So many times, when asked about the most important skin care product, I rattle off that most everyone should be using a retinoid. I’ve said it until I am blue in the face. But to be honest, this often requires taking a medical approach to skin. So, today, I’ve asked my skin guru and friend to talk a little about the medical approach to skin care.

My fight against hyperpigmentation and early signs of aging just stepped up big time. I’ve already done one peel with Gabriel and will be blogging about my journey as it continues over the next couple of months (more on that later). But today, we have a little introduction about taking skin care up another notch. Take it away, Gabe!

1. What kinds of problems require a medical approach to skin care?

Most people find themselves in my chair when they have exhausted most all other options. As collagen depletes and the effects of sun exposure [earlier in life] start to appear, we get restless. We begin searching for what works…. and what works is what we want. Often what leads people to increase strength in their skincare is the awareness that what they have been doing isn’t keeping up with the pace of aging.

There are many wonderful products on the market for all skin types… they clean, hydrate, nourish and protect the skin as much as they are able. But the environment, in which we live, is drastically changing and not for the better. The UV rays are stronger, the air we breathe is full of toxins and pollution, that not only our bodies have to filter… but our skin as well.

Hyper-pigmentation (sun spots) are, in my opinion, one of the most noticeable (and usually the first) signs of the aging process… much like a banana peel, we start to show pigment with “ripening”….LOL. Lets call it “ripening” hence forth, shall we? Secondly, the weight of excess dead tissue causes crevassing/wrinkling in the skin, which tend to appear more quickly in thinner tissue… around the eyes in particular. These issues require ingredients, or should we say “strength of ingredients” that you won’t find in over-the-counter products. THAT is when we should seek a medical approach to skin care.

2. How do peels work and what kind of results can patients/clients expect over the course of treatment?

Chemical peels originated in burn centers… when patients recovered from a “burn”, their skin would repair itself by sending collagen and elastin to the area rebuilding what had been damaged. Unlike sun damage, a “burn” not caused by UV exposure, can be healing in the long run. It caught on… they knew if they could control the level of “burn” to the skin, they could induce collagen production and basically help rebuild the damaged tissue.

The process of “peeling” skin doesn’t always involve a physical peel. That’s a common misconception. There is only so much dead tissue to remove, at any given time. We use acidic compounds that are designed to affect certain portions of the skin. We can target pigment at different levels of the skin. We can cause collagen production that not only replenishes the healthy skin but also removes the tired, grey, lifeless tissue as well if the skin is in need of deep exfoliation. The collagen building is the MOST important part. The flaking and peeling of the skin becomes less and less with regular treatment and attention. Home care is a vital part of this process.

The best news is that in the over 20 years I’ve been in this field….. the way we utilize these agents has changed. More and more, patients/clients having seen people go through “Samantha from Sex and the City” responses to strong chemicals, want to treat the skin issues as they arise… people are much more aware of what healthy skin looks like, so they are starting sooner.

If you pay attention to small changes.. they are much easier to reverse than years of neglect and over exposed skin left to try and protect itself. The skins’ only choice in prevention is melanin… Melanin is the brown pigment we see popping up as we age. Uneven tone and texture = less attractive skin.

The Peel experience depends on several components… the issue(s) being treated, the pre-conditioning of the skin prior to treatment, the level of treatment necessary and the patients compliance in regard to aftercare. Now a days, you can effectively rectify most “ripening” issues with peels that will fit into your life without much “downtime.”

Downtime is a very individual experience. Some people consider flaking “downtime” while others think nothing of that. It depends on your daily activities during the time of “healing.” The healing of procedures range from just pink, flushed tissue to rather inflamed and “burnt looking” skin that usually takes a week to peel away. All of these factors, mixed with the condition of the skin on each patient, make it hard to make a blanket statement in regard to “downtime.”

Some of these treatments will induce a collagen production that will take a couple of months to see the result, others work by speeding up the cellular turnover and exfoliating dead cells revealing a much more healthy glow to the skin. All of that being said, you should consult with someone when embarking on this journey. It’s important to get to know them and how they approach your issues. If it sounds too good to be true… it probably is. Tragically cliché… but true.

3. Why is using an at-home retinol so important? And at what age should we start using one? Do you always recommend a prescription version?

You know, there are new reports coming out constantly about retinoids and their place in skincare. It’s super exciting to a skin geek like myself but the effects of just about any level of retinoid in your routine, are positive.

Basically, in order to correct damaged tissue, we use full strength Retin-A, sometimes, depending on the patient and the doctors recommendation, there may not be a need to discontinue use. Retin-A is, to my knowledge, the most effective collagen producing product on the market and should have a place in your routine. Again, inquire with a medical skin professional to determine what level is most appropriate for you.

4. What is your approach to treating hyper pigmentation?

There are a few different methods of treating hyper pigmentation, my favorite is the use of a “pulse therapy” method of using Retinoids and Hydroquinone at 4% twice daily until the pigment is suppressed and the skin has evened in tone and texture. Once we achieve that level of correction (usually about 6 months), there isn’t a need for continual hydroquinone use.

As long as you protect the skin (faithfully), and avoid sun exposure you can maintain that even tone with regular skin maintenance and continual retinoid use. If you become hyper pigmented because of over exposure or hormonal imbalances etc., the use of hydroquinone can easily be brought back in. Chemical peels assist this process by keeping the skin exfoliated and collagen production flowing, allowing the skin to remain healthy and vibrant for years to come. Unnecessary pigment is such an individual, case by case, issue… consultation and medical direction are paramount, in my opinion, to ensure a safe and effective treatment.

If you’d like to learn more about Gabriel, please check out his Facebook page here. I encourage everyone in Tulsa to go see him for a consultation!