Dark skin and chemical peels

[Archive]

Originally posted by Denise

Just received glycolic acid exfoliator 50 % from Lachaderm.
Only I stumbled on a site that says that black/mediteranean people should
stay away from glycolic peels, along with salicylic and alpha-hydroxy peels
because of risk of scarring and of worsening hyperpigmention! I just paid
90 $ for this product. The site in question did not deal specifically with
kp but it's quite worrisome to me. I'm very prone to scarring and hyperpigmentation
from minor cuts or skin conditions such as eczema already. Most of the kp is on
the torso. Anybody with dark skin had glycolic peels done? Erika? I know your post dates
from july... Anyone else? I'm a bit spooked about trying it out now. But my kp is really bad.
Then again, I found another site that says that for severe cases of kp, these peels might be
helpful. So what's the deal?

[Archive]

Originally posted by JC

I am so sorry that you spent $90 on the glycolic peel. From what you’ve decribed in your postings, any aggressive product (like a 50% glycolic peel) should be avoided at all costs. The fact that you suffer from spontaneous keloids, that you scar from intensive scrubbing and that you suffer from hyperpigmentation indicates to me that a glycolic peel of that strength would most likely be extremely harsh and damaging to your skin. The site you found that said that they are helpful from severe cases of kp isn’t completely off target though. Depending on factors like sensitivity, some severe cases of kp can benefit from strong glycolic peels. However, skin that is finicky and dificult to treat due to unpredictable reactions, allergies and high sensitivity levels would almost surely not find these benificial. In order to avoid further agrivating the keloids and hyperpigmentation, you need to address specific lifestyle issues that may be influencing this: Sun induced hyperpigmentation, Hormonal hyperpigmentation and ***Post-Inflamatory Hyperpigmentation: the three greatest aggrivating factors your dark kp skin will encounter (Especially Post-Inflammatory hyperpgmentation… I’ll explain later). 1… Sun exposure: for dark skinned people wearing a full spectrum sunblock (spf 25+) EVERY day is a must… think of it like a layer of clothing. In fact, did you know that you should even put sunblock underneath your clothing?? UVA/UVB rays can penetrate some fabrics and contribute to your problem, even on cloudy days. 2… Hormones: sometimes oral contraceptives, estrogen (hormone replacement), pregnancy or other hormonal fluxes can cause hyperpigmentation. 3… ****Post inflamation: (like you said, scrubbing too hard) CAN cause scars, discoloration and hyperpigmentation, especially in dark skin. Scratching and picking can lead to secondary infections, slow healing and can, again, promote hyperpigmentation. Harsh chemical exfoliation (strong keratolytics) work by micro-damaging the surface of your skin which (in your specific case), MUST be avoided due to your tendency to post-inflamatory hyperpigmentation and keloid scars. Also, strong keratolytics will make your skin more sensitive to the sun and other enviormental influences leading, in turn, to dark spots. Fortunatly this leaves us with a plan of action (by elimination): a non-aggressive treatment that works to diminish the bumps (kp), soothe AND prevent the irritaion (again, EXTRMELY important for your specific case) and lighten the dark spots (hyperpigmentation). (it almost sounds so easy
:-) Your reginmen really shouldn’t focus on the use of strong keratolytics (6%+salicylic acid, 50% AHA’s, etc). Instead you should look into light acid peels, (conservatively used) topical alpha hydroxy acid and retinoids in formulations containing hydroquinone and other brighteners (these are intended to specifically target hyperpigmentation). Retin-a (not a keratolytic) has been shown to have considerable success with people who have your type of skin (you won’t see instant results… you’ll have to wait it out but it just might be worth it). A skin lightener might also work: In black skin, Dermal and epidermal hyperpigmentation can be resistant to commercially available skin lightening agents. Try to find a good, professional quality lightener formulated with glycolic acid (the acid will serve as a transport for the lighteners/brighteners)… Patch testing is a MUST, especifically if dealing with lightening formulas containing Hydroquinone. If you find that HQ causes an adverse reaction, you can try kojic acid, licorice root extract and ascorbic acid. Again, you need to avoid irritation at all costs due to your proneness to post-inflammatory hyperpigmentation. If your skin gets irritated, skip a day or two of all "active" products and use only a non-fluorinated cortisone cream like LOCOID and sunblock. As far as mechanical exfoliation (in the shower), avoid harsh washcloths, nylon bath scrubs or anything that might cause the slightest amount of irritation. Buff with a small particulate lotion scrub instead. I’m thinking that your skin can benefit A LOT from an steam enzyme peel (professional treatment you might want to consider). Finally, I really encourage you to explore deeper into other issues that might be triggering or agravating your condition of atopism (allergies, eczema flareups,
etc.). <span style="font-size: 12.0pt">Sometimes we focus too much on topical
treatments while overlooking these factors. The key is a comprehensive approach.
I hope this helps!</span>

[Archive]

Originally posted by Denise

JC, I can't thank you enough for taking the time to write all this information. Where did you get all this? I've searched the net extensively and didn't come up with much for my specific circumstances... I wish I'd waited before ordering that expensive 50 % glycolic peel lotion... Mind you, I did a patch test on my hand today and I didn't notice any inflammation, but I think you're right and that it might not be wise to use it on affected areas. I must admit I'm at my wit's end with this kp. It seems like I've tried everything, from Lachydrin to urea based lotions to Accutane (Yikes!) to rays in a cabin (double Yikes!) and nothing has worked! (Retin-A seems to be the only thing left, assuming it is different from Accutane. Right now, I'm using a 10 % glycolic acid lotion from NeoStrata (I just started)and I bought a salicilyc acid-based body scrub from Neutrogena. I was banking on doing a lot of scrubbing but now, I guess that's pretty much out... If that doesn't work, I'm completely out of options (which is what the dermatologist who diagnosed me had said in the first place and I refused to accept). It seems from the information that I've gathered that exfoliation is key in the management of kp to prevent keratin buildup and I'd just started to do just that twice a day, but now I'm afraid of the consequences. Without exfoliation, how can I manage this? My kp is extremely resistant and widespread. You mentioned the use of sunblock daily. They tend to be oily, I think (I've never used any-- I figured I had natural protection). Won't that block pores and aggravate the kp? As for allergies, I'm prone to them. I have relatives with hay fever, and I'm prone to eczema since I was 5 years old. And then the keloids around adolescence (another problem I can't do anything about!). I'm also lactose-intolerant (although diet doesn't seem to be a factor in kp...) I know that there is a connection with the allergies and genetics but I'm not sure as to what aspect of this I should explore that would help my kp. Before I was diagnosed, I went to dozens of dermatologists with no experience in treating black patients who completely misdiagnosed me (one even took a biopsy, leaving me with a very unsightly keloid, only to tell me that the test was inconclusive!) This disorder has completely destroyed my self-esteem and body image (walking around looking like you have a transmissible disease all the time will do that to you). You would think that with kp being so widespread, they would take some interest in doing research and come up with a damn cure! Anyway, I'm just blabbing on and on. I'm depressed... Maybe I just need to accept that this is it. It's a hard pill to swallow...