A Look At the Use of Acids In Skin Revision Treatments


Article By Dr. Danné Montague-King

Now that the "acid reign" is almost over and alpha hydroxy acids (AHAs) have very nearly been put back into the hands of the professional skin practitioners where they belong, doctors and therapists in many parts of the world are having to deal with clients whose skins are over-traumatized by excessive use of acid formulas; especially from home-care products.

Asians, possessing skins that are already at a slightly lower pH than most Caucasians have particularly been victims of indiscriminate acid use. Repeated applications of glycolic acid have created a “hardened” effect to many Asian skins, often resulting in hyperpigmentation and all sorts of congestion.

Professionally used, acids are a very effective tool in dead skin cell removal – but I still view the claims of glycolic acid as moisturizing with a jaundiced eye.

The simple fact that alpha hydroxy acids are hydroscopic in nature and actually work ‘off’ the moisture in the skin, pulling upward into the dead corneum which in turns starts the surface cells swelling up like little balloons overloaded with water. These then burst open and the fragments detach from the skin-hence the peeling effect.

This in fact is a desirable action for professionals who can monitor the client and replace the bilayer lipids and natural moisture at the conclusion of the treatment. Daily use of these acids in products at home will eventually pull ALL of the natural secretions of the skin upwards to the surface and out, which results in gross dehydration and dark, uneven toned skins.

Occasionally one of our practitioners will prescribe a home use formula containing AHAs for a specific reason. The client is then carefully monitored for signs of dehydration or discoloration, etc. But chronic users of AHA products have begun to report conditions, which I call “acid hardened skin.”

There are two basic manifestations of this condition and sometimes a combination of both:

(a) The skin takes on a thin, glassy, hardened look and feels dehydrated and darkened in areas

(b) Hard pustules or nodule-like pimples form under the skin and do not erupt quickly onto the surface

To treat this type of condition, and flush all of the hardened sebum and acid out of the skin, we must perform a series of special enzyme treatments followed by disincrustation treatments and radical pH reversal protocol used at home.

Acid hardened skin needs to be rebuilt as well. I never believed the “laying down of collagen fibres” story that often has accompanied AHA brochures or literature. Certainly collagen can be forced to proliferate beyond its natural rhythm and now cells can be forced to the surface to combat surface trauma, but this is not a natural cell renewal under normal skin metabolic conditions.

This action is in fact one of the defence mechanisms of the skin, and not a normal collagen enhancing action such as can be obtained with vitamin C therapy and other tissue building modalities.

AHAs are good for removing dead and dying cells from the skin only, and offer a very safe and predictable result on any skin regardless of age, race or color if the pre-treatments, application techniques and post treatments are performed properly.

When our practitioners perform our six layer Pro Alpha Peel on patients, or our medical Hydrozyme Peel, they subject the patient to at least two enzyme treatments first, followed by five nights of retosin, sort of a “liquid laser” vitamin A, retinol type lotion.

The actual Pro Alpha procedure takes a half-hour in-clinic to perform but total desquamation takes about six days. After the six days most of the skin is de-epithelialized, sometimes detaching in sheets and less often granulating from the epidermis. This depends on the age, race and condition of the client's skin. It also depends on how many pre-enzyme treatments they have had.

There is, however, no real erythema even on the first day of application, no swelling or pain and rarely any weeping. The skin particularly that of Asians and blacks becomes very dark just before epilation takes place.

We caution the patient that we will be fully dehydrating their skins for several days? We believe in being up front on what AHAs really are. Then, after the procedure is finished we perform a series of hydrophilic treatments to restore the moisture balance back into their skins.

It is like going to the bank and putting money back in. The result is glowing, firmer; less wrinkled and quickly "revised” skin.

The Pro Alpha Peel treatment is not better than our enzyme treatments, it is just faster and therefore more expensive for the patient (time is money to most people). Clinical research has shown that many people are happy with one Pro Alpha treatment followed by enzyme treatments and their Danné Home Prescriptives for a lifetime. Others have one Pro Alpha a year, and still others with badly damaged skins have up to six in one year.

Articles By Dr. Danné Montague-King

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Danné Montague-King South Africa

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