Exfoliation

Exfoliation is the removal of uppermost, accumulated cell layers of the stratum corneum. These "dead cells" dull the skin's appearance, making it look older. Sloughing these dead cells (corneocytes) has a significant effect on improving the appearance of many skin conditions.

Performing exfoliation is not a foreign concept to your body. Your natural cell growth and the renewal cycle causes skin cells to slough off. However, this natural process may be slowed or inhibited by a number of factors, including:
* Excessive oil, causing cells to clump or pack together
* Stresses such as pollution, aging, hormonal fluctuations, makeup etc.

As we age, the natural cycle typically decreases. Utilizing exfoliating techniques has been proven to enhance the cell turnover rate. Assisting the natural cycle of cell desquamation can be achieved through a variety of methods, typically classified as mechanical or chemical. Mechanical exfoliation involves physically removing corneum cells from the skin's surface using scrubs, gommages, and microdermabrasion. Checmical exfoliation, as you might expect, uses both natural and laboratory-designed chemicals to loosen dead cells from the skin's surface (AHAs, enzymes, resorcinol pastes, TCAs, and BHAs).

Because some is good does not mean more is better!
Despite what I believed in my younger years, one can exfoliate too much. Doing so increases the risk of destroying the skin's protective barrier. Over-exfoliated skin may experience an increase in susceptibility to sensitivity and irritation, resulting in a reduction in the skin's ability to handle skin care products without adverse reactions.

The Bene's
Each type of exfoliation works best with certain skin conditions and thus provides its own set of specific benefits. But generally, exfoliation works to:
* Uncover follicles that have been blocked by cellular buildup
* Help prevent formation of blackheads and other skin blemishes
* Smooth skin texture
* Assist in evening skin's color and tone
* Lessen the appearance of aging and sun damage

Is exfoliation for you?
Well, as we dig in to the types and methods, you'll have a better idea about what will work best for your skin condition and goals. Here are some general contraindications (we'll review more as we discuss each technique):
* Sunburn
* Heightened skin allergies
* Inflammation
* Open wounds
* Medication that can cause skin sensitivity (keratolytics such as Retin-A or Accutane)

TFN!

Like Mechanical Exfoliation (to be discussed in the future), Chemoexfoliation can be performed at home, by an esthetician and by a plastic surgeon or dermatologist. Obviously the last two practitioners perform much more in-depth exfoliations that are referred to as "deep skin peels" using very high percentage acids as well as other non-chemical methods such as laser resurfacing and dermabrasion.

We're going to focus on chemical methods that can be used at home or by an esthetician. The primary two groups are Alphahydroxy Acids (AHAs) and Betahydroxy Acids (BHAs).

Here are the general contraindications for chemoexfoliation. Discuss your skin type and goals with your practitioner to ensure you're using the product that's best for you.

* heightened skin allergies
* an extreme sunburn
* open wounds or open lesions
* medication that can cause skin sensitivity
* recent facial cosmetic procedure
* rosacea, pustular acne, or serious sensitive-skin disorders and/or infections

Glycolic acid is the most commonly used AHA, although lactic, malic, tartaric, citric, and even BHAs can be used and frequently, combined together in specific formulas. Additionally, these formulas are often supplemented with fruit acids such as passionflower, grape or apple extracts.

AHAs are believed to work by loosening the chemical bonds between the keratinocytes (the top cells of the epidermis). AHAs also act on the surface barrier function, breaking up the lipids that make up intercellular cement. These actions cause keratinocytes to be loosened and shed from the skin's surface. This shedding helps to reduce build up in the follicle wall, accelerates the removal darkened cells (filled with melanin, creating hyperpigmentation), and stimulates cell renewal. The heightened rate of cell renewal increases the production of intercellular lipids which in turn increases the ability of the epidermis to hold moisture and lowers the rate of transepidermal water loss (TEWL), which causes dehydration.

With an Esthetician:
AHAs used by estheticians at higher concentrations can benefit many skin conditions. Combined with a home care program, AHAs can help improve acne-prone skin, clogged pores, hyperpigmentation, signs of aging and sun damage, dehydration and rough-textured skin.

You will be requested to utilize an AHA product at home for two weeks prior to the first treatment.

A series of six treatments performed once a week for six weeks is strongly recommended for best results; some practitioners may require that you adhere to this program.

Typically you will be requested to sign an agreement stating that you understand the treatment and your obligations for avoiding irritation.

At Home:
Use a cleanser for your skin type but ensure that is not soap and does not strip the skin (make it feel too tight and dry).

Use an alcohol- and fragrance-free toner that rebalances the skin's pH.

A dime-sized amount of product is usually enough.

The thinner skin of the eye area requires that you use only AHA products that are made for that zone; and, avoid usage on the upper lid.

Must use sunscreen of SPF-15 or higher daily and throughout the day (one application is usually not enough).

Can be used to spot treat pimples or in combination with other drying agents to spot treat.

General recommendations are to use AHAs 4 to 5 x/week with about one week off per month (use that week for facials, waxing etc.)