Skin surface cells are continually shedding from birth throughout life. This process of exfoliation allows new cells to rejuvenate the skin surface. Ordinary mechanical forces each day, such as rubbing the skin or towel drying removes some surface cells. Complete cell turnover occurs about every two weeks in an infant, but this cell turnover process slows as we age until at age 65 the turnover time has increased to 12 to 13 weeks. Thus we can visualize older dead cells at the surface accumulating in thicker layers. The result is for the skin to lose its youthful glow and become rough and frayed at the surface.
The key to restoration of youthful skin is to stimulate exfoliation. Any exfoliation or removal of a surface cell stimulates new cell growth in the basal layer. It is possible to increase the exfoliation rate by mechanical or chemical methods. An ordinary washcloth can be very effective. The most effective washcloth for skin exfoliation is actually a cheaper washcloth that is relatively rough as compared to a smooth velour cloth. This is much preferred over loofah sponges or exfoliation brushes, which are usually left in the shower to accumulate bacteria and which can make acne worsen.
Exfoliation scrubs containing granules of any type should be avoided. Harsh granules cause microscopic abrasions resulting in inflammation that requires a healing process. In addition, the mechanical effect causes only haphazard or intermittent exfoliation of surface cells. This results in less than optimum smoothness.
Chemical exfoliation most often involves the use of an alpha hydroxy acid or salicylic acid, which is a beta hydroxy acid. Salicylic acid in low concentrations may be preferred for acne prone or oily skin as it has better penetration of sebaceous or waxy skin secretions. This is a cornerstone of the Reversion Acne Control System. Persons with aspirin sensitivity must be tested before using salicylic acid due to possible sensitivity to this chemical.
Both glycolic and lactic acids may be used in lower concentrations on a daily basis for exfoliation of the skin. The method of action for alpha hydroxy acids is to loosen the “glue like” material between cells that holds dry dead skin cells one to another. To be effective as an exfoliant any alpha hydroxy acid must be at least 10% in concentration, must be un-buffered, and must have a pH of less than 3.0.
Although glycolic acid has been highly touted in the lay press, it is the least desirable of the alpha hydroxy acids. Glycolic acid comes from vegetable sources and must be excreted in the human by the kidney. It can be toxic to humans. Because the kidney excretes it as crystals, it has proven to cause kidney damage and even destruction of a transplanted kidney in at least one patient. It is very harsh in its reaction on the skin in effective concentrations and cannot be tolerated by all persons.
The Queen of alpha hydroxy acids for exfoliation is lactic acid. Lactic acid occurs in every cell in the human body so it has no toxicity. It is an excellent exfoliation agent when used in a 10% concentration and causes little or no irritation. Lactic acid has some very beneficial effects as well. It is a principal mediator of the immune system. When applied to skin topically it causes an increase in tumor necrosing factor to actually help prevent the formation of skin cancers. It is safe to use during pregnancy or by mothers who are nursing. If applied immediately after a burn from hot grease that splatters, touching a hot oven, or even a severe sunburn, the next day there will be no pain, no blister, no redness, and no peeling of the skin later on.
Lactic acid in a 10% aqueous/alcohol solution, such as the Theraderm Fruit Acid Exfoliant is gentle enough to be used twice daily. There should be no irritation and other active products or ingredients such as humectants or moisturizers will be more easily absorbed. In a matter of days, one will see luxurious, soft skin. The use of this exfoliant truly enhances the quality-of-life.
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