THE 101

The 101: Poly Hydroxy Acids

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You know AHA’s but have you met any PHA’s yet? If you haven’t you will. Polyhydroxy acids were first discovered, researched and patented by Neostrata, the inventors of the gylcolic peel (literally) and one of my favorite brands.

But, as all good things come to an end, their patent ran out- and lots of beauty brands are now incorporating PHA’s into their products. I spoke with the lovely Sara Spruch-Feiner for a story she was doing on PHA’s. Check it out here!

The 101: CBD in Skincare

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There is huge demand for cannabidiol (CBD) due to its medicinal benefits for a wide range of health concerns, and it's also been showing up in topical skincare and body care products. Just like most substances, there's a big difference between getting CBD into your bloodstream though oral tinctures and vaporization vs absorbing it through the skin via a topical skincare product.

But first, some background..

What is CBD?

Cannabidiol, or CBD, is a cannabinoid derived from varieties of the cannabis plant. Cannabinoid is a term used to refer to chemical compounds that are found in the cannabis plant and/or that interact with cannabinoid receptors, as well as the derivatives, and transformation products of those compounds. There are over 80 different cannabinoids found in these plants, but THC and CBD are the most common. CBD on its own has no psychoactive properties, whether its taken orally or applied topically.

What are the sources of CBD?

The most common sources are 

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  • CBD derived from industrial hemp lawfully grown in the US

  • CBD derived from hemp lawfully grown outside the US

  • CBD derived from a cannabis plant that does contain THC, this plant is commonly referred to as marijuana

  • Synthetic CBD

Hemp is a variety of cannabis, but it's a strain thats been bred down to have less than 0.3 percent THC by dry weight, so while hemp technically may contain some THC—the amounts aren't considered psychoactive at all. Whether the CBD comes from hemp or a plant that has THC, it still has no psychoactive properties. Also interesting, whether the CBD is derived from either hemp or cannabis that has THC, the human body treats it the same.  Also to note, hempseed oil is from the seeds from hemp and contains no CBD, while hemp extract is from many parts of the hemp plant and can contain CBD along with other cannabinoids. Martin Lee, co-founder of Project CBD, told Leafly (a huge cannabis online resource) that hemp fiber and seed contain no usable amounts of cannabinoids. “Cannabidiol can’t be pressed or extracted from hempseed,” he writes. “CBD can be extracted from the flower, leaves, and, only to a very minor extent, from the stalk of the hemp plant. Hemp oil start-ups lack credibility when they say their CBD comes from hempseed and stalk.” 

What does CBD do?

A few studies suggest CBD may help reduce anxiety, insomnia, pain related to arthritis and fibromyalgia, and general muscle and joint pain. However most of the research on CBD has been focused on reducing certain types of seizures. Just last month, the end of June 2018, the US FDA approved Epidiolex, a CBD oral solution for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome. This is the first FDA-approved drug that contains a purified drug substance derived from marijuana. Under the Controlled Substances Act (CSA), CBD is currently a Schedule I substance because it is a chemical component of the cannabis plant. In support of this application, the company conducted nonclinical and clinical studies to assess the abuse potential of CBD. As part of the approval process, Epidiolex must be rescheduled from its current Schedule I before it can be made available to patients. They state: "Rescheduling is expected to occur within 90 days and Epidiolex is expected to be available to appropriate patients by Fall 2018."  I believe if a big pharma has a version coming out, there must be something to this. On the flipside to "CBD only" over the counter products or pharmaceuticals, there is also a widely debated category of utilizing a combination of cannabinoid compounds for maximum benefit, commonly referred to as the "entourage effect."

For an up to date detailed list of published research including cannabinoids, click here and here. 

If CBD is still considered a 'Schedule I substance' then how is it being sold in health food stores across the nation and online? 

Confusing is an understatement.  In November 2017, the FDA has written warning letters to companies selling CBD products outside of a legal, licensed cannabis store, but that doesn’t seem to be stopping sales and availability. On a federal level, the DEA considers it illegal- but CBD laws vary from state to state. Rod Kight, a lawyer that specializes in business law and cannabis policy, has written excellent posts that get into legal technicalities of CBD. He says CBD is legal or not, based on its source and the jurisdiction in which the plant is cultivated. 

I've seen CBD products online and even at my local healthfood store here in NYC, where only medical (not recreational use) is legal. Am I actually getting a real CBD in a product if isn't purchased from a licensed retail cannabis store in a cannabis legal state? The answer is....maybe? A big factor is where its purchased from. If adult use cannabis is legal and regulated in that state, then the CBD products available in licensed retail cannabis stores must pass state-mandated lab tests to assure their potency and purity. Outside of those tests, consumers must put their trust in the manufacturer. More legalization will most likely lead to more quality control. The FDA did a random test on some CBD products in 2016 and they found some had less CBD then what was advertised. Only two of the 24 CBD products from eight companies passed the agency’s test for having the amount of CBD in the product that matched the amount claimed on product labels. Also doing testing was the Journal of the American Medical Association (JAMA). They published research letters with results of research done on the labeling accuracy of products sold in dispensaries online (2017 letter) or in shops (2015 letter). More legalization will eventually lead to more quality control. 

What if you don’t get your CBD product at a legal, licensed cannabis store but online, a heath food store or random retailer? Consumer Lab's advice is to look for products that list the amount of CBD per serving, not just per bottle. If a product lists only “cannabinoids” it may contain CBD but you won’t know how much. Products that list ‘hemp extract’ may have significant amounts of CBD, but don’t expect any CBD if ‘hemp oil’ or ‘hempseed oil’ is the only ingredient. 

Some companies are changing the CBD wording on their products and websites in an attempt to avoid government interference. This is great story on how some brands are facing hurdles selling CBD infused skincare. 

Now what about CBD in skincare?

There were some studies early on that showed CBD could have a myriad of skin benefits. In 2009, The Department of Physiology at the Research Center for Molecular Medicine said  "The newly discovered endocannabinoid system (ECS; comprising the endogenous lipid mediators endocannabinoids present in virtually all tissues, their G-protein-coupled cannabinoid receptors, biosynthetic pathways and metabolizing enzymes) has been implicated in multiple regulatory functions both in health and disease. Recent studies have intriguingly suggested the existence of a functional ECS in the skin and implicated it in various biological processes (e.g. proliferation, growth, differentiation, apoptosis and cytokine, mediator or hormone production of various cell types of the skin and appendages, such as the hair follicle and sebaceous gland). It seems that the main physiological function of the cutaneous ECS is to constitutively control the proper and well-balanced proliferation, differentiation and survival, as well as immune competence and/or tolerance, of skin cells. The disruption of this delicate balance might facilitate the development of multiple pathological conditions and diseases of the skin (e.g. acne, seborrhea, allergic dermatitis, itch and pain, psoriasis, hair growth disorders, systemic sclerosis and cancer)."  

There was a 2014 study that used biopsies of human scalp and arm skin to try to determine whether CBD could suppress acne. This also showed potential anti-inflammatory effects. Research has also been done on human cells, suggesting there could be applications for inhibiting hair growth, managing skin disorders characterized by sebaceous gland dysfunctions, and sweat gland derived disorders (some tumors) characterized by unwanted growth. This is a comprehensive list of dermatological studies. 

Botanix Pharmaceuticals, a dermatological company, just announced the completion of its Phase 1 clinical trial for an acne drug that incorporates synthetic cannabidiol (CBD). Zynerba Pharmaceuticals has been conducting a Phase 1 study in Australia of its drug ZYN002, a synthetic CBD gel. This gel is aimed at treating epilepsy and osteoarthritic knee pain. The says the clear gel is designed to provide consistent, controlled, and sustained drug delivery in twice-daily dosing.

Easily attainable cannabinoids were first being sold and used in topical products to treat localized pain relief, muscle soreness, tension, and inflammation. There are products even making claims to treat psoriasis, dermatitis, and cramping. The endocannabinoid system consists of many cannabinoid receptors, and a large portion of these are found in the skin.  The concept in using it in beauty & skincare is that CBD has antioxidant properties and an impact on controlling skin inflammation, which would then make it useful for treating a multitude of skin issues.  Keep in mind, as with any ingredient that doesn't have a ton of research yet, the other ingredients in the product also play a role. Also, while cannabinoids seem to be showing potential in the dermalogical issues, potential side effects and negative consequences haven't been discussed in most of the research I looked at. Additionally, I can't find information on the pros and cons of endogenous cannabinoids versus synthetic cannabinoids.

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Almost any beauty product retailer (at least here in NYC) carries at least one beauty product with CBD, whole-plant phytocannabinoids, or hemp extract. There are retail websites with beauty sections dedicated to it, and one I found that exclusively only carries cannabis beauty products. I've been buying some to try, and will report back on that soon!

If legalization and research continues to grow, we will start to understand and learn more about cannabis as well as the endocannabinoid system and its receptors- and I predict an even bigger market for these products will begin to develop. 

 

 

 

THE 101: Acid Exfoliation

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Hello! If you follow me on Instagram or are one of my clients (thank you, I appreciate you!) then you also probably hear me talk about acid exfoliation often because it should be an essential for almost everyone. I've always gotten a lot of questions about how, when and why to exfoliate, so lets talk acids!  If you want to skip to my acid exfoliator reviews, click here. 

 

Why should I exfoliate?

Removing built up skin and increasing cell turnover is part of keeping skin looking fresh and smooth. Our skin does this to some extent naturally, but as we get older along with so many types of environmental damage, the skin's natural ability of shedding these cells slows down. Exfoliating helps in preventing clogged pores and breakouts, evens out skin tone, improves texture, reduces signs of aging like fine lines and lets your other skincare products work even better since they will have less of a barrier to get through. 

How exactly does an acid work?

Simply put, acids dissolve the 'glue' or the bonds that hold dead skin cells together. This act of breaking down these bonds promotes exfoliation at varying depths. For my technical science friends that love chemistry and want references, check this out from one of my favorite blogs.

Which type of acid should I use?

Acids can be naturally occurring, or be synthetically made. I personally think both are equally effective. If you prefer to use organic or eco-friendly products, there are absolutely acid brands in that category too! Depending on your skin type, and your skin goals, you'll want to look for products with specific acids. All skin types will benefit from AHA's and PHAs but oily and acne prone skin should use AHA and BHA, or just BHA. Experiment and see what works best for you! There are dozens of acids, but I'm going to go into detail about the most commonly found acids.

Glycolic Acid: Gycolic is the most researched and most common AHA found in acid exfoliators. It's water soluble and hydrophilic so even though it has some degreasing properties, it mostly stays away from the lining of hair follicles and pores. This a great acid for all signs of aging and normal to oily or normal to dry skin. Because of the very small molecular structure of glycolic, it also can sometimes result in inflammation on sensitive skin types. Very sensitive skin may do better with acids that have larger molecules, like lactic acid, polyhydroxy acid, or salicylic acid.

Lactic Acid: Lactic is another popular AHA, but has a larger molecular structure than glycolic which means it penetrates into your skin slower and therefore resulting in less of a chance of inflammation if you have sensitive skin. Lactic has shown to have antimicrobial benefits and inhibit tyrosinase production (which means its helpful in reducing pigmentation). This acid also functions as a humectant, making it ideal for normal to dry skin but beneficial for all skin types

Mandelic Acid: Mandelic, an AHA, has been growing in popularity. I've seen it used primarily in Asian Beauty brands for years, but recently have seen it in US brand formulations. This acid has potent antioxidant properties and is fat soluble with antibacterial properties making it great for normal to oily skin prone to breakouts.

Malic Acid: Malic, another AHA, is found in some fruits and veggies (most commonly in apples) which is why its commonly referred to as a 'fruit acid.' I see this acid often in more eco-friendly brands since its easily derived from natural sources. Malic has shown to be somewhat less effective then other AHA's so its usually combined with other acids. Its humectant properties make is great for normal to dry skin.

Azelaic Acid: This belongs to an acid group called dicarboxylic acids. Not only does it have exfoliating and antibacterial properties, but it's also shown to have antioxidant activity. Working with doctors, I have seen firsthand the miracles that azelaic acid topical prescription products have had on stubborn acne and rosacea. This is a great alternative for skin that is allergic to benzoyl peroxide. I've seen it in non-rx formulas up to 14%, and expect more formulas to start using this acid.

Salicylic Acid: Salicylic is in the BHA (beta hydroxy acid) group. It's oil soluble and lipophilic, meaning it can exfoliate in your actual pores. There are similar ingredients to sal acid, like betaine salicylate that work similarly. The antibacterial and anti-inflammatory properties makes this ideal for oily, acne prone skin types. 

Gluconolactone: This PHA (polyhydroxy acid) is part of the newer exfoliating acids and has been shown to have humectant and antibacterial properties. This is ideal for all skin types, but the larger molecular structure makes it less irritating than glycolic and worth considering for skin types that are sensitive or are on retinoids.

Other Acids :There are even more exfoliating acids in the world of skincare. Tricholocetic acid (or TCA)  and retinoic acids are used in many peels that I perform at my office, but rarely seen in leave-on acid exfoliators available to consumers. Lipohydroxy acid is a derivative of salicylic acid that has a slow penetration, but I believe it's exclusive to L'Oreal brands. Tartaric acid is another 'fruit acid' naturally found in grapes. I don't see it in many products but its considered an AHA and has antioxidant properties.

How do I use an exfoliating acid? 

Acids can come in all forms of skincare: cleansers, toners, serums, creams, or masks. I recommend using them in leave-on form since cleanser doesn't stay on your skin long enough to really exfoliate. I personally prefer acids in liquid form (serums or toners) because I find them easier to incorporate into my skincare, however you can experiment with an acid in a lotion or cream- it's really your preference. Generally lighter texture products are ideal for oily skin but any skin type can use them. Cream and lotions with acids work best for normal to dry skin. Depending on what issues you are treating and the concentration of the acids will determine how often to use it. Apply your exfoliant after you cleanse and tone. Then apply hydrating products if needed. Even though I recommend using acids at night, acid exfoliation will make your skin more sensitive to the sun, so SUNSCREEN IS MANDATORY :)

How often should I be using an acid exfoliator?

Acids with a concentration from 2% to 10% can be used daily (preferably at night) or every other night. Acids above that can be used one to three times a week. If you are thinking "Jordana, please, you're lucky if I wash my face most nights" and can't commit to adding an acid to your routine, try an over the counter peel twice a month or see an esthetician or a dermatologist for a peel! 

Who shouldn't use an acid?

If you have very sensitive skin, highly reactive skin, and/or a lot of allergies, then patch test your acid first. If you are on accutane or prescription retinoids, you probably won't need an acid exfoliant, but you can try mild formula once or twice a week. When my clients are on non-prescription retinoids, I'll usually have them use mild acid exfoliants on the nights they don't use their retinoid. I recommend getting your skin used to either a retinoid or the acid before using both. Don't apply acids over irritated skin, or active herpes/cold sores near or on the mouth. Avoid eyelids but you can experiment with using under your eyes, just stop about half inch from the lower lid. If you are pregnant or breastfeeding, ask your doctor if you should use acids. I feel most are totally safe but it's best to go over that with your doc.

How I patch test: Apply the product to one side of your lower face, near your lower ear/ jawline. Don't apply any other products over it when you patch test. Give it 24 hours to monitor for any reactions. Tingling sensations can be normal, but should subside within minutes. If all looks well after that 24 hour period, then try on your entire face. 

What acid exfoliators do you recommend? 

Reviews can be found here. Happy exfoliating! 

 

THE 101: Adult Acne

I contributed some information to Glamour Magazine for an article they were writing on adult acne. There is so much great information in this story,  I wanted to repost it in full.

 

The Totally and Completely Unfair Reasons You're Still Breaking Out in Your 20s and 30s
By Katheryn Erickson

There are a lot of things I don't miss about being a teenager: My chemistry teacher's sarcasm, basketball practice, the challenge of sitting in a school hallway in extra-low-cut Frankie B. jeans (it was 2004, but what was I thinking!?), curfews. There’s another thing, however, that I'd like to add to that list—that’s somehow lingered with me well into adulthood (I'm 28). And that's acne.

Here’s the thing: I honestly feel like I don’t have an excuse for breakouts. I’ve been working as a beauty editor since I graduated college, and with this job I have access to the best skin care pros in the world. I get regular peels. I do light laser treatments. I’ve been prescribed multiple rounds of antibiotics. I take Spironolactone, a mild blood pressure medication that’s prescribed off-label for acne, as it suppresses androgens. But—aside from the seven blissful years when I took a combined oral contraceptive pill that gave me The Clearest Skin Ever—I’ve always broken out. (The pill also gave me a blood clot, so relying on it for my skin is no longer an option. Cool!)As a result, I’m always in some way working to prevent a fiasco with my at-home skin care routine. I exfoliate every night with Lancer The Method: Polish Blemish Control, $75, which has purifying tea tree oil, before cleansing; I use Skinceuticals Phyto Corrective Gel, $64 to control breakout-related inflammation; and I alternate between Tammy Fender Purifying Lucent Masque, $215, and Eminence Hungarian Herbal Mud Treatment, $46, once a week to keep my pores clear. I even do this thing where I wash my face after shampooing and conditioning my hair because I’m paranoid the fragrance and ingredients like silicones in hair products is yet another trigger. All of it combined keeps my breakouts mostly under control, but I still deal with more pimples than I’m cool with—on my cheeks, chin, back (as I write this story I have a cute one on my cheek). It’s getting old.

And it turns out, I’m not alone. Adult acne (the kind that occurs in women 25 and above) haunts many of my closest friends—and, to varying degrees, effs up their lives. “I’m the perfect candidate for your story,” my friend Laura joked when I mentioned I was working on a piece about adult acne. She’s taken Accutane twice, and still relies on Spironolactone, like me, to minimize breakouts. “I was getting cystic acne—it wasn’t all over my face but I’d have two or three large cysts at a time. I will never forget when I met my husband’s family and I had two huge zits on my chin and cheek; I was so embarrassed,” she told me on the phone. “I had already been on Accutane once at that point. I was 35 or 36 at the time and I was like, ‘Why am I 35 and still getting acne?’ I assumed that I should have normal clear skin; I wanted that. But even after the second round of Accutane, I still got occasional cysts—they’re just embarrassing and huge—so I started taking Spironolactone. It helps a lot.”

Then there’s my friend Sarah, who is dealing with acne for the first time in her life. “I’m beside myself,” she told me in an email. “I NEVER broke out as a teenager, but now that I’m an adult and experience real stress, I do. I feel like I’m too old to have zits and I get really embarrassed. I’ve definitely canceled plans because of a breakout.” Same, girl.

My college roommate Eve, on the other hand, has more or less accepted zits as a part of life. “As a teenager they made me a bit depressed, but I’m less self-conscious about my skin now,” she explained. “I like to focus on the overall condition of my skin. But it does take longer to get ready if I have to cover pimples up!” Whether you’re cool with your acne or not, spending extra time covering up your zits is yet another thing we don’t need in our lives.

So why are we still breaking out? Truth is, the answer isn't completely clear. "Unfortunately, we don't totally understand the difference in the cause of acne in teens versus adults," New York City-based dermatologist Dr. Joshua Zeichner says. "The main causes of acne are skin oil, acne-causing bacteria on the skin, sticky skin cells blocking your pores, and inflammation. Hormonal fluctuations, stress, and diet all likely play a roll as well.” One potential difference: “Where you’re a teenager your hormones are naturally fluctuating and you can’t control it,” Jordana Mattioli, a medical esthetician in NYC says. “But when you’re an adult your hormones are fluctuating because of things like inflammation and stress.” (More on that later).

The good news: We’re constantly discovering new ways to treat acne. There’s a lot of research underway about how the microbiome—the massive colony of bacteria and organisms that live on our skin (gross, I know, but also kind of cool)—might affect skin conditions like acne and rosacea. Differin is launching the first ever over-the-counter topical retinoid in January. And we’ve come a long way from the old school method of dehydrating your face and using only “oil free” in an effort to keep skin smooth. Below, Zeichner and Mattioli share their top tips on the best, most up-to-date approaches to dealing with acne as a grown-up. Read them, try them, and know this: You’re not alone!

First, cut the heavy creams
Indulging in over-the-top skin care is something I’m personally guilty of. I mean, is there anything better than slathering your skin in a rich, yummy cream right before bed and binging on Netflix? Good skin care makes up for lack of sleep, right? “Once women hit 21, they automatically start buying anti-aging products,” Mattioli explains. “But most are too rich for their skin type. They’re designed for mature skin that doesn’t produce as much oil as it used to.” Whoops!

Spot treat with your products
Heard of multimasking? You can do the same thing with your skin care products, Mattioli says. In other words, if your skin isn’t dry on your forehead, go ahead and skimp a little on moisturizer there. “I’ve been dealing with acne my entire life and if I don’t keep it under control I will be a breakout mess,” she says. “I only moisturize where I need it.”

Err on the side of gentle
Layering a 10% benzoyl peroxide acne treatment all over your face may seem like a great idea and you may actually wake up with clear(er) skin. But you’ll likely also be incredibly inflamed. “More is not always better, especially with acne,” Zeichner says. “Higher concentrations of ingredients like benzoyl peroxide have been shown in studies to be no better, but certainly more irritating, than lower concentrations.”

Pick the right spot treatment
Consider what type of acne you have: Do you have scary red bumps? If so, it’s likely bacteria causing the inflammation and you’ll need something that combats it, Mattioli says. “Benzoyl peroxide kills acne-causing bacteria and reduces inflammation,” Zeichner explains (try Clinique Acne Solutions Emergency Gel-Lotion, $17.50). If you have blackheads and whiteheads, on the other hand, you’ll want something with salicylic acid (which comes in 1-2% formulations). “It helps remove excess oil and exfoliates dead cells from the skin’s surface,” Zeichner says.

Do light therapy
It used to be that you needed an appointment for an LED light treatment—or you could try the smaller at-home lights that take 45 minutes to treat your face. Neutrogena’s Light Therapy Mask, $40 uses a mixture of red and blue LED lights and takes just ten minutes. “Red light has been shown to be anti-inflammatory while blue light kills acne-causing bacteria,” Zeichner explains. Bonus: It makes for a hilarious selfie.

Simplify, simplify, simplify
Mae West may have said “Too much of a good thing can be wonderful,” but that philosophy shouldn’t apply to your acne treatment game plan. “Applying too many products and washing your face too often causes more harm than good,” Zeichner says.

Check your diet
“Dietary factors like high glycemic index foods have been shows to aggravate acne in predisposed people,” Zeichner says. “The increased sugar load promotes inflammation that in turn leads to breakouts.” Mattioli recommends cutting back on processed sugary foods in favor of anti-inflammatory options like wild fish, nuts, and fresh fruits and sticking with organic, hormone-free meat and dairy.

Try yoga
Seriously. Most of my friends listed stress high on the list as the cause of their breakouts, and it’s true: crazy amounts of stress do indeed affect your hormones. “Stress causes hormonal fluctuation that increases oil production and leads to acne breakouts,” Zeichner says. “Anything you can do to minimize stress—yoga, meditation—can help.”

Don’t pick
As tempting as it is to try to be your own esthetician in your bathroom, you must fight every single urge to squeeze. “Acne in adult women tends to be angry, underground pimples.” Zeichner says. “They are inflamed and cannot be easily opened by picking. It leads to more harm than good, a disrupted skin barrier, inflammation, and potential scarring.”

If all else fails, see a derm
If you’ve tried everything and you’re still breaking out, get thee to a dermatologist. Zeichner’s go-to solutions for adult acne in women: Aczone, an anti-inflammatory gel that “clears pimples while causing almost zero irritation” and Spironolactone (my personal favorite).

 

 

THE 101: LED light therapy

LED = Light Emitting Diodes. This is one of my favorite technologies the past few years that I include with almost all of my facial and skincare services, it can even be done as a seperate stand alone treatment without a facial for those that want to come in more often. LED can be done a number of ways. In an office setting, we use the OmniLux LED device it to treat aging skin, acne, and rosacea, and they can be done in a series (of weekly treatments) or just once in a while with your facial, depending on what we are treating. The treatments are painless, relaxing, have no downtime, and safe for almost everyone unless you have a history of epilepsy or on medications that cause light sensitivity like tetracycline.

Now onto the science on HOW this awesome light therapy works! The general function is the LED penetrates through the epidermis into the dermis layer of the skin, energizing the fibroblast cells that are responsible for producing collagen. Collagen and Elastin are produced in cells called fibroblasts and Inside these cells is a smaller cellular structure called mitochondria. Mitochondria are responsible for converting nutrients into an energy carrier known scientifically as Adenosine Triphosphate (ATP). This (ATP) fuels the cell's activities; it basically gives the cells the needed energy to do their job. This is the reason Mitochondria are frequently referred to as the powerhouse of the cell. LED sends light rays into the Fibroblast cells, which in turn excite the Mitochondria into producing in some cases up to 10 times more ATP. This fuels the cell's activities, which causes more of the needed Collagen and Elastin to be produced, as well as other needed materials for the skin.  Over time the dermis layer fills up with collagen pushing the fold of the wrinkle out. Collagen helps to plump up the skin thus diminishing fine lines and wrinkles. Nice! The process is similar to plant photosynthesis. the light emitted by the LED is absorbed by epidermal cells and produces a cascade of events. As the light passes through the skin, different components of cells are affected by various wavelengths, stimulating certain beneficial effects:  

-stimulates tissue granulation and connective tissue, which is part of the healing process of wounds, ulcers, and imflamed tissue
-reduces MMP-1 (collagenase) in the papillary dermis, therefore increasing collagen deposition and improving skin texture
-reduction in small blood vessels; infrared increases vascularity by increasing formation of new capillaries, a process called angiogenesis.

There also is blue LED light, which can be great for skin types that are sensitive or allergic to topical antibacterial products. The blue LED has its own set of benefits, it causes the development of oxygen radicals that kill P. acnes bacteria without damaging healthy skin. For acne, I recommend using a combo of blue and red devices. The red treats the inflammation and redness and the blue treats the bacterial component. 

Here are some great studies showing the benefits of LED, but a quick google search can lead you to hundreds more!

http://media.wix.com/ugd/d80b7e_763ee0dae52e03de53c81b25e9487799.pdf
http://pubs.acs.org/doi/full/10.1021/cg8000703
http://www.ncbi.nlm.nih.gov/pubmed/16414908
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4479368/
 
Another way to get the benefits of LED is to try an 'at home' device, which have been gaining popularity the last few years. While an FDA approved LED device for home use will usually have similar specs as the professional devices we use in our office, the main difference will be the number of LED's being used. For example, the machine in our office will have hundreds of LEDS, while an at home device will usually have 25 to 50, so the in office professional treatments will gave you faster results. However if you are diligent with using your at home device, it can absolutely improve your skin, and even be used to prolong the results of your professional in-office treatments. I feel the decision on professional treatments vs using an LED at home, comes down to a few things to consider: 

-Time: In office treatment takes about 20 minutes once a week (or twice, depending on how fast you want to finish your series) but at home LED can take up to an hour to treat the full face. However, if you only want to treat a small area of the face, for example eye area, or random acne prone areas, then your home treatment time won't be a huge factor. In office treatments mean you are making a trip to the office, where as using an at home device gives you more flexibility.
-Professional guidance for more serious conditions. If you struggle with rosacea or acne, having professional treatments and monitoring your condition, combined with an effective at home regimen may give you faster, or more effective results. 
-Cost. Office treatments cost between $75 to $150 per session, where as the initial investment of a home-use LED device will run around $300 to $500.

Two great devices I recommend often are the Baby Quasar and Light Stim. Recently, I started playing around with a new FDA-approved device from Truth Vitality that has three different modes, red, blue and ultrasound. These are used independently as in they don't work all at the same time, which is nice so you can treat separate areas with the specific modality you need. As for how the ultrasound works, it enhances product penetration and increases fibroblastic activity and collagen formation. You can read more about how the ultrasound works directly from them here. So far I have been really impressed with this device! It's a great price, and easy to use. I will report back on the ultrasound benefits, as they are cumulative, and I'm giving it a full 3 month test run!