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Ideal Skin Care Routine
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18 Responses to “Ideal Skin Care Routine”

  1. I should probably stop researching, and leave well enough alone. But now I’ve read about using BHA a few minutes before Retin A at night to increase it’s effectiveness. If feel like I’ve hit a plateau. it supposedly gets that Retin A right to the good stuff! what do you think?

    Posted by Lisa | March 5, 2013, 3:30 am
    • Never stop researching! Lol! :)

      I actually haven’t read that anywhere before nor have I thought of doing so, though now I can see how that would theoretically make sense in certain situations. But anyways, I did a quick search on PubMed, and I found no study to corroborate this claim. Can you post the link where you read this information?

      Posted by John | March 5, 2013, 12:47 pm
    • Sorry, I pasted the whole article, couldn’t get the link to work.

      Skin Biology healthyskin.infopop.cc Forums Products Healthy Skin AHA, BHA & Retin-A

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      carrot
      posted 01 August 2010 12:05 AM
      Dr. Pickart,

      Do need your advice!

      I got confused by the info I gathered from the web.

      Can we use AHA/BHA with Retin-A in the same evening?

      I’d like to use a 2% BHA toner followed by Lascal, CP Serum & then Retin-A.

      From the internet, some say that AHA & BHA are not compatible with retinoids; some say they are not.

      What are your thoughts?

      Posts: 43 | Location: Texas | Registered: 09 January 2010
      carrot
      posted 07 August 2010 11:28 PM Hide Post
      Dr. Pickart,

      May you shed light on the effects of AHA & BHA on tretinoin.

      Posts: 43 | Location: Texas | Registered: 09 January 2010
      Dr. Pickart

      posted 08 August 2010 01:17 PM Hide Post
      They have different actions but can work together.

      1. The AHAs and BHAs remove older skin. This allows newer skin to rise to the surface. AHAs work more on the skin’s surface. BHAs work more on the deep layers of the skin.

      2. The copper peptides help adult stem cells create new skin cells. The retinoic acid (retin-A) acts to helps push this process along by helping the new cells differentiate into cells needed by the skin.

      3. Retinoids is a broad word. Retinoic acid reduces skin oils. But retinol (vitamin A alcohol) can increase skin oil under some circumstances.

      4. Generally we recommend using the Retin-A after the copper peptides. But you can use them with the hydroxy acids.This message has been edited. Last edited by: Dr. Pickart, 08 August 2010 06:18 PM

      Posts: 6759 | Location: Skin Biology | Registered: 15 September 2004

      Posted by Lisa | March 5, 2013, 4:33 pm
      • Huh interesting. It’s not an article, rather it’s just a forum where someone made a comment.

        More impotantly however, I don’t think “Dr. Pickart” actually says that SA helps to improve the efficacy of tretinoin. So I’m not quite sure where you got that idea. :(

        Posted by John | March 6, 2013, 2:03 pm
      • How do you suggest incorporating Niacin and aha/bha into my routine? So far, I do Vitamin C in the AM, Retin A 5 nights a week. The other two nights a week, I do an aha peel. been reading about Niacin. I want to add it in, not sure when. also hoping to increase Aha use to daily, not sure when. Thanks for your help!

        Posted by Lisa | March 20, 2013, 2:56 pm
        • I’d recommend using niacinamide after your Retin-A application, making sure to wait an hour–something that most doctors already instruct to do.

          Posted by John | March 20, 2013, 7:22 pm
          • thanks! I started. Niacinamide moisturizer after Retin A, then within a day or two added a strong AHA (alpha hydrox soufflé in the morning after the Vitamin C serum. whoa! Back to the dry scaly patches. Not sure which one caused it. stopped both new products, trying to decide how to move forward. I read that the ideal routine includes: 1. Retin A 2. Niacin 3. Vitamin C (antioxidants) 4.. Sunscreen 5. Aha/bha/exfoliation.

            what I’ve learned would pair up 1 and 2 at night and 3,4,5 in the morning. not sure which led to the flakes and ugliness, niacin or the aha. What would you do?

            Posted by Lisa | March 21, 2013, 3:20 am
            • Mhm, nice work! I see that you’re paying attention to the Ideal Routine. :) They indeed are comprised of hydroxyl acids, retinoids, niacinamide, antioxidants, and sunscreen.

              But anyways, I’m almost 100% sure that it’s the AHA that’s causing the flakiness.

              Posted by John | March 21, 2013, 4:50 pm
  2. makes sense, thanks! conflicting information is out there ( Dr Bailey’s site), so allow me to beat this to death: I’ve hit the age (48), and want the powerhouse of skin care. my Retin A and DIY Vitamin C (l-ascorbic acid at about 18%) are doing a great job. but I feel like I need to add a third thing (aha, sacacylic, glycolic etc) I recently got Bare Minerals skin revved upper and don’t know how to incorporate it. I read that it cannot be used with vitamin c, so the only option is to use it at night alternating with the retin a. I don’t want to give up any retin a nights! Waiting for your ideal routine to spell it out:)

    Posted by Lisa | February 4, 2013, 4:21 am
    • Sure I’m happy to answer all of your questions. :)

      I’ve actually already addressed this issue in the comment sections of this post: http://www.futurederm.com/2012/10/25/should-niacinamide-and-l-ascorbic-acid-be-used-together/ Since there are 90+ comments, I’ll just post the relevant reader’s (two) questions and my corresponding answers.

      FYI, I answer several questions actually, and I’d recommend reading through everything. . It might help you understand even better.

      Q:

      “Hi John,

      I have a question that relates to your response to Nook above. I also use glycolic acid, but in the evening. I thought its use in the morning was NOT recommended? Is it actually OK to use it in the morning, as long as I use a sun block afterward?

      Also, I read (in this webpage: http://www.theherbarie.com/Niacinamide-USP-Vitamin-B3.html) that Niacinamide cannot be used at a PH below 5, so I assume that it cannot be paired with glycolic acid either, right?

      Taking all of this into account, would you approve of the following regimen?

      AM: Glycolic acid product + vitamin C product followed by a 30-minute-wait, and then: Olay moisturizer (Complete Sensitive Skin SPF 30) with Niacinamide (I should find another sun block without Niacinamide, but I’ve used this one for years and love it so much… I know you recommended the 30-minute-wait to others above, so I am hoping this will work…)

      Evening: Retinol product + Olay serum with Niacinamide

      Thanks in advance John for your invaluable advice!

      France

      PS
      Your idea to create an “ideal routine” portal/page for all skin types on your blog sound like pure genius to me!”

      AND

      “After writing my comment above, I looked up a link that someone else posted about Vitamin C’s “half life”, and found the following information in Dr. Bailey’s blog: “…vitamin c and glycolic acid can’t both be on the skin at the same time…”, and then, even more confusing: “The half-life of vitamin C in the skin is four days, meaning it sticks around for a while.”

      Wow, I am so confused now! If it is true that vitamin C stays in the skin for 4 days, then maybe Niacinamide should not be used at all by someone who uses a vitamin C product?

      Also, what do you think about the use of glycolic acid and vitamin C together, taking into account Dr. Bailey’s comment above?

      Here is the link to Dr. Bailey’s blog, where I found this info:
      http://www.drbaileyskincare.com/blog/whats-the-best-anti-oxidant-skin-care-product/

      Thank you so much John for taking the time to read everybody’s comments and replying… Peach wrote “I trust you” at the end of her comment above… I feel the same!!!”

      A:

      “First comment:

      It is OK to use glycolic acid during the daytime. However, it is preferred for evening use, just because it does slightly increase the skin’s sensitivity to the sun. I mentioned this in my hydroxy acids series, specifically in part III. Have a read if you’re interested:

      http://www.futurederm.com/2012/05/10/hydroxy-acids-part-iii-common-misconceptions-of-hydroxy-acids/

      But considering the antioxidants and sunscreen, this slight increase in sensitivity shouldn’t have too large of an impact. I too only use glycolic acid at nighttime, but for Nook, I just didn’t want to change her routine too much. Is Nook even a girl’s name? Lol. Anyways… moving on.

      It’s not that niacinamide CAN’T be used below a pH of 5, it’s just that that some of it may convert to nicotinic acid, which may result in some redness and flushing. However, I think that the 5-7 pH range was given ith the idea of “better safe than sorry” in mind. But in reality, it has little relevance. For example, this study: http://onlinelibrary.wiley.com/doi/10.1002/jps.2600510710/abstract, indicates that the MINIMUM conversion rate happens when the pH is between 4 and 6. So, glycolic acid products are typically formulated between pHs of 3 and 4. And waiting 30 minutes after application (something that I recommended for all acidic products), should take care of this interaction. And from personal experience (I use a glycolic and/or salicylic acid product at nighttime, wait 30+ minutes, then apply a niacinamide product) I have never experienced noticeable skin flushing, which suggests that no significant amount of nicotinic acid was formed.

      Does that make sense?

      As for your routine: You already know that I’d would prefer for you to use a non-niacinamide sunscreen, but hey, it’s completely your choice! It’s still way better than using no sunscreen. The 30 minutes wait time may theoretically reduce the complexation interaction between L-ascorbic acid and niacinamide, but that’s just it. We don’t know; can only hope for the best.

      But the rest of your routine seems fine.

      Second comment:

      Relax! Don’t freak out. While the half life of vitamin C is 4 days, you have to remember that measurement is theoretical and in the absence of things that degrade it: for example sunlight, oxidation processes that occur all the time in the skin, and other sources of free radical generation. So the vitamin C content in your skin doesn’t stay static and at the same level in real-life scenarios because it’s constantly being used up. I mean you want to protect your skin as much as possible, right? So it makes absolutely no sense to only apply vitamin C every 4 days. It’s a ridiculous notion.

      As for using glycolic acid with L-ascorbic acid, I have no idea why Dr. Bailey would say that. There is absolutely no documentation that supports her claim. Furthermore, when she responds to the various people asking her about it, she doesn’t show any evidence nor explain WHY they can’t be used together. I can think of no reason why they can’t be used together, except for the fact that some glycolic acid products are formulated with a pH above 3.5; they don’t typically go above 4.0 however. Now, a pH of 3.5 or less is recommended for L-ascorbic acid to properly penetrate into the skin. However, that number isn’t absolute. The diction makes it sound like a product with a pH of like 3.51 would be completely useless. And that’s not true at all. L-ascorbic acid is like any acid; it obeys all the same rules. Not to get too much into detail, just know that L-ascorbic acid can definitely be used with glycolic acid. I mean, L-ascorbic acid’s pKa is 4.17, while glycolic acid’s is actually lower: 3.83. I’ll definitely be doing a complete post on this in the near future. I may make it a two part series; we’ll see.

      But in the meantime, here are two brief examples to ease your mind: Both the two phrases that Dr. Bailey quotes: “Vitamin C has a half-life of 4 days” and “L-ascorbic acid requires a pH of 3.5 or less to penetrate the skin” are from studies done by the people behind the brand Skinceuticals. Here’s one of their studies: http://www.nature.com/jid/journal/v125/n4/full/5603565a.html. Now, if L-ascorbic acid isn’t compatible with glycolic acid, why in the WORLD would Skinceuticals include a product that contains BOTH ingredients?! http://www.dermstore.com/product_C+++AHA_1911.htm Clearly, they can be used together.

      Finally, as for the niacinamide, just try not to use it together with L-ascorbic acid. Forget the half-life in 4 days thing with L-ascorbic acid. It has no significant relevance.

      I hope that helps!”

      Let me know if you have further questions!

      Posted by John | February 4, 2013, 4:30 pm
      • thanks. This sentence is cut and pasted from your article, the five things your skin cannot live without on future dream. It says not to use aha with vitamin c. So when can I use aha if I do retin a at night and vitamin c in he morning?

        3. Antioxidants
        The Benefits: The body defends against free radicals (one of four major contributors to skin aging) with antioxidants, which impede or slow the chain reaction. Antioxidants like beta carotene andvitamins C and E “break the chain,” stopping free radicals from ripping electrons off of other molecules, while other antioxidants, like superoxide dismutase, catalase and glutathione peroxidase, slow the free radical chain reaction by stabilizing the unstable, reactive free radicals. As the body does not produce or ingest enough antioxidants to neutralize all of the free radicals, which come from processes that are both endogenous (within the body, such as human metabolism) and exogenous (outside the body, from pollution, smoking, alcohol, and UV radiation, amongst other sources), free radicals accumulate a great deal of damage within the body over time (WebMD). As a result, many experts recommend use of antioxidants and sunscreen to prevent UV-induced free radical damage. According to Sheldon Pinnell, a dermatology professor at Duke University of School of Medicine who created Cellex-C about twenty years ago and later assisted in the creation of Skinceuticals CE Ferulic: “I was interested in how it [topical vitamin C, an antioxidant] could stimulate collagen synthesis. But we found that it was really good for protecting against sunlight.” As many new antioxidants are coming out over time, a rating system called EPF (environmental protection factor) has been proposed to rank antioxidant strength.
        When to use them (from Allure): In the morning, after cleansing, before sunscreen. (It also does not hurt to use them at night in conjunction with hydroquinone and EITHER retinoids OR AHAs.)
        What to use with: Sunscreen, as antioxidants boost the protective capacity of sunscreen against UV-induced free radical damage.
        What not to use with: Take care when your antioxidant is vitamin C. Do not use vitamin C with alpha hydroxy acids (AHAs) — the two acidic ingredients can irritate the skin.
        When to toss: Six months after opening. Also, take care not to expose your vitamin C products (those with L-ascorbic acid in particular) to light, heat, and air, which can destabilize the vitamin C.

        Sent from my iPad

        Posted by Lisa Mueller | February 4, 2013, 5:29 pm
        • Huh.

          Well actually, I didn’t author that post: http://www.futurederm.com/2008/01/01/five-ingredients-your-skin-cant-live-withoutand-how-to-use-them/ Nicki did.

          And while I don’t agree completely with the article, she does state that you won’t want to use both ingredients together as they “can irritate the skin.” However, she doesn’t say that they CAN’T be used together. Irritation is a very personal thing, as it will vary from person to person. However, there’s no chemical reason NOT to use them together. For example, there’s no negative interaction between them, like that which occurs between niacinamide and L-ascorbic acid.

          Does that all make sense?

          Posted by John | February 4, 2013, 5:40 pm
          • This is the last time I will bug you, I promise: After much research, I trust your site over all others. I use prescription Retin A every night. I love using this every night and have just worked up to 7 nights a week. I use a home made Vitamin C serum each morning and love it! These 2 are a one two punch that is working well. I feel like I should add an AHA/glycolic moisturizer/primer as a 3rd part, but don’t know how. AM: Exfoliating Cleanser, Vitamin C, CeRave, sunscreenPM: Exfoliating cleaner, Retin A, sometimes CeRave. How do you add AHA’s to this? You say, go ahead and use it with Vitamin C, so now the next issue: When? My gut tells me that AHA is exfoliating, so if I apply that and then put Vitamin C over it, wouldn’t the AHA slough the Vitamin C right off my skin? But if I put Vitamin C on first, won’t the AHA exfoliate all the benefits right off? Just spell it out for me in order if you will! Thanks!

            Date: Tue, 5 Feb 2013 01:40:46 +0000 To: lisamueller@live.com

            Posted by Lisa Mueller | February 5, 2013, 6:22 am
            • That’s a very good question. And don’t worry about bothering me. I’m here to help.

              I’d personally recommend applying the AHA before, rather than after the vitamin C. This is because yes, some of the vitamin C will go into the cells that are then going to be exfoliated off the skin. Overall however, the stratum corneum will be thinner, meaning that the vitamin C has less layers of skin to go through before penetrating into the viable layers underneath, which is the most important goal.

              If you apply the vitamin C first, more will get go into the cells of the stratum corneum, which will then be exfoliated off. Less vitamin C overall, will go into the viable layers of the skin.

              However, keep in mind that this is mostly theoretical and postulative musings. And in the end, the order of application between vitamin C and glycolic acid shouldn’t make that large of a difference in terms of efficacy.

              Also, have you considered mixing the two ingredients? Since their optimal pH values are similar, they should be compatible.

              I hope that all makes sense.

              Posted by John | February 5, 2013, 6:01 pm
  3. help! I use prescription Retin A at night. Vitamin C every morning. I want to add an aha moisturizer, primer. can I put it on top of my Vitamin C right away?

    Posted by Lisa | February 2, 2013, 4:38 pm

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