Acne

links: Estrogen Gut Skin reference: https://raypeatforum.com/community/threads/georgi-dinkov-haidut-on-acne.38753/#post-605880 4-11-2021

Acne #

An issue which starts in the gut, then in hormones, then finally in the skin.

• In skin affected by rosacea, blood flow circulation was 3-4x higher than normal.
  • This may be due to an inability to extract oxygen from the blood, or to use it to produce energy; which would indicate a deficiency in Citric Acid Cycle.
    • http://raypeat.com/articles/articles/rosacea-inflammation-aging.shtml
  • Estrogens potentiate corticosteroid effects on the skin.
• What’s the role of vitamin A intake and acne? Am I getting too little?
  • 100,000 IU/day for 6 months obtained satisfactory results
    • https://raypeatforum.com/community/threads/the-origin-of-rays-association-of-vitamin-a-and-hormones-with-acne.17140/
• “Estrogen causes the oil glands to atrophy, so the skin doesn’t support bacterial grwoth so well.”
  • https://raypeatforum.com/community/threads/long-standing-bacne.8965/post-139179
• Brain-Skin Connection: Stress, Inflammation and Skin Aging
• Sebum from people with acne have a higher viscosity, melting point, and characterized by an unbalance of lipids—namely: squalene, wax esters, and triglycerides:
  • Sebum analysis of individuals with and without acne
    • *Free fatty acids were the only lipid group that was reduced in the sebum of acne subjects. The specific lipid that differed the most between the two groups was squalene, which was upregulated in acne subjects by 2.2-fold on a quantitative basis. Squalene also represented a significantly greater proportion of the
    • total sebaceous lipids in acne patients compared to controls (20% vs. 15%).*
  • SEBUM EXCRETION AND SEBUM COMPOSITION IN ADOLESCENT MEN WITH AND WITHOUT ACNE VULGARIS

Scarring #

• I’m thinking: For the face: few TCA peels every few months, then a few PRP microneedling treatments every 3 months. Then finally laser resurfacing as the final step (start with the deepest treatments first.)
  • I’m not sure if I superset a bit, or it several TCA → several PRP treatments is the only way to go.
  • Subcision is also an option after TCA, for rolling scars.
  • Can do intralesional kenalog (triaminolone) (a synthetic corticosteroid)) for keloid removal
• Medical schools where dermatologists in residency might have dedicated scarring clinics. There’s probably lots of stuff anywhere. Realself has the clinic locator stuff

Subcision #

Perfectly efficacious. Good for rollover.

TCA #

• Work up to it with glycolic peels and stuff (like the classic TO AHA+BHA) before starting with ~10%. TO is equivalent to maybe 8% TCA, but TCA still has different chemical effects (protein coagulation, and legit damages tissue, rather than just dissolving bonds in skin cells and exfoliating)
• The concentration for DIY is something like ~15-20% tops.
  • Concentration = directly related to depth. So frequent low concentration just isn’t it.
  • Your face will start peeling on day 3-5 and only clears up after 7-10 days.
    • With 12.5% concentration you may or may not totally peel; might just be flaking. So yeah, good to start with that.
  • Can cause burn scars etc - but at the dermatologist, you can go up to 100%. Costs a few hundred per session, typically.
  • And yeah, you can get even worse scarring if you fuck it up going overkill on your entire face. Gotta look into how to avoid that. I guess just use different concentrations on different areas.
  • Cleanse like crazy and wipe the skin with alcohol + acetone to degrease.
• So there are 3 different depths of peels. Superficial is only in the epidermis, and I think that’s all you’re really able to do when DIY, where you just rub it on. Deep goes pretty far into the dermis, just above the vasculature.
• TCA cross is focused delivery, usually on atrophic/icepick scarring, with like a toothpick/instrument. It tunnels in, causing a wound, and the idea is that collagen will fill over.
  • By design, the scars get wider. (So some people get worse results) But as the scar floor raises after several treatments, you can do resurfacing.

• For up to ~10 days afterwards, you look really bad, peeling and cracked like you’re sunburnt asf, shiny and thick, with lots of hyperpigmentation coming to the surface… Doing this not in the winter seems crazy. Be aggressive with sunscreen BEFORE too.
• Wearing makeup/concealer after is fine… might be necessary… overall, be gentle as possible, with no picking/scrubbing/etc.
• Sometimes, priming agents are given weeks prior to peels (which can include retinoids like tretinoin—or glycolic acid) to even out the surface of the epidermis, like you’re sanding it. Ideally post-purge.
  • Same side of the coin though, I’ve seen it recommended to stop all BHAs/AHAs, etc., or retinoids at least for ± 24 hours.
• https://www.platinumskincare.com/tca-peel-13-20-30/
• BIENPEEL 35 % TCA The No “Peel” Peel. It contains compounds that deliver TCA past the stratum corneum in order to prevent frosting and excessive peeling. I think it’s probably a meme.

Microneedling #

See also Hair Loss Good for rolling and boxcar scars.

• Is it permanent? Girl on youtube and lots of mainstream sites say you need to continue treatments to maintain result - plebbit says it’s permanent though, especially for scars. Like I don’t see why it wouldn’t be.
• Just go on Ebay for Dr. Pen A6 cartridges for like $12 for a 10 pack.
• EGF!
• PRP (Platelet-rich plasma, where you use your own blood)
  • Platelets have a high concentration of growth factor, namely of course PDGF, and VEGF.
• RF microneedling (radio frequency, literally sending waves into your shit). Few hundred per treatment?… Closer to $1000
  • Infini/Genius, intracel, intensif, vivance, etc. Must be insulated. Do them 3 months apart.
• It seems that weekly is the best for hairline/scalp. Face might be a different story, though.
• 1.5-2.5 sized dermaroller for 20-25 minutes every 1-2 weeks is common for the scalp
  • I think it needs to be 1.5 for acne scars.
• https://looksmax.org/threads/solutions-for-nasolabial-folds.468912/post-7728116
  • According to random chart, it doesn’t recommend >.5mm for most areas of the face. 1-1.25 for scarring and 0.5-1mm for cheek area.
• https://www.youtube.com/watch?v=B1i0xE7P_Zk
  • Releases VEGF, PDGF. Might stimulate through (FGF-7) upregulation in dermal papilla cells.
• https://dermaroller.owndoc.com/dermaroller-instructions.pdf
  • 1.5 every 3-4 months or 2.0 every 5 weeks.
  • 1-needle for between the eyebrows.
  • In our experience, dermarolling did not improve this skin condition
  • Apply skin-lightening products after dermaneedling for improving sun/age spots, melasma, brown pigmentations, etc.

Laser Resurfacing #

Best for boxcar.

• Fraxel, Sciton, V-Beam and whatnot.
  • V-Beam heats up blood vessels, causing them to shrink and die! It’s used for treating rosacea and stuff. Kinda cool. Wonder if I could use this, if I really wanted to go Griffith mode like my face is a sheet of paper
    • Guy on nootopics said this basically abolished the aesthetic effects of Astaxanthin for him.
• ~$400 to over $1k per session. Cheaper outside the US of course though
• There’s ablative vs. non-ablative. Pretty sure the latter is kind of pointless for scarring.
  • CO2 is ablative. It can even be applied itself (it works like/is dry ice).
    • A guy on looksmax said to do CO2 if white, erbium yag if dark-skinned
• Treatments can be about a month apart
• Can be used alongside intradermal PRP administration.

Looksmax threads etc #

Mainly talking about acne scars here, since at least that’s all I really have to worry about: https://looksmax.org/threads/acne-scar-looksmax-plan.495337/

• 15% TCA peel (Trichloroacetic acid) - possibly followed by stronger depth (20%+).
  • This is recommended because it will make your scars shallow, especially icepick scars.
  • Then, CO2/laser resurfacing or RF/PRP microneedling.
• Do RF microneedling → Laser → and the peels last.