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Monday, 27 July 2009 14:11

The Need for Speed

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The concept of exfoliation is nothing new, and this most certainly is not the first article you have ever read on the topic. There are ever changing products and equipment for exfoliation. However, the one thing that doesn’t change is the physiological way your skin functions. With that in mind, let’s talk about what it is, why we need it, and how to determine when enough is enough!

The concept of exfoliation has been around longer than we can even imagine. The first practice of exfoliation is given to the ancient Egyptians, if you will recall, Cleopatra used to bathe in milk, a.k.a. lactic acid! In the Middle Ages, wine was used as a chemical exfoliant, with tartaric acid as the active agent. In Asia, the practice of exfoliation started hundreds of years ago. Uses of exfoliation were not simply to beautify the skin, but also noted for ridding the body of illness, rites of passage, detoxification, and removing evil spirits! For purposes of the 21st century, let’s stick to beautifying and improving the health of the skin.


A Little Skin Physiology
We all understand the concept of cell renewal. New skin cells are created in the basal layer of the skin, via a process called mitosis. Over time, cells migrate to the surface of the skin, undergoing a process known as keratinization, becoming more acidic and resulting in hard, flattened keratinized skin cells, called corneocytes. Keratin, the protein substance that makes up our hair, nails, and skin, plays a crucial role in protecting the skin from outside elements. In young, healthy skin, the approximate time it takes for a cell to travel from the basal layer to the stratum corneum to be sloughed from the surface is about 28 days.

The Reality of it All…
The skin is a truly amazing organ. Without it, no other organ would survive; it has the ability to control body temperature, waste removal, detoxification, provide structure and protection, as well as to make us look good. It also has the unique ability to completely replace itself, all on its own. The reality is that it is designed to do it by itself! Until of course, you throw in… the "human factor."
Now, we won't take all of the blame, but let's look at factors that influence the rate of cell turnover. As we age, especially following menopause for women, the natural process of skin erosion becomes uneven, which results in a loss of retained water, a dry, rough, and uneven texture. Obviously, we can't stop the natural aging process, but we can do something about factors that contribute to the "unnatural," or pre-mature aging process. External factors such as pollution, UV exposure, smoking, poor diet, stress, medications, illness, improper product use, and excess exfoliation all contribute to early aging of the skin, and an inhibited rate of cell turnover. Now I don't know about you, but I can't even come up with a dozen people that I know that have not fallen to one of the factors on
that list!

The Simple Process…
Exfoliation removes the outer layer of skin to reveal the newer skin beneath, while simultaneously triggering the repair response in the dermis. Activating fibroblast cells and basal cells to kick into overdrive, in an effort to replace that outer layer that was just removed. The deeper and more aggressive the method of exfoliation, the more intense the repair activation. Although intended to be a benefit to the skin, exfoliation, of whichever kind, is a form of damage to the surface of the skin.

The Down Side…
As I just mentioned, exfoliation triggers the skin's natural repair mechanisms, promoting cell turnover, but also triggers other protective mechanisms, such as melanogenesis, the process in which melanocytes produce and deposit melanin, resulting in hyperpigmentation.
Excess exfoliation, whether it be at home or professional, results in an inability of skin cells to function in any sort of normal behavior. Resulting in a constant state of the skin thinking it needs to "repair and protect" itself, and not knowing when to "shut off" and function as normal. This scenario is very common with the excess use of acids and acid peels such as glycolic. I often say it's like a "drug" for the skin. The more we use, the more we want/need, and then when we stop, we end up in withdrawal, not knowing how to function.

Now What do we Do?
We start by taking some responsibility. The aesthetic business has absolutely exploded over the last few years, and statistics from the research department of the department of labor says that we have only just begun. Our profession will thrive not only in numbers, but in revenue as well, by an increase in as much as 34 to 40 percent in the next eight to 10 years! How much do you love your job now?
However, with the growth in our profession comes a major responsibility, knowledge, and education. The tide has already begun to turn. Day after day aestheticians are seeing clients that are coming to them and relying on them for options in caring for, maintaining, and altering the appearance of their skin. They are desperate for solutions to sensitivity, early aging, hyperpigmentation, acne, proper product choices, and quite simply, healthy skin.
You must have a complete and thorough understanding of skin physiology. And I don't just mean what you learned in aesthetic school, took a test on, and then never reviewed again… I mean, really have a complete understanding of each layer of the skin, the function it serves, and the role it plays in the overall process of keratinization.
You must be knowledgeable of the workings of the dermis, both layers, because without it, we would most certainly not have an epidermis. Understand fibroblasts, collagen, elastin, melanocytes, and langerhan cells. You should not only be capable of identifying theses skin components, but understand where they are located, the role that they play, and the types of things that stimulate and impede their growth and production. Discuss and describe melanogenesis and the skin's natural inflammatory responses… because what you do as a professional aesthetician can alter the physiological functioning of all of these cells, cellular components, and processes. Everything you do to the surface of the skin, especially when it involves exfoliation, will have either a direct or indirect impact on the dermis.

Types of Exfoliation...
Mechanical exfoliation involves physically scrubbing the skin with an abrasive such as microfiber cloths, adhesive exfoliation sheets, microbead facial scrubs, scrubs with particles of polyethylene beads, crepe paper, crushed apricot kernel or almond shells, sugar or salt crystals, pumice, or abrasive materials such as sponges, loofahs, brushes, and various forms of microdermabrasion.
Chemical exfoliation consists of products containing fruit enzymes, that act to dissolve dead, surface skin cells; betahydroxy acids, such as salicylic acid; alphahydroxy acids, such as glycolic acid, citric acid, or malic acid. These all may be applied in various concentrations. More recently the chemical properties of wine producing grapes have been used in the practice of "Vinotherapy," especially for body exfoliation.
Every day a new ingredient, technique, or machine is introduced, and there isn't nearly enough room to cover each one in this article. What you do need to know, is that regardless of the exfoliation method that you choose, you absolutely must understand what it is, how it works, why it works, and who it is best suited for.

Home vs. Professional
Home care exfoliation methods range everywhere from a washcloth or a loofah, to enzymes and acids… and even at-home microdermabrasion machines or chemical peels! You know your clients as well as they do, if not better. Help them make the proper choice in home exfoliation. At-home exfoliating options should be tailored to the specific skin needs of the client, should only be performed three to four times per week, and should be adjusted with seasonal, hormonal, medical, or any other changes.
Young, healthy skin can benefit from a mild facial scrub or gommage. Nothing too abrasive, and designed to simply remove excess dirt, debris, environmental pollution, and promote the overall health of the skin. Abrasive scrubs are more suited for the body, especially the arms and the legs, and can activate inflammatory responses in facial skin, scratch the skin, and stimulate sebaceous gland activity.
Dry, sensitive, or dehydrated skin would benefit from a gentle enzyme exfoliant. Only to be used two to three times per week, and suited for this particular skin type.
Oily skin can benefit from an enzyme exfoliant or a mild salicylic exfoliant. To be used three to five times per week, depending upon the condition of the skin, and the physical activity level of the individual. For instance, if it is a male who plays outdoor sports, and sweats a great deal, he would be more suited for the five day exfoliation schedule. Keep in mind, excess exfoliation can actually stimulate excess sebaceous gland activity.
If hyperpigmentation or pre-mature aging is the concern, then enzymes and acids are fabulous, especially lactic. However, this is home use, not professional. Be sure to recommend mild abrasives with acids of low strength and moderate pH, above 3.5-4 for home use.
All home care exfoliation products should absolutely go hand in hand with an entire home care maintenance program, that includes, at the least, proper cleanser, toner, moisturizer, and sunscreen. This is also another part of your professional responsibility. Exfoliation speeds up cell renewal. It is necessary that in turn, clients are taking the proper steps to care for and protect those renewed skin cells.
Professional exfoliation is one of the most popular services that our skin care customers seek. Ranging from mild exfoliants and gommage products used during a facial to enzymes masks/peels, and the entire range of alphahydroxy acids, betahydroxy acids, and multiple forms of microdermabrasion. I know what you are thinking… aren't these the same things you mentioned in home care? Well, they are, but in considerably different strengths and concentrations. Professional exfoliants can be as superficial as the home care selection, or as aggressive as removing several layers of the stratum corneum to penetrating even deeper into the epidermis.
Having a visible impact on the health and condition of the skin is the reason customers have professional skin care services, and all of the just mentioned options are our tools for success. The key is to use those tools for the right job.
First time clients can always benefit from a mild gommage or mechanical exfoliant product after cleansing, and most certainly from an enzyme treatment. These are both designed to soften, smooth, deeply cleanse and place the skin in tip
top shape.
Clients with oil concerns, acne, and clogging are excellent candidates for enzyme treatments as well as salicylic treatments. For the client with mature skin, hyperpigmentation, or sun damage; enzymes, lactic and glycolic are fabulous options. Microdermabrasion is an excellent tool for all skin types to remove superficial dead skin cells instantly, smoothing tone and texture, and increasing product penetration. Depth of abrasion is dependent upon the particular needs of your client. Microdermabrasion can be used occasionally for mild exfoliation and healthy overall glow, or it can be used more aggressively when working on uneven texture, pigmentation, or very fine wrinkles.
Achieving optimal benefits from these treatments is up to you, the professional. Creating a treatment protocol is where the level of efficacy will prevail. Any type of exfoliation treatment can be performed on a monthly basis, or during a scheduled facial service. However, for visible improvements and measureable differences, they should be performed in a specific series, and closely paired with their home care regimen.
This is where a fine line can be drawn – when is enough, enough – and when is it too much. That all depends upon your client and the goal you are trying to achieve. The only way you can determine this is by:

  1. knowing your clients skin and
  2. knowing your product; because every client and their achievable result is different.

You then need to have a plan. Any treatment can be a "one time" service, but just how achievable any result will be is impossible to say. Once you have determined what your clients would like to achieve with their skin, it is your job to recommend a treatment protocol to meet those needs. Use your multitude of exfoliation options in order to meet those needs, with a specifically tailored treatment plan.
For optimal results, your chemical exfoliants and microdermabrasion achieve maximum benefits when performed in a series, once every seven to 10 days, for six treatments. Occasionally this time period can be extended for another series, but should never exceed a 10 to 12 week period. It is absolutely necessary to discontinue weekly treatment of AHAs, BHAs, and microdermabrasion in order to allow the skin the opportunity to return to its' normal, healthy state of functioning. Remember, with all forms of exfoliation, they work by inflicting damage to the surface, forcing an increase in cell renewal. A series is also best suited with a change of seasons, or at four times a year.
A Review of Exfoliant Ingredients
Enzymes are proteolytic agents designed to dissolve dead surface skin cells., which results in a soft, smooth texture, and removal of any excess dirt, debris, and corneocytes.
Chemical Peeling agents dissolve the bonds that hold skin cells together, improving the desquamation process and ridding the upper layer of the epidermis of sun damage, corneocytes, and pigmentation, resulting in an enhanced youthful appearance.

  • Lactic Acid – mild alphahydroxy acid that improves moisture levels as well as pigmentation; excellent for sensitive and dry skin types.
  • Glycolic Acid – powerful alphahydroxy acid used for pigmentation and early signs of aging
  • Salicylic Acid – a beta hydroxy acid that promotes cell turnover and dissolves sebum, making it an excellent choice for oily and acneic skin
  • Microdermabrasion – a mechanical means of removing the top several layers of the stratum corneum, depending upon suction and intensity of the machine, and number of passes on the skin. The most popular forms of microdermabrasion are aluminum oxide crystal machines and diamond tip, crystal free machines.

The beauty in your business is that only you can control the results that you achieve with every and any form of exfoliation. They all have their place, and the client they are best suited for. It is up to you, the professional, to have the knowledge to properly pair the two together. You can only accomplish that goal with knowledge, education, and confidence.

Michelle D’Allaird is a New York State licensed aesthetician and International CIDESCO Diplomat. She is the owner of the Aesthetic Science Institute aesthetic schools in Syracuse and Latham, N.Y. She is a consultant and educator for international cosmetic companies around the world. D’Allaird is a contributing author to major industry trade magazines, as well as a host and speaker for International Congress of Esthetics & Spa conferences in Miami, Philadelphia, Dallas, and Long Beach. She is also a co-author of Salon Fundamentals aesthetic textbook. Her expertise lies in education and curriculum development for aesthetic, medical, and laser courses.

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