Daily Skin Care Tips for Rosacea

Here's some tips for treating rosacea skin. Keeping your skin clear will take some dedication on your part. Following a regular cleansing and medication routine will make treatment easier and more successful.

Here are some simple steps to follow:

1) Cleanse gently with a very mild cleanser. Avoid products that contain alcohol or other irritants. Dermatologists often recommend Cetaphil Gentle Skin Cleanser, a gentle soapless product available at most drugstores.

2) Medicate according to your dermatologist’s instructions.

3) Moisturize with a good quality, “noncomedogenic” (meaning it won’t clog pores) moisturizer as needed. If your treatment includes a topical medication, you can usually apply the moisturizer after the medication has dried. The Cetaphil product line also includes a moisturizer that is specially designed for sensitive skin.

4) Protect with a sunscreen of SPF 15 or higher. Look for a noncomedogenic product that does not contain alcohol.

5) Makeup can help hide your rosacea. Oil-free foundations with yellow (not pink) undertones are recommended, as are special green-tone products specifically designed to be worn under foundation to disguise facial redness. Yellow-tone cover-ups are available from many brands.

6) Maintenance requires an understanding that rosacea can’t be cured. You will need to continue using your prescription and treatment plan even when your symptoms have cleared up. Without regular therapy, your symptoms may return and possibly get worse over time.

Once you have started to enjoy results, maintaining your course of treatment becomes easier and more successful.

Rosacea

Rosacea is the fifth most common diagnosis made by dermatologists. Rosacea is not acne however; often it is referred to as “adult acne.” It begins as a tendency to flush or blush easily and progresses to persistent redness in the center of the face that may gradually involve the cheeks, forehead, chin, and nose. With time, small blood vessels and tiny pimples begin to appear on and around the reddened area. When rosacea first develops, the redness may come and go.

Dermatologist, Dr. Neal Schultz author of It’s Not Just About Wrinkles, offers this definition of rosacea. “Rosacea, a chronic disease that affects men and women in their thirties, forties, and fifties, is characterized by redness (blotches or telangiectasias) of the central area of the face due to dilation of small blood vessels.”

How to Recognize Rosacea

Small red bumps, papules and pustules appear on the face. These may be accompanied by persistent redness and the development of many tiny blood vessels on the surface of the skin. In more advanced cases, the oil glands enlarge causing a bulbous, red nose, and puffy cheeks. Thick bumps may develop on the lower half of the nose and nearby cheeks. This condition called Rhinophyma occurs more commonly in men.

“Rosacea is more common in certain ethnic groups, in particular Celtic and northern European people,” according to Dermatologist Dr. Nicholas Lowe, author of Away with Wrinkles. Fair skin adults between the ages of 30 and 50 may develop rosacea. Since it may be associated with menopause, women are affected more often than men.

The International Rosacea Foundation identifies four stages:

1. Patients experience repeated episodes of flushing or blushing and often leads to a more persistent redness that become more noticeable to all with hard raised lesions (papules) and pus filled acne pimples (pustules).


2. Areas of the face are persistently red; telangiectasia becomes more prominent along with papules and pimples appearing on the nose and cheeks. The skin may take on a roughened, orange peel texture with large open pores.


3. Patients appear quite grotesque with nodules, hyperplasia, and being quite noticeable as they have already entered rosacea treatments in an earlier age. Their disfigurements include severely inflamed, thickened, edematous skin with large pores and with coarse features of thickened skin folds.


4. A seasoned older weathered appearance of skin layering appears due to extensively inflammatory infiltration, connective tissue hypertrophy, massive fibrous and elastosis, diffuse sebaceous gland hyperplasia, and extreme enlargement of individual sebaceous glands forming dozens of yellowish unbilicated papules on the cheeks, forehead, temples and nose.

What causes Rosacea?

No one knows for certain what causes rosacea. According to the International Rosacea Foundation, researchers have suggested several factors that may be related to its development:

• A disorder of the blood vessels that causes them to swell, leading to flushing.


• A genetic predisposition combined with certain environmental factors that may irritate the skin.


• Clogging of the sebaceous gland openings with skin mites called Demodex Folliculorum, which live in facial-hair follicles.


• Vitamin-B deficiency, local infection, hydrochloric-acid (stomach acid) deficiency, infection with Helicobactor pylori, and/or digestive disorders.

Treatment

Many people with rosacea do not recognize it in its early stages. Identifying the disease is the first step to controlling it.

Dermatologists often recommend a combination of treatments tailored to the individual patient. Creams, lotions, foams, washes, gels, and pads that contain various topical antibiotics, metronidazole, sufacetimide, benzoyle peroxide, and retinoids may be prescribed. A slight improvement can be seen in the first three to four weeks of use. Greater improvement is usually noticed in two months.

Oral antibiotics tend to produce faster results than topical medications. Cortisone creams may reduce the redness; however, they should not be used for longer than two weeks since they can cause thinning of the skin and flare-ups upon discontinuation. The persistent redness may be treated with a small electric needle (electrodessication) or by laser surgery to close off the dilated blood vessels.

The key to successful management of rosacea is early diagnosis and treatment. It is important to follow all of the dermatologist’s instructions. When left untreated, rosacea will get worse and may be more difficult to treat.

Home Care for Acne

Whether you are 12, 22, in your 40’s or 55 and over, acne is not just a phase to be tolerated or “gotten through.” It can be embarrassing and infuriating. It is not caused by improper cleansing or poor diet, though it may be aggravated by one or both.

Acne is not a disease to be cured; rather it is a condition that can and should be controlled with daily and periodic care. Acne is a genetic disease affecting the skin by a series of recurrent, infected breakouts such as blackheads, milia, pimples and cysts. Most cases of adolescent or adult acne can be controlled with topical treatments from one or more of the following sources:

1. Daily home care with professional skin care products
2. Clinical treatments by a licensed skin care therapist
3. Medical treatments by a physician or dermatologist

Excellent skin care and hygiene are vitally important to remove the excess oils and bacteria that stimulate acne.

Why do some people in their forties, fifties and sixties start having breakouts?

Stress and hormonal changes are the primary cause of the re-emergence of acne for adults between the ages of 40 and 60. According to researched compiled at The International Dermal Institute, "several factors can make a person more susceptible to acne breakouts. People who are prone to breakout should only use products that are non-acnegenic or non-comedogenic. Many of these skin-sensitizing products contain ingredients such as lanolin, artificial fragrance and colours, S.D. alcohol or mineral oil which can clog and irritate the skin.” Dermalogica’s products are non-greasy and completely water-soluble, making them ideal for breakout-prone skin. For more information visit their website http://www.dermalogica.com/.

Follow a Strict Regime in Caring for Acne Blemishes

1. Cleanse twice a day with tepid (not hot) water.

2. Use over the counter skin care products or professional skin care products faithfully; proper use can help prevent, as well as clear up, blemishes.

3. Sleep no less than seven hours per night on a consistent basis. Your body works best on a regular routine and with plenty of rest.

4. Eat a healthy balanced diet with plenty of variety and fiber.

5. Drink 6-8 glasses of water every day. Water flushes wastes from the body and helps to maintain a balance.

6. Limit seafood, salty foods and dairy; all contain iodine, which can trigger acne breakout in sensitive individuals. Avoid iodides in the diet:

Fast foods, all processed foods, seasoned salt, soy sauce, products with MSG, seaweed, sushi, Chinese food, Mexican food, nuts, processed meats (lunch meat, deli sandwiches, bacon, franks, sausage),vitamin supplements and condiments containing kelp. Cheese is one of the major acne aggravators. Hormone-laden foods, including wheat germ and peanut products, should be avoided. Some cold and flu medications contain bromides and can aggravate acne.

7. Get regular exfoliating treatments like enzyme peels with steam, or light peels (glycolic, lactic, PolyGel). They help topical medications and exfoliants, to penetrate better, and boost your home care efforts. Do not use a washcloth or buffing pad. Do not rub your face dry with a towel. These “mechanical” exfoliation methods can over-exfoliate your skin, cause excessive irritation, and can make your acne care products sting and irritate. What can be helpful is after cleansing, apply a thick coat of Peter Thomas Roth Sulfur Cooling Mask, allow it to dry for 7-10 minutes, and rinse off.

8. Change pillow cases and sheets more frequently; oils and bacteria from your skin can build up in bedding and further aggravate the matter. Wash your clothes in fragrance-free detergent, use 25% less detergent, and wash 25% less clothes at a time. Whenever possible, run an extra rinse cycle. Avoid fabric softeners, especially “sheets” thrown in the dryer. Use a white satin pillowcase laundered in fragrance-free detergent without fabric softener.

9. Stop PICKING! Picking pushes acne lesions and ingrowns deeper into the pores, slows down the healing process, can cause scarring, and can turn ordinary breakouts into larger black, brown, red or purple spots. Rub ice cubes in a circular motion on red, inflamed lesions twice a day for 2 minutes to help reduce inflammation and swelling.

10. Be certain you remove any residue of hair care products from your skin. Avoid oily products containing isopropyl myristate and its chemical cousins, cocoa butter, coconut oil, vitamin E, fatty acids and natural oils, except safflower, sunflower and mineral oil.

Facing Acne

Lifestyle changes can often improve your skin. Stress is the Number One acne aggravator so try to do whatever it takes to reduce stress in your life. Limit your intake of caffeine and cigarettes, which stimulate the adrenal glands to wreak havoc on the skin’s natural processes. Minimize your sun exposure and reapply oil-free sunblock often when exposed to direct sunlight.

Most importantly, avoid oily cosmetics and products that may also contain D & C red dyes including blushes and powders. Some “oil-free” products actually contain synthetic oils (called fatty acids), D & C red dyes, detergents, etc., that are known acne-aggravators.


With the numerous advances in skin care formulations, increasingly more people are combating their acne with regular facial treatments and complementary at-home regimens.

Topical Vitamin C Revitalizes Aging Skin

Topical Vitamin C is an important component of most anti-aging skin care regimens. The amount of collagen in the skin tends to decline with age, an ongoing process that is accelerated by a number of factors like sunlight, smoking, free radicals, and inflammation. As the synthesis of new collagen slows down, topical vitamin C provides one of the most effective ways to boost collagen synthesis and slow its degradation.

In the June 2009 issue of Skin Inc. Magazine, Dr. Peter T. Pugliese, MD stated in his article Vitamin C in Skin Care, “Vitamin C was originally used in skin care products in the form of ascorbic acid. At a 10% concentration and low ph, ascorbic acid has been shown to stimulate collagen, decrease wrinkle depth and have lightening effects on pigmentation. It was thought that a minimum 10% concentration was required but newer information indicate that lower concentrations (5%) may have benefit.” According to other reports, Topical Vitamin C products should be a strength of 0.3 to 10% for optimal effectiveness.

Topical Vitamin C is used in skin care because it is an antioxidant. This means that it is able to neutralize oxygen free radicals. Free radicals over time will damage the skin cells and deteriorate the underlying structure of the skin resulting in changes of the skin’s complexion, sun spots, and wrinkles. The use of vitamin C is a major line of defense in the treatment of aging skin because it is essential to the formation of collagen, mitigates the effects of free radicals, and helps to maintain firm and youthful skin.

The forms of Vitamin C

Magnesium ascorbyl phosphate, L-ascorbic acid, ascorbyl glucosamine and ascorbic acid are various forms of vitamin C considered stable and effective antioxidants for the skin. Vitamin C in the form of Ascorbic Acid is very expensive. Vitamin C is very unstable and difficult to get into a formulation which explains why ascorbic acid skin products tend to be very expensive.

The problem with Ascorbic Acid creams and serums is that because they are unstable, they are oxidized very quickly and once it is oxidized it does not provide any benefit to the skin at all. Even in stabilized formulations there is a risk that before vitamin C cream or serum is used it may be damaged.

The indicator is in the yellowing of vitamin C serum which indicates oxidation. As it undergoes oxidation the ascorbic acid takes on a yellowish tinge, and if there is any yellow discoloration the product needs to be discarded. However, there is a problem with the color check because the first stage of oxidation is colorless, so prior to going a yellowish tinge it can be in an oxidized state that cannot be detected.

The problem becomes more difficult because many vitamin C serums are tinted making it difficult to detect if it is oxidized by visual checking. Best advice is to not to buy tinted formulations of vitamin C.

Packaging is Important

Since Vitamin C is easily broken down by air and sunlight, the packaging is extremely important. To be beneficial, vitamin C should be packaged in tubes, capsules or pumps that do not allow air in unlike jars or clear containers which will render vitamin C worthless.

Benefits

The most effective method for replenishing vitamin C in the skin is to apply it directly to the skin. When topically applied, vitamin C provides a skin-rejuvenating effect by improving collagen synthesis in the skin that slows down with aging, as well as limiting skin damage from free radicals. Applying topical vitamin C to the skin is 20 times more effective than oral ingestion.
Vitamin C is one of the most effective and important ingredients to treat a number of skin problems, including aging skin, acne and pigmentation disorders.

An Evening with SkinMedica

Recently, I attended an “Evening of Beauty” at Soleil Salon & Spa in Windham, NH. A number of invited guests were in attendance for a featured presentation on their Exclusive Medical Skin Care line, SkinMedica. The speaker was Debbie Neilan, Skin Educator and Sales Consultant for SkinMedica. She was informative and very personable in presenting the physician strength products of SkinMedica. Her style of explaining what SkinMedica ingredients do for your skin was complemented by her professional PowerPoint presentation.

The Soleil Salon & Spa made this evening fun and enjoyable, offering appetizers, sangrias, raffles and giveaways. There was a special 20% discount on all SkinMedica product purchases of $150 or more; in addition, to a 15% discount given with the purchase of a series of three Vitalize Peels. These attractive discounts resulted in nice purchases for invited guests.

Soleil Salon & Spa

Soleil Salon & Spa http://www.soleil-salon.com/ is owned and operated by Luisa Garcia and has been in business over 7 years . Soleil in French means sun. Luisa believes, “It is the sun that gives us light and energy. It is the energy that we put into the services we offer our clients.” She has incorporated her Spanish and Puerto Rican influences in the interior design of the Spa. Warm earthy tones carry you from room to room. The experience is similar to an inviting, beautiful oasis.

She’s created a full service salon and wellness spa committed to beauty and well-being offering professional hair, nails and skin care products. Services include a styling staff featuring latest trends in cuts, fashion, and styles. Asethetics services offer revitalizing facials, body treatments, and eye treatment specialities. A range of massages are also offered along with pedicures services.

SkinMedica

The SkinMedica line http://www.skinmedica.com/ with NouriCel-MD (TNS Recovery Complex) as its core category of products offers a complete line of skin care products. NouriCel-MD is a combination of growth factors that are important to the regeneration of healthy skin. TNS (Tissue Nutrient Solution) is the trade name given to identify products in the SkinMedica line that contain NouriCel-MD. SkinMedica has leveraged this unique technology with other innovative ingredients to create an entire collection of TNS products that provide optimal skin rejuvenation.

Physician Strength

Debbie Neilan introduced us to SkinMedica by explaining what is meant by physician strength in their product line. First, their aesthetic product line is based on the science of the skin’s own healing abilities. As skin ages, elasticity decreases, lines appear and overall appearance is diminished. To counteract these effects, SkinMedica products contain the highest level of active ingredients that work below the skin’s surface to regenerate the health of the skin.

Second, its clinically proven recovery compounds include ingredients ranging from Vitamins C and E to retinol to NouriCel-MD which is a blend of growth factors, soluble collagen, antioxidants, and matrix proteins. The appearance of fine lines are reduced, age spots and discoloration fade, and skin texture and elasticity are improved. Debbie spoke at length on how specific ingredients like peptides, retinol, hyaluronic acid, and antioxidants help our skin.

Vitalize Peel

Debbie continued her presentation by talking about SkinMedica Vitalize Peel which is a chemical peel that rids dead surface skin. It works by a combination of Alpha and Beta Hydroxyl Acids and retinoic acid. The Vitalize Peel is a treatment that is appropriate for all skin types and has been clinically proven to help reduce the visible signs of aging. Results are cumulative and maximum benefits are seen with a series of three or more peels. This peel can take years off aging skin and is excellent for acenic skin, hyperpigmentation and melasma.

The Feel of the Product

Throughout Debbie’s presentation she took questions, and allowed us to sample products. Her knowledge was extensive, and the guests walked away with an appreciation of how products are packaged and especially labeled into categories for better understanding of their primary purpose. It was a great opportunity for “hands on”! The experience of opening and applying a small drop of serum, cleanser or moisturizer kept everyone engaged. Feeling the texture and smoothness proved very beneficial especially in the number of purchases at the end of the evening.

Evening Highlights

The highlights to the evening were the elaboration on the TNS Essential Serum and TNS Recovery Complex. Both work to transform and regenerate your skin for a youthful appearance.

TNS Essential Serum is an age defense product used to soften fine lines, brighten the complexion and fill surface folds. It’s the first to provide the growth factor serum, TNS Recovery Complex in one chamber and APS Corrective Complex, (a mixture of antioxidants, peptides and other anti-aging ingredients) in the other chamber.

TNS Recovery Complex is a gel formulation containing 93.6% NouriCel-MD to reduce the appearance of fine lines and wrinkles, diminish the appearance of age spots and dyspigmentation, reduce roughness, and firm skin texture. Its aim is to flood area of skin damage with 110 growth factors!

All of SkinMedica’s products are developed by a dermatologist and bioengineered to work together to enhance the beauty of your skin.

A Closer Look at Aging

As we grow older, our skin experiences several significant changes. The skin’s natural support system begins to break down, causing fines lines, wrinkles and loss of elasticity. Additionally, the skin’s surface begins to show dark and light spots, roughness and redness. There are two theories that provide the answer for skin aging.

Intrinsic aging

This theory focuses on our bodies decreasing ability to stop free radicals from destroying our cells. Free radicals are toxic molecules formed from things such as air pollution, smoking, and exposure to sun. They break down the basic skin biochemicals that maintain skin structure and safeguard hydration. Free radicals promote the dissolution of collagen, hyaluronic acid, and elastin. “Intrinsically aged skin can have fine or small wrinkles, a loose or sagging quality and skin growths that do not become cancerous, according to Dr. Lawrence Green author of The Dermatologist’s Guide to Looking Younger. Intrinsic aging refers to one’s genetic programming that changes the skin due to the passage of time and is beyond our control.

The effects of aging:

• Our skin becomes thinner and less resilient
• Gravity takes its toll and firm skin starts to sag
• Corners of our mouths turn downward
• Crossing lines on our faces more noticeable
• Movement of fat to jowls and lower eyelids
• Loss of fat from cheeks

Extrinsic Aging

This theory claims the main cause of aging is sun damage. Years of sun exposure accumulate and contribute to the most visible effects of facial aging, a process dermatologists refer to as “photoaging,” states Dr. Lawrence Green. Environmental exposure, pollutants, air quality and humidity affect the skin’s health. Pollutants in air from factories, and automobile exhaust affect the surface appearance of the skin and change the health of the underlying cells and tissues.

Photoaging effects:

• Wrinkles deeper
• Skin rough and leathery
• Pigmentation occurs
• Tiny blood vessels appear
• Cancerous growths possible

Dr. Nicholas Lowe author of Away With Wrinkles provides a rough guide to the first signs of facial aging.

Signs of facial aging:

Teenage years - firm elastic skin with no wrinkles

Twenties- reasonably smooth without any major lines

Thirties- a point when genetic predisposition begins to show; appearance of sunspots, red precancerous skin lesions and creasing of the skin from repeated muscle activity begins to show.

Forties - signs of past sun exposure is more likely to show. Increased frown and smile lines and loss of firmness. Loss of plumpness in the lips may be apparent and some lines on the lower face.

Fifties to sixties-a sagging eyelid or brow droop. Deeper facial lines more noticeable and sun spots and pre-cancer spots will show.

Sixties to seventies-Depending on the amount of sun exposure, lines and brown spots will start aging the skin more severely.

Md Formulations’ www.mdformulations.com aging skin care regimen suggests:

• Cleanse and exfoliate daily with a gentle exfoliant such as glycolic acid to remove aged skin cells.
• Keep your skin well hydrated by using a moisturizer that balances skin lipids.
• Use ant-aging ingredients such as Vitamin A, glycolic acid and BHAs to help reduce fine lines and wrinkles
• Incorporate antioxidants such as superoxide dismutase, Vitamin E and C and plant extracts into your skin care.
• Use skin brightening products to help diminish age spots and improve skin tone.
• Avoid sun exposure and use a physical sunscreen containing zinc oxide every day.

Smoking and drinking contribute greatly to the aging process. The constant dilation and contraction that occurs on the tiny capillaries and blood vessels, along with the constant deprivation of oxygen and water to the tissues, quickly makes the skin appear lifeless and dull. Your skin will age according to your skin type, genetic factors, and lifestyle choices.

Ceramides

Scientists are uncovering the important role that ceramides play in the barrier function of the skin. The top layer of the skin is the epidermis and the top layer of the epidermis is the stratum corneum. Even though the stratum corneum is very thin, like one-tenth the thickness of a piece of paper -- it is the main barrier of the skin. It keeps chemicals that come in contact with the skin from absorbing into the body, and it keeps water inside the skin from leaking out.

Ceramides defined by Milady’s Standard Fundamentals for Estheticians, are lipid materials that are a natural part of the intercellular cement. The intercellular cement between the skin cells consists of ceramides, lipids, glycoproteins, and active enzymes.
Ceramides are natural lipids (fats) and a major component of skin structure. These fats allow skin to retain moisture.

The Role of Ceramides
Ceramides are essential in helping to form multiple layers of lipids, which, in turn, retain water. Ceramides play a central role as water regulators primarily because of their abundant presence in the skin and high capacity to prevent water loss. This is why ceramides are so effective in creating a barrier-recovery effect.

Lipids in the Skin
The stratum corneum contains three types of lipids:

• ceramides,
• cholesterol
• and free fatty acids.

These lipids have different chemical compositions and different functions throughout the body.
The quantity of these diminishes as we age, resulting in a decrease in the skin’s suppleness, softness, smoothness, and the tendency towards dryness.

Lipids provide a barrier against the loss of moisture and provide protection from other types of external elements. In the corneum, 40-50% of these lipids are primarily composed of ceramides.
Ceramides and other lipid-type materials have been called “cellular cement,” because they make up the foundation for materials, which hold epidermal skin cells in place. Without these lipids, the cells would simply slough off after moisture is lost. Ceramides are important in the treatment of dry skin. Externally applied ceramides help replenish and improve the skin’s ability to reduce desquamation.

In general, ceramides and synthetic ceramides are added to cosmetic formulations such as moisturizers and other beauty products to replenish the content of lipids within the upper layers of the skin. This leads to an increase in skin softness and smoothness and a reduction in the amount of constantly escaping moisture. Moisture loss leads to dehydration, excessive scaling or flaking, desquamation and increased potential for irritation.

What do Ceramides do?
In cosmetic applications, ceramides provide the skin with materials, which are slowly depleted during the aging process, but are responsible for maintaining a youthful appearance by reinforcing the natural barrier function of superficial epidermal layers.

Ceramides used in cosmetic preparations may be obtained from biological, botanical, marine or synthetic sources. The different types of ceramides are distinguished by analysis of their unique chemical structure.

Most cosmetic labels will accurately list ceramides by using their own specific terminology names such as the following:
Glycosphinogolipids
Sphingolipids
Glycosyl ceramides

Other comparable listings found to be of benefit include:
Phospholipids
Cholesterol
Essential fatty acids (called EFAs)
Linoleic acid
Arachidonic acid

Ceramides are necessary for the skin’s water-retention capacity as well as for cell regulation. Adding ceramides to skin-care products can help to restore the skin’s barrier system.

Facial Masks

Masks are designed as an intensive treatment for various skin problems. Masks fall into two general categories:

Setting masks harden and dry after a few minutes of exposure to air. They are used for cleansing, to remove surface dead cells, and to absorb sebum. Setting masks are good to firm mature skin by trapping moisture in the surface layers.

Non-setting masks are moisturizing and soothing masks. They do not harden or dry but absorb very readily. These masks are intended for dry and sensitive skins.

A mask is ingredients such as herbs, vitamins, and oils combined with clay, seaweed, or hydrating bases that together tightens, tones, hydrates, and nourishes the skin. Masks come in powder form or are already premixed.

They provide numerous benefits for the skin:

• Tighten and tone the skin
• Draw impurities out of the pores
• Clear up blemishes
• Hydrate
• Nourish
• Calm and soothe
• Rejuvenate the skin

Clay masks draw impurities to the surface of the skin as they dry and tighten, and stimulate circulation. These masks contain clay, kaolin, bentonite, or silica for their tightening and sebum-absorbing effects. Stronger clay masks are used on oily and combination skin. Clay-based masks with sulfur have healing and antiseptic properties and have a beneficial effect on acne.

A couple of things to consider in choosing a mask:

1. Pinpoint the skin care issue that needs attention and your skin type. Masks provide a good boost to common skin concerns such as acne, dullness, oiliness, and dryness.
   
2. Look for moisturizing and nourishing ingredients. For dry and flaky skin, moisturizing masks add a good boost of hydration. Look for these ingredient; glycerine, honey, plant oils, and antioxidants. For acne prone skin look for ingredients such as salicylic acid, glycolic acid, sulfur, and tea tree oil. To deep clean and clarify oily skin, ingredients such as green clay, umbrian clay, and kaolin clay give skin a fresh appearance.

Facial masks are most commonly used by women but are also used by men.

Products worth recommending:
Dermalogica and Peter Thomas Roth both offer masks for all skin conditions.

Dermalogica Masques: (To find a salon near your location www.dermalogica.com)

• Skin-Hydrating Masque is an orange flower based masque used on all skin conditions to hydrate and replenish.
• Skin Refining Masque is a clay-based mask designed to absorb oils and refine texture. Good for acne prone/oily skin conditions.
• Anti-Bac Cooling Masque for acne-prone skin conditions works in reducing inflammation and regulates sebum.
• Intensive Moisture Masque used for dry to ultra-dry skin conditions. This masque features essential fatty acids and honey to restore moisture and help to alleviate fine, dry lines.
• MultiVitamin Power Recovery Masque used for sun damaged and irritated skin with vitamins A, B5, C, E and F to provide repair.

Peter Thomas Roth Masques: (Sold in retail stores and on line www.peterthomasroth.com.)

• Cucumber Gel Masque is an anti-irritant gel masque for all skin types. Recommended for daily use as a hydrating and calming masque.
• Hydrating Nutrient Masque is a non-drying nutrient clay masque that adds moisture and anti-oxidants to dry, dehydrated, sensitive and mature skin.
• Oxygen Detoxifying Masque is rich in advanced bioactive and anti-oxidant vitamins. This masque revitalizes dull. Congested skin and helps tighten pores and improve the appearance of fine lines and wrinkles.

PTR Acne Masques include:

• Sulfur Cooling Masque is an aromatic medicated masque with eucalyptus, sulfur and purified clay designed to exfoliate dead skin cells and inflamed acne.
• Therapeutic Sulfur Masque is a medicated masque with sulfur and purified clay designed to exfoliate dead skin cells for problem and non-sensitive skin types. Cleanses oily, T-zone and clogged pores.

A good mask can noticably improve the appearance of the skin.

Getting to Know the Skin You're in

When we’re looking in the mirror we rarely think about the function of our skin nor do we know what is going on under its surface. Let’s take a closer look at the skin we’re in.

Our skin is divided into three layers:

1. Epidermis serves as a protective barrier consisting of five layers.
2. Dermis is the skin layer below the epidermis. It is thicker and provides the main ingredient for holding skin together.
3. Subcutaneous Layer is an important insulating layer providing cushioning and protection.

The epidermis contains 5 layers. From top to bottom, the layers are named:

Stratum corneum (top layer)
Stratum licidum
Stratum granulosum
Stratum spinosum
Stratum basale (bottom layer)

The epidermis is strong and is constantly renewing and growing from the bottom upward.
The bottom layer, the stratum basale, has cells that are shaped like columns. In this layer the cells divide and push already formed cells into higher layers. As the cells move into the higher layers, they flatten and eventually die.

The top layer of the epidermis, the stratum corneum, is made of dead, flat skin cells that shed about every 2 weeks. This layer provides your body with an overcoat that protects deeper cells from damage, infection, and from drying out.

The Epidermal Structure

“The most frequently occurring epidermal cell is called the keratinocyte, or cornifying cell. These cells are produced in the lower levels of the epidermis and then migrate gradually outward over a two-week period. The outermost part of the epidermis is known as the stratum corneum, or horny layer, and by the time the keratinocytes reach this part of the epidermis, they have changed from plump, round cells with nuclei to flattened cells that have started to lose their nucleus. This takes another two weeks. This process is known as cornification and is important in helping the skin to fulfill its function as a barrier,” according Dr. Nicholas Lowe author of Away with Wrinkles.

Skin Structures in the Dermis

The Dermis is the layer of skin that lies under your epidermis. The dermis is composed of three types of tissue that are present throughout but not in layers.

The types of tissue are:

• collagen
• elastic tissue
• reticular fibers

The Dermis contains sensory nerves, sweat glands, blood vessels, and hair follicles.

Subcutaneous Tissue

The subcutaneous tissue is a layer of fat and connective tissue that houses larger blood vessels and nerves. It is mostly made up of fat cells called lipocytes that are held together by collagen bands. This layer is important in the regulation of temperature of the skin itself and the body. The size of this layer varies throughout the body and from person to person.

All three main layers; the epidermis, the dermis, and the subcutaneous layer play an important part in how the outer surface of the skin appears. At the surface, skin is a tough outer layer that keeps the body waterproof and protected from invaders such as the sun, cold, burns, viruses, and other germs. But it also fights off the stress we inflict upon it with razors, bleaches, hair products, makeup, and abrasive skin-care products.

Finding the Right Moisturizer

Moisturizers are products formulated to add moisture to the skin. Lotions, hydrators and creams are all referred to as moisturizers. Depending on the formula, moisturizers can seal in moisture and protect the barrier layer of the skin. They can also hydrate and balance the oil/water moisture content of the skin.

Moisturizers are available for all skin types ranging from acne-prone skin to dry and mature skin. Even oily skin needs hydration or it will have overcompensated for dryness and produce more oil or become dehydrated.

The more oil a moisturizer contains the more effective the moisturizer becomes however, the greasier and the more unpleasant it feels. Thus, it is more likely to aggravate acne in people with oily and combination skin. Oil-based moisturizers contain emollients and are designed to protect the surface of the skin and trap water under the cream.

“Moisturizers can also be a source of acne-producing substances. In order to make these moisturizing products smooth onto the skin easily, they’re often manufactured with ingredients such as acetylated lanolin, searic acid, and cetyl alcohol. All of these ingredients are considered to be comedogenic,” says Dr. Herbert P. Goodheart, dermatologist and author of Acne for Dummies.

Moisturizers also function as humectants, i.e., by actually attracting water into the stratum corneum to hydrate the skin. Examples of this are glycerine and sodium hyaluronate, both of which are moisturizing ingredients. Hydrators also known as humectants, are ingredients that attract water to the skin’s surface. An example would be sorbitol, seaweed extracts, and algae extract.

Keeping moisture in the skin preserves the skin’s youthful freshness. Water is held in the skin by certain lipids, or fats. Dermatologist, Dr. Leslie Baumann recommends consuming omega-3 fats to hydrate the skin. Contrary to popular belief, drinking water will not help skin dehydration although it is helpful for other reasons.

Dr. Baumann is the author of The Skin Type Solution and has recommended a specific moisturizer when confronting facial redness. She says, “Due to your skin’s naturally occurring oil, moisturizers may clog your pores and increase oiliness.” Dr. Baumann recommends using Rosaliac Hydrante Perfecteur by La Rohe-Posay, because it contains thermal water with selenium and niacinamide, both of which are good anti-inflammatory ingredients.

Dermatologist Dr. Neal Schultz author of It’s Not Just about Wrinkles, describes the effect of moisturizers on various skin types:

• Extremely dry or mature skin type when using an oil–based moisturizer produces an extremely moist effect.
• Very dry or mature skin type when using absorption type moisturizer produces a very moist effect.
• Dry skin type using water-in-oil emulsion moisturizer gives a moderately moist effect.
• Normal to dry skin type using oil-in-water emulsion moisturizer produces a mildly moist effect.
• Normal to oily skin type using oil free, water based moisturizer gives a slightly moist effect.

Finding the right moisturizer is an integral part of any skin care regimen. Water-based moisturizers increase the water content on the outer layers of the skin and give it a softer, more comfortable feel. Oil-based moisturizers work by holding in or retaining existing moisture.

What's an Ultrasonic Facial?

An ultrasonic facial is a facial using ultrasound frequency that works with the skin layers. Dermasound is the trade mark name for Glymed Plus, www.glymedplus.com. This technology uses low frequency ultrasound to loosen and remove dead cells and debris from the skin’s surface. DermaSoundTM Elite is a simple, three-stage system for mechanical exfoliation, molecular product penetration and healing micro amp therapy.

Three phases are incorporated using the ultrasound frequency:

1. Peeling Phase
2. Lead-in Phase
3. Patting Phase

The Peeling Phase helps to remove between 20%-50% of the stratum corneum which is the layer we are continuously shedding. This phase provides exfoliation with no irritation or inflammation. It uses no crystals, salts or chemicals. How does it work?

A product is used to help retain water on the top of the skin and filtered water is applied. By using the wand applicator (hand paddle) and by lightly pushing the water over the skin, creates a plume from the water. This spinning of the water molecules on the skin is what separates out the corneocytes, removing dead skin cells.

The Lead-In Phase consists of penetrating specific product chosen for the client. The lotion, cream, or serum is applied to the skin. The hand paddle is then lightly pulled over the skin. The ultrasound frequency penetrates the product.

Antioxidant infusion takes place when low frequency ultrasound waves open microscopic pathways between the cells through which a chosen treatment product can flow. This penetration reaches the deepest layers of the dermis where new cells are forming new skin.

The Patting Phase normalizes the skin. The paddle is lightly pulled in sections over all areas of the skin. This creates a slight pulsing and warming on the face. The low level electrical current reaches injured cells and restores them to normal balance and function. The padding phase helps to normalize the electric current within the cells and promote regeneration of healthy ones.

The benefits of an ultrasonic facial:

• Provides greater penetration of product to help hydration, acne, fine lines and wrinkles
• Helps to breakup and kill bacteria for acne or problem skin
• Stimulates and promotes collagen and elastin reproduction

The Ultrasonic Facial is a simple, painless treatment that offers another means for removing dead skin cells and penetrating product.

Active Ingredients are great performers.

If you were to compare skin care products and ingredients of a retail store to that of a professional line, you would realize that some products are better than others.
The main difference between a cosmetic product from a pharmaceutical is that the cosmetic’s ingredients will remain on the surface of the skin and the pharmaceutical will penetrate.

Active ingredient defined by Milady’s Skin Care and Cosmetic Ingredients Dictionary, is an ingredient with “treatment value.” When placed on the skin, it would perform a therapeutic or beneficial function such as healing, hydrating, soothing, and toning.

Ingredients can be derived from plants, vitamins, or animals, and are also synthesized from chemicals. A preservative is an inactive ingredient which is necessary to the product formulation. What allows products to spread, gives them body and texture, and a specific form such as a lotion, cream, or gel are the functional ingredients.

Active ingredients are sometimes called performance ingredients. They are used in prescription-only products and cause the actual changes in the appearance of the skin.

Examples: glycerin which hydrates the skin surface; alphahydroxy acids AHAs which exfoliate the corneum; and lipids which help patch the skin’s barrier.

Use of an Active Ingredient

We choose active ingredients according to our skin type. When using the right active ingredient in the appropriate form such as solution, serum, cream, lotion, or ointment, the result of the product becomes evident.

“Sometimes you will need to use more than one active ingredient; the synergistic mechanism of two or more active ingredients can often increase efficacy and results” said Dr. Neal B. Schultz author of It’s Not Just About Wrinkles. He goes further to say, “When using more than one active ingredient, begin with the product that is in the lightest form. A lighter product will never penetrate a heavier product.”

First: Use water or alcohol-based products;
Second: solutions, serums, or lotions;
Third: creams;
Last: petroleum-based products.

In Away With Wrinkles, author and dermatologist Dr. Nicholas Lowe, clarifies what to look for in the active ingredients of creams:

• Moisturization from humectants such as glycerine or sodium hyduronate


• Antioxidant mixtures, e.g. vitamin E (tocopherols), vitamin C (ascorbic acid, ascorbyl palmitate)


• Low levels of retinoids, such as retinal, retinaldehyde, and vitamin A

What about Cosmeceuticals?

Cosmeceuticals are products intended to improve the skin’s health and appearance. They are scientifically designed topical products that meet chemical, pharmaceutical and medical standards but they do not change the structure and function of the skin. In other words, they are not classed as pharmaceutical prescription creams. They contain ingredients that influence the biological function of the skin. Cosmeceuticals improve appearance, and they do so by delivering nutrients necessary for healthy skin (e.g. neither too dry nor too greasy.)

Dermatologist Patricia K. Farris, MD, FAAD, clinical associate professor of dermatology at Tulane University School of Medicine in New Orleans states:

“Cosmeceuticals are divided into three categories based on their active ingredients:

1. Anti-oxidants can reduce the harmful effects of free radicals, which are molecules that injure the skin's cells, causing inflammation, increasing sun damage and contributing to the development of skin cancer.


2. Peptides are smaller proteins that stimulate the production of collagen and thicken the skin.


3. Growth factors are compounds that act as chemical messengers between cells and play a role in cell division, new cell and blood vessel growth, and in the production and distribution of collagen and elastin.”

Dr. Patricia Farris recommends:
For day, wear sunscreen and consider also using products containing anti-oxidants, as they have sun-protection properties. At night, use products containing retinoids, peptides or growth factors for their repair properties.

What is Microdermabrasion?

A microdermabrasion treatment is a mechanical form of exfoliation that uses very small crystals which is vacuum sprayed (sucked) across the surface of the skin, causing the removal of surface skin cells. It is akin to a glycolic peel that only removes part of the uppermost layer of the epidermis. Microdermabrasion machines are used in skin care clinics, spas and medical offices.
The treatment entails spraying microcrystal’s composed of aluminum oxide, salt, sodium chloride, or sodium bicarbonate across the skin’s surface through a closed stainless steel or glass pressurized wand. By employing the mechanics of negative pressure over the surface of the skin, the dead cells are exfoliated.

Dermatologist and skin surgeon, Dr. Nicholas Lowe, author of Away with Wrinkles, states, “Microdermabrasion has been shown to be particularly beneficial when used in conjunction with glycolic acid chemical peels and topical creams such as Retin-A and skin-lightening combinations for problems such as facial pigmentation (such as dark skin or mask of pregnancy).”

The depth of the microdermabrasion treatment is created by several factors including:

• Method of skin preparation
• Number of passes over the skin
• Level of suction on negative pressure machines (stronger suction will create a more aggressive treatment). The same can be said with pressure of the hand piece over the skin.
• Frequency of treatments and the condition of the skin
• Use of an AHA peel either pre-treatment or post treatment

According to Michelle Palmer, a Certified Traditional Naturopath and Medical Esthetic Specialist and member of the Editorial Team of Medical Esthetics said, “The benefits of microdermabrasion to the skin have been claimed to reach far beyond simple exfoliation of the epidermis. It has been claimed to accelerate skin cell turnover. And by stimulating fibroblast activity, it is believed to actually increase collagen production.”

Useful Tool for Treating:

• Thick, rough skin.
• Comodones and small acne spots
• Irregular pigmentation
• Small, shallow scars
• Dull skin by increasing circulation, making the skin look revitalized
• Fine lines and minor wrinkles
• Enlarged/clogged pores
• Excessive oiliness

Contraindications of microdermabrasion:

• Rosacea
• Oral blood thinners
• Skin cancer and auto immune disorders such as HIV or AIDS
• Vitiligo
• Telangiectasias
• Eczema of seborrheic dermatitis
• Sun burned skin
• Viral lesions, Herpes Simplex, Shingles
• Active, uncontrolled or brittle diabetes

If microdermabrasion is correctly performed, there should be no visible problems other than a slight pinkness of the facial skin. If the treatment is performed too deeply, there can be surface bruising and a change of skin color.

"While the vast majority of microdermabrasion patients experience visible improvements after just one microdermabrasion treatment, long-lasting results are only achieved through multiple sessions. Most aestheticians and cosmetic dermatologists recommend that patients have between four and eight treatments at two to three-week intervals. Many microdermabrasion advertisements of salons, spas, and dermatologists quote the price of a single session. However, some salons and dermatology practices have special microdermabrasion packages that lower the price of multiple sessions," http://www.docshop.com/.

According to the American Society of Plastic Surgeons, the cost of microdermabrasion ranges from $75 to more than $200 per session. Microdermabrasion is a relatively safe treatment, when performed by an adequately trained skin care or medical professional, with properly maintained equipment.

What’s good about AHAs, BHAs and BPOs?

Alpha hydroxy acids (AHAs)

The family name for a group of naturally occurring acids referred to as “fruit acids.” AHAs are derived from a variety of sources including sugarcane, apples, grapes, citrus fruits, sour milk and rice. They are used in moisturizers, emollients and exfoliants. Their activity and benefits are dependent on the type of AHA used, the concentration employed and the pH of the formula.

They are proven to produce a reduction of fine lines and superficial wrinkles, a lightening of surface pigmentation, and softer skin with improved hydration. They work by dissolving the “glue” that holds dead cells together on the surface of the skin.

The three most commonly used alpha hydroxy acids are lactic acid, glycolic acid and pyruvic acid:

• Lactic acid is used mostly as a body moisturizer to remove superficial, scaly dead cells and to lessen the rough, irritated skin that occurs on arms and legs. Lac-Hydrin 30 is a higher concentration of lactic acid available by prescription only. Lac-Hydrin 30 joins Renova as the creams that reverse some of the sun aging process.

• Glycolic acid is used for restoring even color and smooth texture to the skin. The strength of glycolic acid is crucial to its effect. Dermatologist Dr. Neal Schultz, author of It's Not Just About Wrinkles believes, “glycolic acid is the most effective active ingredient with the widest therapeutic margin -of all the keratolytics. You have to use it in the right strength and form to see results.”
  Over-the-counter glycolic acids generally contain less than 10 percent (3 or 4 percent) of glycolic acid whereas prescription strength glycolic acids generally contain more than 10 percent free acid concentration.

• Pyruvic acid is used in doctors’ offices to do a controlled peel of the skin. It’s designed to remove enough layers of the skin to cause crusting.

Beta hydroxy acid (BHAs)
Beta hydroxy acids are naturally derived compounds. Salicylic acid is the best known example of a beta hydroxy acid. Used to reduce wrinkles and dry flaky skin, aging skin, acne and can help reduce mildly uneven pigmentation. Salicylic acid is classified as an aromatic acid that is primarily used to treat childhood and teenage acne. Since the anti-aging market arrived the uses of salicylic acid expanded into astringents, cleansers, creams and chemical peels.

Dermatologist Dr. Lawrence Green, author of The Dermatologist’s Guide to Looking Young states, “At present salicylic acid is also being used to help reduce the appearance of sun-damaged skin. Some dermatologist believe that salicylic acid, used in superficial peel strength formulation, can be as effective as but less irritating than alpha hydroxy acids in reducing sun damage.”

Benzoyl Peroxide (BPO)
A drying ingredient with antibacterial properties commonly used in acne treatments. It irrigates and sloughs out acne impactions. BPOs reduce the level of free fatty acids and the level of skin infection. The function of BPOs is to force peroxide into the pilosebaceous orifice to reduce the population of P. acnes . "Benzoyl peroxide dries and peels the skin and removes dead cells, helps to clear blocked follicles, the non-inflammatory comedones, and it works on the papules and pustules," states Dermatologist Herbert P. Goodheart author of Acne for Dummies.

AHAs and BHAs can be added to gels, lotions, serums, or creams. However, recent research suggests that alpha hydroxy acids may make the skin more sensitive to sunlight according to Dermatologist Dr. Leslie Baumann. Therefore, do not be lax about sunscreen use.

Guidelines for an Effective Skin Analysis

An accurate skin analysis requires not only skill, but the ability of the skin therapist to apply their knowledge about skin types and skin conditions into the factors that affect the skin’s health. Start by looking at the skin’s visible appearance and ask yourself.
What active ingredients will best meet the needs of this particular skin type and the conditions that are present?

While it is easy for a client to look in a mirror and see issues on their skin, it is the skill of the skin therapist to ask the client some qualifying questions about their skin before the facial.
For example:

When was the first time you loved the look and feel of your skin? What did you like about it?
What challenges are you currently having with your skin?
If you could change anything about your skin, what would it be?
What products are you using for your skin care? Are you pleased with the results?

Analyzing the skin starts with looking and touching the skin.

Visually noticing the client’s skin before cleansing is extremely helpful for certain issues will be eliminated once the skin is cleansed. In particular, looking to see if there are areas with an oily shine, flakiness, or if erythema is present. These visual observations along with a thorough health consultation enhances facial treatments.

An effective skin analysis starts by using either a magnifying lamp/light or the woods lamp. Once the client is cleansed, then the detail observation can be charted.

Guidelines:

Skin Type: Identify whether the skin is a Normal, Dry, Oily, Combination, or Sensitive Skin Type.

Secretion: Determine whether the client is oil-rich, oil-poor, or has a balanced oil production. Oil-rich is within the T-Zone and oil-poor falls outside of the T-Zone.

Hydration: Identify whether the condition of the skin is dehydrated, lacking water by signs of tightness, and flaking of the skin. By pinching the skin together on the forehead, does the appearance of tiny lines show? Does the area around the lips appear cracked and dry? If so, then the skin is dehydrated. A hydrated condition feels soft and moist. If the skin springs back upon pinching the forehead without any tiny lines then the skin is hydrated.

Sensitivity: Note the blood circulation especially if the sensitivity is more or less after cleansing than before. Normal circulation shows a healthy pink look. Over stimulated circulation has the appearance of redness. Sluggish circulation has a pale, yellow, sallow appearance.

Texture: Run your fingers across the skin and feel if there is any lack of slip or ease. Observe flakes and the presence of large pores that are most obvious on the nose, lower forehead, chin, and inner aspects of the cheeks. Chart whether the skin is fine-textured with small pores; even textured with medium pores; or rough textured with large pores.

Pigmentation: Identify the skin tone. Hyper pigmentation is an over production of pigment contributing to areas of brown discoloration. Hypo pigmentation lacks pigment contributing to any white, colorless areas.

Lesions: Identify if any red lesions are present.

• Telangiectasias are most common on the side of the nose. Dilated blood vessels appearing as tiny straight or curved red lines.


• Cherry hemangiomas are tiny and round, bright red spots that occur as a function of getting older.


• Spider hemangiomas are small red raised spots with little red lines emanating from the center.


• Red blotches are a large cluster of tiny enlarged blood vessels that appear as a red spot.
  Also, note any comedones, papules or milia present.

Muscle Tone: Determine the elasticity of the skin. The area under the chin is the best indicator. If the skin under the chin springs back easily it is a Firm tone. If the skin is less elastic then it is a Lax tone. If the skin has no spring or elasticity then it is a Slack tone.

There are many different types of facials, peels, products and ingredients available for each skin type. Effective care of the skin offers solutions that allows for customization. However, before making any product or facial recommendations, “The standard in the industry has to include a complete analysis of the skin,” said An G. Hinds, the president of Catherine Hinds Institute of Esthetics in Woburn, MA.

What's the Focus of a Facial?

Facials help to maintain the health of the skin and correct certain skin conditions through deep cleansing, massage, the use of masks and other products, and various treatment methods. But, the focus for providing a facial treatment, needs to be clarified.

There are four overall objectives in performing a facial treatment:

1. Balance the hydrolipidic film
2. Inhibit keratinization
3. Control the metabolism of the skin
4. Control conditions

Balance the Hydrolipidic Film

The hydrolipidic film is made up of water and sebum and protects the skin from becoming dehydrated. It is responsible for maintaining the flexibility of the skin. The goal of the skin therapist is to create a balance of oil and water by the use of correct products.

If the skin is oilier, the skin therapist uses water based products. If the skin is dehydrated and oil dry, the skin therapist uses oil based products.

Inhibit Keratinization

Keratinization occurs when the dead skin cells remain dormant and lifeless on the surfaces of the skin. Through means of exfoliation the buildup of these skin cells, oil, and debris on the surface of the skin is inhibited resulting in a fresher, healthier look.

The skin functions better when this is maintained and can be accomplished by the skin therapist using either topical peeling agents, enzymes, scrubbing or microdermabrasion.

Control the Metabolism of the Skin

Controlling the metabolism of the skin can be done with either a stimulation process or a sedation process. When the goal is to minimize the appearance of sluggishness, congestion, blackheads, and milia by methods of stimulation the skin therapist applies steam, heat, or massage. When the goal is to minimize the appearance of irritation by methods of sedation the skin therapist will applied cold packs, or masks.

Effective stimulation helps the skin by supplying increased amounts of nutrients to the skin, inhibiting the degeneration of collagen and elastin fibers, and slowing the reproductive abilities of the cells in general. Stimulation is the key to an effective skin care program.

Some examples of stimulation's methods:

Chemical/Acid Peels, Topicals with Low pH, Warm towels, Steam,
High Frequency, Microdermabrasion, Electronic Stimulators, Massage

Sedation slows down the rush of blood flow to the skin which results in a non-irritated state.

Some examples of sedation methods:

Cool towels, Ice packs, Soothing Masks, Soothing Topicals, Vascular Lasers

Correct Conditions

After making an effective skin analysis and determining what condition is present, associate the condition with either being stimulated or sedated. Help to correct the specific condition(s) within the skin by various methods of stimulation or sedation techniques or the use of topical products.

For a prescription-strength product line used by physicians, skin care therapists, and patients, Obagi Medical Products can help transform your skin http://www.obagi.com/.

Skin therapists have many tools in which they can affect the outer most layers of the skin, as well as, the internal mechanisms within the tissue to minimize certain skin conditions and achieve healthier skin.

Some comments about Skin Conditions

Skin conditions are defined as an abnormal appearance, texture or coloring of the skin. The causes include both intrinsic and extrinsic factors that affect the skin.

The intrinsic factors include:
Free radicals, dehydration, vitamin deficiency, hormones/menopause, smoking, improper nutrition, alcohol, caffeine, lack of sleep, stress, response from some medications or the symptom of an inflammatory response.

The extrinsic factors include:
Sun damage, environmental exposure, pollutants, humidity, poor skin care and misuse of skin care products. Also allergies, genetics/ethnicity, and medical conditions such as, heart conditions, diabetes, lupus, and pregnancy are considered extrinsic factors.

Skin Conditions

Being able to distinguish between a skin type and a skin condition is necessary in providing a facial treatment. Making this an important point in their education is the International Dermal Institute, which offers postgraduate education in skin and body therapy, www.dermalinstitute.com . As part of their education, five skin conditions are presented enabling the skin therapist to effectively identify and help to correct with the use of Dermalogica products for treatment. These conditions are the following:

• Dehydrated
• Sensitized
• Pigmentation
• Aging/Premature
• Congested/Breakouts

The most common skin condition is adult acne.

The following skin conditions are also of concern and are seen most often by estheticians:

• Milia: whiteheads filled with oil and dead skin cells beneath the surface of the skin.
• Erythema: redness caused by inflammation.
• Keratosis: a rough hardened texture resulting from a build-up of cells.
• Seborrhea: oiliness of the skin caused by over production of the sebaceous glands.
• Telangiectasias: dilated blood vessels particularly common on the nose resulting from weakening of capillary walls, sun exposure, rosacea, alcohol consumption, pregnancy, and birth control pills.
• Hyperpigmentation: brown discoloration in irregular patches.
• Hypopigmentation: white discoloration in irregular patches.
• Rosacea: characterized by redness confined to central part of the face; papules and pustules, swelling of the nose, and spider veins.
• Asphyxiated: a dull, sallow, yellowish color skin with clogged pores and wrinkles common with smokers.
• Wrinkles/aging: deeper facial lines and signs of sun damage; poor elasticity.

African American Skin
Certain skin conditions are more common among African Americans:

• Post-inflammatory hyperpigmentation - area of skin darkens after a cut/scrape or in cases of acne.
• Vitiligo - pigment cells are destroyed resulting in irregular white spots or patches on the skin.
• Keloid scars – develop when a raised scar spreads beyond the size of the original wound.

Overall, improving your knowledge of skin conditions and understanding what can affect the skin, better prepares you for treating your client and helping them cope with their concerns.

What's the skinny on skin types?

Skin type is determined by genetics and ethnicity. The amount of oil secretion in the skin is a key factor for defining a skin type. The cosmetic giant Helena Rubenstein was the first to divide skin into four categories: Normal, Combination, Dry and Sensitive.

The distinction regarding skin type is whether or not you have excessive oil production. This factor determines if you can use products that contain oil. Today, licensed estheticians and skin therapists work with these five skin types:

• Dry skin: Feels dry and tight, has a dull color, small tight pores, texture can be rough, spots of flakes, and prone to wrinkles. This skin type does not produce enough oil.

• Normal skin: Feels soft, moist, and plump. Free of blemishes, normal pore size, and has a healthy color. Little or no wrinkles or fine lines. This skin type has a good oil balance.

• Combination skin: Feels a little dryer or oilier a short time after cleansing. Forehead, nose and chin, (T zone area) is oilier with larger pores in this area. The outer areas of the face can be dry. This skin type has oily and dry areas at the same time.

• Oily skin: Feels greasy, looks shiny, and pore size is larger over most of face. Skin texture is course with comedones and possible breakouts. Little wrinkling is present. This skin type has excessive oil production.

• Sensitive skin: Feels delicate, thin, and blood capillaries can be visible. Erythema (redness) is present. Vulnerable to skin reactions. Easily irritated through friction, or heat. This skin type has areas of dry or areas of balanced oil production.

The advanced field of dermatology has emerged with a broader range of skin differences. Dr. Leslie Baumann, author of The Skin Type Solution, and Director of Cosmetic Dermatology at the Miller School of Medicine identified sixteen skin types, http://www.drbaumann.com/. The Baumann Skin Typing System (BSTS) measures four factors for typing your skin:

• oily vs. dry
• sensitive vs. resistant
• pigmented vs. non-pigmented, and
• wrinkled vs. tight.

BSTS reports four very different subtypes of sensitive skin:

1. Acne subtype: develops acne, blackheads, or whiteheads
2. Rosacea subtype: develops recurring flushing, facial redness, and hot sensation
3. Stinging subtype: develops stinging or burning of skin
4. Allergic subtype: develops redness, itching, and flaking of skin.

Dr. Wendy Roberts, a specialist in cosmetic dermatology and the needs of ethnic skin, is founder of Desert Dermatology Skin Institute and pioneered the Roberts Skin Type Classification System (RSTCS) http://www.wendyrobertsmd.com/. The RSTCS identifies skin type characteristics and provides data to predict the skin’s likely response to insult, injury, and inflammation for individuals of global skin types.

Having knowledge and information about your skin type empowers you to know how to care for your skin, by using skin care products that are most beneficial for your skin type.

Exfoliation allows new skin layers to emerge

The process of removing excess accumulations of dead cells from the corneum layers of the epidermis includes superficial peeling, exfoliation, keratolysis and desquamation.

Exfoliation is defined as the peeling or sloughing of the outer layer of skin. We exfoliate to speed up the breakdown of dead keratinocytes, which are scale-like cells found on the skin’s surface. This is accomplished manually (scrubs) or chemically, by the use of specific products (glycolic acid) formulated to achieve specific results.

Cell Renewal Factor

A natural process that slows down with age is the cell renewal factor (CRF). CRF is what keeps cells from building up. Dead cells made primarily of soft keratin called keratinocytes, are continually shed and replaced by new cells coming to the surface of the corneum.

The average CRF rate for adults 50 years and older is 42-84 days. This may appear normal. However, when the adult CRF rate is compared to the CRF rate of babies which is 14 days; adolescents, 21-28 days; and then middle-age adults which is 28-42 days; the need to exfoliate once or twice a week is clearly understood. Gentle exfoliation helps the skin to look more alive and healthy.

Two types of exfoliation treatments

Mechanical is a method of rubbing dead cells off the skin by granular scrubs, or by the use of brushing machines. This is done once or twice a week depending on the skin type. Exfoliate occasionally if you have rough or dry skin.

Mechanical exfoliating ingredients such as, polyethylene and jojoba beads are added to cleansers or granular scrubs to physically rub dead cells off of the skin. Newport Cosmeceuticals, Buffing Granules is one such product, www.newportcosmeceuticals.com.
Pevonia Botanica, Gentle Exfoliating Cleanser combines soapwort, horse chestnut and chamomile to eliminate dead cells, www.pervonia.com. These products can be found at salons and spas.

Chemical exfoliation dissolves dead skin cells by chemical agents. Alphahydroxy acids (AHAs) and betahydroxy acids (BHAs) work by loosening the bond between cells “intercellular glue” in the surface of the corneum. Enzyme peels are designed to digest the dead cells on the surface. They can be a cream or powder that produces a more even peeling of cell-build up. Peels use keratolytic enzymes that break down the keratin protein in the skin. The most often used are papain and pancreatin.

Benefits of Exfoliation:

• Increases cell turnover rate more rapidly
• Improves the skin’s ability to retain moisture
• Facilitates effective delivery of product ingredients into the epidermis
• Stimulates blood flow
• Produces smoother skin

With any good thing, one needs to be careful. Over-exfoliation can cause irritation, damage the skin and capillaries, and impede normal cellular functions.

An important note, skin care therapists/estheticians use treatments designed to penetrate only the epidermis. Dermatologists, use procedures designed to penetrate the dermal layer of the skin.

Acne at any age can be a problem

Both adults and teens are troubled by acne. Quoting GlyMed Plus, “Acne is the most common dermatological problem faced by physicians and their patients in the U.S. today. Stress, diet, puberty, sunlight, pregnancy, cosmetics, menopause – all of these and more, contribute to the many types of acne that plague most of us at some time in our lives.”

GlyMed Plus is an acne management skin care product line intended for use as part of a supervised skin care program. http://www.glymedplus.com

Acne is a chronic inflammatory disorder of the sebaceous (oil) glands, characterized by comedones (blackheads) and blemishes. A genetic disease also referred to as Acne Simplex or Acne Vulgaris. Acne is found on the face, back or chest and the skin appears greasy. It ranges from mild breakouts to disfiguring cysts and scarring. Flare ups usually begin when reaching puberty however, adult acne is quite common.

A progressive deterioration includes the following:

• Lesions: any mark or abnormality.
• Comedones: clogged pores filled with oil and dead skin cells. Blackheads are dark because they are exposed to air.
• Papules: a pimple containing no fluid.
• Pustules: an inflamed papule containing pus.
• Scarring: light-colored mark formed by tissue loss after a lesion has healed.
• Nodules: small bumps caused by scar tissue, fatty deposits, or infections.
• Cysts: nodules made up of pockets of infection.

Since acne is triggered by hormonal changes, having a good understanding of its causes is important.

Causes:

Clogged pores - dead skin cells that haven’t shed and the pores are filled with sebum (oil).

Bacteria –an overproduction of oil causes a buildup of additional cells. Inflammation occurs.

Cosmetics and product ingredients - Certain ingredients like waxes, oils, heavy emollients can trigger acne.

Hormones, stress, and foods - Stress causes hormonal fluctuations which increases sebum production. Processed and packaged foods, especially fast foods can irritate acne. Foods high in iodine such as, shellfish, seaweed, iodized salt, MSG, kelp, cheese can lead to breakouts.

The severity of acne is determine by the amount/number of lesions, comedones, papules, pustules or cysts present. Acne is classified into four grades.

Grades of Acne:

• Grade I -Minor breakouts, open comedones , a few papules and pustules.
• Grade II -Many open and closed comedones (whiteheads), and more papules and pustules
• Grade III -Skin is red and inflamed. Many papules and pustules
• Grade IV -Inflammation is present. Cysts with comedones, papules, and pustules.
  This grade is called Cystic Acne. Larger lesions have the appearance of ice pick scars; thick, deep, and narrow where the pore is stretched.

Grades III and IV can only be treated by a physician or dermatologist.

Acne can have a permanent effect on the appearance and condition of your skin. Most importantly, it can affect your self-esteem and sense of well-being throughout your life.

Grades I and II acne are treated by licensed estheticians/skin therapists with regular facial treatments and recommended home care products.

A few good comments about facial cleansing.

How many of us know someone using regular bar soap to clean their face? When was the last time a client told you they have been using soap for years?

One of the first things learned in esthetics school is how highly alkaline soap can be to the face. It can damage the acid mantle and cause dryness. The acid mantle is a protective barrier on the skin formed by sweat and sebum. The pH of the acid mantle is between 4.5 and 6.2. It’s important to keep the pH at a safe level and skin care products are designed to produce a safe and non-irritating product to the skin.

Why do we cleanse?

We cleanse to remove dirt, oil and makeup. Cleansers dissolve makeup and prepare the skin for other products. Dermatologist Dr. Neal B. Schultz, author of It’s Not Just About Wrinkles writes, “Cleansers range from very moisturizing to very drying and should be chosen to match your skin type. A lot of cosmetic companies market lipid cleansers because they are very effective in removing oily makeup. These cleansers leave an oily residue and are especially effective on dry skin. They are also gentle and effective for mature or sensitive skin. However, highly alkaline soaps and detergents are extremely drying and should be avoided.”

There are many cleansers on the market designed for all skin types and skin conditions. For instance; cleansers containing ingredients like glycolic acid hydrate, exfoliate, and moisturize the skin and antioxidants help prevent wrinkles.

Cleansers come in three basic forms:

• Face washes
• Lotions
• Creams

Foaming cleansers are face washes and have a slightly acidic pH. Oily or combination skin types usually like foamy cleansers.

Cleansing lotions are water-based emulsions for normal and combination skin.

Cleansing creams are oil-based emulsions. They are heavier than cleansing lotions and usually used to dissolve makeup.

Most facial care products recommend cleansing in the morning and evening however, avoid over cleansing, for this can cause the skin to dry out. It may be necessary to adjust your cleansing routine slightly according to the season, for your skin can change in different environments.

Cleansing the eyes

This area needs to be carefully cleaned. The eyelid skin is very thin and sensitive to irritation. It contains few sebaceous glands and can be prone to dryness. Eye cleansing products containing humectants can help to prevent drying of the eyelid.

Benefits of Cleansing

• Removes dirt from unblock pores.
• Softens dry skin especially cleansers with emollients.
• Helps certain skin problems due to the cleanser ingredients.
• Prepares the skin for applying makeup.

Use a product that rinses clean with water and is not too harsh for your skin.
Peter Thomas Roth has a product line of Creamy Cleansers and Gel Cleansers. www.peterthomasroth.com.
M.D. Forte’ cleansers are free of soap and fragrance. www.mdforte.com

What's the buzz with UVB and UVA rays?

A neighbor of mine mentioned that she'd been to a tanning salon since the weather didn't allow for her to sun bathe at the pool. Even though she's aware of sun damage to the skin, the look of white winter flesh in a black dress at a wedding overruled caring for her skin. How many women would choose the same alternative regardless of knowing the damage caused by ultraviolet light?

Dermatologist Dr. Leslie Baumann, author of The Skin Type Solution writes, "When UV light hits the skin, it stimulates an increased production of skin pigment, which is what we call tanning. This is the skin's major defense against further UV damage. In addition to tanning skin, ultraviolet light worsens melasma and causes sun pots (solar lentigos)."

UVB and UVA

The sun and its ultraviolet light reach the skin in two different forms and influences the skin at two different levels. When frequent doses of UV light penetrate the skin it can alter melanin. Melanin is designed to protect the skin from the sun.

UVB rays cause immediate sunburn. Often referred to as "burning rays." They cause tanning of the skin by affecting melanocytes, (cells that produce pigment granules).

UVA rays cause long term damage. Often referred to as "aging rays." They weaken the skin's collagen and elastin fibers, which causes wrinkles and sagging in the tissues.

The sun and UV rays have a huge affect on how our skin ages. According to MD Formulations, "Even though our skin does "naturally" age, research has shown that 90% of premature aging is due to harmful environmental elements particularly UV radiation or sun exposure."

Most importantly, apply the sunscreen. A broad spectrum sunscreen protects from both UVA and UVB rays. The Sun Protection Factor (SPF) number indicates how many times longer you can stay in the sun before starting to burn while wearing sunscreen than if you were not wearing any sunscreen protection. With a higher SPF number, the concentration of ingredients is higher. Look at the active ingredients listed. The chemicals in sunscreens either interact with skin to prevent the sun from burning it, or physically block the sun. Blocking sunscreens are less common than chemical sunscreens.

Physical sunscreens prevent the sun's rays from penetrating the skin by blocking and reflecting the sun's rays from reaching the skin's surface. All of the sun's rays whether they are ultraviolet A or B are blocked. Two points:

1. Most effective when the ingredient silicone is added to them.
2. Active ingredients: Titanium Dioxide and Zinc Oxide

Chemical sunscreens provide a protective layer of sunscreen ingredients that are quickly absorbed by the skin and can be both waterproof and sweat proof. Several points:

1. Provides Ultraviolet B ray protection or
2. Provides additional protection against ultraviolet A rays
3. Active ingredients: Parsol 1789 and Oxybenzone

Best protection is one with an SPF number greater than 30 and offers protection against ultraviolet A rays.

Check out Dermalogica Solar Defense product line. To find a salon near you visit: http://www.dermalogica.com/