Aesthetics with Aundrea – Feeling comfortable and confident in your own skin.

Non-Surgical Medical Aesthetics is a growing sector of the health and wellness industry. We often hear people say in order to be happy, you need to feel comfortable in your own skin. While there is obviously a much deeper meaning to this that goes well beyond a purely aesthetic perspective, how you feel about the health and look of your skin does play a big part in how you feel about your overall appearance and self-confidence.

So, with that in mind, it only makes sense that you would want your skin to be as beautiful and healthy as possible. Not only is your skin the largest organ of your body, but it serves multiple purposes, most importantly, acting as a barrier against such things as UV light, pathogens or germs and viruses and chemicals or other toxins, as well as potential injury to your internal body. Your skin also helps regulate your body temperature, allowing your body to release or retain water. As an aesthetic nurse, I work most often on the facial region, so this article will focus on the skin in that area. 

In general, your skin has three major layers—the epidermis, dermis and the subcutaneous layer or hypodermis, which together, provide structure and strength to your facial features.  Each layer serves a different purpose and varies in thickness and function. For simplicity, the epidermis is the outermost layer of your skin that serves as a protective, waterproof barrier and is responsible for your skin tone. The dermis is the layer beneath the epidermis, which is where you will find connective tissue, sweat glands, as well as hair follicles. Finally, the hypodermis or subcutaneous tissue mainly consists of fat and more connective tissue. 

As we age, our skin naturally begins to lose elasticity, allowing gravity to take over, causing sagging or drooping that are most visible in areas such as your eyebrows and eyelids. You will begin to see a loss of fullness under your cheeks and a looseness in the jaw area that results in a ‘double chin’ effect. Your natural facial movements will begin to develop fine lines and eventually deeper lines and wrinkles, which can start anywhere from your 30s to 40s. There are a number of things you can do however, to counter these effects that are relatively easy and very safe. Today, more than ever, I find more and more people (men and women) are opting to simply enhance their natural beauty. And I have to say, that even though I have been using cosmetic injectables for the past ten years to both enhance and protect the skin and the structure and features in this area, I am always amazed at how well this work to help achieve soft, subtle enhancements, especially when using neuromodulators, such as Botox, coupled with hyaluronic acid-based fillers. For this article, however, I am going to focus on a few other treatments you can take advantage of, such as microneedling, salicylic acid, glycolic acid, lactic acid and retinoids.


Microneedling is a procedure that uses a device (dermaroller) with tiny needles that essentially puncture the first layer of your skin (epidermis). By doing this, it triggers your skin to naturally rejuvenate by generating more collagen, which then helps reduce the look of wrinkles and fine lines as well as the overall texture of your skin, resulting in a smoother, firmer and generally more toned skin. It is also widely used to treat sunspots, acne or other scars and even large pores. Before treatment, I numb the skin for about 20 minutes, so the actual treatment is relatively painless. Patients can usually see the most dramatic results within four-to-six weeks, and I typically recommend, depending on the patient, five-to-six treatments, spaced about four weeks apart. After the numbing, the microneedling process itself only takes about 30 minutes. 

Salicylic Acid Peels and Creams

If you ever had acne, you are probably familiar with salicylic acid, but this product has other beneficial uses as a skin treatment. For instance, salicylic acid, a beta-hydroxy-acid (BHA), is used to exfoliate skin cells by loosening and breaking apart desmosomes, which are basically the attachments between cells in the epidermis, also known as a desmolytic effect. This helps to brighten the skin and can aid in reducing freckling, age spots or sunspots. It can also unplug the dead skin cells that cause acne, and it has an anti-inflammatory effect. Apart from a peel, there are several wonderful skin creams and products that contain salicylic acid that I often recommend to my patients as a great addition to an anti-aging skin regime.

Glycolic Acid Peels and Creams

Glycolic acid is an alpha-hydroxy-acid (AHA) derived from sugarcane. Much like salicylic acid, it dissolves the bonds between dead skin cells in the epidermis, which can then be easily removed resulting in a much younger, smoother feel to the skin. Because it is the smallest naturally occurring AHA, it can easily and more deeply penetrate the skin than other AHAs such as lactic acid. A glycolic acid peel is great for people who want to treat hyperpigmentation or fine lines and wrinkles and such things as sunspots, melisma (pigmentation disorder that causes brown or gray patches on the skin) and acne scars. Glycolic acid is often found in skin creams or serums, which can also be effective in a daily skin regime.

Lactic Acid Peels and Creams

Lactic acid is derived from milk and is another effective anti-aging AHA that is helpful for reducing wrinkles and pigmentation. When used in a chemical peel, lactic acid also removes the epidermis, although stronger formulas can also be used to target the dermis layer. Lactic acid is milder than glycolic acid, so I often recommend this for people with sensitive skin.  Like the other peels above, lactic acid can treat age spots, hyperpigmentation and generally help to improve and brighten dull and uneven skin, while also improving skin tone and even help reduce large pores. While you can find lactic acid in many commercial skin creams, professional-grade skin care products are typically more effective and reliable.


Retinoids are probably one of the best known anti-aging products on the market. They are derived from vitamin A and are widely known to boost cell turnover, which can help smooth fine lines, improve age spots and pigmentation as well as help build collagen, improve skin tone and elasticity for an overall youthful glow. Unlike the AHAs and BHAs, retinoids do not remove the dead skin cells, instead the small molecules in the retinoids penetrate deep below the epidermis to the dermis where it then helps neutralize free radicals and boost elastin and collagen production, which creates a plumping effect that reduces the appearance of fine lines and wrinkles. It can also help reduce the size of pores and act as a mild exfoliate, which works wonders to improve skin tone and texture and it can even help balance skin hydration.

If you have purchased anti-aging skin creams you are probably familiar with retinol, which is not exactly the same as retinoids. Retinol is just a specific type of retinoid usually found in commercial skincare products. It is weaker than retinoids, which are typically prescription-level products. While both technically have the same results, retinol takes longer and more consistent use before you typically see any significant results. As well, retinoids are FDA approved before sale, so you know they will work, while retinols in commercial skincare products aren’t always as reliable. One caution with retinoids and even retinols, is that they can irritate your skin and cause redness and even peeling. Obviously the stronger the product the more risk, but I always give my patients clear instructions on how to use the products, which includes starting out slowly until your skin becomes used to it. It is also good to mix it in with your anti-aging cream to ensure you stay moisturized.


by Aundrea Ritchie