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Vitamin C in Skin Care

By: Peter T. Pugliese, MD
Posted: June 2, 2009, from the June 2009 issue of Skin Inc. magazine.

page 5 of 11

Topical treatment should center on individualization. Basically, there are three degrees of damaged skin and remember, aging skin is damaged skin.

Minimal damage. Minimal damage results in fine lines around the eyes and mouth without sagging cheeks, and wrinkles that are a hair line in depth.

Topical treatment for minimal damage. Start with a chemical peel of either salicylic acid or lactic acid. Use a night cream with 0.1–0.5% retinol and vitamin C at 3–5%, and a collagenase inhibitor, such as OPC. During the day, use 5–10% vitamin C in a serum or cream, along with vitamin E and OPC, as well as an SPF of least 15. Remember that vitamin C will slow down sun damage. See the client every month for three months, then every two months. Lastly, if she smokes, it is crucial to try to convert her.

Moderate damage. Moderate damage appears as deeper, longer, stringlike lines around the eyes, with more pronounced nasolabial folds and the accentuation of the labiomental fold, as well as pigmentation changes as colored spots here and there, sagging cheeks and forehead wrinkles.

Topical treatment for moderate damage. Stop the damage and then reverse it. This will take some time, and perhaps a life change. Start with a salicylic acid peel and the day and night regimen as dictated for minimal damage treatment in the previous paragraphs. For the next visit in one month, do a Jessner’s peel, and schedule another appointment for the next month. The client will also benefit from an occasional oxygen treatment and an enzyme treatment. You can repeat the Jessner’s in three to six month and should recommend a vitamin C serum for daily use. Remember that vitamin C is essential in rebuilding collagen.