“I’m of the firm belief that you’re better off having a strong peel just once a month at most”
A Peel Too Far
Who’d say no to a fresh, glowing and healthy skin? For decades, continuous peeling away of the top layers of skin has attained this goal. But in our search for perfection, in our quest to erase actual or imaginary blemishes, are we going too far? Are we making ourselves look older, not younger and refreshed? Learn how you can avoid thin, waxy or papery skin, the result of overdoing the acid peel routine.
Posted: 2 August 13
When asked by a New York Times journalist, “What does the ideal complexion look like?” a medical aesthetician at Dangene Enterprise, replies that the skin should be smooth and almost powdery. “And it should have a nice glow, like you’re a 3-year-old who just woke up from a nap,” she says.
Although it’s true that this glow and freshness is achievable with the products and resources we have on hand, many people who’ve spent a lifetime removing layers of skin, end up with thin or waxy skin that eventually looks a little like stretched shrink-wrap instead. This is the result of over exfoliation.
Exfoliate, but, in moderation.
Its true that the most popular means of achieving radiant skin in the past has revolved around skin exfoliation, which means removing the outermost dead layers of skin to reveal fresh, new, undamaged skin layers.
The problem lies in not knowing where to draw the line. Exfoliation, like all good things, should be done in moderation. Moderation is highly subjective and depends on each person. There is no guideline, no easy way to know how much exfoliation is too much for the skin to handle. It all depends on the skin type and the individual. Unfortunately, many people—women mostly—mistakenly believe that the higher the frequency the better. There is also a belief that more exfoliation improves the effectiveness of anti-ageing and other topically delivered skin care treatments. Neither belief is true.
Excessive or too frequent exfoliation using chemical peels or Retin A can open up a whole new set of problems.
Overly exfoliated skin is not healthy skin.
The thin waxy look eventually gives way to stretched, translucent and crepe-like skin that is more likely to develop fine lines, not less. In Caucasians, the capillaries of the skin will become visible. Compared to untreated and healthy skin, overly exfoliated skin is more likely to suffer damage from exposure to the sun’s harmful and cancer causing UV rays. People with dark complexions will suffer over-peeling. They may also experience an unusual darkening of the skin or hyper-pigmentation that is permanent.
Overexposure to exfoliants—such as alpha hydroxy, salicylic, glycolic and lactic acids used in chemical peels—causes inflammatory responses in the skin, including redness and skin damage. Once you reach this point, it is very difficult to get your skin back to normal. Dermatologists face a dilemma in treating people with such conditions, because anti-inflammatory steroids can further contribute to thinning the skin. This is another reason why defying the limits imposed by your dermatologist, do-it-yourself peels and going overboard with off-shelf beauty products can be bad for your skin. It takes knowledge and experience to get this right; and you don’t want to take chances with the skin on your face.
Skin ages due to inflammation. Most anti-ageing routines make it worse.
Our skin ages when it is unable to completely repair the inflammation-based damage that takes place on an ongoing basis. We lose a little bit of our skin (the dermis) each year. Skin processes slow down gradually. If ageing is caused by the inability of the skin to handle even naturally induced levels of inflammation, how can inflicting more inflammation by way of anti-ageing processes be a solution?
“My belief is that we have identified swelling and scarring as successes because they temporarily improve pigmentation or generate a temporary tightening effect that looks like an anti-ageing event for the one day to one year that such an effect lasts,” says skin care specialist Ben Johnson, MD, a member of the Society of Plastic Surgery Skin Care Specialists. In his view, people think the results of a treatment lasted six months or a while, because “…the body continued to age and caught up with the improvements created by the procedure”. Otherwise, how could the loss of ‘results’ coincide so perfectly with how long it takes the body to heal the damage?
Forcing the skin to exfoliate at a rate faster than its natural pace is a mistake. Despite the benefits of skin lightening, improved firmness, acne clearance and improvement in fine lines, skin exfoliation techniques are inflicting lasting damage. Something has to give, and the skin responds with increased levels of free radical damage that ages skin and heightens cancer risk. We spur on scarring by adding more irritants to already irritated skin. Just as we increase absorption of anti-ageing topical applications, we are also increasing the capacity for absorbing environmental toxins through the skin. And we are making the skin more prone to dehydration, which can turn normally healthy skin into oily or combination skin.
Trust your skin. It knows what it’s doing.
Dr Johnson is convinced that the “skin slows down because it has lost its food/immune cell supply due to lost circulation and overwhelming repair efforts that occur as a part of ageing. Just like every other process in the body, when faced with declining nutrition, skin metabolism (turnover) slows.”
And that’s aside from the extra burden we place on our skins by more and more anti-ageing procedures. The skin repair work goes on for as long as three weeks after such treatments, with collagen production continuing up to that time. Repeatedly abused skin “does not get progressively better”, says Johnson. Instead of reversing or preventing ageing, in his view, decades of alpha hydroxyl acid, retinol and Vitamin C in high doses, retinoids and other treatments have proven effective neither in reversing nor preventing ageing. Instead, we see an increase in severe cases of rosacea, skin cancer, melasma and hyperpigmentation.
Need for more gentle alternatives.
If the goal is to minimise additional inflammatory effects on the skin, we must move towards alternatives that are gentler on the skin. According to Johnson, certain laser treatments, such as infrared and LED have mild to moderate effects, helping the skin in its healing efforts. Improved delivery systems that target dermal rather than epidermal layers in the skin also hold much potential. While many delivery-enhancing technologies are available, including dermarollers, blading and liposomes, Johnson says he prefers liposomes, as they do not contribute to further inflammation. Instead, lipisomes improve the penetration factor multi-fold over other creams.
Currently over-used Retin A is toxic and immunosuppressing, he says. And long-term use has not been effective. Non-toxic alternatives include retinaldehyde, which is as effective as Retin A, but is safer because it is stored in the skin. Both Retinol and Vitamin C are good for the dermis, but not for the epidermis. And more work needs to be done on improved delivery systems to prevent inflammatory effects. Other proven non-inflammatory collagen stimulators include Chlorella, Lipoic Acid, Beta Glucan and EGF.
Should we give up peels and exfoliation altogether?
Not really. Until more gentle options are developed, you can just stick to occasional peels without overburdening your skin. That essentially means sticking to the routines set by your dermatologist, and not going behind his or her back to feed your your peel addiction. It is also necessary to take it easy on do-it-yourself or routine off-shelf products.
According to Dr. Macrene Alexiades-Armenakas, an assistant professor of dermatology at Yale School of Medicine, our skin turns over every 28 days. “I’m of the firm belief that you’re better off having a strong peel just once a month at most,” she says, which gives the skin a “chance to recover, rebound and rejuvenate itself”.
Because the rate of skin turnover slows down with age, beginning in our late 20s and early 30s, exfoliation, done within limits can help improve appearance. Another reason why skin care routines should be tailored to individual skin.