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C L I N I C A L

aestheticmed.co.uk SKINCARE ACIDS

e use acids in skincare as superficial peeling
agents to treat acne, scarring, pigmentation
and ageing. Alpha hydroxy acids and beta
hydroxy acids (better known as AHAs and
WBHAs) are the two main classifications
of hydroxy acids, though in recent years polyhydroxy,
L-ascorbic and retinoic acids have seen an increase
in popularity.
In skincare products, acids act on both dermal and
epidermal levels. Overuse or improper application can be
dangerous and sensitising to the skin, resulting in immediate
stinging and burning sensations; while prolonged over-
exfoliation compromises the skin’s acid mantle, disrupts the
microbiome, and can increase inflammation and irritation in
a detrimental way.
The phenomenon of social media “skincare gurus” has
spawned a new type of client – the “skintellectual” expects
results-driven skincare that achieves visible changes to
their skin in a short space of time. While these clients pride
themselves on being obsessed with their skin and may use
skin-science terms and understand how ingredients work
on a basic level, they do not have formal training, and their
eagerness to see results can lead to skin problems. They
are encouraged to exfoliate their skin to achieve a much
sought-after glow, which means that our clients are buying
products containing acids that often aren’t suitable for
their skin.
I have seen this on numerous occasions in my own
practice, whereby a very well-marketed consumer
skincare product was causing multiple clients to develop
compromised lipid barriers and skin sensitivity. Eventually,
I only had to look at a skin and I was able to tell the client
that they had used this particular product. It is up to us as
professionals to educate our clients on the appropriate use
of these acids and instil proper guidance when using active
ingredients.
AHAS
AHAs improve subcutaneous barrier function by increasing
proliferation and thickness, as well as restoring hydration
by increasing the skin’s level of hyaluronic acids. They
interact with the water in the upper layers of the skin,
reducing the superficial pH of the skin’s surface. This
weakens the ionic bonds of the lipids that hold the dead
cells together, resulting in the sloughing of dead cells. The
most commonly used AHAs are glycolic, lactic, mandelic,
malic and citric.
Glycolic acid has the smallest molecule that can easily
penetrate the skin. It is derived from sugarcane, as well
as synthetic sources. It can be used at 3% upwards, but
anything over 10% should be used at night only and under
supervision of a professional. Combining AHAs with retinol
should be advised with caution. As these actives are both
known for effectively increasing cell turnover, it is not
recommended to use them together in the same night
routine. If a patient’s skin responds well to both of these
then at most, alternating nights would be the way to go.

Aesthetic Medicine • June 2020 41