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Combination Therapy for Optimal Results

By: Jennifer Linder, MD
Posted: June 24, 2010, from the July 2010 issue of
Woman receiving LED treatment

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Antioxidants are also crucial to healthy skin. These offer protection against cellular oxidation, which significantly contributes to several skin concerns, and while there are many available, some of the most beneficial antioxidant options are: resveratrol from grapes, soy isoflavones, epigallocatechin gallate (EGCG) from green tea, and tocopherol or tocotreinols (vitamin E). Consider applying an antioxidant topical product following professional treatments to decrease inflammation.

For more targeted issues, ingredients such as retinoids and vitamin C should be considered. Retinoids describe vitamin A derivatives such as retinol and retinoic acid. Retinoic acid is the bioavailable form of vitamin A; however, topical application of this prescription drug often leads to surface irritation. For this reason, many prefer retinol, which is a commonly used cosmeceutical ingredient that can be successfully converted into retinoic acid within the skin. Studies suggest both effectively increase cell turnover, inhibit melanogenesis, increase collagen and elastin synthesis, and reduce free radical damage.1

Vitamin C is a multifaceted topical agent capable of performing several functions within the skin. L-ascorbic acid is the bioavailable form of vitamin C, and 15–20% is excellent for daily collagen promotion, hyperpigmentation reduction, anti-inflammatory benefits and antioxidant protection.2,3 Like retinol, it is imperative that a vitamin C topical be stable. Look for anhydrous bases and encapsulation technology to ensure optimal results.

Chemical peeling

Chemical exfoliation has been used for centuries to reduce the appearance of skin wrinkling and discolorations. The application of acids or other caustic substances to the surface of the skin encourages desquamation and triggers a cascade of changes within the dermis and epidermis. Chemical peels range in depth from very superficial to deep, with the risk of complications increasing with the aggressiveness. Regardless of the depth, increased collagen synthesis, enhanced penetration of topical products and improved overall appearance is typical with chemical peels.

Superficial chemical peels induce epidermal exfoliation and include alpha hydroxy acids (AHA) such as lactic and glycolic acid, beta hydroxy acids (BHA) such as salicylic acid, and trichloroacetic acid (TCA) in percentages below 30. Blended chemical peels such as Jessner’s solutions (14% lactic acid, 14% salicylic acid and 14% resorcinol) also are typically considered superficial. Blended acid peels are particularly beneficial, as multiple ingredients are able to target several skin concerns simultaneously.4 Look for peels that include not only acids but also melanogenesis inhibitors such as hydroquinone, kojic acid and arbutin for a well-rounded exfoliating treatment capable of performing several functions.