From sleeping on harsh cotton pillows to environmental exposure, the skin experiences daily assault that can impact the development of fine lines and wrinkles – sometimes prematurely. Still, all hope is not lost. Understanding these biological processes of the skin and knowing the best treatment options for defending the skin against these attacks can make all the difference.
When clients look in the mirror and see melasma and other forms of hyperpigmentation, lines radiating out from the corners of their eyes, a descending jaw line, and cheeks that are starting to look like they fell asleep on a chenille bedspread, they are not looking at their true biological age – that can be seen on the tissue surrounding the areola of the breast or the hind end. They are simply looking at skin trying to defend itself against solar damage and environmental surroundings.
From babyhood on, skin is smooth – naturally moist via the secretions from the sudoriferous and sebaceous glands – and the natural probiotic acid mantle is intact around the clock.
Live cells ascend to the epidermis every two weeks, while epidermal dead cells naturally exfoliate.
As time marches on, cell turnover takes longer and, as a defense mechanism, not all the dead cells exfoliate. In fact, more and more build up, kind of like armor plating, in an attempt to shield the new baby cells from environmental attack.
This can be thought of as “the redundant corneum,” meaning that people need a natural corneum but when they have more than is necessary for protection, skin starts to appear as dry and cracks with frequent facial movement, making fine lines appear.
Inside the skin, the matrix – that gel-like substance that gives skin that young, turgidity and bounce – starts to get thinner. The peripheral capillaries start to become congested at the bottom loop and less oxygen from the lungs makes it to the mitochondria – the battery pack in the eukaryotic cells that keeps the cell alive with the energy of ATP. They, then, start to malfunction and eventually die. The cell dies and fewer new, baby cells make it to an epidermis, while the dead ones just keep piling up!
At this point, the moisture-giving secretive glands become congested and smaller. The acid mantle is compromised, with a knock-on effect on the rest of the primary cell’s organelles, including the Golgi apparatus, where the “paint” that becomes melanin originates. Irregular pigmentation appears on the surface as melasma or age spots.
When this rapid aging process is viewed in the mirror, a subliminal stress signal is sent to the hypothalamus gland – the master gland. This signal is passed to the pituitary gland, which relays the message to the adrenal glands, which get all excited and babble the stress story to the testosterone, estrogen, and even the cortisol levels, which releases the adrenocorticotropic hormone into the blood stream. The entire endocrine system goes out of whack, homeostasis in the intercellular fluids in the sub-dermis become unbalanced, and a person intrinsically and extrinsically shows rapid signs of aging – long before they should be looking older! Thus, one must remember, it is the skin on backsides and breasts which shows true biological age – except in the unlikely case that a person runs around nude in the sun daily.
Extrinsically, people add to the damage by sleeping on cotton pillows that grab the skin in one or two places all night long, or by pulling on certain areas of the face, such as pressing their hands up on the cheek with the fingers on the temples while concentrating, eating hunched over one’s plate, or just thinking for long periods of time. Think of all the time people spend with their hands on their faces!
Sleeping on satin pillows may be a good idea to reduce stress on the face at night. They help keep skin smooth without the grab of cotton. Other factors that impact skin negatively include poor and non-compliant skin care and trying too many miracle products loaded with peptides, probiotics, retinols, mass doses of vitamins, and exotic, organic botanicals from the south of France.
While most of these raw materials or ingredients are biologically active and play a role in human tissue chemistry, they are often crammed together in products as buzz words or trends to sell products – with no thought of synergism, very small percentages, and plenty of inactive ingredients that make up the bulk of the product.
The epidermis becomes confused with these irregular assaults and puts up even more defense mechanisms while desperately looking for the chemistry it recognizes and needs to survive.
Further, to make matters worse, many still ignore proper sun care, despite the fact that the ozone layer is getting thinner, allowing more carcinogenic, radiant sun waves to come through. Too often, people think of sunscreen only after they have left the house on a cloudy day and the weather has turned sunny by noon. A great number of people assume that they need to apply sunscreen only at the beach or by the pool.
However, solar radiation leaks through clouds, bounces off windows of buildings, and bleeds through car windows. Many people notice one side of their face ages faster than the other. This is one reason why.
So, what is the solution? What efforts can clients take to improve the health of skin that is attacked from so many angles?
Any type of non-inflammatory or invasive treatment will do at least something to eliminate the redundant cuticle buildup on the epidermis. This, however, is only step one, not the entire show, as many purveyors of peels would have consumers and professionals believe.
For decades, people have been peel crazy touting the blue peel, the green peel, TCA peels, Jessner peels, all-natural, organic peels, and of microdermabrasion.
These methods do remove dead cuticle at some level – often while being unnecessarily time-consuming – and make the professional appear expertly. Yet, peeling is just opening the door –cleaning away the debris in front of the door to get to the real work of helping the newer cells stay alive a little bit longer, with the essential amino acids and co-enzymes they need bringing fresher oxygen to the cells where it can be taken up by the mitochondria and converted to energy (ATP). This creates reverse osmosis, which can clean out cell debris and establish homeostasis within the intercellular matrix, allowing the tissue to do what it does best (with the right topical help) – rebuild itself without the constant focus of defending itself.
Skin is more like an egg, rather than an onion with many layers which can just be peeled off and – voila – new skin! No, there are basically two main layers: the epidermis, and its myriad of complex mechanisms and support systems, and everything else underneath, with cellular structures always shifting and changing configuration.
While by law professionals can only work on the epidermis and must avoid any products that could be systemic and arouse inflammation or deep infections, they can, using various modalities and transepidermal technology, influence the dermis, subcutaneous, and even the often ignored facia by utilizing the connective junctures in tissue, stimulating the ganglia to either be more active, kick starting languid circulatory systems, or put them into sleep mode, calming down couperose conditions that lead to chronic erythema.
They can also influence the immune response guards of the skin, the Langerhans cells and its long dendrites, with a macrophage (mouth) at the end of those tentacles that enable it to reach out, snatch, and destroy any invader of the skin that does not belong there.
The phrase “often ignored fascia” is used because it is never recognized as what it is. It is the largest organ in the body – much larger than the skin – and it was not deemed an organ by the medical community until very recently.
In the early days of surgery in the United Kingdom, surgeons, keen to open, expose, actually see, and catalog human organs, totally ignored the fascia, seeing it as a, dry, dusty unimportant covering of every organ of the body.
The fact is it lines the entire epidermis, has ganglia throughout, and allows skin to slide smoothly back and forth, powered by elastin fibers that act like rubber bands, snapping tissue back in place when the face stops moving. Microcurrent and LED have an influence on the fascia and its ganglia, as do radio frequency and pulsing electromagnetic waves.
Professionals are also able to help the epidermis manufacture collagen types one and three, topically. The other types, including collagen matting, must be addressed orally with at least 1,000 international units (IU) of vitamin C, high quality sea buckhorn, evening primrose oils, and gugglesterones.
Highly active sea buckthorn and evening primrose oils help to keep the intercellular matrix bouncy, thick, and viscous. It gets thinner with age, losing turgidity and bounce, which results in crepe-looking skin, which can be disheartening. Not all of that crepe is caused by loss of elastin
Two things stimulate collagen topically, despite the plethora of claims that accompany hundreds of ingredients: ascorbic acid and retinoids.
Combining both stable and unstable kinds of ascorbic acid is best for maximum product shelf life and bioactivity. The word unstable, to a chemist, is not a bad word – only to psychiatrists. Unstable co-enzymes are often the most powerful, but denature quickly when exposed to oxygen. Stabilized versions are modified to increase shelf life, thus sacrificing a bit of their original power. Using the strongest vitamin C that is unstable and surrounding it – like a corral fencing in a stallion – with the unstable types, ensures a longer-lasting, powerful co-enzyme.
The fibroblast cell is like a factory that produces two products: elastin and collagen. At the front door of the factory are the workers: the amino acid brothers, lysine, proline, and glycine. If the boss takes a day off, these guys will fall asleep on the job and no new collagen will be made for the person whose skin is sagging, with the old collagen fibers fraying and drying out with age and stress.
But, suddenly, the boss unexpectedly returns and yells, “get up you lazy bums; get to work!”
The brothers jump up, assemble the other chemicals needed, and place them onto the conveyor belt (a peptide). Tropocollagen is then formed (baby collagen) and, as it whizzes through the factory, other components are added.
Eventually, at the factory’s back door, the package is thrust out into the matrix, where it becomes strong, teenage-grade collagen and it swims up to support and elevate the old worn-down fibers, which will eventually be absorbed by the body.
This is a good representation of how skin firming takes place and why ascorbic acid or vitamin C – the boss of the factory – is vital to topical treatment.
Retinoids are also essential in skin re-building. Very complex and often misunderstood, retinoids, like a two-edged sword, can both destroy or help skin build itself by creating new fibroblast cells – the factories that produce collagen and elastin. The right combinations of retinoids can be safely keratolytic – they are a noninvasive, removal system.
The wrong combinations can be inflammatory, lead to hyperpigmentation problems, and even become toxic in the cells.
The pH Scale
Finding harmony on the pH scale is another must for the professional. Products are only tools; concepts are the real templates of true science. Good tools, however, are necessary in order to implement judgement calls when diagnosing skin conditions.
It may be necessary to lower the pH of the skin with various acids below pH 3.8 to harden the redundant corneum, allowing dead cells to become brittle and pop off the epidermis, without a lot of defense-triggering trauma. A little temporary erythema is acceptable at this point, but should not become reactionary over 24 hours. This door opening approach with acids, which hardens tissues, is best when dealing with solar damaged skin, greasy skin with thick cuticle buildup, or normal skin just beginning to show signs of aging.
Acne-prone skin with a lot of near-invisible, vellus hair, accompanied by pustules (papules of cyst-like acne), are served better by going up the pH scale with a very alkaline solution, around pH 12.
Anything under 12 can promote bad organisms, such as gram positive and negative bacteria. pH 12 immediately desquamates all protein-based things, including redundant skin cells, sebaceous glands impacted by congested hair follicles, hypotrophic scar tissue, cuneiform scar tissue, and, in the case of rosacea, the intrepid microscopic demodex mites living in the follicle and breeding! Everything is gone within four minutes.
Some severe cases need more time, but timing is essential to this treatment, as well as keeping the solution moist. Dried alkaline can burn as easily as very low pH acids, so special training is in order here. When the desired effects are achieved, the skin must be neutralized and immediately restored to a normal pH to avoid unnecessary reactions.
There are other door openers that are useful for people who are reactionary to rapid and intense pH factors.
Old fashioned enzymes, such as papain, pancreatin, and bromelain, are good at chomping up dead cells on heated skin. Using these three enzymes, with as little filler as possible to maximize their macrophage action, may be effective. But, contraindications, such as swollen eyes and lips and itching nostrils, can and do occur unless special training is adhered to.
Solutions containing gluconic acid, with other ingredients as precursors, are good at dissolving the glue holding dead cells together on the epidermis. Seemingly innocuous and mild, these solutions can be very powerful and, with overuse, can lead to inflamed and irritated skin – especially on the forehead, nasal labial folds, and nose. Hygroscopic alpha hydroxy acid can pull available moisture from the skin up into the corneum, which resemble tiny dried out sponges. The sponges can over-fill, blow up like balloons, and pop, with the fragments detaching from the underlying newer cells.
In conclusion, topical treatments can work if approached using a “remove, rebuild, protect, and maintain (client compliance at home)” perspective. Life-altering results can be achieved that go far beyond medical aesthetics and, yet, work very well with fillers, Botox, and cosmetic or reconstructive surgery.
Using combinations like this requires turning to nature and sticking to the basics. Professionals can only work with what is already there.
Undermining topical treatments as being less important and efficacious than medical procedures is wrong and, indeed, a dying concept, as more advanced education is being promoted in the United States and around the world.
Ultimately, a face lift just removes excess tissue. It does not give a client new skin, new pigmentation, or cellular homeostasis. Best results can only be achieved when professionals work hand in hand with their clients.
DMK founder, Danné Montague-King, is a pioneer in his industry. He has seen the depths of depression associated with poorly functioning skin. In fact, his everlasting passion was born from his dissatisfaction with his own acne as a teenager. From not understanding the condition completely, to failed attempts from top United States dermatologists to cure his acne, Montague-King had to take things into his own hands and, desperate for a cure, became his own guinea pig. A string of breakthroughs, trials, tribulations, and many travels would follow, until he found his first true breakthrough in the 1960s, involving vitamin C therapy. That is all it took to spark what would be decades of developing successful treatments and products that would combine to form the iconic brand that is DMK – sold throughout 30 countries.