Brenda Linday

Brenda Linday

P. Acnes is now C. Acnes

Aesthetics is an ever-changing industry. Skin care professionals must keep abreast of new ingredients, procedures, laws and regulations, the latest research, scientific discoveries, and recent market trends like the microbiome that affect a spa practice. One such change is the renaming of propionibacterium (p.acnes) to cutibacterium (c. acnes).

The percentage of acneic clients that the aesthetician treats varies based on each spa’s specialties, services offered, and marketing practices. Every aesthetician has personally experienced an increase in clients, friends, or family members with outbreaks of maskne due to the onset of COVID-19, which leads to today’s topic – when did p. acnes become c. acnes?

In the basic aesthetic curriculum, skin care professionals learned that acne lesions contain a bacteria called p. acnes. These pathogenic bacteria are rod-shaped, anaerobic, and gram-positive, with a thick cell wall contributing to their resiliency. This bacterium gets its name because of its ability to produce propionic acid, a naturally occurring carboxylic acid. It is liquid in the form of a foul-smell that mimics body odor.

However, skin care professionals are not taught in school that propionibacterium (p. acnes) has 114 different strains that can affect other parts of the body.

Various propionibacterium strains can cause or contribute to chronic blepharitis (inflammation of the eyelids), endophthalmitis (inflammation of the inner-eye, often following cataract surgery),

shoulder infections (usually the following surgery), intestinal issues (can affect the large intestine),

endocarditis (an infection of the endocardium, the inner lining of heart chambers and valves), and

synovitis (inflammation of the membrane that lines the joints found in between bones that move together.) Hyperostosis (bone growth – a form of arthritis), bacterial osteitis (inflammation of the bone), sarcoidosis (an inflammatory disease that develops abnormal masses called granulomas, affecting multiple organs in the body, mainly the lungs and lymph glands), and prostrate inflammation (could lead to cancer) are also contributing.

This list is by no means all-inclusive; however, with 114 different strains, p. acnes affects far more than just the skin.

So, why was propionibacterium renamed now? This is not the first time that the name of this bacteria has changed. Scientific revelations have caused an evolving transformation in the terminology of p.acnes back to the late 19th century.

PROPIONIBACTERIUM

The pathogenic microorganism, known in medical literature as the “acne bacillus,” was first observed by Paul Gerson Unna M.D., in 1896 under microscopic sections of acne comedones. This was the first modern-day documented connection with the bacteria responsible for acne.

 In 1900, p. acnes was officially identified as Bacillus acnes by Thomas Caspar Gilchrist (honorary) M.D., and in 1923, David Hendricks Bergey, an American bacteriologist, placed “acne bacillus” under the Corynebacterium category, renaming corynebacterium acnes purely based on its similarities to other bacteria in this category. Many years of research continued by bacteriologists and dermatologists alike, with documented studies occurring as long ago as the 1960s.

In 1946, Corynebacterium acnes was transferred to the propionibacterium or p. acnes classification, primarily due to its anaerobic and metabolism properties. It remained there until 2016 when further advances in technology allowed the medical-scientific industry new tools to research and analyze findings.

 In 2016, Christian F. P. Scholz and Mogens Kilian, researchers and professors of medical microbiology proposed the reclassification of this bacteria, based on human genome sequencing technology. Human genome studies are where the knowledge of the microbiome comes from.

From 2016 to 2018 medical providers began using c. acnes (formerly known as p.acnes) in medical papers, articles, blogs, vlogs, webinars, and websites. In late 2018, the publication of the c. acnes terminology became more widespread in the medical community.

CUTIBACTERIUM

Cutibacterium (c.acnes) is defined as a slow-growing, anaerobic, gram-positive bacterium linked to acne. The term cutaneous is derived from the Latin word cutis, meaning the skin. C. acnes is no different from the propionibacterium learned in aesthetic school. It just goes by a new name. It is still a pathogenic, rod-shaped, anaerobic, gram-positive, non-spore producing bacteria. It still proliferates in the lipid-rich environment of the hair follicle using sebum as a source of energy. Advanced technology has allowed descriptions and classifications more accurate, including bacteria types. It is time to spread the word – in the aesthetic community. P.acnes is now known as c.acnes.

10 Things About Glycated Skin

Most adults are familiar with diabetes, a disease afflicting over 30 million Americans. Individuals with diabetes have elevated glucose (blood sugar) levels because insulin (the hormone which regulates glucose levels) is not functioning correctly. Insulin acts as a chemical messenger allowing cells to absorb blood sugars, providing the energy needed for cellular function and survival.

 

The blood sugar (glucose) molecules are unable to enter the cell, so they bind with proteins or lipids forming destructive compounds called advanced glycation end products or glycotoxins through the glycation process. These toxic sugar compounds called AGEs cause tissue damage and chronic inflammation, leading to many serious health concerns.

 

Many adults are unaware that AGES are also responsible for glycated skin.

 

The following 10 points illustrate why each aesthetician needs to become familiar with skin glycation and the best ways to address it for successful client outcomes.

 

  1. Skin glycation typically begins around age 30 to 35.1 Most experts agree that the onset of glycated skin or its outward presentation appears consistent with the aging process, in the 30- to 35-year range. The glycation process occurs at the cellular level of the skin; therefore, results are not visibly evident until the damage is well underway. Eventually, the client can experience accelerated aging, causing wrinkles, the loss of elasticity, and even impaired barrier function.
  2. Glycation causes cross-linking. The skin’s dermal layer houses many essential components, including proteins that deliver elasticity, structure, and support. Collagen and elastin fibers form a robust and mesh-like structure, similar to a net, that supports and gives the skin its flexibility. Cross-linking is a destructive process causing collagen fibers to become stiff, brittle, and easy to break, reducing structural support. Loss of structural integrity to elastin fibers contributes to sagginess. The damage attributed to cross-linking prevents the cells and tissues of the dermis from functioning correctly.
  3. Ultraviolet exposure accelerates AGE production.2 Incorporate the use of a broad-spectrum, anti-inflammatory sunscreen into the client’s skin care products. Incorporate client education on all benefits of ultraviolet protection, not just skin glycation. Remember that to add that protection on all exposed areas of skin is essential, as skin cancer and glycation can occur anywhere.
  4. AGEs promote vascular endothelial growth factor (VEGF) production, a contributing factor for rosacea and couperose.3 Endothelial cells produce a signal protein (VEGF) that stimulates the formation of tiny blood vessels called capillaries. Couperose, caused by the loss of elasticity, presents when small facial capillaries expand. Rosacea is a sensitive skin condition that develops in the mid-to-late thirties, causing dilated capillaries, redness, irritation, flushing, damaged tissue, papules, pustules, and even ocular damage.
  5. AGEs repel moisture, leading to dry, cracked, and wrinkled skin; include glycerin, hyaluronic acid, and other humectants to protect against dehydration. AGEs also attach to lipids, meaning that the skin’s protective lipid layer within the stratum corneum and the cellular membrane bilayers at all skin levels are at risk. In addition to humectants, incorporate ceramides AP, EOP, NG, NP, and NS, phytosphingosine, sphingosine, and lecithin for lipid protection into the client’s homecare regimen.
  6. Diets high in carbohydrates and fats increase the amount of AGEs in the bloodstream, promoting oxidative stress and inflammation, which accelerate skin aging. Individuals can combat this destruction by consuming a healthier, low glycemic diet, rich in fruits and vegetables, and by avoiding foods like white bread, white rice, and white potatoes.
  7. AGE production increases by eating processed foods and specific cooking methods, such as grilling, roasting, frying, broiling, searing, and toasting. Today’s busy lifestyles make it very tempting to eat frozen foods for lunch and dinner, or even worse, the drive-through! Avoid processed foods, cook by boiling or steaming, or use a crockpot when possible. Plan ahead. Prepare healthy meals that last through the busy work week.
  8. Low pH inhibits AGE development.4 The skin’s pH is acidic, ranging from 4.5 to 6.2 pH varies by ethnicity, gender, area, externally, and internally. A recent study found that meats cooked with acidic ingredients can cut AGE production in half. Ingredients used in the study were:

 

  • distilled white vinegar with a pH of 2.4 (1,000 times more acidic)
  • lemon juice with a pH of 2 to 3 (1,000 times more acidic)
  • tomato juice with a pH of 4.1 to 4.6 (10 times more acidic)

 

  1. Antioxidants, peptides, enzymes, and coenzymes reduce AGEs.5 Look for products with ingredients, including acetyl tetrapeptide 5, vitamins B1-thiamine, B6-pyridoxine, or pyridoxal-5-phosphate, vitamin C, vitamin E-tocopherol, superoxide dismutase, resveratrol, glucosamine, carnosine, benfotiamine, soy proteins like genistein, arginine, and lysine polypeptide, turmeric, and blueberry stems, amongst many others.
  2. Reduce AGEs through exercise.6 During exercise, muscles pull glucose from the blood for fuel, which lowers blood sugar levels, with effects lasting for 24 to 72 hours. Note, always check with a doctor before beginning an exercise regimen, as the physician knows the amount of exercise activity that is best for their patient.

 

Fighting glycated skin requires a multifaceted approach. The aesthetic professional must:

  • Develop an effective professional treatment plan that consists of anti-glycation components (primarily collagen induction therapies) that may include individual or combination modalities: chemical peels, microneedling, LED, light therapy (laser), radiofrequency, ultrasound, or any additional treatment that stimulates new collagen and elastin production. Additionally, neurotoxins, including Botox, Dysport, Xeomin, and fillers may be utilized to minimize the appearance of glycated skin. Please note, any modality penetrating the dermis requires treatment by a physician, physician’s assistant, or registered nurse. Aestheticians should develop relationships with these medical professionals that are willing to accept patient referrals.
  • Recommend the appropriate daily care products, as topical protection against glycation and its inhibition is a crucial factor in a successful outcome.
  • Educate the client as to how a healthy diet, cooking methods, and exercise affect the skin.

 

The client benefits by receiving a holistic treatment program targeting skin glycation with wellness to achieve an improved state of health displayed by beautiful, radiant skin. Additionally, the improvement in the client’s overall appearance provides unsolicited advertising for your clinical expertise.

 

References

1 Pugliese, Peter T. “Physiology of the Skin: The Impact of Glycation on the Skin, Part 2.” SKIN INC. Apr 2008. https://www.skininc.com/skinscience/physiology/17660024.html.

2 Crisan, Maria, Marian Taulescu, Diana Crisan, Rodica Cosgarea, Alina Parvu, Cornel Catoi, and Tudor Drugan. “Expression of Advanced Glycation End-Products on Sun-Exposed and Non-Exposed Cutaneous Sites during the Ageing Process in Humans.” PloS One 8, no. 10 (2013): e75003. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792075.

3 Wikipedia. 2019. S.v. “Vascular endothelial growth factor.” Last modified 16 August 2019. https://en.wikipedia.org/wiki/Vascular_endothelial_growth_factor

4 Uribarri, Jaime, Sandra Woodruff, Susan Goodman, Weijing Cai, Xue Chen, Renata Pyzik, Angie Yong, Gary E. Striker, and Helen Vlassara. “Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet.” J Am Diet Assoc 110, no. 6 (2010): 911-116.e12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704564.

5 Goldfaden, Gary and Robert Goldfaden. “Prevent Glycation-Induced Skin Aging with Topical Nutrients.” LifeExtension Magazine. Nov 2009. https://www.lifeextension.com/Magazine/2009/11/Prevent-Glycation-Induced-Skin-Aging-with-Topical-Nutrients.

6 Yoshikawa, T., A. Miyazaki, and S. Fujimoto. “Decrease in serum levels of advanced glycation end-products by short-term lifestyle modificiation in non-diabetic middle-aged females.” Med Sci Monit 15, no. 6 (2009): PH65-73. https://www.ncbi.nlm.nih.gov/pubmed/19478714/.

 

Brenda Linday 2014Brenda Linday, L.E., L.E.I., C.A.C., Linday Aesthetic Consulting, is a licensed aesthetician, licensed aesthetic instructor, and certified aesthetic consultant with over 15 years’ experience in the medical aesthetic industry. Linday serves as a consultant for medical and aesthetic companies desiring to build strong sales and education teams. She develops clinical and sales education content and trains sales and educational organizations, clinicians, physicians, and distributors around the world. Linday is also a featured author in many industry publications. Her passion is sharing her wealth of knowledge with other like-minded professionals who believe that education is the key to building lasting relationships with our clients, making each clinician more successful by increasing client satisfaction. This email address is being protected from spambots. You need JavaScript enabled to view it. or @lindayconsult

Triple Threat: An Up-Close Look at Eczema, Rosacea, and Psoriasis

Aestheticians frequently encounter clients with sensitive skin conditions. While a professional’s scope of practice does not allow them to treat eczema, rosacea, or psoriasis, they can provide treatments that supplement the care the client receives from their medical provider. By gaining an in-depth knowledge of each condition, its causes, and standard treatment options, professionals can combine empathy and understanding with superior skin health services to deliver first-rate therapies to this select group of clients.

 

ECZEMA
Eczema, or dermatitis, is the name for a group of non-contagious skin conditions that present with symptoms of inflammation, pruritis (itchiness), and erythema (redness). Over 30 million Americans suffer from one or more forms of eczema which primarily appears on the hands, feet, face, and torso.


The most common form seen in the spa, atopic dermatitis, affects over 18 million Americans. It can present in infancy, teenage years, or adulthood. Individuals with a family history of atopic dermatitis, asthma, or hay fever have a higher risk of developing atopic dermatitis.


Symptoms include itchiness, redness, rash, dry or scaly skin, and open, crusty, or weepy lesions. If an infection develops from scratching, small pustules may form. Lichenification (skin thickening) can occur from excessive scratching and rubbing.


Contact dermatitis has two sub-classifications dependent on exposure to an irritant or allergen. Allergic contact dermatitis occurs with exposure to pollen, dust mites, or other allergens. Irritant contact dermatitis occurs with exposure to irritants like household cleaners. Symptoms include itchiness, redness, rash, swelling, bumps, and blisters. The best treatment for contact and irritant dermatitis is to avoid the offending agent.

 

Cause
The exact cause of eczema is unknown. However, genes and certain triggers are factors. Individuals with eczema have an immune system that over-reacts to outside stimuli producing inflammation. In turn, inflammation triggers the erythema, discomfort, and pruritis.


Researchers have discovered that some individuals suffering from eczema have a mutation of the FLG gene responsible for creating the protein filaggrin. Filaggrin is found in the granules in epidermal skin cells of the stratum granulosum. The epidermis acts as a barrier, inhibiting penetration of toxins, allergens, and bacteria. Filaggrin plays an essential role in the skin’s barrier function. Filaggrin attracts and binds structural proteins, forming tight bundles, flattening, and strengthening the cells to create a strong barrier. The breakdown of the filaggrin proteins leads to the production of molecules, including pyrrolidone carboxylic acid (PCA), that are part of the skin’s natural moisturizing factor which helps to maintain skin hydration. Filaggrin also assists with the maintenance of the slightly acidic pH of the skin (approximately 5.5) which is another essential aspect of barrier function.


Without adequate amounts of filaggrin, a weakened skin barrier can allow moisture to escape through transepidermal water loss. Additionally, bacteria, viruses, toxins, and allergens can penetrate with ease. The weakened barrier causes dry and infection-prone skin.

 

Latest Advances
Research using probiotics to alter the skin’s microbiome is promising. A study discovered that parabens, commonly used as preservatives in skin care products, inhibit the growth of roseomonas mucosa (a gram-negative bacteria), suggesting that parabens might hinder the skin’s defenses against eczema.1

 

Prevention of Flareups
The best way to prevent flareups is to recognize and avoid the triggers.

 

Treatments
The type and severity of eczema often determine the treatment. The medical provider determines the appropriate regimen based on the client’s condition. Knowledge of both clinical care and homecare remedies can help the aesthetician identify the best aesthetic regimens to complement the client’s current medical treatment.

 

Homecare
A regular bathing and moisturizing routine using a gentle, soap-free cleanser and an emollient cream with humectant and occlusive ingredients is recommended to seal in the desperately needed hydration. Pat the skin dry with a towel (no rubbing) and apply moisturizer while the skin is slightly damp. Well-moisturized skin decreases dryness and keeps out allergens.


A 10-minute lukewarm bleach bath (using unconcentrated bleach) sounds harsh but can be calming and can prevent infection. The amount of chlorine is similar to the amount found in a swimming pool: approximately half a cup of bleach for a standard 40-gallon bathtub. The client should only utilize this therapy with their health care provider’s permission and must be sure to thoroughly rinse the skin with fresh warm water to remove all bleach residue.


Wet wrap therapies are beneficial for rehydration. They also help topical medication to penetrate more efficiently. To use this option, clients should apply moisturizer and any topical medications, followed by wrapping dampened gauze or cotton to the affected skin. Then, the client should follow the damp wrap layer with a dry cloth over the top of the dampened wrap and complete the process with nighttime clothing to keep the wraps in place. They should leave this on for several hours, staying moist, or overnight.


Many over-the-counter products – including gentle cleansers, mild steroids, moisturizers, petroleum jelly, mineral oil, and coal-tar-based products, amongst many others – are available to help prevent and control eczema flareups. Clients must be sure to read the labels and follow directions.


Clients should apply all topical over-the-counter and prescription medications as directed by the healthcare provider. Topical steroids reduce cutaneous inflammation. They also tighten and constrict the capillaries, which decreases erythema. They are not intended for long-term use; sensitive areas, including eyelids and genitals, should always be avoided. Topical calcineurin inhibitors (TCIs) can be used for extended periods to control symptoms and reduce flareups because they do not contain steroids. TCIs inhibit the stimulation of the inflammatory cascade, keeping eczema in check. Prescription-grade topical skin barrier medications made from lipids and ceramides help prevent transepidermal water loss and protect against irritants penetrating the skin’s barrier. Topical phosphodiesterase 4 (PER) inhibitors block the PDE4 enzyme, reducing inflammation both on and below the skin’s surface and can be used for extended periods.

 

Clinical Care
Biologics are injectable drugs engineered from proteins derived from living cells or tissues. Biologics target the immune system to slow down its reaction, enabling the reduction of inflammation, redness, itchiness, and rashes.


Phototherapy, or light therapy, incorporates ultraviolet light to slow inflammation and mitosis. A hand-held device or a walk-in light source somewhat similar to a tanning booth may be used. Treatments take place in a doctor’s office several times a week and therapy can last weeks or months.


Immunosuppressant medications suppress the immune system, which reduces inflammation. They can be taken orally or by injection. Methotrexate, cyclosporine, and mycophenolate are three current medications used off label to treat eczema.

 

ROSACEA
Rosacea is a chronic, but treatable, vascular skin condition that is estimated to affect 415 million people worldwide. It usually presents as redness in the central portion of the face when the patient is in their 30s. Left untreated, the condition worsens, resulting in more persistent redness and vascularity. Inflammatory pimples often develop and, in severe cases, the nose may grow swollen and bumpy from excess tissue. Up to 50% of patients have watery, bloodshot eyes that feel dry and irritated. Rosacea is most prevalent in people of northern or eastern European descent; however, all ethnicities can develop this condition.

 

Recognizing Rosacea
Primary presentations on the central face include flushing, persistent redness, dilated capillaries, and papules and pustules. Secondary features include irritated eyes, burning or stinging, itchiness, dry skin, plaques, thickened skin, and edema.

 

Cause
Medical science is still looking for the cause of this condition. Knowledge of rosacea’s signs and symptoms enables the control of the condition with medical therapy and lifestyle changes while a search for the cure continues.


Facial redness presents because the client has an increased number of capillaries (which increases blood flow) that are closer to the surface of the skin. Eyelids may become red and swollen and styes are common. Crusts may accumulate around the eyelids or eyelashes and clients may notice visible blood vessels around the lid margins. Severe cases of ocular rosacea can result in corneal damage and loss of vision without medical intervention.


Clients must see a dermatologist or other qualified physician for diagnosis and appropriate treatment before their disorder becomes increasingly severe and affects their quality of life.

 

Recent Discoveries
Groundbreaking studies funded by the National Rosacea Society focusing on the immune system discovered cathelicidin antimicrobial peptides (CAMPs) affect clients with rosacea differently than healthy individuals. CAMPs speed up physical repair but worsen rosacea symptoms. Researchers Dr. Yoshikazu Uchida and Dr. Peter Elias examined elements along the CAMP production pathway and found a lipid substance known as SP1 that is responsible for increased CAMP synthesis. They also discovered another lipid metabolite, C1P, that stimulates the production of other protective peptides which, in turn, decreases the number of CAMPs. New medications that can intersect the production of these protective peptides may lead to new rosacea therapies.2


Dr. Anna DiNardo and her research team discovered that mast cells play a role in the stimulation of certain types of cathelicidins, an enzyme involved in the immune system response that is over-produced in people with rosacea. Dr. DiNardo’s team determined that mast cells in mice exposed to PACAP – a neuropeptide, produced enzymes that triggered cathelicidin production. This chain reaction did not occur in mice bred to lack mast cells. Additional research is needed to discover if a mast cell stabilizer known as cromolyn sodium will decrease rosacea symptoms.3

 

Treatment
Oral and topical medications treat the various signs and symptoms associated with the disorder. Rosacea-specific therapies are available in various formulations for each client.

 

Medical Therapies
Redness, papules, and pustules are treated with oral and topical therapy for immediate improvement, followed by long-term use of an anti-inflammatory for maintenance. Telangiectasias and rhinophyma are best addressed by lasers, intense pulsed light sources, or other medical and surgical devices. Ocular rosacea is treated with anti-inflammatory medications and recommendations from an ophthalmologist or optometrist.

 

Aesthetic Therapies
The aesthetician must treat the skin very gently. Irritation and heat exacerbate the condition. Avoid the use of harsh chemical peels, scrubs, hot steam, microdermabrasion, or anything abrasive. Consider replacing the European massage with something lighter, like manual lymphatic drainage or pressure point, to minimize flushing due to stimulating circulation.


It is best to avoid aromatherapy or the use of any fragrances on sensitive skin. Consider using a cool spray in place of steam (found in multi-function machines) or adding a Lucas Championaire to the equipment arsenal. Mild chemical peels stimulate cellular renewal replacing damaged skin cells with healthy new ones. Incorporate calming, hydrating, and anti-redness ingredients into masks and serums.

 

Skin Care Routine
Gentle skin care products used daily will calm the skin. Clients should wash with a mild cleanser, rinse with lukewarm water, and blot dry. Suggest non-irritating skin care products as needed and a broad-spectrum mineral sunscreen with an SPF of 30 or higher.


Look for products with ingredients that address: inflammation, such as argan oil, niacinamide, linoleic acid, azelaic acid, ginger extract, bisabolol, green tea, lavender, jasmine, rose, tea tree, and thyme; barrier function, like niacinamide and linoleic acid; and redness, such as sulfur, caffeine, asparagopsis armata, and ascophyllum nodosum. Also, look for antioxidant-rich ingredients like argan oil, soothing and calming ingredients like aloe, hydrating ingredients like honey, hyaluronic acid, and glycerin, and healing ingredients like argan oil, lavender, jasmine, rose, tea tree, and thyme. A physical sunscreen that includes zinc oxide and titanium dioxide is a good idea, as well.


Avoid products with ingredients that sting, burn, or cause additional redness including: fragrances, peppermint oil, eucalyptus oil, drying alcohols, witch hazel, or foaming cleansers, which can be drying. Green-tinted makeup foundations can be used to counter redness, followed by a foundation with natural yellow tones. Avoid pink or orange hues.

 

Lifestyle and Environmental Factors
To supplement medical therapies, rosacea clients can improve their skin health by identifying and avoiding lifestyle and environmental factors that trigger flareups. Identifying these factors is an individual process because what causes a flareup in one person may not affect another. 

 

PSORIASIS
More than 125 million individuals worldwide have psoriasis. Science is still searching for a cure, so patients must work to manage their symptoms. Psoriasis has several forms, with the most common being plaque psoriasis, which presents as a patchy, red rash with silvery, white scales. This form appears most often on the scalp, elbows, knees, and lower back. Psoriasis is an autoimmune disease that must be diagnosed by a physician.


Plaque psoriasis symptoms include flaking, inflammation, and thick, white, silvery, or red patches of skin.

 

Cause
An overactive immune system, the body’s defense against germs, causes psoriasis. It is a chronic skin condition. The body’s immune system mistakes healthy skin cells for damaged ones, then attacks them as if it were fighting an infection. The body responds to the attack by making new skin cells every few days instead of the usual 28 days. The newly formed cells build up on the skin’s surface and form a rash.

 

Treatment
Psoriasis may be treated by using creams, steroids, biologics, laser, and phototherapy, amongst many other options.


Treatment options depend upon the level of the condition. A client is considered to have mild psoriasis, if it covers less than 3% of the body, moderate, when coverage ranges from 3% to 10%, and severe, if over 10%.


The client’s physician will determine the best treatment plan for each individual case. At-home treatments include:

  • topical steroid creams to reduce inflammation and itching and slow the cell turnover rate
  • moisturizers to hydrate and reduce itching
  • salicylic acid to exfoliate, lifting scaly skin cells
  • retinoids to reduce inflammation and normalize
  • the cell turnover cycle
  • calcipotriene or vitamin D (studies have shown that psoriasis patients are deficient in vitamin D)
  • coal tar to slow the rapid cell turnover rate, calm inflammation, and reduce itching and scaling
  • biologics (drugs made from living cells) like Humira and Enbrel to target the immune system
  • prescription medications to target various
  • psoriasis symptoms
  • anthralin (a medication) to slow the cell turnover cycle
  • occlusion methods (wrapping an area treated with cream) to improve product penetration

 

There are a number of natural remedies that may be helpful, as well. Exposure to sunlight may be useful, as UVB rays from the sun work like UVB phototherapy. Aloe is calming and tea tree oil is antibacterial – it will fight any infection from scratching. Oatmeal baths calm irritated skin and epsom salt baths remove dead skin. Studies show that turmeric in foods or taken as a supplement may cut down flareups.

 

Medical Therapies
Light therapy (UVB phototherapy): UVB penetrates the skin to slow the growth of skin cells in an affected area. Skin is exposed to a UVB light source for a set length of time on a regular schedule. Phototherapy can be administered in a medical office or at home. PUVA is a form of phototherapy that combines a medicine called psoralen with UVA light. Excimer laser is FDA-approved for treating chronic, localized psoriasis plaques by emitting a high-intensity beam of UVB light. Biologics can be taken at home orally or by injection or IV in a medical facility.


Aesthetic Therapies: Blue LED light therapy addresses the bacterial components associated with psoriasis, while red addresses the inflammation. Massage can relax the client; stress is a trigger for flareups. Superficial chemical peels can exfoliate surface plaque buildup as long as they are mild; salicylic acid is FDA-approved to treat psoriasis.


Climatotherapy: Dipping into the Dead Sea has been said to improve psoriasis. A combination of the salty water and abundant sunshine is believed to be healing. Recent studies report improvements in psoriatic skin after taking the Dead Sea plunge. Many clients report having no symptoms for months afterward.

 

Prevention or Management of Flareups
Researchers know that approximately 10% of the population carries the gene for predisposition but only 2% to 3% develop the disease, which leads them to believe that environment and lifestyle choices play a factor.

 

Homecare
Just as with eczema, a regular bathing and moisturizing routine using a gentle, soap-free cleanser and an emollient cream with humectant and occlusive ingredients to seal in hydration is ideal. Clients should pat the skin dry with a towel (no rubbing) and apply moisturizer while the skin is slightly damp. They should use a physical broad-spectrum sunscreen with zinc oxide or titanium dioxide for UVA and UVB protection.

 

Armed with the knowledge of sensitive skin presentations, their causes, treatments, and suggested homecare, skin care professionals can deliver exemplary services and product recommendations to a select group of clients that need empathy, understanding, and a gentle touch. There is nothing more fulfilling than seeing an impact made on someone’s life.

 

References
1 Research funded by the U.S. National Institute of Allergy and Infectious Diseases (NIAID) and published May 3, 2018, in the journal JCI Insight.
2 “A novel therapeutic approach via modulation of sphingolipid signaling in rosacea.” National Rosacea Society. https://www.rosacea.org/grants/reports-on-completed-research.
3 “Mast cells play a direct role in the activation of certain types of cathelicidins.” National Rosacea Society. http://www.rosacea.org/grants/reports-on-completed-research.
4 National Eczema Association. https://nationaleczema.org.
5 National Roscaea Society. https://rosacea.org.
6 National Psoriasis Foundation. https://www.psoriasis.org.

 

Brenda Linday 2014Brenda Linday, L.E., L.E.I., C.A.C., is a licensed aesthetician, licensed aesthetic instructor, and certified aesthetic consultant with over 15 years’ experience in the medical aesthetic industry. Linday serves as a consultant for medical and aesthetic companies desiring to build strong sales and education teams. She develops clinical and sales education content and trains sales and educational teams, clinicians, physicians, and distributors around the world. Linday is also a featured author in many industry publications. Her passion is sharing her wealth of knowledge with other like-minded professionals who believe that education is key to building lasting relationships with clients, making each professional more successful by increasing client satisfaction. This email address is being protected from spambots. You need JavaScript enabled to view it. or @LindayConsult

Sebaceous Hyperplasia: Gaining the Upper Hand on those Little Lesions

As time continues, many minor skin abnormalities appear, affecting aging clients’ psyche. Treatment for any anomalism is highly sought-after, as current society values radiant, youthful, and healthy-looking skin.There has been a dramatic increase in photo-aging, skin disorders, and cancers due to the declining ozonosphere. The destructive penetration of ultraviolet rays wreaks havoc on the skin. One of the least understood abnormalities is sebaceous hyperplasia or sebaceous gland hyperplasia.

Fact or Fiction: Psoriasis is caused by a build-up of dry skin.

Psoriasis is a chronic, noncontagious, autoimmune condition where the immune system’s white blood cells (T-cells) attack the skin cells by mistake. There are several varieties of psoriasis. Plaque, the most common form, is recognized by its symptoms – dead cell build-up on reddened, inflamed skin. Other types include guttate, pustular, inverse, erythrodermic, and psoriatic arthritis.

Clinical researchers believe that there are three fundamental theories that cause (or contribute to) psoriasis: genetics, the environment, and a malfunctioning immune system.

Fact or Fiction: Products with collagen can replace the skin’s natural collagen.

Realization that collagen is essential to healthy skin is commendable and should be noted before explaining the physics of the skin and the function of particular ingredients to bust this myth.

It is important to stimulate new collagen production as peak levels occur at age 18, then slowly begin to diminish. By age 30, an individual can lose up to 1.5 percent of their collagen each year.

Collagen is a structural protein fiber found in the body’s connective tissues. It is formed from chains of peptides that are composed of amino acids. It provides the strength; support; and combined with elastin fibers, elasticity to the skin. Unfortunately, collagen has a large molecular structure, making it unable to penetrate to the dermis and lacks any signaling components to stimulate collagen synthesis.

Research Developments in Sensitive Skin Conditions

Recent research brings exciting news for clients struggling with sensitive skin conditions. New medications have been approved by the FDA, studies have uncovered patterns in the development of specific conditions, and research teams have uncovered correlations between sensitive skin conditions and other health disorders.

Fact or Fiction: Skin damage caused by HEV light may be as harmful as the damage caused by UVA and UVB light combined.

High energy visible (HEV) light is high-frequency and high-energy light ranging from approximately 380 to 500 nanometers in the blue band of the visible portion of the electromagnetic spectrum and is also referred to as blue light or near ultraviolet light. Sources of blue light include the sun, full spectrum lighting, flat screen monitors, cell phones, and tablets. Additionally, reflective surfaces, including sand, snow, water, glass, and even concrete, are sources of HEV light.

Choosing the Best Exfoliant Based on Client Concerns

What client does not want to live with perfect skin? Every client's skin is unique and experienced, knowledgeable skin care professionals learn to customize treatment regimens that balance each client's needs and concerns with reliable, affordable, and innovative methods.

Business Development Tips and Tools for the Spa Owner

Every new business owner aspires for consistent progress on their road to success. The smart spa owner will recognize when the timing is right to seize the opportunity to increase market share and formulate a strategic plan to capture it. Strategic planning using sound business tools will help professionals to achieve their goals.

The Insider’s Guide to a Successful Spa Event

Successful spa events are the result of months of preparation. It is not uncommon for an average spa to spend 20 percent of their total marketing budget on events. During these events, clients can enjoy live interactions with other individuals, making them the perfect addition to a spa's engagement marketing strategy. Person-to-person interactions can pull in a prospect for conversion to the sale and upsell existing clients for additional products and/or treatments.

Acne: The Universal Teenage Struggle

Acne is the most common skin condition in the United States, affecting approximately 40 to 50 million Americans and 650 million people worldwide, each year. Eighty-five percent of teenagers and young adults between the ages of 12 and 24 experience acne during their lifetime; this condition can be a major source of embarrassment. A recent survey found that teenagers suffering from acne experience feelings of low self-confidence, shyness, embarrassment, helplessness, difficulty with social interactions, and challenges at school.1

The Beauty of Social Media Share Your Business, Engage Customers, and Build Sales Online

Whether you are a startup spa, an established medical practice, or an independent skin care professional, you know that active client engagement is vital to your success. Without question, reaching your current clientele and prospecting new clients is efficiently and effectively performed through social media, if you are creating the right content and choosing the right platforms to reach your target audience.

Chemical Peel Intervention: Combined Modalities or Adjunct Treatments?

In our zealousness to incorporate new modalities into client treatments, skin care professionals often ask, “Which modalities can I combine with chemical peels?” However, the questions that professionals should ask themselves instead are:

Skin Care MYTHS: The higher the SPF, the greater the protection.

Exfoliation: It’s More Than Skin Deep

Many of our clients’ skin concerns are related to excessive dead skin cell buildup, a compromised barrier function, wrinkles, acne, or discolorations of the skin. To achieve skin wellness, it is necessary to offer a corrective treatment plan that will attain results, such as a chemical peel, that our customer desires.

Melasma in Women: Treat it to Beat it

One must develop a thorough understanding of melasma to achieve successful treatment outcomes. It is one of the most frustrating conditions for skin care professionals to treat and even more confusing and discouraging to the client.

February 2024

Business Blogs

Brands of the Month

  • Celluma by Biophotas, Inc
  • Eminence Organic Skin Care
  • Repechage