Coming Clean

REMEMBER WHEN CARING FOR THE SKIN WAS AS simple as washing with a bar of soap and some warm water, then slathering on a cold cream and calling it a night? Neither do we. Today's skincare products and spa treatments are loaded with complex ingredients featuring benefits that are backed by scientific research and clinical studies. In fact, you almost need a medical degree to understand how some of them work. It's easy to forget there was ever a time when the most you could hope to provide clients with was a thorough cleansing and intense moisturization.

All of that changed in the mid-1970s when dermatologist Eugene Van Scott, M.D., discovered the multifaceted benefits of alpha hydroxy acids (AHAs). These acids brought skincare to a new level. Like their predecessors, retinoids, their benefits could be scientifically proven. But AHAs were better tolerated than vitamin A derivatives, easier and safer to use, and less expensive to manufacture. These powerful ingredients soon began to make their way into dermatologist-prescribed treatments and products and eventually into over-the-counter skincare concoctions. The most widely accepted of this new breed of cosmeceutical was—and still is—glycolic acid.

Many spa-goers rely on glycolic products to help them achieve a glowing complexion.
Many spa-goers rely on glycolic products to help them achieve a glowing complexion.

"Exfoliating the skin with glycolic acid provides a host of scientifically studied benefits," says Rebecca Tung, M.D., a dermatologic surgeon at the Cleveland Clinic in Cleveland. Once applied, the acid gets to work dissolving the "glue" that holds dead cells onto the surface of the skin. Glycolic acid occurs naturally in sugar cane and some fruits but is primarily mass-produced in labs. It's also the smallest AHA molecule, which made it the most popular because it so rapidly penetrates the skin. At dermatologists' offices like Tung's, a patient's skin can be treated with glycolic acid peels that contain concentrations of acid ranging from 40 to 70 percent—much higher than what's typically found in spa peels and at-home products (most spas use peels with 30 percent glycolic acid or lower, while consumer products usually contain 10 percent or less). But even at levels of 30 percent and lower, glycolic acid treatments and products offer consumers the rapid skin improvement they seek.

"We put glycolic acid peels on our menu because we wanted to give our clients the highest level of skincare effectiveness without a doctor," says Guy Lacey, director of purchasing and retail development for the Washington state-based Gene Juarez Salons & Spas. Because glycolic acid peels are still effective in gentler formulations, they require no downtime when performed in spa settings. "People don't want to leave a spa with irritated and red skin, but they do want a facial that will give them benefits they can see and feel," adds Lacey.

Glycolic acid is derived from sugarcane, unripe grapes, and pineapple.
Glycolic acid is derived from sugarcane, unripe grapes, and pineapple.

So just what are some of the ways glycolic acid can help enhance your clients' complexions? The most noticeable and instant improvement is usually in the skin's tone and texture post peel, as sloughing away dead skin cells reveals the healthier ones below. "Old skin cells are opaque and don't reflect light, while newer cells reveal the healthy glow we strive for," says Tung. Clearing away some of the dead skin cells also helps keep pores from clogging, which is especially helpful for clients with acne or those who are prone to the occasional breakout. "Most often, I use alpha-hydroxy acid peels to treat patients with acne," says Washington, D.C.-based dermatologist Elizabeth Tanzi, M.D. Not only does glycolic acid help unclog pores to clear up blackheads and whiteheads, it also has anti-inflammatory properties that help inflamed pores return to normal.

Acneic clients and others affected by hyperpigmentation—like those with sun-damaged skin—will also see a lightening of dark spots after a series of glycolic acid peels, as the acid speeds up the turnover of hyperpigmented skin cells. "Many women are experiencing sun damage earlier in life, so we have clients of all ages asking for glycolic treatments—and they're really seeing a difference in their skin," says Allison Widhson, spa manager at Keldara Salon and Spa in Dedham, MA. Because AHAs don't enter the bloodstream, even women who are pregnant or clients suffering from melasma can safely undergo glycolic acid treatments.

Improved skintone and texture make glycolic acid products and treatments a popular choice among spa-goers.
Improved skintone and texture make glycolic acid products and treatments a popular choice among spa-goers.

The benefits are mainly caused by glycolic acid's exfoliating effects, but the acid also works below the surface of the skin. Studies have shown that the use of AHAs may boost collagen production and increase the skin's level of water-retaining hyaluronic acid. "Theoretically, anything that causes irritation to the epidermis can lead to collagen production," says Kenneth Beer, M.D., a West Palm Beach, FL, dermatologist. This increase in collagen and hyaluronic acid helps plump skin, diminishing the appearance of fine lines and wrinkles. Other anti-aging benefits include a thinning of the skin's outermost layer, leaving the complexion less leathery-looking and the skin more adept at absorbing moisture.

There has been a bit of controversy about the potential side effects of long-term use of glycolic acid, though, with some studies claiming that its application causes increased sun sensitivity and risk of UV damage. "Because products with glycolic acid reduce the thickness of the outermost layer of dead skin cells, there may be a slightly increased risk of sunburn," says Tanzi. "However, this is easily managed with the use of a good broad-spectrum sunblock." Some experts believe that the thinning of the stratum corneum may also compromise skin barrier function, leaving it more susceptible to irritants, but a 2001 study in the British Journal of Dermatology found the opposite to be true, showing that glycolic acid treatments actually improve skin barrier function. There's also evidence that glycolic acid can provide a sun protective effect by acting as an antioxidant and may be able to help reduce the risk of UV-induced skin cancers.

Acid Wash
Acid Wash

As with any potentially risky treatment, it's important that those administering glycolic acid have the proper training to do so correctly. You should choose the brand of product used in your spa's treatments carefully to ensure that the manufacturer provides estheticians with the skills they need. "We require an educator from the product line we are using to train our employees on the specific protocols with our peels," says Andra Diamond, spa director at Wentworth by the Sea Hotel and Spa in New Castle, NH. "Doing so ensures the estheticians are confident in their tasks and knowledgeable about the ingredients." These precautions are key in preventing problems such as redness and irritation that can occur if an AHA peel is left on for too long or applied incorrectly.

With all that glycolic acid treatments have to offer, it's no wonder so many spas around the country offer them. Most incorporate AHA peels into facials, either as part of various services or as an add-on to other anti-aging treatments. To see the most improvement, a series of peels is often needed. Offering four to six treatments in a package can be useful for clients and also ensures return business. At some locations, estheticians are also applying glycolic acid on areas other than the face that could benefit from some extra exfoliation. At the Gene Juarez Salons & Spas, for example, clients can treat their hands to a glycolic acid peel to lighten sunspots. And at the Spa at Camelback Inn in Scottsdale, AZ, glycolic acid is applied to the face, hands, and arms during the Sonoran Rose Facial ($135, 60 minutes). Glycolic peels can also be applied to the back for clients who suffer from "bacne" or frequent body breakouts. What a long way we've come since soap and cold cream.

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