We live in a high-definition, Photoshopped world, where we are constantly bombarded with images of digital perfection. It is easy to become hypnotized and believe that our favorite celebrities have perfect skin, teeth, hair, and bodies. The truth is they do not. Whew! So how do skin care professionals deal with the clients who want to raise the bar on her their skin’s performance and appearance?
The answer without a doubt is exfoliation. Today’s sophisticated exfoliation techniques and products offer us, as skin therapists, the opportunity to deliver more client satisfaction, bump up our professional skill level, and make ourselves more valuable in our highly competitive market space.
The human skin produces about 36 million new skin cells every day. You would think that this staggering fact alone would mean that our skin is always glowing and moist. But nobody is perfect. Cells become damaged, contaminated with pollutants, congestion builds when cells do not shed properly and as we age, the slow-down of collagen production and cell turnover does not help. This is why professional exfoliation is a critical step in any skin health regimen.
An exfoliation program must be tailored to the specific tolerances of the client’s skin. Mild exfoliants such as rice bran extract, corncob meal, and fruit-derived enzymes like papain (papaya-derived proteolytic enzyme which digests keratin protein) and bromelain (pineapple-derived enzyme) are ideal for that sensitive-skinned client. More powerful ingredients such as lactic acid, salicylic acid, or retinol are excellent for those in-betweeners who want to focus on specific concerns and fight the aging process. The heavy-hitters in exfoliation, when the client seeks a significant and dramatic improvement, are high-technology peptides: Hexanoyl dipeptide-3 norleucine acetate (an encapsulated peptide which facilitates cell sloughing), along with galactoarabian (a complex sugar molecule which works well with AHA exfoliation), aminopeptidase (protease enzyme which loosens cell cohesion while stimulating digestion of keratin protein in the epidermis) and of course trichloroacetic acid (TCA) – an oldie, but still a goodie.
Cautionary Tips for Exfoliation
Exfoliation is much more than scrubs. It has to be safe and legal. For instance, in some states, skin therapists are not allowed to work with certain percentages of acids or specific acids on the skin. Do your homework. Know what exfoliation options exist for you, period. Take advanced classes to expose yourself to the newest technologies and network with fellow professionals. As you do this, narrow down what will work for you in your market. Begin with any legal restrictions on specific ingredients. Be thorough in your investigation of any additional insurance coverage which may be needed when using acids.
The mastery of exfoliation requires not only a solid understanding of skin health, but the knowledge of key ingredients. Master exfoliators and know how to effectively combine these ingredients while maintaining a close monitor on pH balance. To fully appreciate the different effects of exfoliation and to reduce the likelihood of any unwanted reactions and complications, take special care to research how your client currently maintains her skin. Clients using Retin-A, Renova, or any
medically-prescribed exfoliating product should discontinue use of these products at least 48 hours before receiving an intensive exfoliation treatment. Also, clients taking Accutane (Isotretinoin) – or who have taken this drug within the past six months – should not receive exfoliation treatments, in order to protect potentially thin and fragile skin. Skin which is already in this compromised condition may respond to professional exfoliation with undesired pigmentation or may be simply unable to regenerate properly.
Peels: Evolving and Uncovering New Possibilities
Massive strides are being made in peels, including the areas of ingredient technology, ingredient combinations, and application methods. Clients already know that peels are an effective way to liberate the skin from a suffocating shell of keratin cell-debris, revealing the more supple, vibrant tissue beneath. The new generation of peels presents the therapist with a tiered deck of potential options, each with a successively more intense result. There is more demand for this category than ever before and to safely and successfully deliver the results your client wants – polished, brilliantly fresh skin with minimal discomfort, inflammation, shedding or downtime – requires skill.
Sometimes less is more. Let me draw upon an analogy from one of our sister professions: hairdressing. Hairdressers reference something called “Blonde Fever.” This happens when the client has decided to go blonde. Once the hair is lightened, there is no turning back, so an experienced stylist will give her client a less drastic lightening than the client insists she wants, at least the first time. Experienced hairdressers know that it is easy to go more aggressive on the second or third appointment if the client chooses to, but it is virtually impossible to put the “blonde” genie back in its bottle if the hair is too light.
Likewise, it is advisable to tread lightly when planning a chemical peel. Like the choice to go blonde, exfoliation should not be an impulsive choice. Holding back slightly will safeguard your client from potential damage and regret. Also consider that today’s client will not accept the post-peel downtime or the long-term shedding that used to be considered normal. Therefore, easy does it. Manufacturers are introducing anhydrous – meaning no-water – textures to try to give clients what they want. Anhydrous textures not only deliver an increase in ingredient potency, as well as higher solubility, but also reduce initial inflammation during the process. While controlled inflammation is required as part of any chemical peel to induce the wound-healing process, the degree of penetration must be tightly monitored. Too much inflammation may trigger unnecessary pigmentation, thinning of the dermis, texture changes, or even long term erythema and wounding to the skin. Again, wait until the client has tested the treatment to go more aggressive.
While high concentrations of glycolic acid and trichloroacetic acid (TCA) have for a long time been considered medium depth, combining these acids with other ingredients offers greater versatility, enhancing their use and effects. The best example is lactic acid, which has a larger molecular structure than other commonly used acids. Combining lactic with other actives can help slow down the combined acid effect, allowing for better wound-control and more precise application. Remember that combining does not change the properties of how an acid originally behaves, and as always, skin therapists should use the acids with great care and work within their scope of practice. Combining in the hands of a skilled practitioner, however, offers the professional a way to “step up” the use of acids and move toward other advanced formulations.
In the Treatment Room: Power Couples
Remember: safety first. We play by the rules to protect our client’s skin along with our reputation. However, with professional skill and expertise, some ingredients may be combined for superior results. Of course, proceed with caution and always check with the manufacturer before doing so to prevent adverse effects. Some combinations to test and explore are:
- Combine a hydroxy mask with a boost of lactic acid to create an intense, effective but safe treatment to smooth rough texture before dermaplaning or after microdermabrasion for a splash of regeneration.
- Layer enzymes with acids for a gentle yet powerful peel. Enzymes can target the bonds of skin cells to change the process of shedding and downtime associated with earlier-generation peels. Ideal for the “overscheduled” client who cannot afford to take several days off around a procedure.
Power On: Electrical Tools to Accelerate Results
Skin health does not just stop with exfoliation. Look to incorporate electrical modalities with your exfoliation for greater effectiveness.
- After exfoliation, follow with a blue light emitting diode (LED) to assist in targeting bacteria and to reduce the rate of oil production.
- Pair your lactic acid with galvanic iontophoresis to further drive hydrating benefits into skin.
- Using an oil-based exfoliant? Massage the exfoliant into the skin using Indirect High Frequency to further stimulate circulation – excellent for dry, dull, tired skin.
Product Fusions: Empower Client Home Care
Of course, always check with the manufacturer before recommending new ways to mix products for clients at home. Some combinations to test first, then recommend:
- Power-cleanse the skin with a gentle physical scrub like naturally rounded corncob particles and the client’s usual daily cleanser.
- Use a clay-based cleanser with a salicylic serum to boost clearing of breakouts. Could also work as a mini-mask treatment.
- Use vitamin C with the usual acne spot-product to dry breakouts and minimize pigmentation that can linger.
- Have clients combine a salicylic based serum with their moisturizer to target hyperpigmentation and congestion without over-drying or irritating the skin. Eventually graduate up to using the serum by itself.
Always keep in mind that the client’s skin accompanies her on every adventure, far from the controlled environment of the treatment room. Take special care to evaluate not only the client’s current skin condition, but her vacation plans as well! Exfoliation may increase skin sensitivity to the sun and particularly the possibility of sunburn, for example – so advise the client to pre-plan her treatments well before that Caribbean honeymoon or ski getaway. While today’s client demands extreme results, our priority as professionals must always be safety first. With the sophisticated array of current products and techniques now available, dazzling camera-ready results are now possible while still maintaining the best practices standards of our industry.
Whitney Johnson has over seven years of industry experience and an extensive background in training and development. Not only has Johnson worked as a director of education for different product lines, but she was also the clinical educator for a multi-door chain of medical spas. Johnson worked directly with the medical director in creating protocols for the medical skin care services and laser procedures. In addition to her licenses as a skin therapist and massage therapist, Johnson holds numerous continuing education certificates in chemical peels, laser and light therapies, is an NCEA candidate, and has served on the editorial board for the PCI journal.
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