ReNew Institute Medical Spa

Skin Anatomy

Understanding skin anatomy can help you better understand why we choose the products and treatments that are best for you. The skin consists of two primary layers, the epidermis and dermis both supported by an underlying subcutaneous layer

The epidermis contains five layers of skin. The two most important layers of the epidermis are the stratum corneum and stratum basale. The stratum corneum makes up the protective barrier of your skin to the outside world. It consists of dormant cells (corneocystes) held together by liquid fat (lipids), which interlock to form a wall against chemical and bacterial invasion as well as locking moisture in. The matrix between the corneocytes and lipids also contains a natural moisturizing factor (NMF) and an exfoliation/desquamation enzyme. Both work better under conditions of hydration. The four components of the stratum corneum are detailed to the left.:

Normal skin function depends upon living cell production at the stratum basale layer. The cells produced there are called keratinocytes. Newly formed keratinocytes migrate up to the stratum corneum to help form the protective layer of the outer skin. Once they reach the stratum corneum, keratinocytes become flat and lose their nucleus. These dead flat cells are now called corneocytes as they pack together to the final skin barrier. Overtime, these cells wear out, slough off, and are then replaced by underlying newly migrated keratinocytes. This healthy restorative process at the surface is called desquamation. When the process is impaired due to poor hydration, trauma, low humidity, wind, sun, or improper use of cleansing agents desquamation becomes incomplete. As a result, surface skin cells become clumped and build up. The result is the feel of dry skin. In fact, what we experience as dry skin is not simply skin that lacks water but is dysfunctional skin with an overabundance of dead, clumped skin cells. The resulting skin feels rough due the clumped skin cells and looks dull because light is scattered by the uneven surface. The altered skin surface also looks pale because the clumped skin cells block the ruddy glow from obscured capillaries. Incompletely desquamated skin can also show visible signs of scaling and become irritated. The difference between normal and abnormal skin desquamation is pictured below:

Exfoliation: the key to healthier skin.
Medical therapies including Cosmeceuticals, Chemical peels, and Microdermabrasion can be utilized to exfoliate dry skin. The goal is to the improve appearance of the damage skin and hopefully restore the epidermis to a more normal desquamation process.

Hydration: another important regimen for good skin care.
Cleansing and moisturizing your skin daily will stimulate the lipids holding your surface skin cells together. Stimulating lipids helps treat and prevent dry skin. In addition, humectants attract water to the surface, which improve hydration. Also, emollients fill in the gaps between the corneocytes, which lead to smoother skin.

The stratum basale also contains melanocytes. These cells produce melanin which migrates up the epidermis to cover the nucleous of the keratinocytes, affording them sun protection. Unprotected skin exposed to Ultraviolet radiation (UVA and UVB) can damage the melanocytes DNA either directly or through free radical formation at the skin surface. Damaged melanocytes can eventually lead to melanoma. Damaged melanocytes also can swell, causing persistent pigmentation in the form of freckles and sun spots(lentigo). Sun damaged melanocytes also don’t produce melanin normally, which leads to uneven brown spots on your skin. These brown spots can be remarkably reduced by alternating treatments of Microdermabrasion and IPL Photo Rejuvenation treatment over a few months. Resistant individual brown spots are then removed by a KTP-Copper Bromide laser treatment. Certain Cosmeceuticals prescribed by our well-trained Aesthetician can also complement your laser and light based treatments.

Prevention is always your first line of defense against the formation of unsightly sun damage and potentially life threatening skin cancer. The most affective way to limit your risk to sun exposure is to avoid the sun completely. This is difficult when fun in the sun has been a favorite pastime in Florida. Also, tanning beds provide unfiltered, higher intensity UV light that can be more damaging than sun tanning. Tanning beds are not recommended at any time. We do offer a line of self tanning products at The ReNew Institute. The next best thing to avoidance is barrier protection clothing including hats, long sleeves, pants, as well as SPF rated attire. If you are going to expose your bare skin to the damaging Florida sun, sunscreens or sunblocks are a necessity. Remember, sunscreens act to weaken ultraviolet radiation before it causes damage to DNA in the nuclei of skin cells. Sunscreens absorb ultraviolet radiation within the spaces between the skin cells, converting that light energy into chemical and then heat energy. SPF(sun protection factor)is a measure of the UV energy required to produce erythema(redness) of the skin comparing protected skin to unprotected skin. The higher the SPF rating of the sunscreen, the longer it takes for sunlight to damage the skin. The SPF scale only works for UVB light, since UVA can be absorbed without causing redness. Therefore, current recommendations are for sunscreens with SPF 15-30 that also have UVA protection to go with the UVB protection. Experts also believe that sunscreens containing SPF greater than 30 should not be used, since they allow people to stay in the sun long enough to get exposed to damaging UVA light without getting the redness/burning signal to get out of the sun. Sunblocks on the other hand, prevent ultraviolet radiation of both types from entering the skin at all. Sunblocks form a thin film of inert metal particles which reflect the UV light back into the atmosphere. Examples include Zinc oxide and Titanium Dioxide. Unfortunately, sunblocks are currently difficult to find in OTC preparations, while sunscreens are very prevalent.

We offer a full line of medical grade sun blocks, sunscreens, and self tanning products at The ReNew Institute

The Dermis lies below the epidermis. It serves as a support structure for the skin. Collagen and elastin help the skin to look fuller and younger. Collagen and elastin in the dermis decline as we age. Sun damage only further decreases collagen and elastin. The result is skin that appears thin, wrinkled, and weathered.

Medical treatments like Microdermabrasion, IPL, Laser Facials, TCA chemical peels, and Cosmeceuticals containing Retina-A all can stimulate collagen to varying degrees. The result is fuller, younger appearing skin.

The Subcutaneous tissue lies below the dermis. It contains the vital blood supply to the skin as well as the hair follicle. The blood vessels travel up into the dermis and lower epidermis to nourish the living skin. These red blood vessels are also a target for the laser when treating the reds of Rosacea and sun damage.See ROSACEA. The hair follicle is actually a complex living structure. Its main components are the hair shaft, a dead coated protein structure, which travels up through the dermis and then the epidermis to the outside world. The hair follicle is the main target of any laser hair removal machine. See LASER HAIR REMOVAL. Attached to the hair follicle is the sebaceous gland, which produces sebum to lubricate the hair shaft. The infundibulum connects the shaft to the sebaceous gland. It produces keratinocyte cells unique to the hair follicle. Bacteria already living in the skin can build up in conjunction with increased sebum production and clogged keratinocytes. Acne is then born among the clogged hair follicles. Various medical modalities can be applied to acne prone skin..See ACNE.

The skin also contains or needs certain vitamins and elements to function properly.
Vitamin C is a potent anti-oxidant, which means its helps to repair and prevent ultraviolet skin cell damage due to oxygen charged chemicals called free radicals. Vitamin C also stimulates collagen synthesis. Vitamin E is also an anti-oxidant and is photo protective. Zinc, Copper, and Pomegranate extract are also classified as anti-oxidants. Accutane and Retina- A are derivatives of Vitamin A. Accutane is well known for its potency treating severe acne, as well as its severe side effects. Retin A treats acne by modulating the cellular production of skin cells. It is also marketed as Renova to thicken fine wrinkles. Vitamin B can help lessen the signs of photoaging(sun spots). New chemicals of focus include peptides and ceramides.

Our well trained aesthetician can help you decide which Cosmeceuticals are right for you.

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