Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Facials, Facials, Facials: Extractions, Breakouts, and What to Do Post Facial October 8, 2012

While researching my book review post about Dr. Jeannette Graf’s book Stop Aging, Start Living I discovered the website Well and Good NYC and spent way too much time going through the site instead of writing my book review.  Though the site has a very organic, holistic, and natural slant which isn’t for everyone, and I found myself not agreeing with everything I read on the site, there was still plenty of  information on the site that interested me.  For example the few articles that I read about facials.

I’ve devoted quite a few posts in this blog to facials since they are my bread and butter as an esthetician, and I want people to better understand them since I find that there are many misunderstandings and misconceptions about facials.  Certain questions come up regularly when it comes to facials such as:  do you perform extractions during your facials (if you need them then absolutely yes), why did I break out after my facial?, and can I put on make-up after my facial?

Extractions

My philosophy about extractions is that if the client has blackheads and clogged pores the esthetician should try to extract them after properly preparing the skin for extractions.  I do not recommend doing extractions on your own at home since you can easily damage the skin.  Estheticians are trained to prepare the skin properly for extractions, know how much pressure to apply and for how long during extractions, and also know how to calm the skin after extractions are over.  Yet it turns out that not all estheticians agree with this outlook.  According to the article Extraction Wars:  Aestheticians Face Off Over Pore Pressure:

For many facialists, extractions play a starring role in a skin-care treatment, with steaming, cleansing, and exfoliating all playing skin-care backup. For others, extractions are cruel and unusual, banned by the Geneva Convention of Aesthetics.

Nothing makes a New York City facialist get on her soapbox quicker than mention of performing extractions, the act of enticing a pore or pimple to give up its impurities (a plug of dead skin and oil). It’s a topic with two opposing camps—and no middle ground. One person’s pinnacle of cleanliness is another’s trauma to the skin. …

The brass ring is clear skin. But most of us are dotted with blocked pores and bumps that we can’t fully clean ourselves—or we shouldn’t. “I don’t want my clients doing it themselves,” says Wright. “You need to know what to look for, what not to touch, and apply the right pressure. I’m good at it,” says [Jillian] Wright, [owner of Jillian Wright Clinical Skin Care] who admits she finds the task incredibly satisfying, “like a treasure hunt.”

Congestion can be partly managed by skin-care products at home, and you can exfoliate blackheads so they’re less visible, but the contents of pores just don’t come out on their own, says Wright. “They just fill and fester and stretch pores to the size of saucers.”

But what about the estheticians who oppose extractions?  What is the reason behind their refusal to perform this service?   According to the article:

In this camp are skin-care professionals who call extractions a “harsh invasive practice” that can leave the skin looking worse for wear. It’s an idea shared by luxe holistic-leaning spas like Sodashi and many French beauty brands. (You’d be hard pressed, ahem, to find a spa in Paris that does extractions.)

“Respecting the skin” is a cornerstone of Clarins, which frowns upon pore pressure to free the dirt and trapped sebum inside them. “We work with the skin, not against it, says Ewa Wegrzynowska, Clarin’s National Skin Spa Training Manager. “Pulling and pressing the pores weakens them and the skin fibers like collagen and elastin.”

Your skin looks good in short term, concedes Elena Chang, an aesthetician at  Clarins Madison Avenue Skin Spa. “But in long run, you’ve got damaged skin that’s lacking strength and elasticity.” And maybe an extra broken blood vessel or two, they say.

Personally, I see no reason to stop doing extractions.  Even following the proper procedures you help people’s skin not hurt it.  I also do not extractions if I see no blackheads and clogged pores.  Those clients luck out with me – they get a longer facial massage.

For my fellow estheticians – Skin Deep published a very informative article about performing extractions called Essential Extractions.  Well worth reading.

Breakouts After A Facial

Sometimes it happens and it’s a bummer.  A few days after a facial instead of your skin looking fresh, feeling smooth, and being blemish free you get a pimple.  It’s happened to me with various clients (including my boss’ daughter once) and though I know it can happen after a facial, it still bums me out to hear about from a client.  The article Should Facials Cause Breakouts? breaks down the reasons for what could cause breakouts post facial:

If you get a facial and your skin breaks out the next day, it’s easy to blame the facialist for flubbing your just-exfoliated gorgeousness. (And investment.) But it may not be her fault. Just what makes skin breakout after a facial treatment—and who’s to blame?

To find out, I asked leading aestheticians—Caitlin Conn, skin care director of Exhale spas, andElena Rubin, the facialist-founder of Ethos Wellness in Soho—for their take on the most common causes of post-facial breakouts.

1. The Chinese Cure

Elena Rubin says that two things are equally true: The skin should not break out after a facial. Yet it’s normal if it does. The latter she attributes to the “Chinese cure,” a term used in acupuncture, which means sometimes the skin (in this case) gets worse before it gets better. “Skin can take the treatment as a sign to detox. And some people have three years of built-up sebum, dead skin cells, and sunscreen in their pores,” says Rubin.

2. Poor Pore Prodding

As a facialist, “you have to be really careful that you finish what you start,” says Caitlin Conn. “A facial stirs up bacteria, and leaving it behind after extractions can absolutely cause a post-treatment breakout.” Conn likes to use anti-bacterial gadgets like light therapy (looks like a Lite-Brite panel or a glowing paddle) and high-frequency wands (sounds like a bug-zapper) immediately afterward. “These technologies are very quick and healing,” says Conn.

3. Over-Reacting Skin

“Some skin reacts to steam, facial massage, new products, or to the very potent drawing power of clay,” says Conn, and it can cause a breakout. “Clay draws out impurities almost too quickly. I’m cautious about using it and may just apply it across the nose in a thin layer, while using a hydrating mask on the cheeks…”

4. Over-Eager Extractions

A good facialist should allow plenty of time preparing skin for extractions—not just with steam, but with exfoliants and pore-opening oils and massage, says Rubin. “It’s about luring out the contents of the pores, not forcing them out,” she explains, a cosmetic courtship with your skin. “Then, maybe I’ll make a second pass over the skin after the oils have helped loosen them.”

5. Skipping the Cool Down

In addition to allowing the skin a 20-minute warm-up for extractions, plenty of time is needed for calming any blotches, inflammation, and irritation from extractions, says Conn. “No one should have welts or bleeding or blotches on their way out the door.” In other words, you should never leave the spa looking like you’ve had a deep cleansing facial, even if you have.

6. It’s Not a Makeover!

A facial isn’t a makeup application. It’s more like a workout at the gym. It doesn’t necessarily make you beautiful the first visit, says Rubin. Unless it’s a red-carpet facial (a treatment intended for immediate radiance or lifting only), “the benefits kick in after a few days, when the skin’s like, ‘Oh, wow. Now I can function better without that dead layer of skin and clogged pores.”

I thought the explanations offered in this article did an excellent job of explaining why you can breakout after a facial.  Personally I usually keep it simple when explaining to a client what happened.  I explain that a facial can bring to the surface a pimple that has been forming beneath the skin (the same is true with chemical peels as well).  Sometimes your skin simply looks worse before it looks better.  It is best to assess the true results of your facial about a week after you had it done, especially if your skin is acne prone.  If your skin is dry you should hopefully reveal radiant and soft skin immediately following your facial.  One last thing to keep in mind, sometimes what you might perceive as a pimple is irritation to your skin instead.  Perhaps a product was used on you that caused your skin to react, perhaps to become red or have small bumps appear.  This too should subside with time, but be sure to mention any post-facial reactions you had to your esthetician before your next facial.  You may even want to call the esthetician you had the facial with so that she can make a note in your chart.  That sort of feedback is actually appreciated by estheticians.

What To Do and What Not To Do After A Facial

I always make sure my facial clients leave me with sunscreen on and a few skincare tips as well.  For instance many times I will tell my client not to do anything to their face until the following morning after a facial simply because I’ve already done enough during their facial.  If  I’ve exfoliated, extracted, massaged, and applied a mask to your skin why would you need to then go home, wash your face, slather your face with AHA (alpha hydroxy acids) or Retin-A?  Sometimes too much of a good thing really is too much.  According to the article What Not To Do After A Facial Treatment you should avoid doing the following post-facial:

1. Don’t visit the steam room or sauna.
Why? You’ve been cleaned and steamed. Heating your face up is just going to strip away your just paid-for glow. Ditto working out. (Not that we like to give you an excuse.)

2. Don’t have a massage.
Why? How does a toilet-seat-shape imprint on your newly poreless complexion sound? Book it before your facial.

3. Don’t wash your face. (Make that, don’t touch your face.)
Why? You’ve just had it washed by a professional who spent 59 minutes more on cleansing your skin than you usually do. You can skip this step in the spa shower and at bedtime.

4. Don’t use at-home peels or Retin A/Renova for at least 72 hours.
Why? Alpha-hydroxy acid peels plus vitamin A is a recipe for redness. Give your skin a two- or three-day break from potent at-home products after a treatment.

5. Stay out of the sun.
Why? Even incidental sun exposure can cause sun damage and skin cancer. And since 100 percent of facials involve a scrub or a peel (anti-aging facials often include both), you’ve got a new batch of vulnerable skin cells on the surface that can easily burn.

6. Don’t pick.
Why? If a facialist leaves pimples behind, it’s usually because they’re not close enough to the surface yet. Leave your pimple for a day—a deep-cleansing facial can make a few naturally surface within 24 hours. Or call your facialist about a follow-up extraction visit, the facial equivalent of a bang trim.

7. Don’t apply makeup.
Why? Okay, you can apply makeup. But why not use your skin-perfecting facial as an opportunity to go au naturel? And if you’re skin isn’t at its best afterward, it’s time for a new facialist.

Personally I think the advice not to use Retin-A for 72 hours is a bit much.  I usually recommend to clients that they can return to their normal skincare routine the day after a facial.  Applying high quality, non-pore clogging make-up such as mineral make-up post facial is fine, in my opinion.  Sometimes people go back to work or out to dinner or run errands after a facial and feel more comfortable with make-up.  Having a mineral make-up on hand to apply following a facial can be an asset to your esthetics business not a detriment.

My Related Posts:

Image from globalfashionreport.com

 

Facials 101 March 15, 2012

Every once in a while I come across a great post on another blog that I feel I need to share immediately with my readers.  The latest one comes from one of my favorite beauty blogs Gouldylox Reviews which is a wonderful resource for anyone since it is filled accessible beauty information and make-up ideas.

Recently Gouldylox Reviews published a fantastic post called What to Expect at Your First Facial.  Truthfully, I couldn’t have said anything better myself!  The post goes step by step through the facial process – from arriving at the spa to entering the treatment room, and even includes really on target tips about how to tell if you are being treated by a good esthetician or not.  I always get a little nervous when I see that people are writing about spas and estheticians since, unfairly and unfortunately, estheticians can get a lot of bad press.  So I very pleased when I read through this post.

Here are some of the things, according to Gouldylox Reviews, that set a good spa and esthetician apart from a so-so one:

Since not all spas are created equally, here are my guidelines for what I look for. I’m picky, so if certain things don’t bother you, then carry on.

1. The esthetician must take time to ask you how you are hoping to benefit from the appointment (unless you are a regular client and they know you really well).

2. If they glower at you when you mention you use drugstore skincare, I would not return again. Nothing irks me more than snobby estheticians who try to profit by making you feel less, looking down on because of how much you spend on your products. Skincare can be very expensive. Many drugstore brands work beautifully and many very expensive brands do not. It’s a personal decision and anyone that makes you feel less than for not using expensive products is missing the point. They should be concerned with what is best for you. It could be that a Kate Somerville product may be perfect for you. But if you can’t afford the price tag, it should not affect the quality of care you receive.

3. The treatment rooms should be quiet and clean. Your esthetician should not smell of smoke, including her hands, or chew gum. Call me picky, but these two things make me insane and feel dirtier, not more clean.

4. They should always observe your modesty.

5. They should be knowledgeable about all products they use or recommend. Skincare is changing at lightning speed, and like any professional, it’s important to stay on top of what’s available and how it works. This includes products as well as treatments like lasers, peels and other medi-spa options.

Finally, if you are happy with the service, you should tip 20%. If you were uncomfortable or unhappy with your service, you should politely tell them why, so they can change and suit your needs better. A good spa will want to know how to improve your experience. While it’s great if you can financially swing a facial each month, it does your skin good even if you can only go quarterly.

Fabulous advice!  I agree wholeheartedly that estheticians should not be trashing a client’s home care regime – no matter where her products come from.  If someone asks me what I think about a specific product I’ll give them my honest opinion, but only if they ask.  Having said that there are some estheticians out there whose whole shtick (aka personal gimmick, attitude, ploy, or persona) is to have a “I know better than you” attitude.  Some people actually like this and don’t mind when the esthetician trashes their skin, their home care routine, and choice of skincare products.  I guess they think that the esthetician is an expert so she knows what is best for them.  Or perhaps they like being around forceful personalities.  Who knows?  Personally I don’t like when people treat me in a condescending way so I try to avoid doing this with my clients at all costs.  Plus I want my clients to come back and see me (and refer me their friends) so I want to make sure that they feel good about their experience.  In my book putting someone down doesn’t equal a positive spa experience.

Though I also agree that an esthetician should be up to date on the latest skincare, make-up, and treatment options available I think you need to evaluate this criteria from a very personal perspective.  If you know more than your esthetician about the latest innovations in skincare and the newest and greatest thing in the beauty industry is important to you than perhaps you should think about finding someone else to go.  But if you just want to relax for an hour and don’t care if your esthetician knows all about the developments in laser technology than you can asess your esthetician on different criteria.  That is a truly personal choice.  But as pointed out above since the whole skincare industry changes at lightening speed, if your esthetician hasn’t heard of something but is open to finding out about new things take that as a positive not a negative.

And if you are a beauty junkie or novice I suggest subscribing to Gouldylox Reviews for on-target beauty tips.

Further Reading:

My Related Posts:

Image from www.facefactsclinic.co.uk

 

What Is Dermal Micro Needling? March 12, 2012

Ever feel like the universe is looking out for you?  I know that may seem like an exaggeration, and I would agree, but I found it interesting that just as I was starting to research this blog post, and failing to find real, scientific information about dermal micro needling, I discovered that the there was a great article on the subject in the February issue of Les Nouvelles Esthetiques and Spa A Collagen Boosting Alternative: Dermal Micro Needling.  Not only did I come across the article I just mentioned pretty soon after coming across that article I was finding articles about micro needling from legitimate sources in different places.  So with the help of these articles let’s jump right into the whole subject of micro needling.

 

All About Dermal Micro Needling

According to the article from LNE & Spa:

The principle of skin needling is to stimulate the body’s own production of collagen.  DMN involves the use of a sterile roller, comprised of a series of fine, sharp needles to puncture the skin.  Medical needling is performed under a local anesthetic; the needling device is “rolled” over the surface of the face to create many microscopic channels deep into the dermis of the skin, which stimulates your own body to produce new collagen.  At a microscopic level, proliferated skin cells, such as fibroblasts, migrate to the point of injury and transform into collagen fibers, resulting in increased fiber strength and elasticity.  This treatment improves your skin by increasing production of collagen, facilitating natural repair and growth and making the skin stronger and thicker.  The new collagen fills depressed scars and wrinkles from the bottom up, lifting the depression so they are level with the surrounding skin.  This process takes two to three months to produce visible results, and can also help thicken thinner, fine skin types.

There are a few different type of dermal rollers, which is what the dermal micro needling devices are called.  The ones designed to be used at home have shorter needles than those used by physicians.  Dermal micro needling can be combined with other skincare treatments and products in order to enhance the collagen building results.  Additionally, the procedure can be used on all skin types.  The side effects are mainly varying degrees of redness; the amount of redness depends on how long the needles used were and how deeply they entered the skin.  Potential complications can arise if the healing skin isn’t cared for properly.  Those complications can be infection, scarring, an outbreak of cold sores if you are prone to getting them, and even post inflammatory hyperpigmentation that can last up to 12 months.   Proper care after treatment involves the use of healing creams or ointments along with a broad spectrum spf for the first day or two after the treatment.  Depending on what you want to fix about your skin you may need between 3 to 8 treatments spaced 3 to 4 weeks apart.

 Yes or No?

To quote the article, again, from LNE & Spa:

DMN has been used successfully to treat fine lines, wrinkles, lax and sun damaged skin to reduce the appearance of stretch marks; improve acne ice pick scars; and induce hair’s regrowth.  It has also been used to tighten skin after liposuction.  The advantages of this procedure are that the skin becomes thicker, with an increase in collagen deposition exceeding more than 400 percent.

But for all this positive talk about DMN there are naysayers as well.  On About.com they have this to say about DMN:

Does It Really Work?

Depends on who you ask. Personally, I’ve seen some pretty dramatic before and after photos – so dramatic, in fact, they made me even more skeptical than before. However, there have been a few scientific studies showing micro-needling to be effective in the treatment of scars. On the other hand, I have seen TV interviews with doctors who have seemed  to be saying that its real value lies in its mechanical exfoliation action on the skin. In researching how it works, it seems like it certainly could be effective for at least some of the conditions it claims to treat. However, I also believe that only time will tell just how effective it is, and whether or not it’s worth it.

Furthermore, according to Annet King in her article for The International Dermal Institute Skin Needling: Hurting or Helping? – there are a lot of variables that one has to keep in mind when considering dermal micro needling:

Effects on the Skin: Medical vs. Skin care
Most of the claims about wrinkle reduction and new collagen growth come from the manufacturers of the rollers or those members of the medical community who are associated (remunerated) by those companies. What’s important to keep in mind is that in most cases, patients in the study also used a topical Retinoic Acid or Retinol based product in conjunction with the skin needling. However some independent dermatologists do claim to see positive scar reduction outcomes in their patients, and another upside is that it does offer a cost effective alternative to fractional laser resurfacing. In general, skin needling is a long term commitment of 1-2yrs of combined in office and at home treatment.

The effects of skin needling differ according to needle gauge, length and the manual pressure that’s used with the roller. Therefore the level of skin invasion and subsequent inflammation on the skin can vary from gentle stimulation to piercing the skin and drawing fluids, i.e. blood and lymph. With the variances of effects skin needling rollers can have, most devices are disposed of in the appropriate biohazard container or are properly sanitized and given directly to the same client for at home use. Whichever method is observed, it is important that correct sanitation measures are followed to prevent the chance of cross contamination from occurring. As with many methods, it’s vital to respect the boundaries of medical, professional, and at-home tools, and skin benefits shouldn’t be confused. Dermabrasion, microdermabrasion, and crystal-containing scrubs come to mind! The marketing hype can baffle the end user and incense the professional!

Different Needles Different Outcomes
A roller with wide gauge, short length needles that are under 0.25mm in length is generally non-invasive and cannot cause trauma to the skin, but rather it stimulates and provides gentle exfoliation while increasing superficial circulation. This action, much like manual massage and other electrical modalities, may enhance the penetration and absorption of active ingredients into the deeper layers of the skin. Therefore, additional age fighting skin benefits can be achieved when skin needling is combined with products that contain collagen boosting and skin fortifying ingredients like Retinol, Vitamin C and Peptides.

The longer, thinner needles around 1.0mm or 1.5mm in length are more hazardous; the potential for breaking the skin, drawing fluids, causing injury and subsequent risk of infection is much higher. Extreme caution must be used as this is considered highly invasive and high risk. It may also be beyond a skin therapist’s legal scope of practice. Therefore, this procedure is best conducted under medical supervision as adverse reactions and post procedure complications can occur. When the barrier of the skin is compromised to this degree, bacterial skin infections, adverse skin reactions, post inflammatory hyperpigmentation and premature aging (due to inflammatory mediators being drawn to the area) can result. Products that are calming and anti-inflammatory would be ideal to soothe any inflammation post needling, and for pre-care the most important aspect is that the skin is thoroughly clean to prevent any possibly risk of infection.

In my opinion the jury is definitely still out on this skin treatment.  I would like to see more real scientific research done on the subject before offering a concrete opinion if this is a skincare treatment to pursue.  If you are an esthetician who does micro needling I would love for you to comment below, and if you have tried micro needling please comment below as well.

 

Sources and Further Reading:

Image from Derma-Rollers.com

 

Dermaplaning Explained February 6, 2012

If you have a lot of fine facial hair perhaps you have wondered what the best way was to get rid of it?  Or have you ever considered why you shave your legs but don’t use a razor on your face?  Have you heard of dermaplaning and always thought “what the heck is that?”.  I hope this post will clear up all that confusion.

What Is Dermaplaning?

LNE & Spa magazine, which I read exclusively online, had an article back in November, 2011 all about dermaplaning, called, appropriately enough – Dermaplaning.  In the article the author Tina Zillman talks both about the technique of dermaplaning and what it does for the skin:

Within the medical community (particularly plastic surgeons), dermaplaning is viewed as a noninvasive surgical procedure that can essentially strip away dead skin to improve the appearance of fine lines, wrinkles, and acne scars.  The technique may be used synonymously with dermabrasion (not to be mistaken for microdermabrasion) on many medical websites and patents – hence the name “derma,” relating to the dermis, and “planing” from the word plane that refers to a tool used to smooth a surface.  The most commonly used tool is a type of scalpel, a surgeon’s tool that can cause irreversible damage if used improperly. …

From an esthetic perspective, dermaplaning has been performed with a scalpel or a disposable safety razor.  Some practices may advertise dermaplaning as an exfoliation treatment, while others use the procedure for hair removal.

Dermaplaning is an ideal treatment for women with fine (otherwise known as vellus) hair all over their faces.  The growth of this type of hair, which can appear like a light fuzz on the face, can make the application of make-up difficult and occurs for many women as they undergo menopause and experience hormonal changes.  Removing this hair with laser or IPL treatments is not a viable option for many since the hair can be white or blonde and the light then cannot capture it for effective hair removal.   Once again, according to the LNE & Spa article:

Hormonal changes in women affect the skin and body, and esthetic dermaplaning essentially shaves vellus hair from the face.  Aside from the loss of elasticity, skin thinning and dryness, vellus hair on the face becomes a visible problem on middle-aged women.   …  Facial waxing is still a common practice for the removal of this hair, but the procedure is prone to many problems.  The hair is so fine that gentle facial waxes may not pick it all up, and a mature women’s skin may be susceptible to burning and tearing.  Combine these variables with exfoliation treatments, cosmeceutical skin care product use at home, and/or use of certain prescription drugs-and the risk of damaging the skin and causing discomfort is even greater.

 

From a medical standpoint dermaplaning is considered a treatment for acne scars. According to the American Society of Plastic Surgeons (and please notice the differences here between dermaplaning and dermabrasion):

Dermabrasion and dermaplaning help to “refinish” the skin’s top layers through a method of controlled surgical scraping. The treatments soften the sharp edges of surface irregularities, giving the skin a smoother appearance.

Dermabrasion is most often used to improve the look of facial skin left scarred by accidents or previous surgery, or to smooth out fine facial wrinkles. It’s also sometimes used to remove the pre-cancerous growths called keratoses. Dermaplaning is also commonly used to treat deep acne scars.

Both dermabrasion and dermaplaning can be performed on small areas of skin or on the entire face. They can be used alone, or in conjunction with other procedures such as facelift, scar removal or revision, or chemical peel.

Well Isn’t It Just Shaving?

In American society it is considered odd for women to shave their faces so dermaplaning is a variation on that procedure that is socially acceptable.  Rumors persist that many celebrities actually shaved their faces in order to maintain their beautiful skin.  According to an article on style.com celebrity esthetician Kate Somerville recommends that women shave their faces:

When it comes to the removal of unwanted hair, women have myriad options. There’s waxing, tweezing, threading, sugaring—all manner of materials and mechanisms to get to the root, as it were, of the problem. Shaving, the most primitive of depilatory forms, has gotten a bad rap in the face of all of these new-fangled approaches. Taking razor to legs still happens with presumed regularity, but gliding these handheld tools against the grain of face fuzz is totally taboo, thanks to the warning that’s been passed from generation to generation: If you shave extraneous hairs, they will come in darker and thicker. Or will they? “It’s a total myth,” aesthetician to the stars Kate Somerville maintains, an opinion she shared with us just a few hours ago in an intimate setting to discuss a bevy of new product launches and her own maintenance must-haves. On good authority (that being Elizabeth Taylor’s personal cosmetic dermatologist, whom Somerville used to assist), the greats (those being Elizabeth Taylor and Marilyn Monroe) shaved their faces for completely bare skin and an added dose of exfoliation.  Somerville herself is a firm believer in the power of the razor—one in particular: Gillette’s Mach 3. Believe it—and ask your S.O. to buy a two-pack next time he’s in need.

I keep reading that Japanese women regularly shave their faces, though I can’t find real proof for this statement, so why are American women so reluctant to shave their faces?  Maybe that will change in the future.  Weigh in with your opinion on this issue in a poll on the Huffington Post website.

So if you still can’t bring yourself to shave your face in order to remove excess vellus facial hair keep the following in mind (once again I’m quoting from the LNE&Spa article):

Determining whether or not a woman shaving her face is socially acceptable may not have a solid answer today.  Some women only shave when their significant other is not looking, some shave next to their significant other, and some will not even entertain the thought-even though they may have had dermaplaning performed by their skin care provider.  The status quo has not settled on whether or not it is acceptable, but that may change in the future.  Most public information about female shaving focuses on the exfoliation aspects, and how it gives the skin a refined appearance and healthy glow; the hair removal is just another perk that comes with the process.  In the meantime, dermaplaning with a disposable, single-use safety razor or eyebrow razor in the treatment room is the safer alternative to facial waxing or light-based hair removal.

Though I work for a plastic surgeon I do not perform dermaplaning.  Once I saw a demo of dermaplaning done on a young woman who had fine, very blonde hair all over her face.  The procedure did an excellent job of removing all that hair.  Then I was given a scalpel to practice on a fake head, but I have to say that it was very intimidating to think that I could on day use a scalpel on a real, live person.  If you are interested in this procedure be sure to go to someone who has been properly trained in order to avoid any unexpected injuries.

If you shave your face or know someone who does please comment below.  Or if you are an esthetician you performs dermaplaning please comment below.

Image from http://www.drinstruments.com

 

Should You Buy Home Laser and Light Devices? Do They Really Work? October 27, 2011

In our quest to look our best many of us have contemplated buying a handheld home skincare device.  Perhaps a light device that claims to erase acne or get rid of wrinkles (check out this new gadget from Japan).  Or maybe a home laser device that will remove unwanted hair (I’ve definitely considered that one).  These devices cost hundreds of dollars and make big promises.  Their appeal is obvious – invest your money once in a device and use it in the privacy of your home, on your time and schedule.  No more trips to the spa or doctor’s office for light treatments and laser hair removal.  The device is yours – for always and forever.  But before you invest in a handheld piece of skincare equipment think again.  Many of these devices are not worth both the investment of money and time.

In her book Feed Your Face Dr. Jessica Wu cautions against buying a handheld focused heat devices like Thermaclear or the Zeno Mini to treat acne (page 91):

There is some scientific evidence that heat may help clear acne.  Pulsed light, lasers, and radio-frequency devices (which are available only at a doctor’s office) have all been shown to kill the acne-causing bacteria P. acnes as well as temporarily decrease inflammation and shrink oil glands.  There are two main differences, however, between these medical instruments and a gadget you can buy at a drugstore:

1.  Lasers and other medical-grade devices typically come outfitted with a fan or a chilled tip so the laser can reach deep into the dermis (where your oil glands and bacteria sit) without burning through the top layers of the skin.  A store-bought device, especially one without a cooling system, won’t penetrate as deeply and therefore can’t be as effective.

2.  Studies show that killing P. acnes bacteria alone isn’t enough to stop breakouts.  To treat acne most effectively, you also need an anti-inflammatory component.  Even some of the antibiotics we commonly use to treat acne (substances that by definition are intended to kill bacteria) are prescribed at very low doses that are meant to reduce inflammation rather than kill P. acnes.  Medical grade lasers work because they kill bacteria and reduce inflammation, something handheld devices can’t.

Before you invest in any device there is something to keep in mind – the FDA clears medical devices for safe use but not devices labeled beauty devices.  The majority of handheld devices are marketed as beauty devices which means that they aren’t necessarily entirely safe for home use.  According to The New York Times article Taking Home the Lasers, Pulsers and Sonic Care there are many medical and compliance issues to keep in mind when it comes to these devices:

Dr. Sandra Lee, a dermatologist in Upland, Calif., fears patients will develop what she calls laserexia. “If it says, don’t use more than once a day, but if you’re a teen and you use it more than once a day, are you then at risk for scarring?” Dr. Lee said. “I worry about misuse.”

Some machines (among them TRIA Skin Perfecting Blue Light; LightStim for Wrinkles; and Levia Personal Targeted Phototherapy, which helps with psoriasis, eczema and vitiligo) have been peer-reviewed by medical experts, but not all. And the Food and Drug Administration clears only medical devices, not beauty devices, a distinction not always obvious to consumers.

“It gets squishy when companies say ‘We’re not making medical claims; we’re making beauty claims,’ ” said Dr. Mathew M. Avram, director of the Massachusetts General Hospital Dermatology Laser and Cosmetic Center in Boston. “What is a medical claim? It becomes a hard area to define.”

“If you make a claim that you can benefit someone’s appearance and you’re going to use a device to accomplish that,” he continued, “I think there needs to be the same level of scrutiny that a device used in a physician’s office would undergo.”

There have been some crackdowns on unwarranted claims. Last spring, the National Advertising Division of the Council of Better Business Bureaus (NAD) requested substantiation for promises made by VISS Beauty, for its Intense Pulsed Light Hair Removal Device. When the company refused to participate in a NAD review, the division referred the claims to the Federal Trade Commission and the F.D.A. And in September, the Federal Trade Commission shut down two smartphone apps, AcnePwner and AcneApp, for claiming that they could treat pimples with lights emitted from their display screens.

Even with effective devices, “there may be unforeseen uses and unforeseen consequences that may arise,” said Dr. Avram, listing the possibility of scarring, soreness, redness and hyperpigmentation, not to mention product malfunctions.

There’s also the “slight potential” for squamous or basal skin cancers from the ultraviolet light sources, said Dr. Neil Sadick, a clinical professor of dermatology at Weill Cornell Medical College, though he said that at-home devices used less energy than the machines in doctors’ offices.

The biggest hurdle, doctors say, is patient compliance; it requires some fortitude to beam a laser on your legs for 20 minutes a day. Dr. Sean Benham, a hair-loss and hair-transplant specialist in Santa Monica, Calif., likes the HairMAX LaserComb, a light-based hair-restoration device that costs about $600. But he said he saw many patients who simply tired of the routine, which involves “combing” the hair with an electronic wand for about 10 minutes, three times a week.

“People drop out of using it,” Dr. Benham said. “It’s so complicated and demanding, most of my patients say it just sits by the TV.”

There are opposing expert opinions to what I have quoted above.  Dr. Leslie Baumann, on her Skin Type Solutions website, has the following to say about handheld home light devices in an article entitled do-it-yourself vs. in-office beauty treatments: Which should you choose?:

At-home vs. in-office light-based treatments 

Dermatologists commonly use blue light in the office to improve acne, but a recent study shows that patients need treatments every three days for optimal improvement.  Not so practical, right?  That’s why at-home devices such as the Tria and Omnilux hold promise for keeping skin clear.  But anti-aging devices are a different story.  At this time, at-home wrinkle-reducing devices aren’t nearly as effective as their in-office counterparts, as while there may be an app for that as close as your phone, medically speaking it’s not going to do much for your skin.  Bottom line:  For acne, at-home devices are a do, but do-it-yourself anti-aging devices are a don’t.

Personally both the time and monetary investment would keep me from purchasing any of these products, but if you feel differently be sure to check out some reviews (like these on Sephora) from actual users before making your purchase.  Certainly none of these products are impulse buy material – be sure to think before you leap into buying such products.

 

Botox Explained January 27, 2011

 

Since Botox’s approval by the FDA for cosmetic use it almost seems like its uses, potential side effects, and safety are taken for granted.  But do you really know how Botox works, how to store it, and how it is injected?

Skin Inc. just published a very comprehensive article that really explains everything you need to know about Botox.  Entitled Chemodenervation From Physiology of the Skin, Third Edition the article succinctly goes into detail about the history of the use of Botox, how it is injected, how injecting Botox affects facial wrinkles and also other body conditions like excessive sweating, and the potential side effects from Botox injections.

If you have ever had any questions about Botox be sure to check this article out.  Reading it will only take a few moments and leave you much better informed in the long run.

 

How to Get the Most Out of Your Facial December 28, 2010

This post was prompted by an article I read in Spa magazine entitled Your Therapist Needs to Know … .  (Unfortunately at the moment I cannot find the article online)  The article outlines what information you should be sure to share with your massage therapist or esthetician before and during a treatment.  Of course I’ll focus on issues that have to do with estheticians and facials. 

Before you have a facial your esthetician will have you fill a questionnaire that will ask about your general health and about your skin’s health.  You’ll also probably be asked what skincare products you currently use, what skincare issues you are concerned about, and what you would like to improve about your skin.  If the questionnaire doesn’t ask you those questions, hopefully your esthetician will ask you a variation on those questions either before or during your treatment.

If you suffer from cold sores, especially if you are currently experiencing an outbreak, be sure to tell your esthetician.  Steam can make a cold sore worse or even spread to another part of your face.  You can still have a facial if you have an active cold sore, but your esthetician just needs to be extra cautious when treating that area.  And by that I mean, the area with the cold sore shouldn’t be treated at all.  If you have sensitive or irritated areas on your face, neck, or chest be sure to point that out to your esthetician.  If you have ever had a negative or allergic reaction to a skincare product tell your esthetician.  Hopefully the questionnaire you have filled out will have a place to check if you suffer from rosacea or eczema, but even if they do be sure your esthetician has made a note of that before beginning your treatment.  Mention if you have had precancerous or cancerous lesions removed from the areas that will be treated during the facial.  If you have just spent a lot of time in the sun or are sunburned mention that too.  Some of these conditions might be completely obvious to your skincare therapist, but it never hurts to gently point them out before beginning treatment.

Also please tell you esthetician if you have an infectious disease, especially one that could be transferred through bodily fluids.  Though esthetician follow universal precautions, which means we have to assume that everyone has an infectious disease, it would be best to alert your esthetician about such a situation.  If you are pregnant, but it isn’t obvious yet, or if you are nursing be sure to tell your esthetician since many skincare ingredients are off limits for pregnant women and nursing mothers.

Hopefully your esthetician will ask you what your expectations are for your treatment – relaxation, intense exfoliation, treatment of acne, anti-aging, etc. – but if she or he doesn’t be sure to let them know if you have any specific expectations from your treatment.  Of course, keep those expectations in check.  A facial won’t make you look 24 if you are really 50 (go to a plastic surgeon if you want that kind of change).  If you are interested in hearing about new skincare products or want to hear the esthetician’s opinion about certain skincare lines – ask.  Personally I love to share what I know about skincare products and most other esthetician do as well.  On the other hand, if you are happy with the products you are using you can politely tell your esthetician that.  Part of our job as an esthetician is to recommend the skincare products that our spas or offices sell.  If you don’t want to hear about other skincare products just politely let your esthetician know that.

In my opinion there are two other essential parts to getting the most out of your facial – ask lots of questions and speak up.  I always tell my clients “let me know if something doesn’t feel good, and I’ll fix it.”  Of course, extractions never feel good, but the rest of the treatment should be pleasant and even wonderful (the massage).  Personally, I’m a talker so I love clients that like to chit-chat about life or just about skincare products.  I am more than happy to share my knowledge, but if you just want to close your eyes and drift off to sleep during your facial tell your esthetician that at the beginning of the treatment.  You’ll enjoy your facial so much more if you speak up about something that might be bothering you during your treatment.  Instead of complaining afterwards to a manager tell your esthetician at that moment so they can correct what is bothering you.  Spas are driven by customer service so we are there to please you – the paying client.

And above all, relax and enjoy!

 

Further Reading –   11 Tips on Getting the Most Out of Your Spa Experience – Spa Magazine

 

 
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