What will skin care look like in the future? This is the question I'll be exploring in my new series of ongoing columns for DERMASCOPE. After 30 years in this remarkable business, I've formed some strong opinions. But you already know that - otherwise you'd stop reading! And, I welcome your input - please be sure to check out the contact at the end of each column.
Of course, the future is now. Are you ready? Just like comic book space invaders, skin therapists indeed have laser-guns-and that's not an intrinsically bad thing.
And, we have a growing-actually exploding-number of latex-gloved, white-gowned clinicians treating the skin as if it were a suit of clothes that's been dropped off by its owner for a quick spiffing-up. But this is not the destination I had in mind for the industry which I love so passionately.
Let me say that I am not anti-M.D. Really. I entrust my own skin to a dermatologist, UCLA's Dr. Joshua Wieder, and he's fantastic, ethical, and wise.
But part of my mission in writing this column is to help all of us forge a better understanding and a better bond between dermatologists and other skin care professionals-- namely licensed skin therapists like myself who do not possess a medical degree.
Are Dermatologists The New "Aestheticians"?
Medical doctors still like to call us "aestheticians"-facilitators of beauty. This is a term I would apply to a make-up artist (and I can't live without a good mascara!), but not to a skin therapist, since we, like dermatologists, are dedicated to the health of the skin and not its beauty.
Maybe because most of them are men, maybe because most of us are women, this doesn't set too well with M.D.s. So for this reason, the term "aesthetician" persists. It's a code-word for someone who doesn't really know much about skin. And I think you really can only fully live up to the term if you keep your frosted hair in pink sponge rollers, have a skinny, "lady" cigarette with at least one inch of ash dangling from your perma-lined lips at all times, and wear a leopard-print polyester smock monogrammed "Sexy Sadie."
Methinks the medical industry doth protest too much. Being a doctor means that you have taken the Hippocratic Oath, meaning that you dedicate your practice to never harming clients who entrust themselves to your care. This means skin, in the case of the clients who entrust themselves to a dermatologist.
Well, has anyone been to Beverly Hills lately? There seems to be a new "scorched earth" policy in place. The name of this sci-fi thriller is "90210-The Revenge of the Translucent Women." Run for your lives-they've all had one-too-many "lunch-hour procedures", and now they want their epidermis back! And of course, these procedures have nothing to do with the health of the skin, even at their best. They are all about aesthetics-so, perhaps M.D.s are actually the new "aestheticians."
Why Do They Do It?
It's a fact that overly aggressive exfoliation, whether chemical, mechanical, or both, jeopardizes skin health. The relentless stripping of the lipid barrier which I observe out in the world can set up a nasty sensitized reaction in the skin. And newly, perilously "thin-skinned" clients may experience allergy-like reactions to all sorts of things, including favorite cosmetics and skin care products which they've used for years.
Many dermatologists have also recently gotten into the business of developing and marketing their own skin care products, targeted at the well-heeled anti-aging market.
I am not denying that the anti-aging market and its financial potential are as seductive as any siren-call. We all want to look good. We all want to feel good. And that's very good! It's good to feel good and I am all for it.
But at the end of the day, the term "anti-aging" actually makes my skin crawl, appropriately enough. I've always worked against the old "hope in a jar" fantasy. I think of the most intelligent response to the passage of time as "age with edge." Call it the Dame Judy Dench Factor. Let's remember-this year, Nabokov's once-notorious novel "Lolita" turns 50. Now THAT's a wake-up call!
It's Not Brain-Surgery!
With this in mind, it's high time that dermatologists take a page from OUR book-the expertise of the professional skin therapist. I can't think of a single dermatologist who knows what we know, or can do what we can do. I don't know of one who can give a proper skin treatment-- much less (with apologies to the mild-mannered Dr. Wieder), a Brazilian or Sphinx!
This may all seem very heady stuff for an M.D., which makes my point that they can learn from us. Yes, US. In order to truly serve the skin and whoever's in it, M.D.s must look at the decades of tradition which surround the practice of conventional medicine, especially in the days when it was entirely male-dominated, from a fresh angle. Rather than detaching from the patient, as doctors genuinely must in order to perform surgery, for instance, M.D.s involved with skin care now must learn to connect with the client. Rather than relying purely upon the cognitive, they must learn to re-integrate the intuitive back into their diagnostic equation, because once upon a time, ALL doctors were healers in a traditional sense and understood the link between body, mind, and spirit. A new form of intimacy must be defined and employed in the professional-client relationship. Only when M.D.s and skin therapists come to an understanding and can work in mutually supportive, truly complementary modalities will skin care clients finally receive optimum treatment from both a clinical and a whole-person perspective.
By the way, Dr. Wieder, how do you feel about leopard-print?