sifting through the noise

Every day, new products come out boasting to be the best in the industry. It’s true that there are some great product lines out there, but what is most important is to make sure that you partner with a clinician whose philosophy aligns with yours.

Some treatments are more aggressive than others, and clinicians need to educate the public and their patients on what is best for their individual skin type. Most importantly, clinicians must be able to explain to their patients what is taking place within their skin when various types of chemical exfoliating products and peels are applied to their skin, as well as why certain procedures have been chosen.

The term “chemical peel” creates many scary images in the minds of our patients, especially when the term “chemical” is used in conjunction with the word “peel.” However, the good news is that peel formulations have become very sophisticated over the years and many actually improve the overall health of the skin.

In simple terms, there are different depths of penetration. The deeper dermal peels which literally remove the epidermis, require long periods of downtime and are typically applied in a physician’s office,  are still used for deeper wrinkles and surface imperfections such as acne scarring. This is usually what comes to the patient’s mind and causes a significant amount of fear.

Superficial – or epidermal peels – are designed to only penetrate into the upper layers of the skin.  Many peels are now formulated as blends which are even more gentle than a single-ingredient formulation and, in some cases, are so gentle the patient may not even see any visible exfoliation; however, they will still be able to see visible results with little to no downtime.

There is also some confusion surrounding chemical peels causing thinning of the skin when used on a regular basis.  It is most important to understand that the epidermal cells are continuously produced and are supported by the body’s own epidermal stem cells.  There is no limit to this cellular production; however, as we age and with over-exposure to UV rays, our natural cell turnover slows down and our epidermal stem cells aren’t as active as in younger skin.  Superficial, blended chemical peel formulations actually encourage cellular renewal and help to speed up cell turnover while stimulating collagen and elastin production, reducing the appearance of brown spots, fine lines and wrinkles; many also introduce important hydrating ingredients back into the skin.  There are even formulations gentle enough for sensitive skin and rosacea.  It’s really all about the blend!

Remember that these are superficial peels only designed to penetrate within the upper layers of the skin; dermal peels do penetrate into living tissue, and there would be significant damage to the skin if peels such as these were performed on a regular, monthly basis.

Share your peel experiences below or at the PCA SKIN Facebook page now!

Vogue dives into chemical peels with PCA SKIN’s expert advice

In the May 2013 issue of Vogue, PCA SKIN®‘s chief scientific officer, Dr. Jennifer Linder, is featured dispelling myths about chemical peels and assuring readers that they are the best thing you can do for your skin. The article, titled “Lift Off,” highlights Ultra Peel® I and explains the many benefits regular chemical peel treatments have on skin health, while amplifying the effects of daily care in the process.

Vogue, May 2013

“I always say, ‘You don’t have to peel with a peel,’” Dr. Linder says. Regarding Ultra Peel® I, she noted that following the treatment, “the skin takes on this lovely glow and looks more even.” When performed regularly, Linder said, “you can get to the same end points with peels as you can with lasers.”

article highlights

• The latest cocktails have yielded gentle peels for virtually every skin type and issue: Have sun damage or discoloration? There’s a peel for that. Bothered by fine lines? Or just dull skin? Get a peel. Is acne a problem? A peel will help.
• The new thinking trades the no-pain-no-gain mentality for the more palatable slow-and-steady-wins-the-race: Combinations of multiple exfoliating acids in lower strengths encourage the skin to shed its top layers, along with dead, complexion-clogging surface cells and impurities.
• Beyond the luminous, near-instant gratification achieved by so many peels, [there is] another reason to incorporate one into a regular regimen: They help pave the way for daily skin care to perform better by removing dead surface cells that may be impeding its absorption.

Linder ends the piece saying, “Peels are the one thing that every dermatologist can do to help their patient’s age gracefully. The experience is much like getting a facial, but you get more out of it. You’re actually doing something to change the long-term health of the skin [and] it’s such an easy thing to do.”

Pick up the May 2013 issue of Vogue, on newsstands now, to read the full article. Follow PCA SKIN on Facebook and Twitter, and share the story on your own social channels to get customers buzzing about your peel offerings!

Interested in offering Ultra Peel® I in your practice? Call PCA SKIN at 877.PCA.SKIN [722.7546] or visit pcaskin.com for more information.

shaving considerations for men

The skin industry is finally making a dent on the treatment of men.  There are many different products that are marketed toward men’s skin health, but what about when they come to your treatment room? Men, too, have acne, uneven skin tone and aging concerns, all of which can be addressed with a chemical peel treatment.

Image courtesy of http://www.getbodylase.com.

 

PCA SKIN® has blended and enhanced peel solutions, such as the Sensi Peel®, which creates little to no irritation and downtime — exactly what men want, not to look like they just had a treatment done!

But there are some different contraindications when treating men’s skin as opposed to women. The most important, and often overlooked, is shaving. Approximately 1.3 billion men use a razor blade to shave worldwide, with 75% of them shaving their face daily. Shaving not only removes unwanted hair, but also removes part of the stratum corneum, much like microdermabrasion or a light dermabrasion treatment. When performing either of these two treatments prior to a peel, we know the peel penetration will increase due to the removal of dead surface cells. Therefore, a man shaving the same day as a peel treatment will cause similar results as doing a microdermabrasion with a peel.

Keeping this in mind, it is recommended to ask your male patients when they last shaved. This will help you gauge their sensitivity and may alter the peel treatment you were planning on performing. We always want to ensure men wait at least 24 hours to shave after the peel treatment as well to limit any undue trauma and irritation that can aggravate current skin conditions.

Another great recommendation would be to have them use Total Wash Face & Body Cleanser as a shaving gel. This formulation is blended with surfactants, calming and soothing agents, as well as hydrating ingredients. It helps to clear follicle debris while providing the perfect amount of slip and glide for shaving. This is also great for women to shave their legs, too.

PCA SKIN’s Total Wash Face & Body Cleanser

Have you treated male patients with any specific PCA SKIN peel to achieve incredible results? Share your story in the comments below or on the PCA SKIN Facebook page.

myths/truths about chemical peels

When patients hear the words “chemical peel” they have many different thoughts as to what the actual outcome will be. Due to a lot of misinformation readily available on the internet and in the general media, chemical peeling can make people nervous. It is the clinician’s responsibility to explain treatment outcomes and why they may vary. Discussing patient expectations during the initial consultation to clear up any misconceptions surrounding chemical peels ensures a positive experience for both the patient and the clinician. Our philosophy incorporates a progressive, rather than aggressive, approach. This way, patients will experience little or no downtime following a peel, yet still achieve outstanding results.

PCA SKIN’s peels are self-neutralizing, leaving patients with little to no downtime following treatment.

myths and truths

1. Skin should “peel” after having a peel treatment – As clinicians, many of us have had the experience of treating a patient with a chemical peel, after which they come back to you and say, “Your treatment didn’t work because I didn’t peel.” Visible exfoliation doesn’t determine the efficacy of treatment. Generally, healthy skin has less visible exfoliation. Exfoliation often takes place at the cellular level and is not always apparent to the naked eye. Conversely, some patients’ skin is so impacted that it can take a few peels to loosen dead cells enough to allow them to shed. Typically, these patients will see little or no peeling initially, and then see sloughing after a few treatments. Using analogies that a patient can relate to can be an incredibly useful tool when explaining to a patient why they may not peel. For example, feeling drowsy after taking pain medication is a side effect, just as peeling is a side effect to a chemical peel; some people may feel drowsy when taking the medication and some may not, just as some may experience exfoliation from a peel and some may not – either way, the efficacy of the medication or peel is not contingent on the side effect.
2. My skin is too sensitive for a chemical peel – Sensitive skin is defined as a heightened intolerance to topical products or external factors. Sensitive Skin presents itself as red, irritated or scaly. PCA SKIN utilizes ingredient blends to combat sensitive skin presentations. Our philosophy follows the low-dose approach; meaning, inducing the least amount of trauma to the skin to achieve optimal results. Sensi Peel® is formulated primarily for extremely sensitive skin types. This multi-faceted treatment also provides calming and soothing properties and helps to clear follicle debris, making it an excellent choice for helping sensitive skin types. Hydrate: Therapeutic Oat Milk Mask was strategically formulated to soothe and hydrate impaired skin conditions of all kinds. Oat milk is also a potent antioxidant that effectively manages dry or sensitive skin conditions.
3. All peels must be neutralized – Straight alpha hydroxy acid (AHA) peels, such as glycolic and lactic acid, require neutralization with either water or a weak base like sodium bicarbonate. Unfortunately, the neutralization process can free hydrogen and, therefore, reactivate the acid and increase the heat sensation and discomfort in the skin. This increases the potential for negative outcomes and side effects. However, peels such as the Jessner’s and trichloroacetic acid (TCA) peels, and retinol treatments do not require neutralization. The water and lipid content in the skin leads to self-neutralization of the aforementioned acids. PCA SKIN combines AHA acids with TCA or Jessner’s peels, along with ingredients like retinol, salicylic acid, antioxidants and calming and soothing agents in bases that provide excellent delivery systems. The synergy of these ingredients is such that the peels are self-neutralizing, allowing for maximum effectiveness with little or no downtime.
4. It’s fine to hit the gym after having a peel – The epidermis is comprised of several layers and when a chemical peel is applied, even if it’s very superficial, it can cause a separation of these layers. Any activity that induces heat and sweating, either from a work out, an athletic activity or sitting in the sauna, can cause water to become trapped between the epidermal layers. This may result in blistering and, depending on the severity of the blistering, lead to an uneven skin tone. Another reason to stay cool following a peel is that internal heat can also lead to uneven skin tone. PCA SKIN recommends remaining cool for 48 hours post-peel to avoid any heat-related complications post-treatment.
5. Acetone is best to prep skin for peels – Skin must be clean and degreased to maximize penetration of chemical peel solutions. While acetone is often used because it is a strong and biocompatible solvent, it is not ideal for pre-peel prep. Acetone not only removes excess sebum that hinders peel penetration, but it also over-strips skin of essential cholesterol and lipids. This can leave skin overly dry post-procedure and last for weeks following treatment, causing undue discomfort for patients. The lactic and citric acid base of Smoothing Toner provides an astringent that gently and effectively removes any remaining sebum and debris post-cleansing, without drying out skin.
6. My patient can expect the same outcome each time they receive a peel – The amount of visible exfoliation depends on current skin conditions, combined with atmospheric conditions like humidity, which may cause flakes to adhere to the skin more so than in dry climates. Further, there may be a lot of visible exfoliation after the first treatment and less for the second, but this does not mean the first treatment worked better than the second. Moreover, someone who has previously had peel treatments may not have as much visible exfoliation as someone who has never or rarely gets treatments, as these patients will have more build-up. Everyone has a different tolerance for peels and that tolerance tends to grow with every treatment.
7. Peels are not indicated for drier skin types – A well-formulated chemical peel minimizes the amount of impacted skin cells lying on the surface of the skin while delivering hydrating, firming, strengthening and brightening ingredients into the skin. Once the skin is free of the dull surface layer, any products applied topically will penetrate better, leaving skin healthy and hydrated. PCA SKIN’s elegantly blended peels offer options for all Fitzpatrick types and skin conditions.
8. Frequency of treatments is not important – Regular in-office treatments are critical to maintaining optimal skin health. We recommend basing frequency of treatment on the condition. Uneven skin tone may be treated every three weeks and acne (all types) may be treated every two weeks. Sensitive skin may be treated every four weeks, while aging skin may be treated every three weeks.
9. A daily care regimen and sunscreen only matter if I have problem skin or I’m out in the sun all day – Along with receiving regular treatments from a clinician; a patient’s daily care regimen is just as important to maintaining skin health. Patients must manage their own skin at least twice a day; that’s 60 times in any given month vs. a single monthly treatment from a clinician. Therefore, one professional treatment won’t be beneficial if the patient is not doing his or her own part on a daily basis to maintain the health of their skin. Further, using a broad spectrum sunscreen is especially important post-peel as the procedure sensitizes skin to the sun. Remember, peels work at the cellular level and are still working long after you’ve had the treatment. Thus, it’s important to incorporate sun protection into your daily care regimen.
10. Peels are safe for patients with vitiligo – Vitiligo is an autoimmune disorder in which the body attacks its own pigment-producing cells (melanocytes), resulting in areas of depigmented skin. Because its presentation is on the skin, it makes sense that patients would think that chemical peels would help to “even out” skin tone. This, however, is untrue. Because this is an autoimmune disorder, treating it topically with a chemical peel will have little to no effect. While chemical peels are not the recommended course of action, there are other prescription medications and therapies available.

PCA SKIN originated advanced blended chemical peel formulations. Our vision is to improve people’s lives through our professional treatments for healthy, beautiful skin. PCA SKIN treatments and products are available exclusively through licensed skin health professionals that have been trained and certified by PCA SKIN.

If you have any questions about chemical peels, feel free to contact our highly trained team at 877.PCA.SKIN [722.7546] or email us at info@pcaskin.com.

PCA SKIN celebrates black history month

In honor of February being Black History Month, we wanted to focus this blog on treatments that are great choices for ethnic skin types. Many consumers may not know that chemical peel treatments are safe for people of color. PCA SKIN understands that everyone’s skin is unique and many of our treatments and products are safe and highly effective on ethnic skin.

The following are appropriate for all Fitzpatrick types:

Peels

Sensi Peel® – This gentle solution is a blended trichloroacetic acid (TCA) treatment formulated primarily for ethnic skin. Lactic and l-ascorbic acids help to hydrate and strengthen, while kojic and azelaic acids brighten skin. Arbutin additionally helps even out skin tone.

Smoothing Body Peel – This two-step treatment combines TCA with lactic and salicylic acids to smooth and hydrate skin.

Note: The PCA Peel® with Hydroquinone and PCA Peel® Hydroquinone free can be used on Fitzpatrick types I-IV or I-V, respectively.The Ultra Peel® I can be used on Fitzpatrick types I-V.

Peel Alternatives

Detox Gel Deep Pore Treatment – This solution blends lactic, glycolic and salicylic acids to effectively penetrate pores and dissolve blackheads.

Oxygenating Trio – This three-step treatment combines alpha and beta hydroxy acids with superoxide dismutase and hydrogen peroxide to stimulate cutaneous oxygenation and rejuvenate stressed skin.

Therapeutic Masks

Hydrate: Therapeutic Oat Milk Mask – Utilizes oat extracts to remedy dry skin conditions, taking hydration to a new level.

Revitalize: Therapeutic Papaya Mask – Combines an active blend of papaya, honey and fruit extracts to revitalize skin.

Clarify: Therapeutic Salicylic Acid Mask – Combines 20% salicylic acid to clarify dull complexions.

Note: The Retexturize: Therapeutic Pumpkin Mask can be used on Fitzpatrick types I-IV.

Boosters and Enhancements

Esthetique Peel or Ultra Peel® II – Either optional retinoid booster may be used post-treatment for all peels, peel alternatives and masks.

Replenishing Gel and Calming Balm – These enhancements may also be added to any protocol for additional protective and soothing benefits.

Treatment outcomes can be maximized by learning the art of customizing with PCA SKIN’s multi-faceted corrective daily care products.  Always complete treatments with ReBalance and protect skin from harmful UV rays with the appropriate SPF product depending on skin type.

Remember that gentle treatment delivers more dramatic and consistent outcomes. Healthy skin naturally glows from the inside, resulting in beautiful skin!

Feel free to call us at 877.PCA.SKIN [722.7546] or email us at info@pcaskin.com anytime with questions about treating ethnic skin.

combination therapies – The key to treating the aging face – Part II

As mentioned in Part I, because we all age differently and everyone’s skin is different, we may need to utilize other types of therapies to address multiple signs of aging. We talked about how injections can be combined with professional chemical peels and daily care products; however, there are many other types of treatments available that can also be implemented into a current regimen. The question is, however, at what intervals can professional chemical peels be performed before and after these other types of treatments?

When patients begin having injections, it is safe to administer PCA SKIN^® superficial chemical peels two days before or after the injections and every three weeks continuously.

Microdermabrasion is beneficial for stimulating collagen production and facilitating the penetration of peels and topical products. When administering a peel during a microdermabrasion treatment, it is recommended to do one pass in one direction and to apply no more than two layers of the following treatments:  Sensi Peel^®, Ultra Peel^® I, Ultra Peel^® II, Esthetique Peel. Our peel alternatives, Detox Gel Deep Pore Treatment and Oxygenating Trio^®, may be performed at the same time as well.

Courtesy of http://health.howstuffworks.com.

Intense pulsed light (IPL) is a beneficial treatment modality for collagen stimulation, coagulating fine, visible veins and also helps to address UV-induced pigmentation issues. By combining these treatments with regular superficial chemical peel treatments, patients’ results will be prolonged and collagen production will continue long-term. It is safe to administer PCA SKIN chemical peel treatments alternatively every two weeks with IPL.

Light amplification by stimulated emission of radiation (LASER) resurfaces the epidermis while stimulating collagen production. It will also assist with lifting pigment, and reducing port wine stains and leg veins, depending upon the type used. Begin treating patients with PCA SKIN peels one to two months before LASER treatments begin to prepare and strengthen the skin. Depending upon the level of ablation, PCA SKIN chemical peels may be performed two weeks after the LASER treatment to reduce the risk of hyperpigmentation and prolong results.

Surgery is beneficial in tightening sagging muscle and skin; however, it will not address hyperpigmentation, textural or other skin conditions. Treat patients with PCA SKIN chemical peels one to two months before and after surgery to reduce any existing or potential hyperpigmentation issues, and to encourage collagen production.

Always remember that throughout these suggested treatment intervals, daily care and SPF should be used. This not only maintains any other treatment therapies patients may be receiving, but will also retain your practice’s income and foster long-lasting relationships.

you don’t need to peel with a peel

When you treat a patient with a chemical peel, and they come back to you and say, “your treatment didn’t work, because I didn’t peel….”  how do you explain this?  When patients hear the word “peel” they have many different thoughts as to what the actual outcome will be, and it is the clinician’s responsibility to explain treatment outcomes and why they may vary. Patient expectations must be discussed during the initial consultation.

Courtesy of demeterclarc.com.

Visible exfoliation does not determine the efficacy of the treatment.  For example, if there is a lot of visible exfoliation after the first treatment, and less for the second, this does not mean the first treatment worked better than the second.  The function of the ingredients used in the treatments is the same from treatment to treatment – kojic acid will suppress hyperpigmentation; vitamin C will function as an antioxidant, suppress hyperpigmentation and increase epidermal thickening – regardless of the amount of visible flaking.  There are also other factors involved:

1.  Many times the same patient won’t have the same experience with each treatment. The amount of visible exfoliation can depend on the current state of the skin combined with atmospheric conditions; for example, humidity may cause flakes to adhere to the skin more so than in dry climates.

2.  Someone who has been treated with peels monthly for the past ten years may not have as much visible exfoliation as someone who has never or rarely gets treatments, as these patients will have more build-up.

3.  Some patients are so impacted that it can take two or three peels to really loosen those cells and allow them to shed.  Typically, these patients will see little or no peeling initially, and then get a very good sloughing after several treatments.

4.  We shed microscopically, continuously, throughout the month, rather than in one big slough every 28 days.  The accurate way of explaining this would be that in some circumstances our natural  desquamation process is interrupted because of an impaired barrier function and our stratum corneum does not shed off appropriately, even though our cells are turning over beneath the surface.  In this circumstance, using one of our peels may induce more flaking than if we were desquamating correctly.

5.  Healthy skin has less visible exfoliation.

PCA SKIN^® peels deliver excellent, visible results whether or not actual visible peeling occurs. Frequently, exfoliation is at a cellular level and not apparent to the naked eye; however, our peels will create a tighter and firmer complexion and appearance. PCA SKIN professional treatments are formulated to preserve, promote and protect healthy skin, regardless of whether the patient sees visible exfoliation following treatment. In today’s busy society this progressive, rather than aggressive, approach is advantageous, as patients will experience minimal downtime yet still have outstanding results.