’ holding corneocytes together to cause a peel and signal skin cells to make collagen and elastin.”
Zein Obagi, MD, renowned dermatologist, and founder and medical director of ZO Skin Health (www.zoskinhealth.com), adds that formulating the same old acids with a self-neutralizing base “makes the peel completely controlled. The ZO 3-Step Stimulation Peel uses TCA, glycolic and salicylic acids with saponin in controlled amounts. It also includes 6% retinol, which gives the skin a push to renew,” he says.
“Peel technology has certainly gotten better,” says Heidi Worth, MD, dermatologist and medical director of Allure Medical Aesthetics and Laser Center, Summit County, Colorado. “My favorite peel is the VI Peel and the VI Peel Precision (Vitality Institute Medical Products, www.vipeel.com). Like many of the newer peels, they are a proprietary mixture of acids. They are simple to apply, painless for patients and offer a predictable result.”
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