Skin Remodeling Lesson 4: Strength Building

Many effective active ingredients are irritating when they are initially used, especially at the highest concentrations available. Active ingredients need to be used at a certain range of percentages in order to produce collagen, elastin, and increase cellular turnover. Unfortunately, the most effective formulations are too irritating for skin that hasn’t been exposed to lower concentrations of the ingredient. People often apply a strong, effective product, experience irritation, and then assume that they can’t tolerate the active. This is usually not the case, and most people will be able to use the strongest actives by strength building.

Strength building is the process of allowing your skin to acclimate to strong concentrations of an active ingredient. It is a very important part of a skin care routine designed to treat skin damage. It is possible to harm your skin by using the strongest products right away. In the case of chemical peels, you can literally burn your skin and end up with scarring and discoloration.

Starting with Mild Products

Most people can avoid experiencing irritating side effects by gradually increasing the strength of their products. You can do this by using milder products for the first couple of weeks and then moving on to a stronger product. You’ll often be able to find your chosen active ingredient in at least three concentrations. Many mild products do not list the percentage on the label, but are good to start out with. Stronger formulations will often list the concentration so that you’ll know exactly what you’re getting with mid strength and strong products. There is a lot of variation in human skin, so it is hard to tell how long it will take each person’s skin to adjust to skin care actives. Sensitive skin will typically take longer that other skin types.

Products that contain lower levels of actives are often creams and lotions. These moisturizers are ideal starter products because the active is delivered to your skin in a soothing, moisturizing base. Any irritation your skin might have from initial exposure to an active is often reduced if the skin is well hydrated. Many of the strongest products are serums, which lack calming and hydrating ingredients. If you have a choice, go with creams and lotions while you are strength building. If you are using a serum, try applying a moisturizer 5 minutes after the serum, preferably something natural that contains calming botanical ingredients like oat, aloe, and cucumber.

Example: Let’s say you want to start using the most effective Vitamin C serum containing 20% ascorbic acid. This type of serum is likely to irritate your skin, especially if it is on the sensitive side. Instead of starting off with your desired product, start using a Vitamin C cream or lotion that contains around 5% ascorbic acid for around 2 weeks. Then get a 10% ascorbic acid serum or lotion and use that for 2 weeks, and a 15% serum for the following 2 weeks. At this point, you can start using a 20% serum, with a low chance of experiencing irritation.

Diluting Strong Products

You can also dilute a strong product into another cream or water, but be aware that you will be affecting the preservative system. An inadequately preserved product can be contaminated easily. This can cause a skin infection, especially if the skin has recently been heavily exfoliated. If you are going to dilute a strong product, do not make one large batch that is stored at room temperature. It is best to dilute a product in small batches that are used within a week and stored in the refrigerator.

Diluting a product can be very cost effective. You might not use up your mild and mid strength products before you are able to move up to the strongest, most effective formulations. You can purchase only the strongest product and dilute it in several batches, each one being stronger than the last, until you are able to use the undiluted formulation. Diluting a cream into water may cause it to separate because there isn’t enough emulsifier to keep it together. Mixing with a neutral cream or lotion should keep this from happening. Serums do better diluted in water, but they can also mix into a moisturizer. Mixing a serum into a lotion also reduces the risk of irritation because the active is delivered to your skin in a moisturizing base.

Example: You bought a 20% L ascorbic acid Vitamin C serum and starting using it daily, but experienced irritation after the fourth day. You stop using it for a week, and the irritation subsides. Instead of buying a new product, you can dilute the serum you already have. In a separate container, like a small glass jar, mix equal part of your serum with a facial lotion that doesn’t contain any active ingredients. This will create a 10% serum that also has soothing moisturizing ingredients. Only make a small amount of this serum, and keep it in the refrigerator for no more than a week. After using that mix for 2 weeks, mix the serum and lotion in a 3:1 ratio, making a 15% serum, to use for the next 2 weeks. After this routine, your skin will be much more likely to tolerate the original 20% serum without experiencing irritation.

Increasing Frequency

Another way to strength build is by gradually increasing the frequency that you use a product. Many people don’t experience irritation from an active until they have used in several days in a row. Some people’s skin can tolerate starting with the strongest products if they start using it once or twice a week, and gradually work up to daily use. You can also try to start off using a strong product by gradually increasing how long it is left on your skin. Wash the product off after it has been on you skin for 15 minutes for the first week, after 30 minutes for the second week, etc.

Example: Your friend gave you a .5% retinol serum. You’ve used retinol in the past, and developed red, itchy skin patches, so you decide to start off slowly. You use the serum once the first week, and twice the second week. Everything is going well, so you try to use it every other day for the third week. After a few applications, you start seeing redness and your skin it slightly inflamed. You take a week off to let your skin calm down. You start using it every other day again, but this time you wash it off after it’s been on your skin for a half an hour. Since you aren’t having any problems after a week, you continue applying it every other day, but you start to leave it on the whole night. You continue this for two weeks, and then start applying it every night, monitoring your skin for an adverse reaction.

Introduce New Strength Gradually

Even if you take precautions to gradually expose your skin to an active, you can still experience irritation when switch to a stronger formulation. Most often, the irritation you’ll experience from stepping up to a stronger product will be mild. Redness, itchy skin, mild inflammation, and small, irritated patches are common reactions to a new strength of product. It will typically heal if you stop using the stronger product for a few days to a week, then resume with the routine you were using before. Transitioning to a new strength of product gradually will help avoid complications. Instead of using the new strength daily, start applying it every other day or every third day, using the lower strength formulation on the alternate days.

Example: You’ve been using a mid strength Vitamin C serum containing 10% ascorbic acid for the past 2 weeks. The 20% serum you’ve been working up to goes on sale, and you decided to go for it. You start applying the 20% serum daily, but experience irritation after the third application. After letting you skin heal for a week, you start using the 10% serum daily again for a week. Now you’re ready to try the 20% serum, but you know you probably won’t tolerate it well yet. So for the next two weeks, you apply the 20% serum every third day and the 10% serum on the other 2 days. That goes well, so for the following two weeks, you apply the two serums on alternate days, using the 10% serum one day, the 20% serum the next day, then back to the 10% serum, etc. After doing this for a week, you can try the 20% serum daily, with much less chance of irritation.

Multiple Actives

Most routines designed to regenerate the skin will involve multiple active ingredients. It’s important to introduce new ingredients and techniques into your routine at separate times. Making multiple changes to your routine quickly is likely to produce an adverse reaction, especially if you are adding several strong actives with the potential for irritation. Go slowly when you first start out. Get your skin used to one product first, before strength building with another ingredient. Typically, the first active is the hardest to get used to, and adjusting to additional products is much easier. Once your skin is used to acidic products, it will typically react be easier to add another acidic ingredient.

Example: Let’s say you’re excited to get rid of wrinkles and some age spots, and you want maximum results. You decide that you’d like to use a prescription retinoic acid serum in the evening, a Vitamin C serum that contains between 15% and 20% ascorbic acid in the daytime, along with an antioxidant moisturizer with sun protection. You’d also like to do a glycolic acid peel twice a month, and a microdermabrasion treatment weekly. You’re concerned about facial sag, so you’re considering using a DMAE cream as well. That is a pretty advanced skin care regimen that can be very effective, but if you start out doing all that, your skin will not be happy. So break it down into steps. Most antioxidants won’t irritate your skin at all; in fact, the are likely to protect your skin against irritation from other actives. So you can start using an antioxidant cream with a good SPF right away. Since the prescription retinoic acid product is likely to be the most effective, and will take the longest to get used to, you start using a mild retinol cream in the evening. A microdermabrasion treatment is the least invasive exfoliating procedure, so after 2 or 3 weeks on the retinol products, you can do a light, at home treatment. Just discontinue the retinol for a day before, and one or two days afterward, and be sure to moisturize well before and after the treatment for a couple of days. This is probably all you should do until you are using a strong retinol serum, or perhaps the prescription product, which may take 8 weeks to build up to. Once you’ve been using the your desired strength of retinoid for few weeks, you can try to add a mild 10% ascorbic acid Vitamin C serum. If that goes well for 2 weeks, step up to a 15% or 20% serum. At this point, I’d wait an entire four-month collagen producing cycle to evaluate your results before considering chemical peels or DMAE. This routine should have enough gradual exfoliation and increased cellular turnover, as well as stimulating collagen and elastin production that you’ll probably be seeing big changes in your skin. You should also make sure that you have an optimal diet before adding more topical treatments. If you’re skin isn’t getting what it needs nutritionally or is fighting chronic inflammation, topical remedies will only go so far.

Other Considerations

Alpha hydroxy acid products, including chemical peels, are some of the most effective exfoliating formulations used in skin resurfacing. They also have the greatest risk of irritation and the most potential for skin damage if things go wrong. Don’t start off with chemical peels. Use a glycolic or lactic acid lotion or cream for a few weeks to prepare your skin for a peel. When you do start using peels, use a mild peel for your first treatment, like a 20% lactic acid peel. Be sure you moisturize your skin well after your peel. Peels that remove live tissue expose more delicate skin below that won’t be able to tolerate strong actives like Vitamin C or retinoids like your normal skin does, even if you’ve gone through the process of strength building those actives. Depending on the strength of your peel, you may need to wait a few days to a few weeks before you can start using your actives again. It’s also advisable to discontinue using strong actives, especially retinoids, for a few days to a week before a strong peel.

Every so often, it’s a good idea give your skin a break from using actives altogether. Even if you aren’t experiencing irritation, occasional breaks from 1 day to a week can enhance your results. It will also reduce the chance that your skin will stop responding to an active ingredient. Remember, skin remodeling is a long process, and results can’t be rushed. It takes approximately 30 days to complete just once cycle of generating new skin cells, and four months to produce new collagen and elastin. Your skin will improve along the way, but don’t expect miracles in the short term.