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Skin Clinical

SAN FRANCISCO

How to speed visible results from a retinoid

7/6/2020

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In all my years as a practicing esthetician, the importance of this one step is often overlooked. We know to successfully treat multiple skin conditions like pigmentation, acne, enlarged pores and lines/wrinkles, you must be using a retinol or a powerful alternative. What is not obvious is the need for a very important supporting role so the star of skin care can truly shine. 

What is this little known co-star of skin rejuvenation? Well, it's actually very well known but often under or over used. Its exfoliation! this seems like a basic concept. I mean isn't all of skin care and facials centered around exfoliation? Yes, but it's also the most misunderstood component of skin care. Some think it should be used daily and others say weekly or monthly. In my experience, using a retinol, boosted by the correct frequency of exfoliation will create the most visible changes to the skin. Find the right retinol for your skin.

What is the right frequency for exfoliation? For most skin types and conditions this means exfoliating EVERY 3 DAYS! The reason for this exact frequency is because of the way retinoids are processed in the skin. When retinoids increase cell turnover (create new skin cells), those cells make their way to the epidermal layers, flatten and die to form the outermost layer (stratum corneum). These dead cells tend to build up if not exfoliated properly. This can lead to less effective absorption of ingredients. In order to keep the skin moving and absorbing, you need to remove these dead skin cells. However, if you exfoliate everyday this can be too much of a good thing and result in a damaged barrier. This leads to allergens and pollutants entering the skin which in turn creates inflammation, dehydration, breakouts and premature aging. 

TIP: Set a reminder on Siri or Alexa to remind you every 3 days at a time you know will work for you! When you stay on track with this frequency, you'll notice new fresh skin every time. 

The best way to exfoliate your skin is with some type of exfoliator every 3 days. I've listed a chart with the different types of skin concerns and what exfoliating formulas will work best. Make sure to avoid any scrubs with Plastic beads or ground nut shells. These can cause more damage to your skin and the planet.  For a more detailed profile of your skin and product recommendations book a 1 on 1 consultation. 
SKIN CONCERN / CONDITION
EXFOLIATOR / MASQUE
Very Dry, dull skin
Cream Based Enzyme & Oxygen Masque
& Lite AHA or PHA Acid 
Combination, Occasional Breakouts
Physical Scrub &
Lite AHA/BHA Peels
Dry, Sun Damaged, Uneven Pigmentation
Cream Based Enzyme &
Lite AHA/BHA Peels & Vitamin C Peels
Constant Acne with Oily Skin
AHA/BHA Physical Scrub &
​Oxygen Masque &
​Benzoyl Peroxide Daily
Dry or Combo, Adult Acne & Pigmentation
Lite AHA Peels & Cream Based Enzyme 
&​ Vitamin C Peels
Normal, Balanced Oil & Water, Wrinkles
Oxygen Masque, Physical Scrubs
​Lite AHA Peels
Sensitive, Visibly flushed/redness
Oxygen Masque & Cream Based Enzyme
Very Sensitive, Barrier Compromised, Frequent Plane Travel
Moisture Infusion Masque & 
Oxygen Masque
Very Oily, Acne, Non sensitive, Razor bumps
AHA/BHA Peels, 
Physical Scrubs
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How to choose a Retinol / Retinoid  for your skin

7/2/2020

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Personally, I have used almost every type of of topical retinoid on the market and have been using some type of retinoid for over 20 years. I started with drug store based Retinyl Palmitate until I became a licensed esthetician and began exploring the many other forms. Once I began reviewing  the research I discovered what retinoids would actually benefit my skin.  When I worked under a physician, I would only prescribe tretinoin. The great thing about tretinoin is it has the most research and can show the fastest result. Unfortunately, clients would not use it consistently due to the side effects and it consistently prevented treatments due to overly inflamed skin with a compromised barrier.

After years of testing many different retinoids, I now recommend most clients start with Retinol or Retinaldehyde. I believe the healthiest skin regimen will achieve a balance between stimulation, repair, and defense, so the skin can function at its best. Retinol or retinaldehyde formulas will provide the same results as tretinoin but with less irritation. The downside is that the results take longer. I have used retinol formulas that are just as strong as tretinoin in terms of results and side effects. Stronger doesn't always mean better. It depends on what other products you are using and your individual skin type, age, lifestyle, and environment. The most important thing is to start slow to avoid side effects and disrupting the natural barrier of your skin which can lead to premature aging. There is also a crucial step everyone must be doing to maximize the visible results of a retinoid. Read my post on how to speed up skin care results.

The most important thing to know about retinoids is that the only way to get a result is for your cells to process retinoic acid (RA). That is the biological form of Vitamin A that can actually communicate with our skin cells to create change. Most retinoids achieve this to varying degrees. Below I'll list the retinoids I have researched, some I have used in practice  for years. Once you have chosen a retinol make sure to read
 my guide on how to retinize your skin.
The chart below will summarize research, my experience and list brands that I would recommend when trying the different formulas. I do believe that some users will find their skin responds best to a specific type of retinoid. Generally speaking, I have found that almost every client responds well to a combination of Retinol and Retinaldehyde. 

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What, Why and How to Retinize your Skin.

7/2/2020

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So you want to look younger? You want to prevent wrinkles, heal acne, and smooth the look of your skin? Well, you need Vitamin A in your regimen or you won’t have the best tool in your beauty arsenal. In my 16 years as a practicing esthetician, Vitamin A has been the one ingredient I have personally been obsessed with. I have recommended it to every client that would listen. I will quote scientific studies often and you can find the links to my sources at the end of the document if you’re interested. 

What does “Retinize the skin” mean? It's basically a more interesting and shorter term to use when referring to the process of acclimation to topical Vitamin A (Retinoids) treatment. This is known as Retinization. Once your skin has adapted to a retinoid, your skin is considered “retinized”. This process usually comes with side effects if you are using a prescription strength Retinoid or over the counter (OTC) vitamin A in some cases. These side effects may include redness, flaking or sloughing skin, mild to extreme irritation, a spicy feeling or burning sensation and an increased sensitivity to other products such as AHA’s. Side effects are temporary and subside once the Retinoid has been discontinued. Side effects can also be avoided with a careful approach and precise method I’ve developed over the last 16 years as an esthetician.

Retinoid Myth / Fact:  Retinoids do not cause your skin to become more sensitive to UV light. That's right, you can and still should use a retinoid year round.
In general all retinoids will degrade in UV light but they don't cause your skin to burn faster than it would naturally. There is some debate on Retinyl Palmitate creating free radicals when exposed to UV Light unlike other retinoids. To be on the safe side use Retinyl Palmitate only at night. 

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    JoshUA Maniscalco

    Licensed esthetician since 2004. Live, work and play in SF. Health, beauty, food and wine are my faves!

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​San Francisco, CA 94123
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