my dermatologist recommends thinning the top layer of skin..
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free skin care · Thu Sep 03, 2009 2:24 pm

I have been seeing a top London dermatologist for 3 months. She was recommended to me by my heavy-smoker 39 yr old friend with fantastic skin.

This Dr. explained to me that as we age, our epidermis (top layer) thickens and our mid-layer (dermis - the collagen/elastin) thins. Her aim is to reverse both traits.
To thin the top layer she has recommended to me AHA creams and mild acid peels & micro-dermabrasion facials. I noticed almost immediately my skin became clearer and more even-toned. However after just one month, I noticed significant lines appearing round the sides of my mouth. Plus sagging on the nose to mouth lines (labial folds). I have had 2 acid peel & MD treatments and have asked her how exactly does she do the holy grail of beauty treatments - rejuvenate the collagen. But her answers are vague and changeable. She also rubbished my claim that my skin looks like it's ageing faster in the last few months than it has in the last 5 years. But it has (a rather honest father-in-law and too many "have you lost weight, you look gaunt on the face" comments tell me I'm right).

My question is this...if the top layer is thinned without the collagen being plumped, is this going to make my skin sag and wrinkle?

free skin care · Thu Sep 03, 2009 5:22 pm

As far as I know a lot of anti-aging products work on the base of the same principle: thining the epidermis and thickening the dermis. For example, the research shows that the dermis will thicken after the retinol treatment. And a lot of brands use high percent AHA as exfoliator to treat aging skin...For example, MD Forte has cleanser III containing 20% glycolic acid for aging skin and a lot of raving on it. MaMa lotion, too, contains 20% glycolic acid. So I believe it makes sense.

free skin care · Thu Sep 03, 2009 5:23 pm

In fact my knowledge is very limited and I wish to see professional answers!

free skin care · Fri Sep 04, 2009 2:43 am

I completely understand the high acid content products for removing the top dead layer but what reverses the ageing effect on the collagen cells to make them work more efficiently? This must be much harder to do than exfoliating.
I haven't heard that retinol does this - I know none of my products (skinceuticals, Neo strata) contain this.

Would really appreciate some opinions before I waste anymore money on looking worse with this Doctor!!

free skin care · Fri Sep 04, 2009 5:38 am

I know it, but I have to put on a lot of products onto my face, because from the lotion, serum and cream to sunblock, makeup primer and foundation powder, I can not give up either of them.

But I do not clean my face if I plan not to go out in the day time.

free skin care · Fri Sep 04, 2009 5:45 am

Does the peels thicken the inner dermis?

I know Retin A supposedly does that and hence I have just started on my Retin A treatment.

Why dont you try stopping the peels and starting a Retin A treatment. Retin supposedly helps with fine lines as well.

Another boost if you will like will be the LED gadets. I have the Anti Aging LightStim and I love it!

free skin care · Fri Sep 04, 2009 6:21 am

I thought I read somewhere that its the constant repair of the epidermis that causes the dermis to thicken

free skin care · Fri Sep 04, 2009 6:43 am

If we could find a sure fire ingredient that definitely builds collagen, we'd make our fortune! But there are products that are touted to do this, such as certain essential oils, emu oil, Retin-A for example. And there's the gadgets, such as LED devices and RF treatments.

Using AHAs, BHAs or Retin-A is certainly a very popular way to go. But if you find that your skin doesn't take kindly to the acid approach, you could try a non-acid line like 302 Skincare. I know very little about this method, but there is a very long thread on the Forum about it.

http://www.essentialdayspa.com/forum/viewthread.php?tid=28855

free skin care · Fri Sep 04, 2009 7:27 am

funkydory wrote:

Does the peels thicken the inner dermis?

Another boost if you will like will be the LED gadets. I have the Anti Aging LightStim and I love it!

I have been thinking about the LED devices. Just trying to figure out which one. What exactly have you seen happening and for how long have you been using AALS?
The Doc has also recommended a course of red light therapy to kick start the collagen production. But I may as well buy one rather than fork out alot of money for her treatments. Will also look into retinol products.

free skin care · Fri Sep 04, 2009 7:53 am

If the top layer of skin builds up too much, your skin can become congested and flaky and look rough, like mine finally did. As much as I tried to do it at home I had to go in and have some help and it feels and looks younger just from the microdermabrsion. I think that shedding of the top has to keep happening in order for the new fresh skin to emerge and look radiant!
Sometimes your skin can go thru a remodeling process of the uglies before it gets better, but I would keep an eye on this. You can always get a second opinion if you aren't comfortable or you think your skin is overstressed.

free skin care · Fri Sep 04, 2009 8:48 am

I have no problem with the shedding of the top layer either thru MD or peels or products - I understand the benefits of doing it and the treatments I have are leaving the condition of my skin to glow.

The problem is with the thinning of the top layer and no visible signs of collagen rejuvenation, there is nothing to keep my face shape in place! ie with a thin rather than thick top layer, everything maybe glowing and spot free but it's all heading south.

Men have a thicker top layer of skin - is this why they have less sagging as they age? In which case, is all this thinning out we do detrimental to looking youthful?

free skin care · Fri Sep 04, 2009 9:28 am

Miranda.

In case you are interested, this is what Professor in Dermatology, Leslie Baumann, has to say about home light devices in her blog (March 20th 2009):

Quote:

It seemed to me that the newest talk was on at home light devices. The ones currently on the market are not very strong, but there is interest in developing stronger ones. None are worth the money yet - except - maybe the ones for acne.

...

Many have asked me about the Dermawand. The Dermawand emits a stream of low level micro-current impulses up to 168,000 cycles per second. The claim is that it massages and rejuvenates skin. It is safe, but I have never seen convincing data that it is effective. Some wound healing research implies that electrical current may stimulate skin cells to make collagen, but we do not know what kind of current and how much is best, so I would not waste money on this type of device at this time. Wait for the technology to get better.

http://skintypesolutions.com/blogs/usa/

And this is from Dr Baumann's Q & A about skincare on miamiherald.com (02/01/09):

Quote:

Q: What are your thoughts on products on products like Baby Quasar Red that use infrared light to improve the condition of the skin? I value your advice and opinions on skin care/skin care products and would love to know if these types of at-home spa products are worth the money.

A: Not yet, but good ones are coming in 2 - 3 years.

http://www.miamiherald.com/qna/forum/cosmetic_dermatology/index-p5.html

free skin care · Fri Sep 04, 2009 9:40 am

First of all, I would like to know if you smoke. Smoking is not good for your skin, as it dehydrates the skin. Secondly, do you use SPF creams on your face before exposure to the sun? Thirdly, do you use a good moisturizer on your face? All these factors are important.

In order to maintain the result from your doctor, you must take care of your skin too after. Good balanced diet is important and drinking lots of water.

Whatever you do, you can not rely on doctor alone. You also must do your part as well to maintain the result.

This is Miranda wrote:

I have been seeing a top London dermatologist for 3 months. She was recommended to me by my heavy-smoker 39 yr old friend with fantastic skin.

This Dr. explained to me that as we age, our epidermis (top layer) thickens and our mid-layer (dermis - the collagen/elastin) thins. Her aim is to reverse both traits.
To thin the top layer she has recommended to me AHA creams and mild acid peels & micro-dermabrasion facials. I noticed almost immediately my skin became clearer and more even-toned. However after just one month, I noticed significant lines appearing round the sides of my mouth. Plus sagging on the nose to mouth lines (labial folds). I have had 2 acid peel & MD treatments and have asked her how exactly does she do the holy grail of beauty treatments - rejuvenate the collagen. But her answers are vague and changeable. She also rubbished my claim that my skin looks like it's ageing faster in the last few months than it has in the last 5 years. But it has (a rather honest father-in-law and too many "have you lost weight, you look gaunt on the face" comments tell me I'm right).

My question is this...if the top layer is thinned without the collagen being plumped, is this going to make my skin sag and wrinkle?

Fri Sep 04, 2009 11:03 am

It sounds to me like your doctor has 'over-exfoliated' your skin. There comes a certain point where you can disrupt the skin's barrier, the acid mantle and this will cause a dry, crepey look.

I agree with everyone else on the Retin-A. Retinoids have been proven to thicken the lower layers of the skin while thinning the upper layers. I'm sure your doc is aware of this but she would make less money the retin-a way. Wink

I think simplifying your routine would be very beneficial. A mild cleanser morning and night. A retinoid at night after cleansing followed by a good moisturizer and a good vitamin C serum in the morning followed by sunscreen. It might be wise to baby your skin for a while and stay off exfoliating for about 2 weeks. You'll notice your skin will come back around and start looking normal again.

free skin care · Sat Sep 05, 2009 12:26 am

jade-1234 wrote:

First of all, I would like to know if you smoke. Smoking is not good for your skin, as it dehydrates the skin. Secondly, do you use SPF creams on your face before exposure to the sun? Thirdly, do you use a good moisturizer on your face? All these factors are important.

In order to maintain the result from your doctor, you must take care of your skin too after. Good balanced diet is important and drinking lots of water.

Whatever you do, you can not rely on doctor alone. You also must do your part as well to maintain the result.

This is Miranda wrote:

I have been seeing a top London dermatologist for 3 months. She was recommended to me by my heavy-smoker 39 yr old friend with fantastic skin.

This Dr. explained to me that as we age, our epidermis (top layer) thickens and our mid-layer (dermis - the collagen/elastin) thins. Her aim is to reverse both traits.
To thin the top layer she has recommended to me AHA creams and mild acid peels & micro-dermabrasion facials. I noticed almost immediately my skin became clearer and more even-toned. However after just one month, I noticed significant lines appearing round the sides of my mouth. Plus sagging on the nose to mouth lines (labial folds). I have had 2 acid peel & MD treatments and have asked her how exactly does she do the holy grail of beauty treatments - rejuvenate the collagen. But her answers are vague and changeable. She also rubbished my claim that my skin looks like it's ageing faster in the last few months than it has in the last 5 years. But it has (a rather honest father-in-law and too many "have you lost weight, you look gaunt on the face" comments tell me I'm right).

My question is this...if the top layer is thinned without the collagen being plumped, is this going to make my skin sag and wrinkle?

But I do think she is right, that we had better not to apply too many layers of skincare on our face. Because after all, our skin have to breath, but too many moist and oily skincare and makeup would make our skin sick and with meagre oxygen, although it really moist enough.

free skin care · Sat Sep 05, 2009 3:09 am

jade-1234 wrote:

First of all, I would like to know if you smoke. Smoking is not good for your skin, as it dehydrates the skin. Secondly, do you use SPF creams on your face before exposure to the sun? Thirdly, do you use a good moisturizer on your face? All these factors are important.

In order to maintain the result from your doctor, you must take care of your skin too after. Good balanced diet is important and drinking lots of water.

Whatever you do, you can not rely on doctor alone. You also must do your part as well to maintain the result.

HI Jade, yes you're right, we have to do our bit as well and not just rely of magic solutions but I do not smoke, I drink at most 2-3 glasses of wine a week, no coffee or tea and at least 8 glasses of water a day. My eating habits are extremely healthy (even the odd square or two of chocolate is dark!), I have never dieted in my life and I don't over-exercise. My weight doesn't fluctuate despite 2 kids. It is because of this lifestyle that last year at age 40, most strangers would put my age between 28-32 (as long as I hid the grey hairs!). I also now use the Doc's recommended SPF cream and her recommended moisturizers (and have used good stuff since my late 20's).

The point that keeps getting missed is this...
the condition of my skin spot-wise and glowing-wise is great since I started seeing this dermatologist doc 3mths ago - I originally went to see her about my monthly hormonal eruptions - but in the last 3 mths my skin has become more wrinkled round the eyes and mouth and sagging (its not crepey just thin lines but it doesn't feel dry or oily just perfectly balanced).

Is this coincidence or because of her regime of thinning out my top layer, my face is falling south at an alarming speed??

free skin care · Sat Sep 05, 2009 3:26 am

vananners wrote:

It sounds to me like your doctor has 'over-exfoliated' your skin. There comes a certain point where you can disrupt the skin's barrier, the acid mantle and this will cause a dry, crepey look.

I agree with everyone else on the Retin-A. Retinoids have been proven to thicken the lower layers of the skin while thinning the upper layers. I'm sure your doc is aware of this but she would make less money the retin-a way. Wink

I think simplifying your routine would be very beneficial. A mild cleanser morning and night. A retinoid at night after cleansing followed by a good moisturizer and a good vitamin C serum in the morning followed by sunscreen. It might be wise to baby your skin for a while and stay off exfoliating for about 2 weeks. You'll notice your skin will come back around and start looking normal again.

I did back off the AHA moisturizers for 3 weeks and started using the top-layer thickening Creme de la Mer (which the derma. Doc hates) but the spots, eczema and dullness returned and the lines and sagging didn't disappear. I looked even worse! I'm wondering if I've done permanent damage or if I need to leave off the AHA's permanently or if I just continue with the thinning of the top layer but find a collagen-boosting cream/device/tablet.
But first I want to find the answer if the AHA's and peels to thin the top layer are responsible for the wrinkles and sagging (think about how well most men age with their much thicker top layer).

free skin care · Sat Sep 05, 2009 7:04 am

This is Miranda wrote:

The point that keeps getting missed is this... the condition of my skin spot-wise and glowing-wise is great since I started seeing this dermatologist doc 3mths ago - I originally went to see her about my monthly hormonal eruptions - but in the last 3 mths my skin has become more wrinkled round the eyes and mouth and sagging (its not crepey just thin lines but it doesn't feel dry or oily just perfectly balanced).

Is this coincidence or because of her regime of thinning out my top layer, my face is falling south at an alarming speed??

I don't think anyone can give you a concrete answer to your question. I wonder if you have thought if any of the changes to your skin could be hormonal? I started noticing my skin taking a turn for the worse when I hit 40. I just wonder if your skin issues could be related to being perimenopausal?

free skin care · Sat Sep 05, 2009 8:46 am

rileygirl wrote:

I wonder if you have thought if any of the changes to your skin could be hormonal? I started noticing my skin taking a turn for the worse when I hit 40. I just wonder if your skin issues could be related to being perimenopausal?

I certainly wonder about this...My skin has aged rapidly since I started seeing the dermatologist 3 months ago but this could be coincidental and infact the ageing has nothing to do with her routine but is infact changes going on within me. But I hope not!! What can one do about hormonal ageing?

Also I checked my bathroom cupboard and realised I have tried the Retin-A cream. It tore my skin apart on both my face and stomach (used it for old stretchmarks).

free skin care · Sat Sep 05, 2009 11:37 am

I honestly am not sure what can be done if your skin issues are hormonal. I think seeing a GYN would be the first start, or just your regular doctor to check your hormone levels. (I am due for this myself!) Then I think it really all depends on what the values show as to where to go next!

free skin care · Mon Sep 07, 2009 9:02 pm

Septembergirl wrote:

Miranda.

In case you are interested, this is what Professor in Dermatology, Leslie Baumann, has to say about home light devices in her blog (March 20th 2009):

Quote:

It seemed to me that the newest talk was on at home light devices. The ones currently on the market are not very strong, but there is interest in developing stronger ones. None are worth the money yet - except - maybe the ones for acne.

...

Many have asked me about the Dermawand. The Dermawand emits a stream of low level micro-current impulses up to 168,000 cycles per second. The claim is that it massages and rejuvenates skin. It is safe, but I have never seen convincing data that it is effective. Some wound healing research implies that electrical current may stimulate skin cells to make collagen, but we do not know what kind of current and how much is best, so I would not waste money on this type of device at this time. Wait for the technology to get better.

http://skintypesolutions.com/blogs/usa/

And this is from Dr Baumann's Q & A about skincare on miamiherald.com (02/01/09):

Quote:

Q: What are your thoughts on products on products like Baby Quasar Red that use infrared light to improve the condition of the skin? I value your advice and opinions on skin care/skin care products and would love to know if these types of at-home spa products are worth the money.

A: Not yet, but good ones are coming in 2 - 3 years.

http://www.miamiherald.com/qna/forum/cosmetic_dermatology/index-p5.html

Septembergirl, Dr. Alastair Carruthers (who co-invented Botox Cosmetic) tells me that in the next three years or so, a laser will be available that will effectively treat crepey skin. It seems that J&J are on to something, likely in cooperation with Palomar. I keep hearing this "next three years" statement from a few derms-in-the-know. Let's all pray Smile

free skin care · Tue Sep 29, 2009 5:14 am

I think I may have found the answer as to whether thinning the epidermis is a good thing or not.

http://www.dermogenesis.com/roll-cit/Clinics_of_N_Am_2005.pdf

Basically a snapshot of what they say is this;

Why destroy the epidermis to make the skin smoother? The epidermis is an extremely complex, highly specialized organ. It may be only 0.2 mm thick but it is our sole protection from the environment.
We should never damage the epidermis unless the risk of leaving the epidermis intact is greater than the risk of removing it. Wrinkles are hardly a good excuse to destroy this wonderfully complex interface that we have with the world. Whatever we do, we should try to ensure that the basic normal architecture of the skin is never altered. To rejuvenate facial skin and really look young, we need a perfect epidermis with natural dermal papillae, good hydration, normal color, and normal resilience.

This is from an article about dermarolling but the page 1 & 2 explain very well the dangers of stripping down the epidermis.

I will no longer be having peels or microdermabrasion - no matter how mild and I've already stopped the nightly AHA cream. Should I exfoliate? Very mildly and not too often.
Whether I can undo the damage done remains to be seen but thank you for all the advice given here.

free skin care · Wed Sep 30, 2009 3:37 am

Septembergirl wrote:

Miranda.

In case you are interested, this is what Professor in Dermatology, Leslie Baumann, has to say about home light devices in her blog (March 20th 2009):

Quote:

It seemed to me that the newest talk was on at home light devices. The ones currently on the market are not very strong, but there is interest in developing stronger ones. None are worth the money yet - except - maybe the ones for acne.

...

Many have asked me about the Dermawand. The Dermawand emits a stream of low level micro-current impulses up to 168,000 cycles per second. The claim is that it massages and rejuvenates skin. It is safe, but I have never seen convincing data that it is effective. Some wound healing research implies that electrical current may stimulate skin cells to make collagen, but we do not know what kind of current and how much is best, so I would not waste money on this type of device at this time. Wait for the technology to get better.

http://skintypesolutions.com/blogs/usa/

And this is from Dr Baumann's Q & A about skincare on miamiherald.com (02/01/09):

Quote:

Q: What are your thoughts on products on products like Baby Quasar Red that use infrared light to improve the condition of the skin? I value your advice and opinions on skin care/skin care products and would love to know if these types of at-home spa products are worth the money.

A: Not yet, but good ones are coming in 2 - 3 years.

http://www.miamiherald.com/qna/forum/cosmetic_dermatology/index-p5.html

I wouldn't expect Dr Baumann or any Dermatologist to endorse home LED units! How is that going to benefit them??..."its coming in 2-3 years"...BUNK! That keeps you going to their office for treatments but the truth is, it's already here now! The Anti Aging Light Stim has done soooo much for my skin (8-9 months of use thus far.) There are plenty of people on this forum that have also had wonderful results!

free skin care · Wed Sep 30, 2009 6:28 am

Miranda, I don't really know the answer to your problem. It seems to me, though that your wrinkles and sagging increasing significantly at the same time as starting with this dermatolgists treatment is no coincidence. I think that you should get a second opinion or maybe try to find a forum online where you get a dermatologist or doctor answer your question (the makemeheal plastic surgery site is one that you might be able to ask a doctor). Your condition may be a case of it's gonna get worse before better, or it may be that your derm's new routine damaged your face. Whatever the case, I think you need a good second opinion.

free skin care · Wed Sep 30, 2009 7:05 am

mountaingirl wrote:

I wouldn't expect Dr Baumann or any Dermatologist to endorse home LED units! How is that going to benefit them??..."its coming in 2-3 years"...BUNK! That keeps you going to their office for treatments but the truth is, it's already here now! The Anti Aging Light Stim has done soooo much for my skin (8-9 months of use thus far.) There are plenty of people on this forum that have also had wonderful results!

Dear Mountaingirl,
You've made a very good point there. Of course they don't want us doing it at home for 1/10th+ of the cost!
I see by your signature that you also have olive skin, have you noticed a chalky-ness to the colour of your skin? I look so much better when I use a strong bronzer gel to give me the colour I had 10 years ago.
Also one question - how do you know it's the AALS that's doing the good work and not the dermaroller, facial exercises and/or vit c ?

I've just ordered a 1.5mm dermaroller for my stomach and having read alot of info on it, I'm very impressed by the simplicity of how dermarolling works. But I'm also impressed by the ageless facial exercises/massage I've been doing for 3 weeks and I've just received from Ebay a Tua Viso, which I'm hoping is going to make an even bigger difference.

When you are doing many things, I'm curious to know how have you pinpointed The One that is really making a difference?

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