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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 6 of 11

Severe damage. Severe damage is illustrated by very deep and long wrinkles everywhere on the face, much sagging, discoloration of all types and pigmentation disorders, eyes beginning to sink, deep folds of nasolabial and labiomental wrinkles, and a turkey neck.

Topical treatment for severe damage. Severely damaged skin is a real challenge. If the wrinkles are deep enough to hold a straw, you should refer a deep peel by a physician and follow up after the procedure. If this isn’t done, the client will need periodic Jessner’s peels, which should be preceded by an enzyme peel. Follow closely because the client may need retinol treatment levels from 1–2%. You should have experience and some training in these levels to use them. How often you perform a peel will depend on the client’s response and your level of skill.

Hyperpigmentation

There are three main types of skin hyperpigmentation.

  • Melasma is a general term describing darkening of the skin.
  • Chloasma is typically used to describe skin discolorations caused by hormones, such as pregnancy, birth control pills or estrogen replacement therapy. Frequently, melasma and chloasma are used interchangeably.
  • Solar lentigenes is the technical term for darkened spots on the skin caused by the sun. Lentigenese describes a darkened area of skin that is quite common in adults with a long history of unprotected sun exposure.

Vitamin C can block tyrosinase, which is critical in the formation of melanin. It may take as long as 4–12 weeks to reduce pigmented spots. Vitamin C works well with lactic acid as a combined treatment. Magnesium ascorbyl phosphate, L-ascorbic acid, ascorbyl glucosamine and ascorbic acid are various forms of vitamin C considered stable and effective antioxidants for skin. It takes high levels of ascorbic acid to reduce pigment, up to 10% of some forms. Generally, ascorbic acid works best with other agents. Dermal pigment is diagnosed with a Wood’s lamp. A new observation indicates that a Wood’s lamp can be used to determine the depth of melanin pigmentation in the skin.8 Combining mandelic acid at 5% with ascorbic acid at 5–10% is often effective for dermal pigmentation. It is always best to refer a client with dermal pigmentation to a dermatologist. Your Wood’s lamp is one of the best diagnostic tools you have, so learn to use it well.

Scars and scar treatment

Facial scars are not easy to treat. Scar formation is a result of the process of wound-healing that promotes collagen formation. Vitamin C is essential in this process, but, at times, it will overproduce collagen, resulting in scar formation.