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Healthy, youthful, attractive skin is the goal physicians and patients strive for, and it should be possible for persons of all skin types to achieve, whether through a skin restoration program alone or in conjunction with a procedure.
At Sydney Inner West Vein Centre Dr Jilliam Tatham has been performing skin rejuvenation treatments for well over a decade. The programs offered at our clinic are based on proven scientific principles. Dr Tatham attempts to reduce the confusion surrounding the wide choice of products available to patients over the counter, by developing individual programs using key ingredients in simple and inexpensive formulations.
As a medical practitioner she is able to prescribe the active ingredients in higher concentrations than those available commercially. By tailoring the program to suit the individual patient she is able to alter the concentrations to achieve greater improvement and usually in a shorter time frame.
In addition to these benefits she can also advise if supplementary treatments are required. These can include medical strength facial peels and wrinkle management using line softening injections and dermal filling agents.
The “key ingredients” for skin restoration are: Alpha hydroxy acids, retinoic acid, hydroquinone and antioxidants (specifically Vitamin C).
Alpha hydroxy acids (AHAs) are fruit acids and are commonly available in a range of cosmetic products in low concentrations. The main action of the AHAs is exfoliation. In low concentrations they produce little if any visible exfoliation (shedding of the upper cornified layer of the skin).
In higher concentrations they have an improved action and can significantly thin the upper layer of the skin (epidermis) and thereby increase the skin’s flexibility and light reflection. Used in appropriate concentrations they have been shown to increase collagen production and are good moisturizing agents as they improve the skin’s ability to hold water. These effects lead to a smoothing of the skin and an increase in the cell turnover rate. The effects are short lasting however, and if discontinued the skin will not show any lasting improvement.
Unlike AHAs, retinoic acid works at a much deeper level in the skin, is more potent and has a longer lasting effect even when discontinued. Retinoic acid not only improves the structure of the skin but also its function. Clinical studies have shown that it can result in the formation of new blood vessels that improves the blood flow through the skin allowing rapid clearance of potentially toxic substances. It stimulates the immune function of the skin which in turn inhibits the growth of skin cancers. It also increases the collagen content and improves elasticity.
Hydroquinone is a topical depigmenting agent that specifically targets the melanocyte system (the pigment producing cells in the skin) and interferes with the production of new melanin. Skin lightening is not immediate because hydroquinone only prevents the formation of new melanin and production resumes when its use is discontinued. Medically prescribed hydroquinone is 4% strength and higher percentages have not been shown to be more effective.
When hydroquinone is mixed with either
AHAs or tretinoin in correct proportions it has an added effect to that of depigmenting and this is known as “blending” – that is, the pigment (melanin) is distributed more evenly throughout the skin. This is especially important for people who are prone to pigmentation problems and results in a more even skin tone.
Vitamin C is a vitamin of great importance to the skin. Vitamin C is from the anti-oxidant group and functions as a neutralizer of free radicals in the skin. Free radicals are produced in the skin from normal metabolic processes as well as sun exposure, pollution, stress and smoking. Free radicals cause damage to the cell membranes and DNA components. They are implicated in the development of some forms of skin cancer.
Vitamin C needs to be applied to clean skin and in a concentrated form to work effectively.
Most products purchased over the counter only contain low concentrations of the effective ingredients, otherwise they would not be able to be sold in this way. It is often still possible to incorporate higher concentrations of the key ingredients with the products you are currently using. Gradually you can then replace these products with more effective (and less expensive) programs of skin care maintenance.
AHAs and retinoic acid used in higher concentrations can often cause some skin irritation when they are first used. I try to minimize this by gradually increasing the concentration of the active ingredients over a period of time so the skin can adjust to the program. However, the sooner the skin can be conditioned to the treatment program the sooner you will enjoy the benefits of improved skin function and appearance. These early irritations are a good indication that the program is working.
The single most significant factor in ageing of the skin is exposure to the sun (photoageing). Continuing to allow the sun to damage the skin will quickly reverse any improvement your skin makes. A broad-spectrum sunscreen is an essential part of the programme. During a skin consultation we can advise how to include sunscreens daily in the skin restoration programs.
© 2011 Sydney Inner West Vein Centre