Enerpeel® Mandelic Acid Protocol For Rosacea and Telangiectasia
Mandelic Acid is an alpha hydroxy acid but it has a number of chemical properties apart from acting as an exfoliating solution which does not trigger erythema. Its ability to help control rosacea has been shown but its actual mechanism of action in treating rosacea symptoms of reddening and thread veins is unknown but there is evidence that may point us in the right direction. It is ideal for those prone to reddening.
It is known to be antibacterial and antiviral and also helps to encourage vascular turnover and regeneration while suppressing reddening skin chemical reactions. Enerpeel MA 40% will reduce the thickness of the stratum corneum from 37 microns to 25 microns immediately after the peel and then it will reduce further over next 24 hours to 23 microns.
So Enerpeel MA is an exfoliating peel where the Mandelic Acid AHA molecule size means it is absorbed more slowly and hence does not trigger Erythema and therefore does not trigger excessive reddening or post inflammatory pigmentation, in fact it may act as a tyrosinase inhibitor and help control over active pigmentation. It can also be used as a pre peel similarly to Jessners.
Enerpeel MA incorporates a 5% concentration of MSM deep into the skin
MSM (Methylsulfonylmethane) has been shown to exhibit significant anti-inflammatory and antioxidant properties but is thought to act in a number of other ways and is still being researched as to its full spectrum of action.
MSM is an inflammatory agent and free radical scavenger but also interacts with key reddening pathways and works synergistically with the Mandelic acid. Mandelic acid is a peeling agent which acts in part as the vehicle to get deep penetration of the MSM. This MSM activity is supplemented with the Tebiskin range. The impact of this is to increase and raise reddening trigger tolerance thresholds and to suppress over active release of reddening inflammatory chemicals like interleukin 1 alpha as shown in the graphs seen below with consequent suppression of skin reddening.
It seems that the combination of Mandelic Acid and MSM incorporated into an Enerpeel carrier system can prove very effective when supplemented by MSM containing creams to reduce the symptoms of rosacea. Below are a number of Clinical Study Results which demonstrate the activity of MSM on interacting on a number of pathways known to be involved in the development and progression of rosacea. These results were obtained with the Tebiskin range which contains 5% MSM in a cream. The Mandelic acid peel incorporates 5% MSM deeper into the skin and therefore has an additive effect.
Clinical Study Results
Click here to see the level of Erythema control
Click here to see Anti-Inflammatory activity
Click here to see Control of Thread Veins
Protocol For Rosacea and Telangiectasia
- 4 treatments with Enerpeel MA
- Can be applied in multilayers
- Length of Exposure, 2 minutes up to 10 minutes
- Interval between each treatment = 7 to 14 days
- Number of Sessions per year = 2 (or as determined by clinician)
- Prepare the skin with Smoo Clean and Smoo for 2 weeks before first MA
- Use Tebiskin Smoo Clean and Tebiskin UV between MA
- For 30 days after last MA use Smoo Clean and UV in the morning and Tebiskin Smoo Clean and Smoo at night
- After 30 days continue with Smoo Clean and Smoo morning and night
- Treat as per other AHAs
Mandelic Acid ~ 40%
- The chemical exfoliation based on Mandelic Acid / MSM.
- This chemical exfoliation can be performed in a single layer (superficial exfoliation) or in multi layers (after application of the 2nd layer it is possible to obtain a superficial-medium exfoliation; the application of further additional layers can result in a medium exfoliation).
- The chemical exfoliation process can be controlled through the process of neutralisation.
- Composition: Mandelic Acid 40%
- Technology: ENERPEEL Technology.
- Chemical exfoliation: superficial, very superficial - medium.
- Average application time before neutralisation: from 2 to 10 minutes according to the indication, the degree of photo ageing, the genetic-racial characteristics and photo type of the patient.
- Container: Vialbrush.
- Vial Contents: 2 ml.
Possible Related Data as to the Activity of Mandelic Acid
Mandelic acid is a compound which can metabolise into inhibitors of trypsin in like serum proteases which includes thrombin. Thrombin is known to play a central role in coagulation. It activates platelets, leading to platelet aggregation, converts fibrinogen into fibrin monomers, which polymerise spontaneously into fibrin polymers, and activates factor XIII, which In turn cross links the polymers to form insoluble fibrin.
Furthermore, thrombin activates factor V and factor VIII leading to a "positive feedback" generation of thrombin from prothrombin. By inhibiting the aggregation of platelets and the formation and cross linking of fibrin, effective inhibitors of thrombin would be expected to exhibit antithrombotic activity. In addition, antithrombotic activity would be expected to be enhanced by effective inhibition of the positive feedback mechanism.
This activity may have medical uses but it may also play a role in helping to moderate underlying triggers, causes and outcomes in the development of rosacea. There is other evidence of mandelic acid and derivatives having an anti-viral action and is being assessed as an antiviral including in HIV.
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