As aestheticians, we are licensed to work with the integument, treating it according to what was learned in school and what is allowed within our scope of practice. As a practicing aesthetician with over 16 years of experience. I have heard my share of skepticism regarding product efficacy and the effectiveness of topical treatments as compared to more invasive modalities. Surprisingly, such skepticism is generally expressed by doctors who argue that methods like fillers, lasers, microneedling with radiofrequency (RF), and other nonsurgical options are the only way to prevent premature aging and reverse existing damage. Some doctors understand the unequivocal benefits of topical skin care and regular visits to the aesthetician, but it seems they are the minority in the profession. 

Dasha Saian Marchese is the co-founder and CEO of Saian and has over 22 years of experience in the spa industry. She is a licensed aesthetician, Aesthetics International Association Ambassador, and serves on the Editorial Advisory Board of DERMASCOPE Magazine. In addition to her aesthetics schooling, Dasha has a degree in business and marketing. She gives lectures and classes internationally and regularly contributes to global trade publications. 

In 1981, the FDA approved bovine collagen for cosmetic injection. Since its approval, dozens of injectable fillers have been developed and approved for cosmetic use. The first filling agents were formulated to help with therapy-induced facial fat loss and lipoatrophy in HIV patients; however, some physicians started administering fillers to their patients seeking cosmetic rejuvenation. The injectable poly-l-lactic acid was the filler of choice at the time, lasting up to three years with maintenance.

Dasha Saian Marchese is the co-founder and CEO of Saian and has over 22 years of experience in the spa industry. She is a licensed aesthetician, AIA ambassador, and serves on the editorial advisory board of DERMASCOPE magazine. In addition to her aesthetics schooling, Saian Marchese has a degree in business and marketing. She gives lectures and classes internationally and regularly contributes to global trade publications.

Aestheticians see a multitude of different clients with varying skin types and conditions, but rosacea clients should get the gentlest of treatment. This skin condition can manifest in different forms from one client to the other. According to the National Rosacea Society, over 16 million Americans are affected by the skin disorder, and as many as 415 million worldwide, according to new research in the British Journal of Dermatology. Despite being a relatively common skin condition, only 18% of Americans with rosacea are currently receiving medical treatment for their condition, and some do not realize rosacea can be treated by over-the-counter and prescription products. As a professional, what is the plan of action for a sensitive rosacea client?

Dasha Saian Marchese is the co-founder and current CEO of Saian and has over 21 years of experience in the spa industry. In addition to her business and marketing degree, she is a licensed aesthetician, certified nutrition and wellness consultant, official ambassador of the Aesthetics International Association (AIA), and certified family herbalist. Marchese is on the Editorial Advisory Board of DERMASCOPE Magazine; she gives lectures and classes internationally and regularly contributes to global trade publications.

This year, the oldest children of Generation Z (Gen Z) will turn 24, and these young people are well informed of the latest trends in fashion and beauty. Moreover, they are already no strangers to cosmetic procedures such as facial fillers and body contouring. With thousands of YouTubers, Instagram influencers, and TikTokers handing out beauty advice on their platforms, it is easy to see how masking and cosmetic injections have become the status quo for this young generation.

Dasha Saian Marchese is the co-founder and current CEO of Saian and has over 21 years of experience in the spa industry. In addition to her business and marketing degree, she is a licensed aesthetician, certified nutrition and wellness consultant, official ambassador of the Aesthetics International Association (AIA), and certified family herbalist. Marchese is on the Editorial Advisory Board of DERMASCOPE Magazine; she gives lectures and classes internationally and regularly contributes to global trade publications.

This short tutorial demonstrates the step-by-step facial using Saian skincare products and the new FirmAge machine.

Dasha Saian Marchese is the co-founder and CEO of Saian and has over 21 years of experience in the spa industry. She is a Licensed Esthetician and serves on the Editorial Advisory Board of Dermascope Magazine. In addition to her esthetics schooling, Dasha has a degree in Business/Marketing. She gives lectures and classes internationally and regularly contributes to global trade publications.

In this tutorial, you will learn how to use our award-winning paraben-free Saian Skincare products to reduce inflammation, brighten skin tone, kill germs and bacteria, get rid of blackheads and whiteheads, and dry blemishes. Natural Paraben-Free, Benzoyl-Peroxide-Free clinical professional products.

Dasha Saian Marchese is the co-founder and CEO of Saian and has over 21 years of experience in the spa industry. She is a Licensed Esthetician and serves on the Editorial Advisory Board of Dermascope Magazine. In addition to her esthetics schooling, Dasha has a degree in Business/Marketing. She gives lectures and classes internationally and regularly contributes to global trade publications.

Cleansing treatment with Saian skincare's ultrasonic skin scrubber spatula.

Dasha Saian Marchese is the co-founder and CEO of Saian and has over 21 years of experience in the spa industry. She is a Licensed Esthetician and serves on the Editorial Advisory Board of Dermascope Magazine. In addition to her esthetics schooling, Dasha has a degree in Business/Marketing. She gives lectures and classes internationally and regularly contributes to global trade publications.

Hyperpigmentation disorders present as skin that is discolored, blotchy, darker, or lighter than normal – this happens when the body produces too little or too much melanin. These disorders can be localized or can diffusely spread about the entire body. The most common types of genetic hyperpigmentation are birthmarks, macular stains, port wine stains, albinism, piebaldism, and freckles. Not all genetic skin colorations will appear at birth – some, like freckles, appear with sun exposure, while others, like melasma, may appear during pregnancy and in middle-age.

Dasha Saian Marchese is the co-founder and current CEO of Saian and has over 21 years of experience in the spa industry. In addition to her business and marketing degree, she is a licensed aesthetician, certified nutrition and wellness consultant, official ambassador of the Aesthetics International Association (AIA), and certified family herbalist. Marchese is on the Editorial Advisory Board of DERMASCOPE Magazine; she gives lectures and classes internationally and regularly contributes to global trade publications.

As women go through the process of aging and childbirth, they may experience changes in their genitalia. The most common changes that can impact a woman’s quality of life are vaginal laxity, stress urinary incontinence, loss of vaginal lubrication, loss of tone of labia majora, stretching of labia minora, and a decrease in sensation. Although surgical vaginal tightening procedures are not new, historically they have been performed for repairs after obstetrical delivery, rather than for sexual or aesthetic concerns. The number of aesthetic treatments, as well as corrective surgical procedures, are on the rise and these treatments are now becoming more and more common. As women become more comfortable discussing these issues with their physicians, the number of treatments available is increasing.

Dasha Saian Marchese is the co-founder and CEO of Saian Skincare and has over 18 years of experience in the spa industry. In addition to her business/marketing degree, she is a licensed aesthetician, certified nutrition and wellness consultant, official ambassador of the Aesthetics International Association (AIA), and certified family herbalist. Marchese gives lectures and classes internationally and regularly contributes to global trade publications.

The COVID-19 pandemic has rapidly changed how  the world population lives, works, and learns. In hospitals around the world, doctors, nurses, and other healthcare workers are fighting an enemy that has already killed more than 100,000 people. Medical workers who are called upon to assist or treat those with COVID-19 experience physical strain of protective equipment such as dehydration, heat, and exhaustion, as well as physical isolation. Many individuals were absolutely distressed and heartbroken to see photos on social media of these everyday heroes with bruised faces after prolonged mask wear.

In those medical workers working around-the-clock with COVID-19 patients, face masks, eyewear, facial hoods, and other personal protective equipment (PPE)  have resulted in red, sore, irritated skin,  bruising and abrasions, and even irritant contact dermatitis. Kinesiology tape manufacturers have stepped up quickly to bring a new form of protective tape to the market. This type of tape is designed to adhere like a “second skin” that is comfortable, breathable, and provides an excellent barrier between the user’s skin and their mask, eyewear, and other personal protective equipment. While the tape can be placed just about anywhere on the skin to protect against  irritation, the most common application uses three strips shaped in a triangle, one across the nose and the other two at either end running down towards the chin to protect from face mask pressure. The gel-like, acrylic adhesive on the strip maintains a seal on the skin without irritation and can be removed painlessly.

The nasal bridge is a problem area, as the mask and the eyewear both sit on it. Mask wearers have been most likely to develop acne followed by itch, rash, post-inflammatory hyperpigmentation and scarring at the bridge of the nose. The type of acne that forms under masks is a special type of acne - acne mechanica. The biggest difference between acne mechanica and acne vulgaris is the cause,  while common acne has hormonal roots, the cause of acne mechanica is completely physical and it boils down to one word –  friction. Anything that traps heat against the body for a prolonged period, rubs or puts pressure on the skin (such as an N95 mask and eyewear) can trigger acne mechanica. Personal protective equipment traps and holds heat and sweat against the skin, causing the pores to become blocked. With continued rubbing, the pores become irritated and those tiny blemishes morph into larger, red pimples. Occlusion of the hair follicles and a warm sweaty environment predisposes to acne flares – this same scenario may also occur under the protective suits as back acne.

To treat acne, it is recommended to wash the face as soon as possible or at the end of the shift with a slightly drying, glycolic acid cleanser. A salicylic acid wash should be used in the areas affected by acne and a topical salicylic-based spot treatment applied only on the blemishes before bedtime. After this nighttime routine, a non-comedogenic, peptide-based moisturizer should be applied to protect the skin and promote healing.

For those healthcare workers that have developed bruising and abrasions, there are several ways to restore and mend the skin. Skin lesions with cuts and bruises require a corneotherapy centric approach – repairing, nourishing the barrier, restoring the skin’s homeostasis, and regenerating the tissues. After removing all personal protective equipment, at the end of the shift, it is recommended to cleanse the face with a gentle cleanser and then layer peptide products from thinnest consistency to thickest – think water-based peptide serum followed by a light, fragrance-free peptide cream. Those with bruising or abrasions from personal protective equipment need to completely avoid any harsh exfoliation, salicylates, or retinoids because their skin is already sensitive. For bruising, the recommendation is to use creams and gels with arnica and vitamin K ingredients, both of which reduce bruising and inflammation.

One of the best ways to treat bruises, pain, and inflammation is with multi-wave LED technology. The correct type of equipment to treat inflammation is a device with a wavelength falling within 630 nanometers red to 660 nanometers red and 850 nanometers infrared, to 940 nanometers. These wavelengths have been proven to help diminish bruising and subdue localized pain. It is recommended to use a handheld LED for three to five minutes per area, or a whole face panel for 20 minutes at a one to two inch distance from the face.

We made DERMASCOPE Magazine’s the A-List! Thank you for believing in our company’s mission and helping us thrive. Staffed by estheticians, FOR estheticians. You can see the full article on Dasha Saian on page 92 of the September issue of DERMASCOPE . Here is an excerpt:
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In 2007, Dasha Saian, L.E., CEO and co-founder of Saian Natural Clinical Skincare, and her mother Margarita started a skin care brand out of their kitchen with only $3,000. At that time, Dasha was finishing college, working at a spa as a receptionist, and going to beauty school for her aesthetics license. The first couple of years were tough – they were operating out of their two-bedroom apartment, which meant living with boxes everywhere. Their social life was virtually non-existent and it was impossible to have company over because the number of boxes was overwhelming. They used to sit and fill bottles with serums and creams all evening and stick labels on them, so that they could drive to San Diego at 5:00 A.M. to teach a class at a beauty school at 8:00 A.M. and hopefully sell something.
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Fast forward to 2013, their business was thriving – new products, automation, staff, and an office. One April day, Margarita lost consciousness and was rushed to the hospital. A day later, she was diagnosed with grade four glioblastoma – a malignant tumor the size of a baseball in her brain. The business was put on the backburner for two and a half years, as Dasha stayed home to take care of her mother and 86-year-old grandmother. In the process of learning about her mother’s illness, Dasha became an expert on oncology care.
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After her mother passed, Dasha found herself absolutely engulfed in work – it was her happy place. Surprisingly, as she relaxed about making more money and focused on providing a better value for the customers, everything fell into place and Saian Natural Clinical Skincare started picking up. Her mother’s legacy of integrity and commitment to clients was what kept the company culture and values alive after she passed. Anyone who has ever taken a class with Margarita would tell you she had a way of making one feel special, but most importantly, she shared all of her knowledge
1-800-291-1130  https://www.dermascope.com/a-list/10991-dasha-saian-l-e-ceo-and-co-founder-of-saian-natural-clinical-skincare

This all-natural spot treatment treats break-outs overnight. Kills germs and bacteria, disinfects and dries blemishes to treat even the most severe and cystic acne without leaving red spots and discoloration. No added color, fragrance, glycerin, fillers or preservatives – all natural, and 100% pure.
1-800-291-1130  https://saian.net

Not all skin is the same and not every product is universal. Aestheticians see clients with a variety of concerns, including acne, hyperpigmentation, dryness, wrinkles, and sensitivity. Which exfoliators are a must in the treatment room and how can professionals determine the most effective treatment protocol for clients?

The client should always come out of the treatment room looking much better than when they entered, which means it may be necessary at times to refuse to administer any harsh peels that cause redness, irritation, or scabbing. Take peace of mind into consideration and just assume everyone has sensitive skin when starting a treatment.

Many clients tend to over exfoliate in hopes of sloughing off dead skin and achieving a fresh and renewed complexion. On the contrary, skin is a very efficient organ and does not require exfoliation more than two to three times per week. In fact, exfoliating as often as daily can strip the skin of its natural oils, which may cause breakouts.

UNDERSTANDING THE EPIDERMAL BARRIER

The epidermal barrier represents a collection of specific functions, many of which occur primarily within the stratum corneum. Among these are maintenance of water content and balance, prevention, and responses to invasion by microbial organisms and antigens, reduction of the effects of ultraviolet light exposure, and counteracting the effects of oxidative stress.

The stratum corneum is composed of 50% ceramides, 25% cholesterol, and 15% free fatty acids. The main components of the stratum corneum of the epidermis layer of human skin are ceramides. Together with cholesterol and saturated fatty acids, ceramides create a protective organ to prevent excessive water loss due to evaporation, as well as a barrier against the entry of microorganisms. Outside factors that can alter the integrity of the stratum corneum cause an increase in transepidermal water loss and alterations of stratum corneum proteins and lipids, progressively leading to compromised skin. Unless these factors are adequately countered by the stratum corneum’s self-repair mechanisms, the skin becomes overstressed, with continued increased transepidermal water loss leading to incomplete desquamation, loss of skin elasticity, increased skin rigidity, and epidermal proliferation.

So, how can this be avoided, knowing that the skin naturally sheds dead skin cells through a process called desquamation? What is cell turnover? And, what are the average rates at which the body replaces skin cells?

According to Milady’s Standard, Fundamentals For Estheticians, below are the average rates of cell turnover by age group:

• Babies: 14 days
• Teenagers: 21 to 28 days
• Middle-Aged Persons: 28 to 42 days
• Those 50 and Older: 42 to 84 days

Cell turnover is the process by which skin makes new skin cells, traveling from the lowest layer of the epidermis to the top layer and then shedding off. This process is what keeps dead cells from building up on the skin’s surface. Skin cells live about two to three weeks. Unfortunately, skin cell turnover slows with age, so exfoliation is useful, but daily exfoliation is excessive.

Sometimes clients are surprised that they still get acne, even though they exfoliate daily. What they do not realize is that their skin is compensating for the loss of oils and is overproducing sebum.

Clients with dry, sensitive, thin skin will benefit greatly if they reduce their exfoliation to one to two times per week, since the oils on the skin keep it moist and supple. Over exfoliating will dry out their complexion and make wrinkles more prominent. In addition to this, they may experience couperose, exacerbated rosacea, and increased sun-sensitivity.

For clients with dry skin, it is recommended to exfoliate one to two times per week, and two to three times per week for those with oily skin. No one way of exfoliation is perfect for all skin types, so this article will mention many possible alternatives, in hopes to inspire selection from all possible options.

MODES OF EXFOLIATION

To make things as simple as possible, there are two types of exfoliators: physical and chemical. Everything that is used to mechanically slough off the dead skin is referred to as physical exfoliation. This includes methods such as a scrub, microdermabrasion, and a rotating sonic brush to scrape off the dead skin cells with friction. This is a very easy way to refresh the skin and it appeals to both men and women.

The easiest and most affordable exfoliating products to use at home are scrubs. Scrubs are affordable, since the ingredients are typically not too complex and can range from larger ground formulas, for the body, to finely ground formulas, for the face. A scrub offers simplicity, especially for the male clientele, but not everyone will benefit from them. Clients with these conditions should avoid scrubs: 

• acne and cystic acne 
• couperose 
• rosacea 
• elderly clientele 
• sensitive skin

The main reason to discourage acne clients from using a scrub is because the rough particles in the scrub will not only damage and irritate the skin, causing redness, but in the case of acne, they will spread bacteria on the face, worsening the situation. For this same reason, do not recommend microdermabrasion treatments or using a rotating sonic brush for clients who have acne, couperose, or rosacea. These types of treatments are too rough and should be avoided. Older clients tend to have thinner skin, which bruises and breaks easily, and using a harsh scrub or any other mechanical mode of exfoliation will cause damage and pain. Recommend a gentle enzymatic exfoliation or, if necessary, a light oatmeal scrub.

Chemical exfoliation refers to acids, peels, and enzymes. Enzymes are a wonderful way to safely exfoliate the skin without breaking capillaries and causing irritation. An enzymatic exfoliation is a good natural way to clean out the pores, get rid of excess oils, and slough off dry, dead skin for healthy cell turnover. Fruit enzymes, such as bromelain (from pineapple) and papain (from papaya), eat away at the oils and dry skin, to expose a refreshed, clear complexion. Enzyme masks are generally gentler and safer than acids and do not thin the skin like Retin-A. Using these masks two to three times a week is plenty and steaming them helps pull out impurities furthermore.

Dry enzyme masks that are activated moments before application have a longer shelf-life than pre-activated, gel-like masks. This type of facial exfoliant usually comes in the form of a mask based on marine clay, bentonite, or oats. This type of enzyme mask is gentler than an enzyme peel, which generally contains 10% to 30% alpha hydroxy acid, and is not suited for everyone. An example of such a product would be a pumpkin peel. It is quite strong, so please refer to guidelines before administering it. Just like a chemical peel, administer an enzyme peel with caution, making sure the client is a good candidate for the product.

Clients with these conditions should avoid peels: 

• acne and cystic acne 
• couperose 
• rosacea 
• elderly clientele 
• tan, sunburned, or tanning bed use
• hypopigmentation sufferers 
• type V and VI on the Fitzpatrick scale 

Alpha hydroxy acids are a class of chemical compounds that consist of a carboxylic acid substituted with a hydroxyl group on the adjacent carbon. They may be naturally occurring or synthetic. Alpha hydroxy acids act on both the epidermal and the dermal levels. When applied to the skin, they stimulate the exfoliation of epidermal cells in the stratum corneum by interfering with the ionic bonding between these cells. This results in the sloughing of dull, rough skin and promotes cellular renewal. Initially used for treatment of hyperkeratosis and other skin conditions affecting turnover, alpha hydroxy acids were found to promote softer, smoother skin, faded wrinkles, lightened age spots, and decreased blemishes. Studies have shown alpha hydroxy acids to improve the stratum corneum’s barrier function, increase epidermal proliferation and thickness, and restore hydration and plumpness. One negative is that alpha hydroxy acids increase the skin’s photosensitivity.

Alpha hydroxy acids are naturally occurring carboxylic acids found in many foods, including glycolic acid (sugar cane), lactic acid (milk), citric acid (citrus fruits), and malic acid (apples), among others. The most commonly used alpha hydroxy acids are glycolic and lactic acids. Because glycolic acid has the smallest molecular size of all the alpha hydroxy acids, it is the most bioavailable and active, allowing it to penetrate the skin the most easily. Salicylic is the only beta hydroxy acid used in skin care; it occurs naturally in wintergreen leaves, sweet birch, and other plants, and is topically an anesthetic and a keratolytic with a mild peeling effect. For milder acne, salicylic acid helps unclog pores to resolve and prevent lesions. It is derived from the metabolism of salicin, which is an alcoholic β-glucoside.

Salicylic accomplishes the same goals in skin care as alpha hydroxy acids, such as lactic acid and glycolic acid, but is used in a weaker concentration. Applied to the skin, it breaks down fatty compounds, such as the oily sebum that can clog pores; taken inside the body, salicylic acid (the main ingredient in aspirin) relieves pain and improves circulation. One of the most important benefits of this ingredient is that it is significantly less irritating than other products.

Salicylic acid acts as a keratolytic, which loosens keratin, allowing thickened, scaly plaques of skin to shed more easily. Using an exfoliant that contains salicylic acid not only sloughs off dead skin like a traditional face scrub, but it also contains mild acids that will decrease inflammation and prevent further breakouts. As a mode of chemical exfoliation, salicylic acid increases cell turnover, refreshes the skin, helps kill germs and bacteria, and tightens pores. It is most useful in oily skin and, like aspirin, it can relieve inflammation and redness.

Over-the-counter treatment products with 0.5% to 2% salicylic acid are safe to use in the treatment room, as well as at home. The problem with most acne products that list salicylic acid as their active ingredient is that they do not contain the correct concentration of salicylic acid at the right pH. For facial products, 2% salicylic acid is used with 98% of the product being a neutral carrier agent. Up to 3% salicylic acid can be used on other body parts and a 10% to 30% spot treatment will dissolve warts.

Compared to alpha hydroxy acids in acne care products, which can be up to 30%, the same treatment is safely achieved by 0.5% to 2% concentration of salicylic acid. Because salicylic acid can cause mild stinging and skin irritation, dermatologists highly recommend using it in moderation.

Salicylic acid is generally a safe compound when applied at proper concentrations for the treatment of acne, but there are some instances where salicylic is contraindicated. People that are allergic to aspirin (which is a similar ingredient) or have rosacea or couperose should avoid salicylic acid. Pregnant women and breastfeeding women should also avoid salicylic acid.

This ingredient also should not be used on children younger than two years old and only with a physician’s prescription for older children because the absorption through skin is greater. Also, doctors advise being cautious in the use of salicylic acid on Fitzpatrick types IV, V, and VI. When treated by salicylic acid, acne in these skin types may be replaced by brown or black hyperpigmentation.

Be careful when using salicylic acid if the client already has a strong exfoliation routine. Advise them to limit exfoliation to two to three times a week and, furthermore, cut back on any facial scrubs, harsh soaps, or exfoliating masks. At home, it is recommended that clients use a salicylic acid exfoliant two or three times a week, but start with once weekly at night to determine how the skin will react. Salicylic acid does not have any effect on sebum production and does not kill bacteria, so it is important to use products with a variety of ingredients, in addition to salicylic acid, when working on acneic skin.

PEELS

Jessner’s solution or Jessner’s peel is the common name often used for a deeper chemical peel solution consisting of 14% lactic acid, a 14% salicylic acid peeling agent, and a resorcinol solvent. The lactic acid assists in the exfoliation of the skin, salicylic acid aids in penetration, and resorcinol assists in the treatment of acne. This procedure was named after Max Jessner, the New York dermatologist who invented it, and is layered on the skin to treat uneven pigmentation, acne, and acne scarring and reduce the appearance of large pores, wrinkles, and uneven skin tone.

After the client’s skin is thoroughly cleansed, the peel chemicals are applied. As a general rule, two to five coats are applied for the best possible results. The client can expect aggressive peeling and occasional crusting within two to four days after the peel has been applied.

Not everyone is a good candidate for a Jessner’s peel. The following clients are contraindicated for this type of procedure:

• clients with active cold sores
• tan, sunburned, or tanning bed use
• severe asthma
• lupus, eczema, rosacea, or psoriasis
• pregnant women
• clients with chronic skin disorders and dermatitis conditions

DEVICES

Perhaps the most well-known device for exfoliating the skin in the treatment room is the microdermabrasion machine. Microdermabrasion is a popular procedure because it works on both the epidermis and the dermis. There are three basic types of microdermabrasion: crystal microdermabrasion, diamond microdermabrasion, and hydradermabrasion. They all offer similar benefits, but the process between the three is slightly different.

During a crystal microdermabrasion treatment, very fine crystals are sprayed over the skin from a receptacle through a wand. The crystals and exfoliated skin particles are then simultaneously vacuumed away through the same wand. Used crystals are sent to a second receptacle on the machine and are discarded after every procedure. Aluminum oxide crystals are typically used because they are not nearly as hard as diamonds. Magnesium oxide, sodium bicarbonate, and even sodium chloride crystals are sometimes used, as well.

Diamond-tip microdermabrasion is a newer procedure where instead of using crystals to exfoliate the skin, a wand with a diamond-encrusted tip is passed over the skin. The diamond tip abrades the skin and, like the crystal version, the exfoliated dry skin particles are then vacuumed away through the same wand. Diamond-tip microdermabrasion is cleaner and there are no stray gritty crystals left behind on the skin. In addition to this, breathing in aluminum oxide crystals can be irritating and can cause short-term breathing problems for very sensitive people. There are fewer aestheticians using crystal and diamond tip microdermabrasion; many are opting for hydradermabrasion devices.

Although regular microdermabrasion often produces great results at first, it can be extremely damaging for skin long-term, resulting in broken capillaries, increased oil production, and thinning of the skin. Hydradermabrasion is a gentler and more effective exfoliating treatment that uses jets to distribute air and water at a high speed. This machine combines simultaneous dermal infusion of products and crystal-free exfoliation. The treatment is effective but gentle, making it suitable for all skin types, including sensitive, dry skin. Antioxidants in serums introduced through this treatment hydrate and decrease inflammation in the skin, reversing photo damage, while protecting lipid membranes, collagen fibers, and enzyme systems.

Another great way to cleanse the skin is ultrasonic exfoliation. An ultrasonic skin spatula or ultrasonic skin scrubber is a small, hand-held device that features a thin plate that vibrates 25,000 to 28,000 hertz per-second and removes dead skin cells, dirt, and debris. The spatula works by creating high speed oscillations that extract pores without pain. For those clients with sensitive skin, ultrasonic exfoliation is a wonderful alternative to skin-cleansing brushes and microdermabrasion (both of which spread bacteria and aggravate redness and discomfort). The aesthetician controls the pressure, angle, and direction of the spatula to delicately work debris from the client’s pores, focusing on problem areas and exfoliating the skin gently without aggressively brushing or peeling it. Since using water or a hydrating toner with the spatula, and not a gritty scrub, the client’s skin will feel very clean and smooth after the treatment.

There is a large variety of exfoliators available to skin care professionals and more innovations entering the market every year. Products are getting cleaner and more natural and devices are becoming more compact, ergonomic, and affordable. One of the best ways to learn about a product is from the manufacturer. Reputable brands always supply protocols and training materials for aestheticians to better further their understanding of the ingredients, science, and treatments. Although the information in this article is good general knowledge, not all products have similar composition and all brands have different protocols. If confused about a certain product, reach out to the manufacturer for the exact directions and guidance.

Dasha Saian is the co-founder and current CEO of Saian Natural Clinical Skincare and has over 17 years of experience in the spa industry. In addition to her business and marketing degree, she is a licensed aesthetician, certified nutrition and wellness consultant, official ambassador of the Aesthetics International Association (AIA), and certified family herbalist. Saian gives lectures and classes internationally and regularly contributes to global trade publications.

Those who know me well know I am absolutely obsessed with raw nuts, seeds, dried fruit, and berries. In fact, I always keep pumpkin seeds, chia seeds, hemp seeds, and a variety of nuts in the house and pack them in my bag daily for easy work snacks. And, do not get me started on airport food – it is just the worst. I am on an airplane every weekend for work, so eating healthy can be challenging. This is why bringing my own snacks has become a habit in my book.

Almonds are one of the most easily accessible type of nuts. You can find raw almonds in any local grocery store, at gas stations, and convenience stores. But, do not let that fool you – they are a super food. Almonds contain vitamins B2 and E, phosphorus, magnesium, manganese, and copper. Most importantly, a one-fourth cup serving contains 49 percent of your recommended daily allowance of biotin. What is biotin? Biotin, also known as B7, is vital for the proper function of the nervous system and musculature and for maintaining cellular processes like growth, metabolism, and energy. It is frequently referred to as the “beauty vitamin” because of its restorative properties for the skin. When we lack biotin, our skin is the first to show the signs of a deficiency. According to the Dermal Institute, these are the symptoms of a B7 deficiency:

• Red, scaly rash around the nose, mouth, and eyes
• Thinning hair, sometimes with shedding and loss of pigment (graying hair)
• Possible depression, fatigue, and hallucinations
• Tingling sensations in the arms and legs
• Muscle cramps after exercise
• Possible high cholesterol and heart problems
• Cradle cap, a type of seborrheic dermatitis of the scalp, head, and eyebrows (in babies, crusty yellowish-whitish patches appear in these areas and may or may not be itchy)
• Increased risk for developing other health issues

To keep healthy and avoid any skin problems like this, you can incorporate almonds into both your meals and your skin care routine. Here are four ways to do this.

INCORPORATE ALMONDS INTO YOUR DIET

Do not be confused by uneducated people telling you that consuming nuts will make you gain weight. Numerous studies have shown that incorporating unsaturated fats (such as nuts and avocado) actually helps stabilize weight.

A 28-month study, involving 8,865 adult men and women in Spain, found that participants who ate nuts at least two times per week were 31 percent less likely to gain weight than participants who never ate nuts. Among the participants who gained weight, those who never ate nuts gained an average of 424 grams more than those who ate nuts at least twice a week.

A serving of almonds has 162 calories, 14 grams of heart-healthy unsaturated fat, and six grams of protein. Remember, one serving of almonds is 23 almonds, which equals one ounce, one-fourth cup, or about one handful. Portion control is key. I also highly encourage you to stay away from processed nuts. I personally avoid any roasted, salted, or flavored nuts at all costs. The best way to eat them is to sprout them.

Sprouting or soaking nuts removes the outer shell, which contains phytic acid. Phytic acid is a naturally-occurring botanical substance. It is a strong chelator to the most essential minerals, such as zinc, calcium, and iron. Whenever you consume nuts with phytic acid present (with the shell on, essentially), those nutrients will be removed and not used by your body, as they were intended. When you soak and sprout the almonds, not only will you remove the outer shell, and the physic acid, but you will also increase the amount of active enzymes in the nuts, making it more easily digestible for those who experience stomach issues during digestion.

USE AN ALMOND SCRUB

Have you heard about microbeads? If not, I would like to educate you on these little plastic culprits. Make sure you stay away from face and body scrubs which list them as an active ingredient. Microbeads are tiny round plastic beads that are found in some exfoliating products and they are causing quite a stir in the environmental world. The plastic waste caused by these microbeads, which are not filtered out during sewage treatment, is damaging water ecosystems and killing marine life.

In 2013, research at the University of Wisconsin-Superior showed that there were 1,500 to 1.7 million plastic particles per square mile in the Great Lakes! Not only are the beads damaging to fish, they are also bad for your face – microbeads can cause eye irritation and promote rosacea and couperose. It is no wonder that Illinois was the first state to ban the use of microbeads in June of 2014 – and I sincerely hope all other states will quickly follow.

Instead of using these plastic beads, I suggest natural options, like scrubs with ground up almonds, seeds, and stone pits from apricots/peaches, crushed walnut husks, oats, coffee grinds, salt, and sugar. I especially recommend sugar, for those dealing with eczema since it is non-irritating on broken skin, and sea salt for psoriasis sufferers. This should not be done more than once a week. All other scrubs can be used three times a week, but not more. Our skin needs adequate time to amass dry dead cells and you definitely do not want to overexfoliate.

USE ALMOND OIL AS A BODY MOISTURIZER

Did you know that different vegetable oils rank differently against each other when it comes to how much they clog the pores? Oils rank from zero to five, zero being least comedogenic, and five being most comedogenic. Almond oil is an amazing two (moderately low), while coconut oil is a high four, rendering it a bad choice for skin care. Almond oil can be used as a hair moisturizer, a body moisturizer, and a wonderful massage oil.

USE ALMOND MILK AS AN ACTIVATOR FOR POWDER MASKS

Who says you cannot play with your food? I love the idea of incorporating almonds in every step of the beauty routine. Almond milk is gentle and soothing on the skin, which makes it a perfect activator for powder enzyme masks. Simply mix the powder with a bit of warm almond milk and apply to the face for seven to 10 minutes. The result is a bright, supple complexion. Using this mask helps to pull out oils, exfoliate, and reduce the appearance of sun damage, wrinkles, cellulite, and even stretch marks. It is perfect for blemished skin, blackheads, and even cystic acne and is excellent for soothing skin conditions such as rosacea, eczema, rashes, psoriasis, and acne.

Dasha Saian is the co-founder and current CEO of Saian® and has over 17 years of experience in the spa industry. In addition to her business/marketing degree, she is a licensed aesthetician, certified nutrition and wellness consultant, official ambassador of the Aesthetics International Association (AIA), and certified family herbalist. Saian gives lectures and classes internationally and regularly contributes to global trade publications.

When it comes to anti-aging equipment, the variety of products and modalities available to professionals today is incredible, to say the least. Yet, having so many options at one’s disposal can be overwhelming, especially when trying to maximize efficiency, client satisfaction, and profits. What factors should be considered when trying to decide between LED and microcurrent or galvanic and radio frequency?

With all the constant advancements in the industry, aestheticians have never been in a better position to achieve the best anti-aging results for clients’ skin. There are endless choices of products and modalities available that promise to improve the bottom line, attract and retain new clientele, and gain a competitive edge over other skin care professionals in the area.

Having a results-oriented product line is one part of the equation, the other is purchasing the right tools and equipment. In selecting the right equipment, take into consideration budget, the space in the treatment room, and clientele demographic. Will this device increase profits and how long will it take to recuperate the cost of the device?

In addition to the factors above, professionals may only operate devices that are listed within their scope of practice as an aesthetician. Although all of the equipment in this article is intended for anti-aging and rejuvenating purposes, not all of it is accessible to aestheticians. For example, intense pulsed light (IPL) and laser devices are designed with different wavelength settings. In a medical aesthetics practice, there may be physicians, nurses, physician assistants, and aestheticians. However, in most states, only a physician or registered nurse is allowed to operate IPL and laser machines. To be sure, check the regulations for the state where the spa is located.

In the United States, there are four classes of medical devices. The class is an FDA classification that refers to how aggressive the device is and whether it requires a physician or nurse under the supervision of a doctor to operate it. Several types of lights will be discussed in this article. They are all different and are classified as Class I through Class IV. LED lights are (most likely) classified as Class I or Class II and IPL and laser are Class III or IV medical devices found in medical offices and medical spas.

Though most IPL and lasers are medical devices and are not included within the aesthetician’s scope of practice, the light device that can be purchased as an aesthetician is an LED light therapy tool, which is the gentlest type of light treatment, with
no contraindications.

LASER

Laser is an acronym. It stands for Light Amplification Stimulated Emission Radiation.

An IPL laser usually gives good results for diminishing redness and fresh hyperpigmentation and stimulating mild collagen growth. A series of six is recommended, and the cost is usually around $500.

Photorejuvenation laser treatments are most commonly used for lightening and removing hyperpigmentation on the face, neck, chest, hands, and other areas of the body, as well as reducing redness and rosacea. It has a lesser effect on improving skin texture through collagen stimulation and improves pore size minimally by temporarily reducing oiliness. Like all laser treatments, it is best to do this treatment in the winter and the client will need maintenance treatments when brown spots reappear, usually once or twice a year. This treatment can be administered by a doctor, certified physician assistant (PA-C), advanced registered nurse practitioner (ARNP), registered nurse (RN), or medical assistant (MA).

During the treatment, the IPL device sends short, concentrated, pulsating beams of light to irregular skin. The light bypasses the epidermis and gently heats the cells in the dermis. The fibroblasts start to produce more collagen, which improves texture and fine wrinkles. The new skin that forms is smoother and firmer. The client has a sensation of light sunburn immediately after the treatment and may experience prolonged redness, swelling, oozing, delayed wound healing, scarring, crusting or scabbing, pigmentary changes, and acne flareups.

Fractional lasers are newer and also treat wrinkles and post-acne scars. The non-ablative fractional lasers may cost as much as $5,000 for six treatments and have a two day down-time. This laser will take two to six months to give the best results.

Ablative fractional lasers have a four to eight day down-time and give better results for the wrinkled areas on the neck. The cost of this procedure is usually $1,000 to $2,000 per treatment and a series of four is recommended over a six-month time span.

LIGHT HEAT ENERGY (LHE)

LHE skin rejuvenation uses the combination of light and heat energy at low frequencies to target the dermis. This process is completely safe for the client and requires little downtime. The natural fusion of light and heat energy increases overall effectiveness of the procedure and speeds up the healing process compared to other skin rejuvenation techniques that only use light or heat. Skin rejuvenation also accelerates blood circulation, allowing better absorption of anti-aging serums and creams.

LHE skin rejuvenation can be separated into several treatments used to treat skin concerns that most clients experience in older age. These treatments include: collagen renewal, wrinkles reduction, rosacea treatment, pigmented lesion treatment, and vascular lesion treatment.

Using LHE technology, skin rejuvenation works by applying short pulses of light and heat energy into the dermal-epidermal joining area deep in the skin. The procedure affects the skin just enough to trigger a wound-healing response, which produces new collagen under the undamaged layer, thereby replacing the old collagen. Fibroblast stimulation then occurs to help further build collagen and elastic fiber cells in the connective tissue of the inner layer of the skin. The effect of the LHE method gives the skin the elasticity it needs to look firm and plump.

The skin rejuvenation process can occur over a few weeks or up to a few months. During this time, the wound-healing response will significantly improve skin tone and texture. The healing process will also fade away fine lines and wrinkles. Depending on the type of treatment, a full treatment course ranges from six to eight sessions spaced one to three weeks apart to get maximum results.

LED

After the age of 30, people lose approximately one percent of collagen per year. To rejuvenate the skin, and stimulate collagen and elastin production, one of the best modalities is LED – a tiny computer chip encased in glass. Red or amber anti-aging LED therapy is non-invasive, painless, and requires no recovery time. It is safe for all skin types and tones and a full treatment requires only 20 minutes.

Each LED wavelength (color) of light provides unique therapeutic benefits. Blue kills germs and bacteria; amber stimulates collagen and elastin; red stimulates circulation and calms down inflammation; and infrared heals and calms the skin, and also improves product absorption. The best combination of lights for anti-aging and skin rejuvenation is red, infrared, and amber together. This type of light synergistically minimizes the appearance of large pores, increases moisture retention, prevents environmental damage, renews the skin, and encourages new collagen production. Such lights are available in a handheld version for home use, as well as panels, for faster and more convenient treatment room services. LED lights can be used by aestheticians in all states with no physician supervision.

Panel LED lights are the most convenient type of phototherapy equipment, since they do not require direct hands-on supervision and cover a larger treatment area than a handheld for a full 20-minutes. This type of treatment can be added as an à la carte to a service menu and is also beautifully incorporated into the facial with clear serums, creams, and masks. Clear products work best because they allow the light to shine through, uninterrupted. Using the LED panel with peptide serums, creams, and masks increases the efficacy of the light and promotes instant and cumulative skin tightening and reduction of wrinkles.

GALVANIC

Galvanic current is a constant and direct current (DC) that uses a positive and negative pole to produce the chemical reactions when it passes through tissues and fluids in the body. The two main reactions of the galvanic machine are ionic iontophoresis and chemical desincrustation.

For the best anti-aging results, both desincrustation and ionic iontophoresis are advised. In the beginning of the treatment, desincrustation is used. Desincrustation is a deep cleansing treatment that softens and emulsifies sebum and is ideal in preparing the skin for extractions. It should be done after cleansing the skin, using desincrustation fluid – a type of alkaline solution, made from sodium chloride, that causes an alkaline reaction to soften follicles for deep cleansing.

At the end of the facial, the galvanic machine can be used to penetrate products. Starting with desincrustation reduces the barrier properties of the skin by assisting with exfoliation, making it easier for ions to move across the skin during iontophoresis.

Although this is a very commonly used machine in an aesthetician’s scope of practice, do not forget to make sure the client fills out the consultation form and is not contraindicated to receive a galvanic treatment. Contraindications for using a galvanic device are pregnancy, metal implants, pins in the face or body, epilepsy, pacemaker, and high blood pressure.

Along with the galvanic machine, some of the most popular modalities among aestheticians in skin tightening and firming are microcurrent and radio frequency. The ideal client for a microcurrent or radio frequency (RF) procedure is anyone over the age of 21 who may be concerned with wrinkles, loss of skin tone, muscle tone, and elasticity, as well as clients complaining of an overall droopy appearance – sagging jowls, flat cheekbones, and pronounced nasolabial folds.

MICROCURRENT

As far as this modality is concerned, it is less about improving the skin’s texture, and more about tightening the muscles. Microcurrent mimics the body’s own natural bioelectrical field and sends tiny electrical currents to muscles. Two ball probes, negative and positive, with currents running between them, stimulate the muscle, causing tightening. Microcurrent devices lift and re-educate muscles, creating a lifted and convex appearance. Combining ultra low frequencies with a modified waveform enables the microcurrent to recharge the electrical potential of the muscle by stimulating the spindle cell fibers that run the length of the muscle.

Originally developed for treating facial palsy, microcurrent devices are used in aesthetic practices to re-educate muscles; increase blood and lymph circulation; enhance the penetration of the active ingredients of skin care formulations; increase the production of collagen and elastin; and increase protein synthesis, gluconeogenesis, and cell membrane transport.

Additionally, research has shown that microcurrents may help with anti-aging at an even deeper level – in studies, it has increased levels of adenosine triphosphate (ATP) in laboratory rats’ skin cells by 500 percent. These devices come in a variety of sizes and intensities, ranging from free-standing units to table tops and handhelds.

RADIO FREQUENCY

Radio frequency (RF) is a procedure commonly used for the treatment of skin laxity from an increase in tissue temperature. This is an anti-aging modality that produces a selective and controlled rise in tissue temperature from a high-frequency alternating current (0.3 to 10 MHz). The rising of temperature and the depth of heating depend on the level of energy used and on the impedance of biological tissues. The goal is to induce thermal damage to, thus, stimulate neocollagenesis in deep layers of the skin and subcutaneous tissue. After a series of treatments, the facial skin in the treated areas appears more firm and tight.

As with microcurrents, RF devices come in a variety of sizes and intensities, ranging from free-standing units to table tops and handhelds.

Take ample time in selecting the best modalities for the treatment room. Consider the devices that are within scope of practice, as well as within budget. Do not blindly follow the trends but do research and make the most educated purchase for client demographic and budget. When used correctly and in combination with the right products, these devices are sure to increase the bottom line and provide the best, non-surgical, facelift results clients are looking for.

Dasha Saian is the co-founder and current CEO of Saian Natural Clinical Skincare and has over 17 years of experience in the spa industry. In addition to her business and marketing degree, she is a licensed aesthetician, certified nutrition and wellness consultant, an official ambassador of the Aesthetics International Association (AIA), and a certified family herbalist. Saian gives lectures and classes internationally and regularly contributes to global trade publications. She is an expert adviser on natural living, alkaline diet, alternative oncology protocols, and positive body image.

Milia occur when keratin becomes trapped beneath the epidermis

Milia, the most commonly used term, is the plural form of milium, as many milia are usually found together.

Milia are also often inaccurately referred to as “baby acne.”

Treating acne requires a proper homecare regimen, an understanding of client allergies and intolerances, and regular visits to a skin care professional. A knowledgeable aesthetician will use a variety of professional products and modalities to deeply cleanse, exfoliate, decongest, and disinfect the skin, as well as soothe and heal any inflammation associated with acne.

How many people have heard about face yoga or facial exercises, but are unsure if these methods really work for tightening sagging skin? There are a number of YouTube tutorials, books, and miscellaneous information on the subject available online, which may confuse the general public.

At one point or another, skin care professionals will all use salicylic acid – it is one of the most popular ingredients in anti-acne skin care. Salicylic is the only beta hydroxy acid used in skin care; it occurs naturally in wintergreen leaves, sweet birch, and other plants, and is topically an anesthetic and a keratolytic with a mild peeling effect. For milder acne, salicylic acid helps unclog pores to resolve and prevent lesions. It is derived from the metabolism of salicin, which is an alcoholic β-glucoside.

How do I choose the right sunscreen? What is SPF? Which sunscreen is safe for my children? Should I use a waterproof sunscreen? Many people, including skin care professionals, have questions about sun care products. There is a vast array of sunscreen products on the market and plenty of conflicting information regarding their effectiveness, toxicity, and proper mode of application. It is important for professionals to thoroughly understand the topic of sunscreen in order to best advise their clients on proper sun care methods.

Many clients tend to over-exfoliate their skin in hopes of sloughing off dead cells and achieving a fresh and renewed complexion. This belief is a misconception; the skin is a very efficient organ and does not require daily exfoliation. Exfoliating daily can strip the skin of its natural oils, which may cause breakouts.

As the first person clients communicate with, on the phone and upon entering the spa, a spa receptionist needs to make a lasting first impression. A great receptionist is on the front lines and has a professional appearance and attitude.

The first thing to look for in a qualified spa receptionist is a tidy, put-together appearance. The spa is a place of beauty, health, and tranquility, so having a receptionist with chipped nails, or messy hair will create disharmony in the overall image of the business. By no means do the employees have to look like supermodels, but excellent hygiene is a must.

Collagen infusion therapy is the perfect treatment for aging skin. Freeze-dried collagen masks enhance moisture levels, hydrate, improve functions of skin capillaries, recover loss of firmness and elasticity, even color tone, and oxygenate and stimulate natural skin collagen production.

While supplements and healthy eating are not often thought of as aesthetic staples, they are vital to skin health and overall wellness. Dietary supplements provide nutrients to the body that may not be obtained in sufficient quantities.

When treating the acneic client, successful results come from a combination of a consistent homecare routine and professional treatments that are tailored to their acneic problems. One of the most important things to remember when treating clients that suffer from acne is that cross-contamination must be eliminated.

The cold and windy wintertime is ahead of us and that can mean dry, flaky, and irritated skin. The majority of clients who wish to hydrate their skin are not sure how and when to use a serum as opposed to a cream; the overwhelming amount of moisturizers on the market can cause much confusion. With the correct professional treatments and targeted homecare, winter skin can be glowing, moisturized, and healthy!

As skin care professionals, we know the importance of skin exfoliation for healthy cell turnover, a refreshed and clear complexion, and better product absorption, but what about the methods of exfoliation? No one way of exfoliation is perfect for all skin types, but there are many possible alternatives that make it easy to find a method for every client! To make things as simple as possible – there  are two types of exfoliators – physical and chemical.

Sanitation and infection control are some of the first things we learn in beauty school, and for good reason! It is crucial to have an understanding of the different kinds of infections you may come across, in order to protect yourself and the client. Clients rely on our knowledge and professionalism and trust us with their health, so we must abide by the law by giving them the best treatment without taking shortcuts.