Approximately 15 to 20 years ago, when the word “paramedical” first surfaced in the trade publications, I was part of a select group of aestheticians who became intrigued and wanted to learn how to practice this emerging type of aesthetics. I wanted to provide something more substantial and scientific to improve the conditions I was seeing in my treatment room. I set out on a mission to educate myself on this “paramedical skin care” I was reading about. I went as far west and east as I could go to get this education, and at that time, there was just not much out there.

What is Paramedical Aesthetics?
Paramedical or “before medical” skin care is a term that was coined 15 to 20 years ago by skin care professionals using science and technology in their work. These therapists were supporting patients and going beyond just treating clients. They were working either in a physician’s office or in a reciprocal relationship with several doctors to support patients who had cosmetic and reconstructive surgeries.
We have broadened the paramedical term to incorporate three types of professional skin care therapists. There is the practitioner who works in a spa environment and provides relaxation therapy and stress relief-focused treatments. Next, there is the clinical skin care specialist who incorporates some relaxation therapy techniques, but is focused on skin rejuvenation through, the use of cosmeceutical formulations that contain the most active ingredients available without a prescription. Finally, there are nurses and physician assistants who collaborate with doctors in various medical office environments to offer selected services for pre and post-operative surgery protocols.

Education Matters
Education has become increasingly important to the educated consumer receiving services from a skin care specialist. Clinical skin care is rapidly emerging as the standard in aesthetics thanks to baby boomers that are driven to achieve more youthful and healthier appearances. The licensed skin care specialist must be equipped to recognize common skin conditions, develop treatment plans, and meet the growing need for skin rejuvenation services in salons, spas, medi-spas, centers and physicians’ offices.
The same complications that aestheticians faced 10 and 20 years ago are issues that we still face today. Since advanced skills are not typically taught in primary aesthetics education, skin care specialists have to search for educational resources that are committed to interactive training in clinical and medical skin care. Practitioners from all areas of skin care need comprehensive product knowledge to identify the skin conditions they see in their treatment rooms.
In addition to creating treatment plans for clients, it is essential that a skin care specialist incorporate technology into treatments for increased results and client satisfaction. Another effective way for the specialist to gain knowledge is created through establishing collaborative relationships with various types of practitioners. These practitioners can share a wealth of information with you and serve as resources for your clients who many require medical supervision and further invasive procedures.
Only a handful of advanced education facilities currently offer certification and continuing education credit. However, advanced skin care specialists must take responsibility to get this type of education. With this education, they may provide their clients with the latest skin and body rejuvenation services and technological advances. Today’s marketplace relies on advanced aesthetics education to deliver the latest scientific treatments, quality products, relaxation, and most importantly, results.

Skin Care Advances
The skin is a magnificent, complex, and multi-purpose organ. In the last 10 years, more has been discovered about the way the skin functions than has been learned in the last two hundred years. Thanks to this increased knowledge, we now see the direct relationship between skin product performance and skin physiology.
Until recently, it was believed that the skin was an impenetrable barrier. Today, we know that product ingredients can penetrate the skin depending on their molecular size and chemical components. A cosmetic product remains on the surface of the skin and does not reach the skin’s dermis, so it does not get absorbed by the blood capillaries. The Food and Drug Administration (FDA) classify products that penetrate the dermal layer as drugs.
Current advances in science and technology have given us a new classification of cosmetic ingredients called “cosmeceuticals.” This classification combines cosmetic and pharmaceutical ingredients and bridges the gap between traditional cosmetics and pharmaceutical products.

Cosmeceutical Ingredients
There are many cosmeceutical ingredients to be excited about in the aesthetics industry. These ingredients focus on specific skin conditions that pertain to all skin types. The most common skin conditions are dehydration, telangiectasia (broken capillaries), sensitivity (redness), premature aging (lack of firmness), hyperpigmentation (brown/black lesions), and hypopigmentation (white lesions). Botanical agents, such as epidermal growth factor, help maintain essential moisture balance that prevents dehydration, which makes skin look tight, flaky, and dry. Natural ingredients like licorice root, papaya, and green tea extract are wonderful when added to cosmeceuticals to relieve the itching and redness often associated with sensitive skin conditions. Innovative formulations containing oxygenating proteins to absorb daily abuse on our skin can retard the aging process. Spin traps are potent antioxidant proteins that absorb free radicals, which cause damaging effects on the skin’s healthy cells and prevent premature aging. These antioxidant proteins hold essential moisture to assist new cell growth, which creates skin firmness and clarity.
Our exposure to our environment, lifestyle choices, and how we take care of our skin are all important factors that increase or decrease skin beauty. With this in mind, sunscreens continue to grow in popularity. Sunscreen is a daily necessity to protect the skin from overexposure to harmful sunrays. Some clients will continue to live in denial, but with time, sun damage can lead to colored lesions that clients will try to hide with exaggerated make-up.
Sunscreens with increased SPF, zinc oxide, and titanium dioxide prevent skin discoloration from exposure to sunlight. Cosmetic companies like Clinique are adding natural pigments to sunscreen to provide consumers with sun protection and even color.

Results-Oriented Products
Oily skin with acne is characterized by the increased discomfort it can cause consumers of all ages. Although over-the-counter products offer some results, consumers suffering from acne are looking for effective products that produce results with the least side effects possible. To address this problem, cosmeceutical formulations are making advances in relieving clogged pores and pustules by adding bacteria-suppressing benzoyl peroxide, oil-controlling salicylic acid, and sulfur to accelerate the healing process from break outs.
Products used today are active and steer away from being placebo. Products of the past were formulated to be pampering cosmetics and many only made skin feel good. But nowadays, cosmeceuticals are revolutionizing the skin care product industry. Pharmaceutical benefits are combined with pampering cosmetic products, creating a new product genre – skin care that produces increased results, minimal side effects, and has the luxurious feel of a pampering cosmetic.
As previous recessions have proven, America’s beauty and spa industry are nearly recession-proof. Not even today’s economic weaknesses can deter a consumer-driven economy to feel good and look even better. The spa industry will continue to grow and expand to meet the needs of clients who have a firm commitment to make informed decisions about their options to look and feel great.

The Industry Market
Only five years ago, microdermabrasion and non-invasive laser therapies were not available to the skin care therapist. Treatments available in the past like permanent makeup – the equipment, topicals, and pigments – have been updated to show improved results and provide increased comfort to the client. Five years ago, there were approximately 5,000 spas in the United States and the spa market was looking for distinctions to take it to the next level and offer clients options that included holistic therapies to make them feel internally as good as they wanted to look externally. Today, that number has nearly doubled and the latest reports show us that there are approximately 60,000 licensed aestheticians currently active.

A Look Ahead
Today’s skin care therapist is a team player in a variety of scenarios. We have gone beyond the paramedical skin care of 15 to 20 years ago. I feel, more than ever, professionals want to be a part of the aesthetics field to connect, touch, relieve, and provide comfort to others. The spa industry is combining advances in technology for skin health with high-touch spa therapies, making it easier for the client to take advantages of traditional and high-tech medical technologies like Ayurveda, nutritional counseling, massage therapy, endermology, microdermabrasion, facial and body toning, non-invasive laser treatments, and permanent make-up. These medical approaches offer clients options to manage the way they age and how they feel. Bringing these types of services into the spa is like one-stop shopping. The wide range of beauty therapies that are available today can be incorporated into a spa business to offer individuals services that will make them look as good as they feel.
These types of treatments need to come from a place the client can trust, where they know that significant time has gone into training the staff. Client retention is a result of confidence in the medi-spa staff and treatments, so clients don’t have to go to three or four locations to get the results they desire. The medi-spa offers clients results, all in one place.
The medi-spa concept is committed to providing serious skin care with unsurpassed attention to details inside and out of the treatment room. It is a resource for outstanding personal services that explore the emphasis of relaxation with results. Medi-spa treatments and therapeutic processes offer instruction, in-depth skin consultations, and personalized programs designed for all clients interested in looking and feeling their best.

Lyn Ross, president and founder of the Atlanta-based Instituť DERMed, is a Georgia-Board Certified Master Esthetician, entrepreneur and an innovator. Utilizing 23 years in skin care as a trainer and teacher, Ross has combined educational opportunities, approaches and products to create a unique MediClinical skin care salon that continues to set trends in beauty and fitness industries. Two Atlanta locations, a teaching institute and an emerging franchise later, she is now offering clients a full range of skin care services and a therapeutic line of cosmeceuticals that contain the highest concentration of active ingredients available without prescriptions. In Fall 2001, Ross renamed her spas Instituť DERMed, formerly known as Dermess, to reflect the importance she places on educating clients and her staff. For more information, you may contact Ms. Ross by e-mail at This email address is being protected from spambots. You need JavaScript enabled to view it..