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Glossary of skin related terms
Adnexal structures
Structures found in the skin that include the hair follicles, apocrine sweat
glands, eccrine sweat glands and the pilosebaceous units.
AHAs (Alpha Hydroxy Acids)
Acids derived from food sources that are effective exfoliants of the skin.
The most common AHAs are glycolic acid and lactic acid.
Angiogenesis
New blood vessel growth that increases skin circulation.
Carbon dioxide (CO2) laser
A modality that uses high-energy, pulsed beams of light to target intracellular
water and precisely vaporize small areas of tissue, layer by layer. A number of
passes are made to reach the desired depth. A CO2 laser has leveling effects and
tightening effects because of the heat-mediated thermal shrinkage.
Collagen
The major structural protein of the dermis. Manufactured by fibroblasts, the
arrangement of collagen fibrils into small groups of fibers which then come
together in thin, wavy, fiber bundles. These bundles are then arranged into a
mat-like pattern - resulting in great tensile strength.
Connective tissue
Collagen and elastin fibers found in the dermis.
Corneocytes
The dead cells of the stratum corneum.
Dermis
The tough, connective tissue matrix found immediately below the epidermis.
Design blue peel
Application of extra Blue Peel solution to selected areas for penetration up to
the Immediate Reticular Dermis (IRD).
Elastic fibers
Fibers, composed mostly of the protein elastin, found in a network in the
dermis. These fibers maintain normal skin tension, and give it the ability to
snap back after stretching. Alterations in the elastic fiber network are
responsible for looseness and sagging of aged skin.
Epidermal sliding
The ability to wrinkle the skin with a slight push when the TCA peel solution
has reached the level of the papillary dermis. It occurs because the TCA has
separated the epidermis from the dermis.
Epidermis
The outer layer of the skin atop the dermis.
Erbium: YAG laser
A laser modality that is more superficial than the CO2 laser and requires more
passes to reach depths equivalent to those reached by the CO2 laser. This is
less effective for correcting wrinkles and scars and causes punctuate bleeding
when the dermis is reached.
Erythema
Redness of the skin due to capillary dilation.
Exfoliation
Removal of various layers of the epidermis. Depth can range from the stratum
corneum to the basal cell layer. Any deeper penetration constitutes a peel.
Extracellular matrix
The shapeless substance that bathes the structural components of the dermis
(collagen, elastic fibers, fibroblasts.) It is composed mostly of
glycosaminoglycans (GAGs). The Extracellular matrix is also known as ground
substance.
Fibroblasts
Cells in the dermis that lie among collagen fibers and synthesize collagen,
elastin and the Extracellular matrix.
Focal dermal necrosis
Death of areas of skin tissue surrounded by healthy parts.
Glycolic acid
A fruit acid used in the topical exfoliation of skin cells.
Glycosaminoglycans (GAGs)
Large, chain-like molecules of polysaccharide linked with a protein that form
the major constituents of the Extracellular matrix of the dermis.
Immediate reticular dermis (IRD)
A very thin zone in the dermis just below the papillary dermis. The IRD is the
maximum recommended depth for the Blue Peel.
Keratinocyte Maturation Cycle
The time it takes for a Keratinocyte to be formed in the basal layer, migrate
upward to the stratum corneum and be shed through exfoliation (approximately 6
weeks).
Keratinocytes
The principal cells of the epidermis. Keratinocytes form in the basal layer and
migrate upward to form the stratum corneum. They are eventually shed through
exfoliation in one skin cycle (approximately 6 weeks or one skin cycle).
Leveling
Smoothing down or bringing different elevations of skin to the same level.
Achieved by penetration to the mid dermis or below. Deeper chemical peels, CO2
laser resurfacing and dermabrasion are effective.
Mechanism of action
The way by which a procedure or product works to produce an intended effect.
Melanin
The pigment present in skin that reduces the amount of ultraviolet light that
penetrates the skin. Increased amounts are formed during tanning. Melanin
determines skin color of racial groups.
Melanocytes
Cells in the basal layer of the epidermis that produce the pigment melanin in
their melanosomes.
Melanosomes
Organelles inside Melanocytes that produce melanin granules.
Milia
Small, white cyst-like eruptions of the skin.
One skin cycle
One Keratinocyte Maturation Cycle - or about 6 weeks.
Papillary dermis
The part of the dermis that lies immediately below the epidermis. It has
vertically oriented connective tissue fibers and a rich supply of blood vessels.
Period of Relative Resistance
The time it takes for the skin to resist TCA penetration from one level to
another because of body defenses that oppose penetration of the acid. The period
is longer with the Blue Peel because the TCA concentration used is less than 25%
and penetration is not fast.
Pink sign (background)
The pink background to the frost present during the Blue Peel when TCA has
reached papillary dermis. It disappears when the TCA has reached the IRD.
Platysma
The layer of muscle that extends from both sides of the neck to the jaw and
muscles around the mouth.
Post-inflammatory hyperpigmentation (PIH)
Hyperpigmentation or skin darkening that occurs with an inflammation-inducing
event such as a peel or laser resurfacing procedure.
Reticular dermis
The thicker, major layer of the dermis that lies below the papillary dermis. It
is composed of densely packed, thick collagen bundles and elastic fibers
arranged mostly parallel to the skin surface. The reticular dermis is the layer
that is responsible for the amazing strength and elasticity of the skin.
Retin-A
Retin-A Gel, Cream and Liquid, containing tretinoin are used for the topical
treatment of acne vulgaris. Retin-A Gel contains tretinoin (retinoic acid,
vitamin A acid) in either of two strengths, 0.025% or 0.01% by weight in a gel
vehicle of butylated hydroxytoluene, hydroxypropyl cellulose and alcohol
(denatured with tert-butyl alcohol and brucine sulfate) 90% w/w. Retin-A
(tretinoin) Cream contains tretinoin in either of three strengths, 0.1%, 0.5%,
or 0.025% by weight, in a hydrophilic cream vehicle of stearic acid, isopropyl
myristate, polyoxyl 40 stearate, stearyl alcohol, xanthan gum, sorbic acid,
butylated hydroxytoluene, and purified water. Retin-A Liquid contains tretinoin
0.05% by weight, polyethylene glycol 400, butylated hydroxytoluene and alcohol
(denatured with tert-butyl alcohol and brucine sulfate) 55%. Chemically,
tretinoin is all-trans-retinoic acid. Retin-A is a registered trademark of Ortho
Pharmaceutical Corporation.
Solar elastosis
Photo damage characterized by massive deposits of thickened, tangled and
degraded elastic fibers.
Stratum corneum
A layer of dead but functionally important cells at the top part of the
epidermis. This layer acts as barrier between the body and the environment.
Telangiectasia
Dilated dermal blood vessels giving rise to a visible red legion on the skin.
Tensile strength
Resistance to being torn apart.
Tightening
Making skin tighter (less lax). Achieved by penetration to the papillary dermis
of the IRD.
Tretinoin
Topical tretinoin cream is a retinoid used to treat mild to moderate acne and is
the active ingredient in the prescription drugs Retin-A and Renova. Although the
exact of action is unknown, tretinoin appears to affect skin cells by
stimulating the cell turnover rate and cell division. Shedding of skin cells
then occurs in a more normal fashion, unplugging blackheads and whiteheads
(comedones), the initial changes in acne formation.
Tyrosinase
The enzyme that allows melanin to be formed from tyrosine.
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