Sunday, February 12th, 2012

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.

Formation

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.

Learn more about the infection, inflammation, and eruption stages!  Continue reading →

Saturday, November 26th, 2011

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!


2007 & 2008

John’s Journey to Fight Acne

I began following a regular skin care regimen about a year ago. At the time, I was experiencing quite resonating ideological and emotional shifts regarding school, my personal life, and relationships. They somewhat darkened my perspective and drove me to behave irrationally and impulsively, which lead of course to grave consequences and regrets. On top of all that, I had to handle my profusion of non-inflammatory and cystic acne. Consequently, I thought quite basely of myself.

The first photo was taken around 2007, when my acne was less cystic but still severe. The second photo was me in 12th grade (around 2008), when I started getting cystic acne. See how the right cheek and side of the nose folded as I winked? That’s because the cysts were so distended that they forced my skin to overlap. The camera’s flash does wash me out, so my condition appears better than it actually was.  To make an extremely long story short, three magical ingredients helped to rid my skin of acne. In order of discovery, they include:

  • Salicylic Acid:  I first encountered salicylic acid (SA), a lipid-soluble aromatic compound, in the form of Step 2 of the Clinique 3-Step system (skin type 4). I began with the Clinique 3-step because it was cost-effective, reputable among friends, and Blair Fowler loved it. The system helped somewhat, but after a few months, my skin worsened. From what I now know, repeated exposure of the alcohol content present in Step 2 had irritated my acne so intensely that it overshadowed the alleged effects of SA.
  • Benzoyl Peroxide:  I turned to other products to use in concurrence with the Clinique 3-step. First, I tried treatments from Neutrogena and Clean & Clear containing 10% benzoyl peroxide (BP), an antimicrobial ROS-generating compound, which should have improved my condition drastically, but due to the high amount of irritation involved, only improved my condition slightly. Since some studies suggest that lower concentrations of BP work just as effectively as higher ones, without the additional irritation, I next tried the Acne.org 2.5% BP product. Unfortunately, the reduced concentration had no positive effect on my skin.
  • Glycolic Acid: By this time, I was already familiar with Paula Begoun’s review website Beautypedia. However, I had never seriously considered using her products because one, the gaping conflict of interests was too impossible to ignore, and two, I hated that her products always received the highest rating possible. However, I was desperate. I purchased the 2% SA liquid treatment, as well as the 8% and 10% glycolic acid (GA) products.  Within two months, my acne had been reduced by at least 75%.

My postulations as to why the introduction of glycolic acid, which is typically better for dry and mature skin, worked so well for my adolescent and oily skin include the following:

  1. Due to the long-term damages of having severe cystic acne, my skin’s natural ability to exfoliate had been damaged,and therefore, functioned erroneously. This is evidenced by the daily buildup of gunk or sebum that would come off in thick layers when I gently scratched my face in the shower. I’d include a picture, but that would probably be gross. Its consistency is best described as a hybrid cream-wax that was sometimes bluish and other times yellowish.
  2. Partly due to its low molecular weight and water-soluble nature, GA is quite adept at exfoliating the surface of the skin. For my skin, this meant thinning of the statum corneum (SC), which had that excess “gunk,” which in turn allowed for the SA to actually penetrate into the pores and induce desquamation at those sites.
  3. Furthermore, the new Paula’s Choice (PC) SA product is a better formulation than the Clinique product mentioned above because of the vehicle and penetration enhancers used. The PC product employed methylpropanediol and butylene glycol to enhance penetration. The Clinique product employed denatured alcohol and butylene glycol. Although denatured alcohol is quite effective at enhancing penetration, it is too volatile, meaning that it evaporates quickly. Once the vehicle becomes volatile, SA becomes significantly less effective. Not to mention that in high amounts, denatured alcohol is irritating.
  4.  The GA, which reduced the excess sebum on the skin, also allowed for the BP to penetrate more deeply. As you can see, GA was the critical component necessary for effective treatment.

*Please note that though changes in stress level, diet, and exercise probably played major roles in the improvement of my condition, they are not addressed because they cannot be easily quantified and therefore, elucidated.

After my skin was basically clear, I set out to repair some of the damage done by my decade of untreated severe acne and lack of daily sunscreen use. There are two ingredients that have largely retextured, rebuilt, and refined my skin. In order of discovery, they are L-ascorbic acid (vitamin C) and retinol (vitamin A). Vitamin C stimulates collagen production while retinol, upon conversion to tretinoin—the active metabolite that the skin utilized, inhibits the expression of enzymes that break down collagen. So the therapy is two-folded. While these two fantastic ingredients exhibit several other beneficial properties, that’s for another time!

Check out John’s current skin care routine!  Continue reading →