Skin Deep-- Learn about microdermabrasion, chemical peels and other dermatologist treatments

about the solutions to your most common skin woes? While injectables are the fastest-growing dermatologist treatment, lasers, microdermabrasion, prescription topicals and chemical peels are also part of the arsenal of tools dermatologists use to help you achieve healthy, beautiful skin. To find a dermatologist near you, visit NewBeauty.com.

Chemical peels

Glycolics: Alpha hydroxy acids in concentrations of 30 percent or more are applied for two to five minutes (or more) to slough away the upper layer of dead skin cells. These peels also penetrate into the upper layers of the dermis to soften fine lines, promote a rosy glow, encourage better penetration of other skin-care products or even dry an acne flare up. Glycolic peels are no-downtime procedures, with mild redness or irritation the only likely aftereffect.

Jessner's solution: The common name for a deeper peeling solution of resorcinol and lactic and salicylic acids, this is commonly applied after a glycolic peel of 30 to 50 percent. The Jessner's solution is layered on the skin to treat pigmentation, acne, acne scarring and other skin irregularities. Aggressive peeling and occasional crusting forms within two to four days after the peel. Redness and swelling may last a week or more. Results are visible with new, clearer skin within seven to 10 days, but redness or other pigment changes may persist for several weeks.

lower concentrations, TCA peels can deliver a no-downtime peel to reduce fine lines, improve skin texture and even soften sun damage. In higher concentrations, well-trained doctors use TCA in lieu of laser resurfacing to soften acne scarring, erase crinkles and wrinkles across the face, and to reveal wholly new skin. Most TCA peels are a one-time treatment and require one to two weeks of downtime until crusting heals to reveal smoother, younger, clearer pink skin. Pigmentation changes are among the risks, and sun protection is an unquestionable must--for life.

Tretinoin: The same ingredient used in Retin-A and Renova to fight acne and fine lines topically is applied in a peel concentration from one to five percent. Tretinoin slowly penetrates the skin to gently slough away sun damage, aging and melasma spots. While this is a no-downtime procedure, you may be peeling for several days after treatment. Multiple cycles of increasing concentration yield the best results. Staying out of the sun during treatment is an absolute must.

How deep should you go?

The level of your peel will depend on how deep your skin issue lies--literally. Generally, the more superficial the skin concern, the less aggressive the selected acid will be. Remember, the deeper the peel, the higher the risk of potential complications.

Superficial: These "refreshing" peels remove a portion of the epidermis. They address blotchiness and acne and are also used to purify the pores. Examples: Glycolic acid (less than 70%); TCA (10 to 20%).

Medium: This strength of peel goes through the epidermis to the upper layers of the dermis. Side effects include inflammation and potential discoloration. Used to address fine lines, sun damage and irregular pigmentation, these peels may not be appropriate for darker skin. Examples: Glycolic acid (70%); TCA (20 to 30%); combination peels (glycolic acid followed by low levels of TCA); Jessner's peels.

Deep: Performed less often than in years past, deep peels require a medical setting, often with general anesthesia. Expect downtime of two to three weeks. Deep peels are not to be taken lightly. They include concentrations of TCA (above 30%), some Jessner's peels, and phenol, a peeling agent that is no longer widely used.

Quick Skin Boosters

Today, dermatologists can kick your peel up a notch with special boosters to target your key concerns.

Citric acid: Vitamin C sloughs away sun damage and provides a youthful boost.

Kojic acid and hydroquinone: Bleach away sun damage, freckles and dark pigmentation.

Salicylic acid: This beta hydroxy acid penetrates to dry up acne at the source.

Lactic acid: Similar to but milder than glycolic acid, this is the key to giving aging skin a rosy glow.

Glycolic peel stories

Derived from sugar cane, glycolic acid is an alpha hydroxy acid that helps reduce blackheads and other skin impurities as well as smooth out fine lines. Glycolic acid is also thought to help stimulate collagen production within the dermis.

At the Dermatologists office: Sara's Story

Sara, 30
After experiencing an uncharacteristic week-long breakout on my face, I decided it was time to seek professional help. After my dermatologist examined my face, sans cover-up, she told me that a mild glycolic peel could really help clean out my pores and help reduce and clear up my breakout. The aesthetician explained that I would feel some stinging and burning as she applied the acid, but she gave me an electric fan to use, which would alleviate the discomfort. First she cleansed my face and prepped my skin with an alcohol toner. Then, with a small paintbrush, she slowly began painting on the glycolic acid. I felt it immediately--a mild burning/stinging feeling, and then a slight itch--but it was nothing I couldn't handle. When she had completely painted my face, she placed wet cotton over my eyes and then after a few minutes drenched my face with a neutralizing spray that stopped the sensation immediately. Looking in the mirror, I saw a definite difference. My face looked so smooth, and my skin tone was really even. I was glowing! Over the next few days my remaining pimples dried out and for the first time in years, my chin area wasn't covered with small bumps. My makeup went on smoothly and my skin wasn't the slightest bit ashy. I'm hooked!

Concentration: 30 to 70 percent, depending on your skin's tolerance. Your dermatologist may increase the concentration over your series of peels.

Treatments: A series of three to six is recommended, spaced no more than two to three weeks apart.

Price: About $150 per treatment.

Provider: Dermatologist or plastic surgeon.

At-home: Kelly's Story

Kelly, 26
Since I don't have time to make regular appointments with my dermatologist--save for an annual checkup--and I am trying to take better care of my skin, I figured I'd give the Lancome Resurfacing Peel a try. Everything I needed was there (even a headband!), and each step was clearly marked so I knew I wouldn't have to worry about making any mistakes. I washed my face and then wiped it with the prep towelette. Then, following the diagram, I brushed on the peel with the fan brush that came in the kit. I felt the faintest tingle and washed my face after five minutes with a few of the enclosed wipes and applied the soothing cream from the package. I didn't think it was doing anything since I didn't really feel anything, but I was wrong. My skin was a little pink, but definitely looked fresher and dewier and felt smoother and softer. I think I'll try it on a Monday morning next time so I look refreshed from the weekend!

Concentration: 8-percent glycolic acid plus 5-percent Physio-Peel Enhancer yields the effect of a 10-percent peel.
Treatments: The kit comes with enough product for eight treatments, not to be performed more than twice a week. After completing eight treatments, wait 28 days before using the kit again.
Price: $145 for package of eight treatments
Where: lancome-usa.com

Prescription topicals

Often the first and best courses of treatment for many common skin issues are prescription topical creams. Many are used in conjunction with in-office treatments for the best results. Listed below are the some of the most often prescribed products.
Renova, Avage, Retin-A, Tazorac: These vitamin A-based retinoids increase skin-cell turnover and are used to address fine lines and can help clear up acne.
Tri-Luma: This cream targets melasma with hydroquinone and tretinoin (a retinoid) to fade hyperpigmentation and bring fresh, healthy skin to the surface.
Elidel: Eczema affects nearly 35 million people each year, and this steroid-free, odor-free, nongreasy cream is the latest weapon used to combat the red, scaly, itchy rash.

Microdermabrasion

Physical exfoliation buffs and polishes your skin to achieve a healthy glow and helps alleviate fine lines, pigmentation, acne and dull, dry skin. The virtually painless procedure uses a blend of abrasion and suction to reveal fresher, younger-looking skin after just one half-hour treatment. You'll leave your session looking pink, but this will fade after a few hours at most. Most dermatologists recommend a series of at least six treatments (plus maintenance) for optimal results. While microdermabrasion is available at spas and salons, dermatologists have access to more powerful equipment for more significant results. However, if anyone other than the physician is going to be performing this treatment, make sure they are operating with the supervision of an on-site dermatologist or plastic surgeon and have the experience and qualifications to use the equipment safely.

Liz's Microdermabrasion story

Liz, 36
The last time I went for my annual dermatologist visit, he suggested that I give microdermabrasion a try to even out my skin tone. Since it only takes about a half hour and he told me it doesn't hurt, I figured why not and scheduled an appointment with the in-office aesthetician. The aesthetician explained the process and the equipment to me. The machine had two clear cylinders on the top--one contained fresh crystals that would be "sandblasted" onto my face and the other was the receptacle for the used crystals and debris that was simultaneously suctioned off during the treatment. (Microdermabrasion crystals should only be used once.) The hand piece, attached to a hose that led back to the machine, had a clear, dome-shaped plastic piece that would be applied to my face. Cool compresses were applied to my eyes, to not only soothe them, but also to protect them from the crystals. The aesthetician then went over my face, treating a tiny area at a time. I could feel the crystals hitting my skin, but the thing I felt most was the slight suction. The whole process took a little over a half hour. When I looked in the mirror I was definitely pink (partly due to the increased blood flow from the suction), but my skin was so soft and the fine lines around my eyes seemed less visible too. The pinkness lasted for about an hour, but the smoothness stayed for a few days. I loved my microdermabrasion--I felt like I was treating myself as well as treating my skin. My dermatologist recommended that I go back at least every two weeks for the next few months, and I think this is one commitment that I won't have a problem making!

Active Ingredients Defined

Sometimes deciphering a bottle of moisturizer is like trying to translate a foreign language.

• Alpha lipoic acid: The antioxidant helps protect genetic material, such as DNA, in the body, which can reduce the effects of aging.
• Coenzyme Q10: Also known by its generic name ubiquinone, coenzyme Q10 plays a role in neutralizing cell-damaging free radicals.
• DMAE: An amino acid. Dimethylaminoethanol (DMAE) may prevent sagging skin and increase skin's firmness.
• Idebenone: A powerful antioxidant. Free radicals are unstable molecules that harm skin cells' DNA. Over time, the damage they inflict can contribute to aging. Antioxidants, especially idebenone, scavenge free radicals, thereby protecting your skin, reducing fine lines and evening out the complexion.
• Kinetin: A naturally occurring compound that fends off free radicals, reduces wrinkles, and retains the skin's moisture. Kinetin is nonirritating and has anti-inflammatory properties.
• Vitamin A: This antioxidant fights free radicals and encourages collagen production in the skin.
• Vitamin C: The antioxidant vitamin is used to combat the effects of aging. Vitamin C is often listed as ascorbic acid.
• Vitamin E: The antioxidant combats the signs of aging and some doctors believe it promotes healing of scars. Vitamin E is also known as d-alpha-tocopherol.
• Vitamin K: The anti-aging antioxidant helps the blood clot properly, allowing wounds to heal, and has anti-inflammatory properties. Vitamin K is also known as phytoquinone and phylloquinone.

Lasers

Lasers are used to treat a wide array of skin issues, from wrinkles and discoloration to sun damage, and even to boost collagen production. One thing to remember: It's important to use sunscreen after any laser treatment due to the skin's heightened sensitivity.

Ablative lasers and their uses

These lasers vaporize the surface layers of the skin. Because the lasers form wounds that must heal completely, these treatments come with serious downtime and meticulous post-treatment care. Upon healing, a fresh, new, healthy layer of skin is revealed.

• CO2: Pronounced lines and wrinkles, irregular pigmentation, acne scars and scarring from previous laser treatment.
• Erbium (Er:YAG): Fine wrinkles and other skin surface irregularities, such as acne scars and irregular pigmentation.

Non-ablative lasers and their uses

Leaving the upper layers of the skin intact, these lasers generate heat in the dermis to stimulate collagen production and improve the texture and tone of the skin. Treatments involve topical anesthetic at most and little (if any) downtime.

• CoolTouch (Nd:YAG): Improving skin tone and boosting collagen production in all skin types and colors, acne scars, large pores.
• Q-Switched (Nd:YAG): Blue and black tattoos, dark pigmentation.
• SmoothBeam: Acne, acne scars and fine wrinkles.
• Pulsed Dye: Fine lines around the eyes, collagen rejuvenation, spider veins, broken capillaries, birthmarks, dark scars.
• Alexandrite/Ruby: Hair removal, including darker complexions.
• Diode: Hair removal, broken blood vessels, pigmented lesions (birthmarks).
• ClearLight: Acne.
• IPL: A broad spectrum (as opposed to a single wavelength) of light is directed into the skin. Though not technically a laser, IPL is based on similar physics principles. IPL is used for hair removal, broken capillaries, acne, pigmentation changes (sun spots), actinic keratoses and photorejuvenation.
• Fraxel SR: This hybrid laser offers the results of an ablative laser with none of the downtime by treating a fraction of the skin's surface at a time. Fraxel is used for fine lines and irregular pigmentation.
• Photodynamic therapy (PDT): Photodynamic therapy involves application of a medicine called Levulan to the skin followed by exposure to one of several types of light sources to activate the drug. The light source can be a laser, an Intense Pulsed Light instrument or a special blue-light device. PDT is used for the removal of precancerous spots, acne, irregular pigmentation and fine lines.

source from http://beauty.ivillage.com