Skin Remodeling Lesson 3: Routine Foundations

There are several different approaches used by skin care enthusiasts to incorporate the previous concepts into a remodeling routine. There are benefits and drawbacks to each.

Topical Only

The topical only approach shuns aggressive measures and is the least risky method. It relies on regularly using the most effective products regularly to stimulate cellular turnover and matrix regeneration. People who are averse to side effects and risks prefer this approach. They are usually content with improving moderate to severe skin damage, and not seeking complete removal. It takes the longest to see results, but there is very little risk of over treating and damaging your skin. Mild exfoliation is used to ensure product penetration only. Many of the strongest actives have an exfoliating effect, so users often only use separate exfoliation treatments in the beginning to get the process started. People taking this approach are usually concerned with maintaining existing skin health, so it is typical to use barrier restoring and antioxidant moisturizers, in addition to the stronger actives and vigilant sun protection. Natural plant extracts and other less researched ingredients are also common; many users taking this approach will try to incorporate lots of actives.

This approach is great for people with dry or sensitive skin that have trouble with stronger methods. If you are only treating to minor damage like fine lines, shallow scars, or discoloration, this routine is usually adequate and will often result in total removal in people under 40 if followed for at least 6 months. More serious damage like wrinkles will also improve, but removal is rare. Most scars and stretch marks are unlikely to see significant results with this method.

Regular Strong Exfoliation

This approach combines consistent use of topical actives with regular strong exfoliation. This exfoliation uses minor controlled damage to increase cellular turnover, stimulate blood flow, and sometimes enhance matrix synthesis. People often use microdermabrasion or superficial chemical peels once or twice a week or a daily moisturizer that contains alpha hydroxy acids. Too offset these potentially irritating procedures, you should use a barrier restoring product and a soothing moisturizer that contains antioxidants. It’s important to use actives that are proven to stimulate collagen production. The use of retinoids to stimulate elastin formation is ideal. Peptides are very helpful with this routine because they aren’t nearly as irritating as other actives.

There is a very low risk of sudden skin damage like a burn, but skin can look worse over time if the regeneration process doesn’t keep up with the damage. This is more likely to happen with facial skin. Balance is extremely important with this type of routine. This approach is less risky on body skin with scars and stretch marks, because the skin is thicker and you can be more aggressive with the exfoliation. Build up your exfoliation gradually, and take occasional breaks if you are going to be on the routine for more than a few months. If a year has gone by and you still haven’t seen significant improvement, more aggressive treatment is probably necessary.

All types of skin damage have been improved with this approach, including scars and stretch marks. It takes a bit longer than the more aggressive methods, but there is less risk.

Sporadic Resurfacing

Combining consistent use of topical actives with occasional strong resurfacing methods is a very effective way to improve serious skin damage. The individual resurfacing treatments deliver enough controlled damage to really stimulate the dermis into regenerating the skin matrix. You repeat a resurfacing treatment every 4 to 12 weeks to keep the regeneration process moving along. They are far enough apart that the skin barrier has time to recover, so that most of the time it is intact. After the skin has completely healed, you resume a topical only approach that uses matrix-stimulating actives and increases cellular turnover. The skin is typically more sensitive after resurfacing, so you may need to use lower strengths of actives for a week or so following the treatment.

The downside of this approach is that the resurfacing treatments are risky. They should ideally be performed in a medical setting due to the risk of infection. However, many skin care enthusiasts will do some forms of resurfacing at home without complications, and everything you need is readily available online. Even when done properly, including in by a professional, complications can arise that can damage your skin. Always do a patch test before each resurfacing treatment. Learn as much as you can about your treatment, even if you are going to a professional. This book spends a lot of time discussing chemical peels and skin needling, the two methods that are commonly used at home. If you are getting laser, dermabrasion, or other treatments done professionally, do your own research on the process and most importantly, the practitioner.

Choose your resurfacing treatments wisely and don’t try to rush results by repeating them too frequently. Remember, the matrix regeneration process takes around 4 months, no matter what you do! For the first four weeks of that cycle, the collagen formed is delicate. Resurfacing too frequently will often compromise the results of the previous treatment. Some resurfacing methods are better than others, but all work on the same concept of controlled damage. In the case of skin needling, the barrier and epidermis remain intact throughout the healing process. Using strong chemical peels is a little more risky, because the stratum corneum and epidermis are often destroyed in order to reach the dermis. If possible, only use strong peel solution directly on damaged skin and leave the skin surrounding it untreated. For example, only swipe additional layers of the solution over a wrinkle or acne scar with a cotton swab.

This approach is very effective on severe skin damage like moderate to deep wrinkles, moderate to severe scars including acne scars, and stretch marks. It isn’t usually necessary for milder forms of damage like discoloration and fine lines. Remember; don’t over treat your skin damage.

Preventative and Maintenance Routines

You should not remain on a remodeling routine indefinitely. Once you’ve achieved your full results, you should move on to maintenance routine. Unfortunately, not everyone can achieve total removal of all types of skin damage. This is more likely to happen in individuals older than 50, because the matrix regeneration process can only be stimulated so much. Very severe scarring and stretch marks are the most difficult to remove entirely, though most people can expect them to improve at least 50-75% after 12-18 months of treatment. The importance of a good diet cannot be stressed enough. If you weren’t eating properly throughout the process, you may want to take a break for a few months while you truly overhaul your diet, and then try again.

Maintenance routines for scars and stretch marks are usually unnecessary. Once the deformed matrix has been regenerated, the results are permanent. Basic good skin care including sun protection is sufficient.

Anti aging efforts can be continued throughout your lifetime if desired, but not at the same intensity of a remodeling routine. You shouldn’t do a weekly chemical peel forever. After you’ve successfully improved wrinkles and discoloration, move on to a preventative routine that is suitable for your age. Light exfoliation, a good moisturizer, sun protection and antioxidant use is suitable for all skin types and is usually all that is needed for those under 40. Using mid strength Vitamin C products regularly is also common practice in anti aging routines of all ages. If you are in your late thirties or your forties, you can also use anti aging products containing peptides, vitamin A derivatives, etc. In your mid forties or beyond, you may want to consider using a prescription retinoid regularly and doing a resurfacing treatment like a peel or needling every year or so. Retinoids and peels can thin your epidermis, so you don’t want to use those methods excessively until the rewards outweigh the risks.