Healthy Skin
Healthy skin is smooth, firm, unwrinkled, evenly colored, properly hydrated, free of blemishes and, has normal tolerance and skin functions. With time and environmental damage, some or all of these characteristics are diminished and skin can then be classified as diseased or deteriorated.
Specific Goals
The Skin Health Restoration approach to skin deterioration is to help make skin healthy and, in the process, correct any existing disorders, such as acne, discoloration, sallowness, and photoaging. Thus, Skin Health Restoration is a process rather than a disease-driven approach. The specific goals are to: restore normal skin function (especially the barrier function), increase skin tolerance, and create soft, radiant-looking skin.
Restoration of Normal Skin Function
Normal skin functions are restored by regulating the function of key skin cells and improving skin circulation. The key skin cells to be regulated are the keratinocytes, melanocytes, and fibroblasts.
Regulation of Keratinocytes
By using a tretinoin preparation that penetrates well together with AHAs and phytic acid, keratinocyte activity is regulated so that mitosis in the basal layer is enhanced, damaged DNA is repaired, and a soft, compact stratum corneum is created.
Clinically, this will result in smooth, clear, and tolerant skin, with an effective barrier function that is also well-hydrated and does not need moisturizers.
Regulation of Melanocytes
Normal, healthy skin owes its natural coloration to the synthesis of a normal amount of melanin and its even transfer from melanocytes to epidermal keratinocytes. Common occurrences, such as ultraviolet light exposure, inflammation, hormonal changes and genetic predisposition, increase melanin production and can cause darkly pigmented patches to appear on the skin. This is called hyperpigmentation or, in certain cases, post inflammatory hyperpigmen-tation (PIH). When dark pigmented lesions occur due to the hormonal changes of pregnancy, it is known as melasma.
Regulation of Fibroblasts
Fibroblasts —- the key cells of the dermis —- produce collagen, elastin and the extracellular matrix. Clinically this translates to firm, tight, well-hydrated skin. However, environmental exposure and the passage of time, can lead to textural changes such as hypertrophy or atrophy and shrinkage of collagen, elastin, and the glycosaminoglycans (GAGs) of the extracellular matrix.
Fibroblasts in the papillary dermis can be stimulated to produce new collagen, normal elastin, and hydrated GAGs in the extracellular matrix. This stimulation is needed to keep skin healthy, moist, firm, and properly hydrated (see Table 1-2).
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Clinical Effects of Fibroblast Regulation (Table 1-2) |
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Collagen and elastin synthesis |
Increased for firmer, tighter skin, fewer fine wrinkles |
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Extracellular matrix production (GAGs) |
Increased for proper hydration |