By John, Skincare Contributor
John describes himself as eccentric–you might find him having a conversation with himself or making “A Beautiful Mind”-like movements while doing so. He’s a stickler for accuracy, so you might find him correcting one thing or another! His goal is to answer questions and provide unbiased, meaningful, and insightful information.
At 21, he is an aspiring dermatologist and will return to school next fall to get those plans moving. John enjoys singing, playing piano, hitting volleyballs, playing video games, and chatting with friends. Some day, he’d love to try more adventurous activities, like skydiving and mountain climbing! Check out his blog, The Triple Helix Liaison!
The Skin Saga: Breaking Blemish
Currently, I have very oily, acne-prone, mildly sensitive skin that occasionally flakes and feels dehydrated in certain areas, like around the nose, mouth, and eyes. I hope to one day have very pale, perfectly-formed, diamond-hard skin that will occasionally shimmer and radiate when exposed to sunlight! This post will chronicle the stages of acne and explain how and what ingredients treat those stages.
A combination of factors including irregular polarization of the keratinocytes, excess sebum production from heightened androgen activity, and inflammation of the hair follicle lining, contribute to the formation of comedones, either as blackheads or whiteheads. The ingredients that block or inhibit this step include the following:
- Topical retinoids (tretinoin, adapalene, tazarotene): Topical retinoids function by reducing the positive and negative polarities of keratinocytes, which will allow for more even and normalized natural exfoliation. They do so by decreasing the levels of transglutaminase, an enzyme that cross-links the trans-membrane proteins present on keratinocyte surfaces.
Recommendations: Besides the brand-name and generic prescription treatments such as Retin-A, Differin, and Tazorac that are available from your doctor, the Peter Thomas Roth Retinol Fusion PM ($65.00), which allegedly contains 1.5% retinol, a precursor of tretinoin that is roughly 20 times weaker, is a fantastic option and I can personally attest that it provides significant results without much irritation. Note that “weaker” only refers to the ratio of retinol that undergoes esterification to become retinal and ultimately tretinoin. The word has nothing to do with the molecule itself because the skin cannot use retinol, only tretinoin.
- Oral retinoids and contraceptives (Accutane, Ortho TriCyclen, Estrostep, and Yaz): Oral retinoids and contraceptives function by reducing sebaceous gland activity. Less sebum means lesser chances of clogs or plugs forming. This may be surprising but retinoids are actually types of hormones because there exist various receptors (RARs and RXRs) throughout the body that are activated by the presence of such chemicals. So while they are distinct, oral retinoids and contraceptives do have overlapping characteristics. Oral contraceptives function by reducing the amount of circulating androgens; they stimulate the production of sex hormone-binding globulin, which inactive testosterone.
Fun fact: Ever wonder why many women experience acne once they reach menopause? It’s because their estrogen levels plummet, which means they can no longer hide the effects of the androgens still present (at now comparatively higher levels). Estrogens exhibit anti-inflammatory properties by decreasing neutrophil chemotaxis (meaning they inhibit and slow down the immune system), while androgens do the opposite. I guess that explains why men love to fight!
- Hydroxy acids (Glycolic, salicylic): This family of ingredients was already discussed in detail during my last post; they will only be covered briefly here. They function by loosening follicular impactions and inducing exfoliation.
Recommendations: Paula’s Choice makes excellent salicylic and glycolic leave-on products with varying degrees of concentration that employ different vehicular bases for corresponding different skin types. Alpha Hydrox makes several good ones as well. They are just less cosmetically elegant in my opinion.
- Regarding cleansers with hydroxy acids: Most hydroxy acids require a certain pH range to function properly, which is determined by the acid’s pKa and molecular electronegativity. Now, when pH = pKa that signifies that equal amounts of the free acid and salt form are present in the solution (50/50). Only the free acid form will allow for meaningful exfoliation. Now, even if a cleanser is in an appropriate pH range, which many are not, it still won’t function optimally because the pH of water is seven. The pKa of glycolic acid is 3.83; salicylic acid’s is 2.97. When you emulsify your cleanser with water and spread it onto your face, the pH will undoubtedly increase. By how much? It depends on how much water you use and if your cleanser is a buffered solution. You will be getting suboptimal or nonexistent treatment for your condition. Cleansers only stay on your face for what, thirty seconds? However, if you are currently using cleanser with a member of the hydroxy acid family in it, continue to use if you enjoy it, but I would advise against purchasing one expecting to see major results.