PEELING AWAY THE YEARS

The Myth and Reality of Peeling Treatments

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Article By Dr. Danné Montague-King

For the last ten years the word “peel” has been a banner for anti-aging treatments, suggesting that the human skin be like an onion. Simply peel off an outer layer and viola! New and younger skin!

There have been many approaches to peels from “medium to deep peels” to superficial peels. But all of these types of peels promise the same thing, newer and younger skin. here is very little advertisement, however, on what the client does AFTER these peels, except to apply conventional cosmetic crèmes and sunblocks. It is almost as if all a therapist or doctor has to do is to perform a peeling treatment on their client and everything else takes care of itself.

The actual scientific facts however, present a totally different picture. The human skin is in fact not like an onion at all but more like an egg! The inside of the skin being a matrix of glycoaminoglycans and essential fatty acids and the outside of the skin a much tougher “shell” or corneum.

This corneum, which is made up of dead and dying skin cells, is not in definite layers that can just be peeled off. It is the outer portion of the epidermis and has hundreds of biological functions on it’s own—far from the “dead cell layer” that a lot of practitioners assume.

But before we take a look at what actually happens with various peels, let’s identify the general range of peeling procedures.

Medium to Deep Peels

As far back as the 1800’s physicians discovered that applying a variety of irritating chemicals to the skin could be used to reduce age-related skin disorders, freckles and acne. All of these chemicals burned but as the skin healed, many changes were observed. These changes were thought to be beneficial. They still are thought of this way today. But the opposite is the real truth.

The chemicals were principally acids such as salicylic acid, trichloracetic acid and phenol acids. The peels were (and still are) classified medium or deep according to the depth of their penetration, blistering effects and inflammation. Most people assumed that the “deeper the peel” the better the result. In fact Doctors seemed very preoccupied about “penetration and depth”. (sounds almost sexual!) It was at this point the mistakes and misunderstandings started and still exist.

What Are Acids?

According to the pH scale, acidity is expressed on a 14-point scale using units called pH, each unit representing a ten-point difference in acid concentration. The pH scale ranges from 0 (highest acidity such as battery acid) to 14 (lowest acidity such as lye, which is alkaline). When the pH is less than 7 on the scale, it ceases to be alkaline and starts to become acids.

Each small change down the scale results in enormous change in acidity. For example, a solution with the pH of 4 is 1000 times more acid than one with a pH of 7.

In simple terms, acidity or pH measures the concentration of positively charged ions (H+) in water.

The first thing an acid will do when applied to the outer skin or the corneum is to harden the dead cells. They become brittle and break away from the surface of the skin.

Some acids, such as Alpha Hydroxy Acids, are also hygroscopic in nature and will pull available water or moisture present in the skin up into the dead cells which resemble old, dry mini-sponges. Like dry sponges that are soaked in water the dead cells puff up, overload with fluids and burst. The cell fragments then detach from the surface of the skin. Constantly applying these types of acids not only harden the skin but dehydrate it as well.

Regular acids such as phenols and TCA’s also stimulate the skin into producing new cells faster—thus promoting younger and newer skin. At least this was the opinion of thousands of doctors and therapists all over the world. But again, the opposite was actually true.

The Regulators and Immune Systems of the Skin

What most people failed to realize is that when under attack from any type of deep trauma, the skin tries to defend itself. This defense varies depending on how deep the attack is. Medium peeling agents (weaker, less concentrated acids with a pH of 3.8) may arouse on minimal defenses such as epidermal dehydration. This happens when moisture is rushed to the surface very quickly and then evaporates.

Another defense system that may occur from medium peels is melanin, the skin’s primary defense against cancer and UV rays. When there is any type of trauma or irritation to the skin beyond a certain point, melanin rushed to the surface in a desperate effort to protect new skin cells. This can create inflammatory hyperpigmentation.

These defense systems at the superficial level leap into action simply because the receptors of the skin (ganglia) send out a signal of stress or trauma. Neither the protective fluids of the skin nor melanin has a brain that lets it know whether the trauma to the skin is from a chemical, a burn or the sun. They just react because they are forced to.

At the deeper peel level however, much more is going on. Strong concentrated acids with very low pH will destroy many of the regulatory cells of the skin as they penetrate deep into the epidermis and even down into the dermis. We call these regulatory cells the “policeman of the skin”. Their job is to regulate the rate of ascent or proliferation of new, baby skin cells to the surface.

If they are weakened, destroyed or compromised in any way, new, baby cells will rush headlong to the skin’s surface far too fast for the normal remodeling of new skin. They become SCARS. Scars are simply new skin cells that have nothing to keep them in line or in a normal form. They have rushed to the surface in an attempt to keep the skin breached against invasive bacteria and virus.

The regulatory cells begin with the desmesomes deep in the skin. These cells link the skin cells together and release the skin cells at the time they are needed in a rythematic fashion. Laser resurfacing or very strong acids destroy Desmesomes. In this case ALL the new cells in the area rush to the surface at the same time.

Collagenase is an enzyme that regulates collagen fibers and determines how much collagen is needed at any given time in the skin. Certain strong retinoid peels and the drug Ro Accutane (RETINOL taken orally) will destroy the enzyme collagenase — thus leaving the skin very susceptible to scarring.

The last possible regulating cell that can save the skin against trauma even if the other two “policeman” are compromised is the Langerhans cell.

Conveniently located right in the epidermis, this octopus-like organism has long tentacles called dendrites that are capable of not only reaching out and destroying invasive virus or bacteria that tries to get into the skin, but it can stop new cells that are rushing to the surface too fast and slow them down to a normal, non-scar producing rhythm. It also reduces erythema (redness) and edema (swelling) whenever these are trauma.

There are ways to stimulate this immune system cell to keep it strong and active. We employ such treatments on laser clients or clients who have had very invasive peels.

Stopping the Skin Damage

While it is true that in order to get a successful result from a peeling acid the pH of the solution must be very low and the concentration high, there are better methods of removal of the dead cell build up on the skin—particularly for Chinese people who are simply NOT candidates for medium or deeper peels.

For Oriental and Asian skins we have discovered enzymatic therapy far more effective than acids and without any of the damage and inflammation that acids can do on Chinese skins.

However if acid treatments or laser resurfacing are performed on clients, there is ways to stop the skin from damaging itself.

Pre Treatment:

A series of the correct type of enzyme treatments combined with properly formulated retinoid products (vitamin A) will strengthen the skin and bring it to optimum health. At this point the skin will be better able to maintain its integrity when assaulted by an acid peel or laser.

Post Treatment:

After the peels or laser the skin is totally vulnerable. The immune system of the skin must be quickly raised. We have already discussed the powerful Langerhans cell and it’s ability to destroy free radicals, virus and bacteria. And we looked at the fact that it also can help regulate the proliferation of new cells to the surface to avoid scarring.

The main ingredients that completely revitalize the Langerhans cell and keep it strong are the Beta Glucan class yeast cell wall extracts. These extracts are expensive to produce but worth it. Beta Glucans stimulate a weakened Langerhans cell within 30 minutes after being applied to skin that has been burned by laser, sun or acids.

The skin contains several types of nerve receptors that send different signals to the brain. These are called nocireceptors from the Latin word nocre. One of these special receptors is called a class C nociceptor.

The class C transmits signals of stinging and burning to the brain. It also triggers redness, swelling and inflammation. Class C nociceptors are distinctly different than class monitors sharp, pricking sensations and other normal, tactile sensations.

Type C nociceptors alert a person to potentially dangerous chemical exposure, but they can also actually damage the skin when they over react to chemicals that do not directly harm the skin.

Research recently has discovered a compound that reduces the sensitivity of the class C nociceptors and part of this compound is present in our own body!

I refer to the trace metal element “STRONTIUM, element #38 in the periodic table. Present in our bodies, strontium, which is similar to calcium, will actually turn down the sensitivity control of class C nociceptors reducing inflammation and burning sensations in the skin.

We are currently working on the ideal, topical delivery system for this common but remarkable and unique trace metal.

Summary

To achieve any result in skin resurfacing at all, acids at high concentrates and low pH must be used.

The actual result of this use is from excessive stress and trauma to the skin, compromising or destroying the regulatory factors in the skin that determines the rate of new cell proliferation. Most results are simply skin in a rapid healing mode.

The skin looks tight and bright and younger at first due to erythema and edema. But six months to one year later the true picture of the skin emerges. At this point the damage can be observed.

In Chinese skin, redness becomes nearly chronic and the skin has an unnatural plastic and porous (coarse) appearance. Hyperpigmentation or hypopigmentation are almost certainties when these acids are used on Chinese skins. Many times the hypopigmentation does not show up until after a year—especially in the case of laser resurfacing.

Removal of skin problems common to Chinese skin is best achieved with enzyme, protein/amino acid therapy, correcting the acid mantle of the skin, inhibiting melanogenisis while performing correct hyperpigmentation treatments and properly formulated retinoid compounds

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Danné Montague-King South Africa

DMK is THE ONE - World Leaders in Paramedical Skin Revision!