Skin resurfacing has been around for many decades but it has changed dramatically since its inception. Back then, skin resurfacing was related to surgical dermabrasion via a CO2 laser or performed by a plastic surgeon using surgical instruments to hand-remove the outer layers of the skin. It sounds scary, but we’ve all seen the iconic chemical peel scene from Sex and The City when Samantha is likened to a beef carpaccio. It’s crazy to think that women underwent such invasive treatments in efforts to turn back time.
Angela Frazer, Prescription Skincare Senior Skincare Nurse Consultant, is a widely respected skincare specialist in Auckland who has extensive knowledge in the world of dermatology. With over 24 years of experience across plastic and reconstructive surgery nursing to injectables as well as skin health, Frazer has always been on the pulse of the ever-changing beauty industry.
Recalling the treatments from over two decades ago, Frazer explains, “with both ablative laser resurfacing and dermabrasion, it depended on how much of the epidermis (outer layer of the skin) was removed. These procedures were a ‘one off’ treatment and the recovery time was around 10-14 days as the skin heals.”
Over recent years, there has been a huge surge in skin rejuvenating treatments, making it all the more confusing for the general public. “There are so many more skin rejuvenating treatments available and they tend to all get put under the umbrella term of skin resurfacing, when really I would say many are more skin retexturising treatments and are working more superficially.”
What treatment is best for which skin type?
When it comes to tailoring a treatment, Frazer shares her three main factors of consideration:
What is the skin type and concern?
This is very important from a safety point of view. An example of this, is that a patient may have concerns with acne scarring or pigment, however if they have a dark olive skin complexion, a resurfacing treatment would not offer them the best/safest result. Or, if someone has very sensitive skin, many chemical peels could flare their skin up if they jump straight into peels without appropriate skin preparation.
What are the goals?
This varies so much from person to person and requires expertise to put a treatment plan in place to suit the client’s skin colour and type.
What kind of downtime is workable?
Many treatments such as superficial peels have no recovery time and so, can work with most schedules. Even the now popular microneedling treatments recommend no makeup for only 24 hours while the skin is pink. Lasers or dermabrasion resurfacing, on the other hand, require around two weeks of healing time and prior time-organisation.
For the sake of ease, we will go through tier by tier of resurfacing treatments with the first being chemical peels. “Again this is a broad umbrella term and nowadays there are an incredibly large amount of peel options available.” Results are dependent on the pH as well as the ingredients and its strength. “It is easiest to think of peels based on depth with deep, medium and superficial peels and under those there are of course sub categories such as superficial/medium,” Frazer explains.
Deep peels such as phenol peels have a similar recovery time as a deeper laser resurfacing of several weeks whereas medium solutions like TCA have a 5-7 day recovery period. The most popular peels are the more superficial peels, and for very good reasons. “I like to have a progressive not aggressive approach, and respect the skin as the largest organ of the body. Having worked with patients with burns, I have a huge respect for the skin and the wound healing process.”
Think of these superficial peels as medical facials. By using ingredients such as alpha-hydroxy acids (AHAs), salicylic acid (BHA) and vitamin A, peels can be combined or used as part of a course. “These peels result in rejuvenation and improvement in the appearance of sun damage, pigmentation, redness and vascularity, acne, superficial scars and pore size…oh, and of course, fine lines and wrinkles.”
During the procedure, patients will have a cleanse and depending on the peel, may receive an enzyme mask or even a dermaplane where the fine peach fuzz is removed alongside a fine layer of skin cells. Lactic acid peels will give a ‘stingle’ but are not painful while salicylic peels create a warm sensation and its antibacterial and anti-inflammatory properties are used to treat acne-prone skin and also to brighten pigmentation.
A fairly new skincare category, pharma-cosmeceutical resurfacing is an innovative alliance between cosmeceuticals and medical prescriptions pioneered by Petru van Zyl, the founder of pHformula. They combine alpha keto, alpha hydroxy, alpha beta and poly hydroxy acids with a unique bio-available delivery complex to get all the benefits without the negative side effects.
pHformula’s innovative complex named PH-DVCTM which promotes the bioavailability of different active ingredients to induce epidermal and dermal functions while inhibiting metalloproteinase enzymes (MMPs) that degrade the skin’s structural integrity.
In controlled chemical skin resurfacing, the efficacy of the individual acids will depend on their nature, penetration capacity as well as proton release potential during contact time with the skin. Once the actives are applied to the skin, they function as molecules with the ability to transport protons to different layers of the skin, resulting in the acceleration of cell turnover and optimum skin regeneration. Available at LookLab.
“Lasers use the laser energy and basically vapourise the layers of the skin and how deep they go depends on the wavelength,” Frazer explains. “They also heat the deeper dermal layer and that is why the result improves even up to a year after the procedure as the collagen support structure in the dermis remodels.” Laser treatments are sought out by those who are suffering from sun damaged, uneven, ageing skin. It also helps with scarring and blemishes due to its plumping effect from stimulated collagen production.
The results are most noticeable around four weeks post-treatment once the cells are renewed.