Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Why It Is Important to Use Moisturizer During the Summer June 26, 2013

When advising clients about a home skincare regime I tell those who have combination or oily skin that moisturizer isn’t a must for them.  They should go by how their skin feels before applying a moisturizer.  Of course, if you have oily skin and are using stronger anti-acne or anti-oil products such as Retin-A or products with salicylic acid you may always need a moisturizer, twice a day, in order to bring balance back to your skin.  I also let clients know that during the summer a separate moisturizer and sunscreen may be unnecessary for them since their sunscreen might be moisturizing enough when the weather is hot (and depending on where you live humid too).  I actually like to recommend the use of a moisturizing toner during the summer for those with oily skin (see my post Let’s Talk About Toners – Again for more information).

Recently I read an article in the June, 2013 edition of Le Nouvelles Esthetiques and Spa that made me rethink the importance of moisturizer even during the summer.  The article Multiple Ways to Hydrate the Skin by Dr. Jennifer Linder (from PCA Skin) explains:

Proper hydration of the skin is often a conversation reserved for the cold and dry months of winter. Attention to skin moisture levels, however, is an essential topic of discussion year-round when seeking to achieve clear, glowing skin. For many reasons, hydrating the skin properly is equally important during the summer. By understanding the elements that influence hydration, as well as the interplay between water and oils, it is possible to maintain balanced, hydrated skin regardless of the season.

Elements that reduce hydration levels

In the intense heat of the summer, moisture is released from the skin at a high rate in order to cool the body internally. This moisture loss becomes even more pronounced if one regularly engages in sports or high impact exercise. Additionally, there is a tendency to shower more frequently and wash the face more often to remove sweat and oil buildup. If the moisture is not replaced (both internally and externally), the skin may appear dull over time, become susceptible to impaired barrier function or get stuck in a cycle of oil overproduction, leading to breakouts.
During the summer months, increased UV exposure can also lead to a reduction in skin hydration. Dry heat (evaporation) and humidity (increased sweating) deplete cutaneous moisture. While ultraviolet B (UVB) rays are at their strongest during the summer, ultraviolet A (UVA) rays remain constant throughout the year, making sun avoidance and protection a must during every season. During the summer months, people are typically outside more often for extended periods of time, therefore increasing direct and prolonged exposure to UV radiation that can set in motion a number of reactions that are harmful to the skin. The higher output of UVB rays increases free radical production that damages the cellular proteins and fats that make up and support the layers of the skin. Overexposure to UV rays can result in burning, cracking and peeling, which destabilizes the skin’s delicate moisture retention mechanisms, often causing permanent damage to the affected areas. To combat this, it is important to practice sun avoidance between the hours of 10 a.m. and 4 p.m., wear wide-brimmed hats and protective clothing, and use a broad spectrum sunscreen with an SPF of at least 30 every day, making sure to reapply it every two hours.

Water versus oil hydration

Many believe that moisturizing the skin becomes less important during the hotter and typically more humid months of the summer. This is not the case, however; regardless of the season, all skin types need moisture. Both oil and water serve important roles in cellular regeneration and moisture retention, and maintaining a balance between the two—as well as understanding the differences between them—is necessary to achieve clear, hydrated and healthy skin.

Water

The most important tasks of water in relation to skin hydration occur internally. The skin is the body’s largest organ, which requires adequate water intake to not only maintain moisture and elasticity, but to flush out harmful elements, regenerate and expel dead skin cells as well. The uppermost layer of the skin is known as the stratum corneum (SC). This protective layer is made up in part of dead skin cells, which act as a barrier to the elements while keeping the much needed moisture inside. Lack of proper hydration reduces the ability of the SC to turn over new cells, allowing old, lifeless skin cells to become mixed with perspiration and bacteria; the result in most cases is cellular inflammation, acne and dull skin.
Additionally, although the skin may appear to be hydrated and moist in the summer due to the production of sweat, it can actually be dehydrated from excessive water loss caused by perspiration. If water consumption is inadequate, the skin is the first organ water is taken from to increase the supply to critical organs and bodily systems. Also, the increased amounts of salt and uric acid deposited on the skin from sweat can be damaging if it is not gently and consistently removed. Insufficient water moisture in the skin also leads to an unwelcome increase in sebum production. This, in combination with increased sweat, is a recipe for breakouts. To maintain sufficient moisture, it is critical to increase water intake during the summer, as well as maintain regular moisturizer use. For those who are prone to oily skin, choose a product that primarily focuses on increasing water moisture without heavy oils.

Oil

We have largely been trained to shy away from using oil on the skin for fear of clogged pores and acne. Oil, however, is an essential component of healthy skin, and using the right oils—even during the summer—can help maintain homeostasis and flexibility within the skin.
It is crucial to ensure that patients understand the importance of maintaining cutaneous oil balance. In most cases, the oil glands naturally produce enough oil to lubricate the skin without causing breakouts; however, this process is easily disturbed. Scrubbing the face excessively or using harsh cleansers and exfoliators will strip the skin below its necessary oil threshold. In response to this imbalance, the skin will actually produce more oil to compensate for the loss. However, the patient often views this as an “oily skin problem,” and perpetually seeks to strip the oil away. Thus, the production of oils is continuously increased, and the skin seems to be unmanageable. Interestingly, studies have indicated that acneic skin is deficient in essential fatty acids (EFAs), which is partly responsible for the overproduction of sebum. By supplementing acneic skin with beneficial oils that are high in EFAs, sebum production can be kept in balance.

Humectants and occlusives

A humectant is a substance that attracts water, and can often hold many times its own weight in moisture within the skin. A humectant can pull water from the air, but in topical skin care the humectants are typically drawing moisture up from the dermis into the epidermis.
Common humectants include glycerin and honey, in addition to higher attraction humectants such as sorbitol, lactic acid, sodium PCA and urea. Hyaluronic acid is a particularly powerful humectant, in that it can attract and hold up to 1,000 times its weight in water. The strategic use of humectants can have profound effects on the condition of your patients’ skin.
Oil is classified as an “occlusive,” meaning that it acts to lock moisture into the skin. Oils that are beneficial to the skin may be used after bathing to lock in the moisture from the water while the pores are still open. Additionally, moisturizing products that contain light oils, such as sweet almond oil or jojoba oil (with compositions very similar to human sebum), are a good choice during the summer months, as they hold moisture within the skin without creating a greasy feel or clogging pores.
Ideally, a moisturizer should contain both humectants to draw moisture into the skin and occlusive ingredients that seal the necessary moisture within the skin. These principles apply to products designed for oily and breakout-prone skin, as well as those with dry skin. It is typically the occlusive agent that varies. For dry skin, a product might use shea butter to occlude, while a product for breakout-prone skin may instead employ niacinamide or jojoba oil to perform the same function, but without the emollience.

Since reading this article I’ve made sure to keep up with the moisturizing step in my home skincare regime.  I found the article persausive enough to remember the importance of moisturizer throughout the year, no matter the weather.  This is information that I will be sharing with my clients as well.

My Related Posts:

Further Reading:

Image from girlishh.com

 

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

 

For My Fellow Estheticians: Our Professional Behavior/Code November 17, 2010

Awhile back I wrote a post about why you should go to an esthetician and how to find a good esthetician.  Prompted by two things I’ve read lately I’ve been thinking about the same subject just with a bit of spin on it.  I started thinking about an esthetician’s behavior while doing his or her job and if there are tried and true standards for how we estheticians should behave on the job.  Though I envisioned this post as a starting off point of discussion for my fellow estheticians, I know that a few other estheticians read this blog, I would love to hear from anyone who has an opinion of this topic.

The first thing that I read that prompted me to think about this topic was a little blurb in the December issue of Lucky magazine.  Now while anyone who regularly reads this blog knows I love Lucky for its fashion advice and loathe its skincare advice I did find the following tip interesting (it was #7 in the article 10 Essential Beauty Tips):

The hairstylist/aesthetician/manicurist who spends her time trashing the job the last person did on you is the hairstylist/aesthetician/manicurist you to replace, stat.  Truly talented people focus on bringing out the best in you, not telling you what’s wrong with you.

Now this is actually beauty advice I can get behind and agree with.  In my opinion, one of the important parts of being a good esthetician is to focus on both the positive and on the client in front of you.  So part of behaving in a professional manner as esthetician is to remain upbeat and to give clients a truly personalized experience.  Even if you think the last esthetician your client saw gave them terrible or incorrect advice you have to be extremely diplomatic about how you present your opinion.

Shortly after reading the above point in Lucky I came across the following article in Les Nouvelles Esthétiques and Spa:  Establish Your Professional Status by Nondy Llewellyn.  In the article the author outlines her view on how an esthetician should behave in order to be successful and also what types of knowledge and steps an esthetician should have or do in order to be a success.  Included in the article is a list of the characteristics of excellent estheticians:

  • Has neat appearance with manicured nails and minimal jewelry
  • Adheres to OSHA, EPA, Universal Precautions, city and state guidelines
  • Wears gloves during services
  • Uses appropriate and professional language
  • Has a spa voice that is pleasant and considerate of quiet surroundings
  • Does not discuss inappropriate subject matter and is sincere
  • Constantly learning and seeking advanced education
  • Stays current with technology and trends
  • Has business cards

I think some of the points above are excellent in particular the ones about following safety and state guidelines, constantly learning, and keeping up-to-date with technology and trends.  I do believe that a professional, neat appearance is a must though I think there should be a lot of leeway about what that means exactly since different spa settings have different ideas of what is appropriate.  I truly believe that individuals should be allowed to express their personality through their clothes, jewelry, hairstyle, etc.  in when they work in a spa setting.

From personal experience I do sometimes find it tough not to veer into inappropriate topics of conversation with my clients.   Two topics that should always be off-limits in a conversation with clients – religion and politics. Believe me – I’ve learned the hard way.  Recently I even had a client tell me something about a recent historical event that I thought was so outrageous I couldn’t believe she thought what she was saying was true.  I quickly changed the topic of discussion and reminded myself again – be careful about what you talk about with clients.

I also struggle with maintaining my spa voice.  Once I start an animated conversation with a client my voice can rise without me even realizing that this is happening.  I have to constantly remind myself to keep my voice down.

I loved the fact that the author of the article mentioned that estheticians need to be sincere.  I think that is of the utmost importance along with being honest.  Don’t oversell anything to your clients – treatment results, product efficiency.  I like to always remember the following:  under sell, over deliver.  And try not to be pushy.  Some estheticians have a quota for the amount of products that they have to sell monthly which puts a lot of pressure of them.  Professional esthetics publications are filled with articles about how to improve your selling ability.  This doesn’t come naturally to a lot us, me included, and can cause an esthetician a lot anxiety.  The experts always tell estheticians – recommend don’t sell – but so many people can see you as pushy anyhow.  It is hard to find that balance, in my opinion.  But your clients will trust you more in the end if you are honest and sincere with them.  You might not sell a lot of extra products or treatments at the beginning, but once you win a client’s trust you will have an easier time selling.  Of course all of that is easier said than done – believe me, I struggle with the above issues a lot.

The one thing I would quibble with in the above list in the statement that estheticians have to always wear gloves.  Of course I always wear gloves while performing waxing services and while doing extractions, but otherwise during a facial I don’t wear gloves.  I constantly disinfect my hands with hand sanitizer throughout a facial.  I think the facial, particularly the massage part of the facial, is much more enjoyable for the client when you do not use gloves.

One more point – we all have bad days and can have a crisis that happens to us outside of work (or unfortunately sometimes at work).  But we can never let that influence how we treat our clients or even let our clients see that we are unhappy.  Estheticians have to check their bad feelings and bad days at the door.  If we want our clients to return to us remaining upbeat and positive is key.  So is being friendly to whomever walks through the door, even to our most annoying client.

I also think estheticians need a few more qualities in order to be successful -namely compassion and empathy.  For example you could have a client who comes in complaining of acne, but their skin really isn’t too bad.   So while you know just how much worse acne can really be, you still need to sympathetic and empathetic towards that client who thinks that their acne is the worse acne ever.  It doesn’t matter what we really think of the condition of their skin.  If they think it is terrible than we need to treat their skin thusly or at the very least never verbally contradict them.  It can be a real balancing act.

That’s are my two cents on the subject.  I would love to hear from my readers about this topic!

 

Also – some people might enjoy reading this New York Times article.  It relates, though remotely, to the topic above:  Beauty House Calls in the Wee Hours

 

 
%d bloggers like this: