ASCP Skin Deep

SEPTEMBER | OCTOBER 2021

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Listen to the ASCP Esty Talk podcast at ascpskincare.com/podcasts 51 Like a Pro A protocol to alleviate clogged pores and congested skin by Mark Lees, PhD CLOGGED PORES AND CONGESTED SKIN are esthetic problems that affect many clients and are one of the primary issues that cause clients to seek professional skin treatment. Clogged pores (a.k.a. sebaceous filaments) are primarily caused by a buildup of cells on the follicle walls, which are then coated with sebum secreted by sebaceous glands. This impaction then solidifies into a follicular plug or clogged pore. Both oiliness and retention hyperkeratosis (cell buildup) are genetic conditions. Technically similar to acne, clogged follicles typically do not evolve into inflammatory acne lesions and simply remain either open comedones or sebaceous filaments. Comedogenic topical agents (ingredients) can coat the inside of the follicle, causing or worsening the development of comedones. In essence, the follicle walls are being coated from the inside by sebum and from the outside by these fatty, clogging ingredients. The "cap" of the plug darkens due to a combination of melanin accumulation and oxidation of the sebum (a fatty complex and fats oxidize easily). Congested, clogged skin can also have a rough surface appearance with enlarged pores. The surface also might become easily dehydrated due to dead cell buildup on the skin surface. And skin that is also sun-damaged can look worse. Outside factors that contribute to clog development might include: • Poor skin care • Soaps, cleansing creams, or other products that leave skin residue • Cumulative sun damage (both short- and long-term) • Skin care/makeup products containing fatty ingredients such as oils (including many natural oils), fatty acids, fatty esters, and waxes that are comedogenic (pore clogging) • Exposure to work-related chemicals (industrial oils, etc.) Treatment of clogged, congested skin involves a combination of in-clinic and specific home-care programs. Ideally, the client should be using a planned home-care program for a week or two before the first extraction treatment. Two weeks of pre-treatment home care makes the extraction treatment more effective and less uncomfortable. The home-care protocol should include the use of: • Rinseable cleansers that help manage excess oiliness. The proper choice of cleanser may vary with the client's oiliness level. Cleansing excess oil without stripping the skin is the goal. A low-pH hydrating toner spray is important to stabilize pH after cleansing. This will help avoid dehydration. • Daily wearable chemo-exfoliant, such as salicylic and/or glycolic acid (or other alpha-hydroxy acid) gel or serum. These agents help break up existing impactions and remove cell buildup from the surface of the skin. They also are to be used continually to prevent cell buildup from recurring. • Noncomedogenic products. These products should be not only lightweight and non-oily, but also independently dermatologist-tested. It's worth noting that most ingredients that are potentially comedogenic are in the vehicle, or spreading agent, of the product. This means that when they are present, they are often present in larger concentrations. This is especially true of wearable products such as sunscreens, treatment creams or lotions, serums, and makeup foundation. In-clinic treatments are usually a combination of light peels and desincrustation-extraction treatments. Salicylic acid is the peel agent of choice, as it is a lipophilic that is attracted to oil (sebum). Alpha hydroxy acids, such as glycolic, are sometimes combined with salicylic for additional surface exfoliation. These agents help remove dead cell buildup and loosen impactions for extraction. Desincrustation and extraction treatments are helpful in acting as a solvent for fat-based pore impactions, and are helpful for easier and effective pore extraction. Clay-based masks, used after extraction, remove softened sebum and further aid in surface exfoliation. Treatments should be administered every other week until the skin is clear. Maintenance treatments should be administered every four weeks.

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