Most skin care professionals attempt to make acne skin transformation daily. They think up strict, skin-clearing regimen comprised of a combination of treatments, at-home products, and lifestyle changes, but the reality is clients do not always listen, which can lead to frustration among all involved. There are the clients who follow everything their treatment provider says to a T. Then there are the ones who blame everything and everyone else besides themselves for their lack of results. And of course, there are the clients who struggle with big-picture focus. 

How can spas and clinics create consistency with a set plan of action and accountability for acne clients? The answer is by creating a specialized acne bootcamp program. A streamlined service, programs are typically a mixture of beneficial services, homecare, and lifestyle changes for acne clients. An outline of the program should be reviewed with applicable clients during their initial consultation to better the chances of mutual success. Acne bootcamp programs imply there is a shared commitment between the client and service provider, rather than a one-off visit.  This should be cemented further with a signed agreement, ensuring full cooperation with both parties to make the client’s skin goals a reality. 

Samantha Dench is a 15-year licensed aesthetician, author, speaker, and owner of Skin Deep. Dench’s passion goes beyond treating skin to include internal health, so she can achieve healthy skin for her clients by finding the root of the problem. Dench loves to educate groups of women and share her knowledge and passion for skin through her book and speaking engagements. 

Acne can be categorized in a few different ways in relation to the age group experiencing it: Adolescent acne in ages 10 to 19, young acne in ages 19 to 24, and adult acne in ages 25 or above. In addition to affecting more than 50 million people annually, acne is the most frequently occurring skin condition in people between the ages of 11 and 30 years old, and it is widely believed that acne affects about 80% or more of individuals in this age group. 

ACNE PRONE

While adult acne has been steadily on the rise, an immense impact on teenage clients is still being seen. The activity of the pilosebaceous unit (the hair follicle, hair shaft, and sebaceous gland) is regulated by sex hormones. Teenage skin conditions are mainly related to fluctuations in hormone levels, specifically androgen hormones like testosterone and dihydrotestosterone. These androgen hormones can increase hyperkeratosis and sebum production, leading to the formation of the microcomedone (noninflamed open and closed comedones). If c. acnes bacteria are introduced, then the microcomedone will become an inflamed lesion (papules, pustules, cysts, and nodules). When treating teenagers, it is important to set the proper expectations. They can certainly achieve and maintain clear skin, but skin care professionals need to normalize that 100% clear skin 100% of the time is not realistic. Hormone fluctuations can have an impact on skin no matter how good a client’s skin care and lifestyle routines are.

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COMMON CONSIDERATIONS

It is not always the first choice of adult clients to seek out a skin care professional for their acne needs, so it typically is not a parent or guardian’s first thought for their kids either. Usually, when a teenage client comes in, they have already tried drugstore or prescription solutions. Both can cause issues on their own, especially when they go straight to the strongest percentages available because they are intentionally trying to dry their skin out. Once the damage has been done to the barrier, worsening acne, irritation and red or flakey skin among other issues can be seen. This gives young clients additional issues to worry about and address. It is so important to focus on barrier repair prior to introducing acids and benzoyl peroxide to clear a client’s acne. If these products are introduced too soon, the professional is only working against themselves and their client’s best interests. Throughout the clearing process, it is important to still focus on barrier health when introducing new or stronger products and treatments. A balanced routine is the key to clear, healthy skin.

EAT, CLEANSE, LOVE

With the many different lifestyle and diet factors influencing breakouts, it is so important that professionals educate and support teenage clients. However, when speaking about diet with younger clients, extra caution should be taken. Teenagers already have enough issues when it comes to self-esteem, body image, or fitting in, so it is important to avoid unintentionally giving them a complex around the food choices they make.

Younger clients may be especially struggling when they are presented with situations where they may not be able to avoid acne-triggering foods. This could be the case for several reasons, such as school cafeteria options, family preferences, or them not wanting to feel like the odd one out. Even though these situations are hard to avoid, moderation is still the focus and that is another important point to make when speaking to teenagers. They do not have to make perfect choices all the time or abstain from their favorite foods and desserts indefinitely. Like with all acne triggers, everyone reacts differently so they will need to keep an eye on what foods or beverages have an impact on them as an individual. It is really all about how often clients consume these foods rather than worrying whether they are or are not. Typically, professionals tell their clients that if they are consuming a trigger food seven days a week, try to cut back to three to four days a week and go from there.

Lifestyle management may also be harder for teenage clients. Topically, they may be at the mercy of whatever cosmetics, hair care, and laundry products the rest of the family uses. With acne and some acne imposters, they will need to avoid comedogenic ingredients and some heavy emollients in the case of fungal folliculitis, or fungal acne. Often, young clients have issues due to their hygiene after gym class and sports; they are not always given enough time in between classes to properly cleanse their skin after gym or sports practices. In some cases, it is unrealistic to expect young clients to want to perform their skin care routine again in the middle of the school day. A way around this is to have them take a Ziplock bag of cotton rounds presoaked in their toner of choice, preferably something with antibacterial properties, to quickly wipe their face when needed. For those that have sports after school, sometimes they are not always able to get home right after. This toner trick works well in those cases as well. For clients who can and will actually cleanse their skin after gym or sports, they can do a condensed mid-day routine consisting of a quick cleanse, moisturizer, and sunscreen.

 THE ACNE-CORTISOL CONNECTION

In addition to hormone fluctuations, lifestyle, and diet, there is a direct connection between stress and breakouts. There are several things that occur when the body experiences stress that effect overall health and skin. This is because the body is sent into a fight-or-flight response and only the most essential functions of survival are considered. Skin is affected due to the stress hormone, cortisol. It disrupts functions, like insulin and blood sugar regulation, and disrupts hormones that regulate sebum production. This increase in sebum production coupled with increased inflammation in the body results in inflamed breakouts. Stress also slows down the body’s ability to heal, which can lead to worsening lesions and more lesions present at any given time. Stress can be hard to overcome, so this is another area to set clear expectations around breakouts. 

HOME TEAM ADVANTAGE

80% of the acne clearing process is achieved at home with a proper homecare routine, diet, and lifestyle adjustments. The skin care routine being curated for clients should support their skin and Fitzpatrick type, while being able to tackle their acne type and severity. Factors, like acne type and severity change throughout the clearing process and seasonality, can affect how oily or dry a client presents, so be sure to constantly check in and adjust when necessary. 

A full acne client routine can look like the following: 

1. Cleanser and toner based on skin type. 

1. Exfoliating serum based on acne type.

1. Moisturizer and sunscreen based on skin and Fitzpatrick type.

1. Benzoyl peroxide preventative based on skin type, Fitzpatrick, and acne severity. 

The reality is not all teenagers are ready, maturity-wise, for a routine with five or more steps so the professional may find themselves having to be more creative when it comes to younger clients. As stated above, focus on barrier health first. It is a waste of time for both the professional and their clients to focus only on active products that will clear their skin because without supporting their barrier, that clear skin will not last long. It is okay if an acne client is only willing to cleanse and apply sunscreen; this is still a win. In some cases, starting with the bare minimum is best for clients to build habits and feel comfortable introducing more products later on. If service providers finds themselves having to provide only basic routines for young clients, they should ensure that the products provided pack a multifunctional punch when able. For example, opt for an active cleanser with mandelic acid, salicylic acid, or benzoyl peroxide instead of a basic gentle cleanser.

When curating a full routine for teenage acne clients, it is vital to pay attention to what their skin and acne are showing and not to worry so much about their age. While it is important to consider a gentler approach for young clients, active products are still beneficial. Something like mandelic acid, a gentle alpha hydroxy acid, makes an excellent starting point. Due to its large molecular weight, it provides even and slow penetration, so it is a much gentler option than a harsher alpha hydroxy acid, like glycolic. If skin cannot handle an exfoliating serum, look at other steps in the routine that can be strengthened. Acne fighting ingredients, like mandelic and salicylic acids, can also be found in cleansers and toners where the concentration will not be as aggressive in comparison to a serum. Customization is key for results.

ACCOUNTABILITY BUDDIES

It is important to constantly manage client routines to ensure the products are still suitable for the current acne, season, or other factors. It is not always convenient for clients to come in person, especially for teenagers who do not drive or who have activities after school or on the weekends. This is where the skin care professional needs to consider different ways to stay in touch. Having a client e-mail pictures regularly as a check-in is an extremely helpful practice, especially when that responsibility is passed on to the client and parent or guardian. Having virtual check-ins available is another helpful practice for those that need more guidance than what can be provided via e-mail. If the spa has a number of older teenage clients, they may have already experienced clients going off to college and coming back on vacation already experiencing breakouts again. It can be helpful to send college student clients off with some tips and important notes about lifestyle and diet, but again, set the expectation that they do not have to make perfect decisions. They just need to focus on moderation. Being able to offer guidance virtually if they run into any issues or changes is a great bonus. Spas must also ensure that they have the ability to dropship to clients or have their own e-commerce store established so clients can keep their homecare products on hand.

IN THE TREATMENT ROOM 

Much like at home options, a client’s age is not a reason to refrain from performing acne treatments. Pay attention to what the client’s acne and skin type calls for but consider a gentler approach to start with. Enzyme treatments are an excellent choice for young and first-time clients. There are so many options out there that can be customized to start off gently and strengthen as treatments progress. Mild corrective peels are also an option for young clients. A good rule of thumb is to start low and slow with the strength and prepare skin prior to treatment, but as long as the skin type allows, even teenagers can benefit from regular peels. This is especially true for clients experiencing post-inflammatory erythema or pigmentation and texture resulting from their acne. While in-clinic consultations and treatments are important, having a virtual consultation available for those with busy schedules is incredibly helpful and opens new opportunities for the business owner.

Though skin care professionals have the best intentions for their clients, some things do not always go to plan. When experiencing compliance issues with young clients, it may be time to have a tough conversation with the client and parent or guardian. It can simply come down to one question, who wants the client to have clear skin – themselves or their parent or guardian? While parents and guardians have the best intentions when it comes to their kids, if the client does not care enough to put it in the work, then the process will be unsuccessful. If teenage clients are not bothered enough by their skin to do something about it, it is not the professional’s place to force their hand or shame their choices. That being said, for clients who do want to put in the work to transform their skin, the licensed professional has the tools needed to give them the skin of their dreams.

References

1. Bergler-Czop, Beata, and Ligia Brzezińska-Wcisło. “Dermatological Problems of the Puberty.” Postepy dermatologii i alergologii, June 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3834713/. 

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Alex Hernandez, a licensed aesthetician of over six years, serves as the lead educator at Face Reality Skincare. In her role, she oversees professional educational training materials, protocols, and classes on a national level. Additionally, Hernandez supports other key departments including marketing, R&D, and Face Reality’s Acne Clinic. Alongside Laura Cooksey, owner and co-founder of Face Reality Skincare, she learned how to educate clients and professionals on the treatment of acne using the brand’s safe and effective signature adaptive protocol. Through diligent practical training and the completion of Cooksey’s personal training, Hernandez became a Face Reality Certified Acne Expert in 2018. Since then, she has worked with hundreds of professionals and acne clients in her aesthetics career and is a daily witness to the impeccable results achieved using Face Reality Skincare treatments and protocols.

There comes a time in every solopreneur’s experience where help is needed. Because solopreneurship is so all-encompassing in its scope, solo business owners likely face all manner of tasks in their day-to-day bustle. Some duties will be intuitive, like caring for a client, scheduling their next appointment, and so on. Other tasks might be a bit more outside the normal expectations for the job. Building a website, establishing application programming interface (API) connections, choosing software, finding a location for the business, selecting a skin care line (or lines) to carry, and many more are responsibilities the business owner may need help with if they are not naturally inclined to solve them on their own. How does a small solo business owner find help? The internet is full of information and there is plenty of aesthetics information out there. From collaborations to consultants, vetting information to getting started, this space has the solo business owner covered. 

Nichelle Mosley’s passion for aesthetics was born out of a desire to help others after failing to find help for her own acne as a young adult. Licensed in 2015, she has worked in clinics, plastic surgery practices, dermatologists’ offices, and with family practitioners. She then opened her own clinic in 2017, Queen City Beauty Group + Wellness. She focuses on integrative aesthetics and holistic solutions for clients’ skin concerns. As a member of the International Association for Applied Corneotherapy, Mosley seeks whole-person solutions while delivering results for clients. She is also the 2019 Skin Games Age Management Champion and 2018 Skin Games Acne Finalist. 

On the verge of being well into my 30s, age-prevention modalities and gizmos are becoming increasingly of interest – naturally. Coming into this age group in 2023 gives me and other millennials an edge not quite seen before. We are old enough to remember when getting older often meant letting go but young enough to witness the cosmetic and wellness boom responsible for giving antiaging facial injections and procedures mainstream status. As with anything that becomes common practice, the options become more and more refined – with popularity, comes ingenuity. 

Not only can age management start earlier and earlier; it can continue with no pain or downtime! Gone are the days when the only hope for age prevention is injectable neurotoxins and fillers. (I find this especially true as my primary concern is nasolabial folds, which I feel are not deep enough for injection intervention.) How is this possible? EMFACE. EMFACE is the first therapy that works on the framework of your face from the inside out by applying patented combination of synchronized radiofrequency (RF) and high-intensity focused electromagnetic facial muscle stimulation (HIFESTM). Synchronized RF heats the dermis to stimulate collagen and elastin production, while HIFESTM selectively contracts facial muscles.

That’s all fine and well, but how exactly does a full-face workout feel like? In so many words? Like a reverse sit-up for your face. Let’s start at the top!

THE EXPERIENCE

I sat on the table with a clean face ready for my closeup. The practitioner fastened three electrodes backed with a sticky adhesive onto my forehead and each cheek, along with a grounding patch on my back. I would describe the treatment sensation as if someone was gently squeezing and releasing my face at its center repeatedly for about 20 minutes. This is caused by the muscles contracting as they are scrunched and released. The most work I had to do was to sit back and relax – a breeze compared to the facial exercises I’m used to doing. 

I personally experienced no discomfort or overexertion. The patches warmed gradually during the treatment due to the radiofrequency. When everything was said and done, I did notice an improvement in my face’s overall volume, but I was told this would be temporary, similar to a workout pump. My full results would take six to 12 weeks. 

I write this at the four-week mark, and I am impressed. The concerns I had about my nasolabial folds have diminished, and it will only go up from here. And based on publish-pending nine clinical trials, where patients saw an increase of 30% in muscle tone, 37% in wrinkle reduction, 23% in lifting effect, 26% in collagen, 200% in elastin, 92.8% in volume, 92.5% in skin evenness, I am a part of the overall 92.3% patient satisfaction rate. EMFACE can act as a tool or a bridge and everything in between for those concerned with aging and getting older. It’s amazing what 20 minutes can do. 

Looking to elevate the client experience of the spa? Having a dream team of professionals that embody the spa’s values, live the mission, and strive to make the vision a reality is the path. The key to building a successful spa team is hiring and training the right people. But how do you ensure that each team member aligns with the spa’s values, vision, and mission? Being clear on who to look for will aid in finding the best fit for the spa’s culture, discovering how to train them, and knowing how to motivate them to achieve great results. 

Melissa Allen has lived many lives as a dance teacher, biologist, and marketing director before becoming a successful aesthetician and spa owner. All of these former positions helped to color her opinions, actions, and style. Allen’s career in aesthetics has also been far-reaching; she has been an aesthetician in the back of a salon, a solo aesthetician, a spa owner with several employees, and a global brand consultant. Allen has experienced many of the paths of aesthetics and is open, honest, and willing to share her adventures. As her time in the treatment room comes to an end, she is focused on mentoring and guiding the next generation of thinking skin care professionals and spa owners.

When it comes to true client results, proper homecare is an absolute must. After all, on average, 80% of your client’s skin health is based off their homecare. Skin care professionals love to see clients regularly, whether it’s weekly or monthly, but the truth is we are only providing limited results.  

There is nothing wrong with holding clients accountable and letting them know the 80-20 rule; sometimes, this is what it takes for clients to understand that they need to take matters into their own hands, with your guidance and support of course. You will have several clients that will tell you they do have a homecare routine but still see no results, or at least not what they are hoping for. The question is whether they have the right products and are using them in the correct way.

Andrea Gregaydis is a licensed aesthetician and international CIDESCO diplomat. She holds multiple additional licenses as a New York state instructor and nail technician, as well as a certified laser technician. Gregaydis is the lead instructor at the Aesthetic Science Institute and has over 10 years of experience as a practitioner, team coordinator, and role model for hundreds of future skin care professionals. She is contributing author to top industry trade magazines, as well as a speaker at various aesthetics conferences across the United States. She is also a CIDESCO International Examiner. 

Continuing education is essential in any industry, and aesthetics is no exception. Many aestheticians leave school feeling lost, inadequately trained, and ill-prepared to face the busy treatment room. Practice and repetition go a long way in improving skills and perfecting treatments, but for new professionals hoping to go the distance and provide outstanding treatments and service to their clients, continuing education is vital. Knowing where to start can be overwhelming with many brand choices, new technologies, and medical options. Deciphering needs from wants in terms of what education to pursue can leave a feeling of overwhelm.

Reference 

1. Bay Atlantic University. (2022, December 23). 8 types of learning styles: The definitive guide. Bay Atlantic University - Washington, D.C. https://bau.edu/blog/types-of-learning-styles/ 

Kirsten Sheridan has a higher national diploma in beauty therapy from the United Kingdom and is a licensed aesthetician. She has 20 years of experience as an aesthetician and educator, holds a teaching qualification through City and Guilds London, and is a CIDESCO diplomat. Sheridan’s other qualifications include massage therapy, aromatherapy, reflexology, and electrology. She has a personal training qualification through the National Academy of Sports Medicine (NASM), although not in active practice. In addition, she is the owner and founder of knowskin.com, an online learning hub for aestheticians. Sheridan has taught for Dermalogica, International Dermal Institute, San Francisco Institute of Esthetics and Cosmetology, San Jose City College, and The Dermal Sciences Institute. 

The ideal skin complexion is not determined by skin tone or color but rather, the state of skin. When given its adequate necessities, such as hydration, lipids, cellular renewal, and a healthy pH, the complexion is radiant, indifferent of skin tone or color. The role of skin care professionals is to help optimize skin health while mitigating factors that compromise the integrity of skin, and thus, the complexion. 

SKIN DEEP

There is more to skin complexion than meets the eye, with both external and internal factors impacting it. Internal factors go much deeper than what is visible on the surface; complexion goes DNA deep. Unpacking the uniqueness of one’s DNA can be like finding a needle in a haystack, but gaining a more comprehensive view of intrinsic factors is not impossible. It simply takes time, education, and professional intention. To understand what unlocks skin’s brilliance, one must first learn about one significantly important cell to skin complexion: the melanocyte. 

Resource

1. Cooper, C. R. (2022). The No Compromise Black Skin Care Guide: The Gender And Teen Equity Edition. Charmaine Cooper

C.R. Cooper is a connective, knowledgeable, and compassionate educator who has been a skin enthusiast for over 24 years. As the education manager and master educator for a renowned global institute of learning in the skin health industry, Cooper values organizational and individual industry standards, professional and personal brand integrity, and, most importantly, the inherent worth in every skin care professional.

It is essential for skin care professionals to understand the unique intricacies that different Fitzpatrick skin types present so that they can confidently treat all clients who walk in the door. The United States Census Bureau projects that by 2044, 50% of the United States population will be of nonwhite descent.1 As the country continues to become more diverse, it is imperative to provide specialized care for conditions unique to their ethnic backgrounds.  

While nearly every single client has unique skin challenges, understanding the challenges of ethnic skin on a broader scale helps professionals solve some of the most common conditions and concerns confidently when treating skin of color.  

SKIN COLOR 

Skin color is a composite made up of four compounds. Hemoglobin (oxygenated blood cells), hemoglobin with non-oxygenated red blood cells, carotenoids (yellow pigment), and melanin (brown to black pigment). The melanocyte, which produces melanin, is directly responsible for skin pigment.  

A melanocyte has a mighty job; it is responsible for making melanin. The melanocyte takes the amino acid tyrosine, and through the action of an enzyme called tyrosinase, it converts to a new compound which is then made into melanin by the action of more enzymes.  

Once the melanin has been produced, the cell must form little packets called melanosomes. Melanosomes are the melanin granules that get transferred to the keratinocytes to be utilized for sun protection. Melanosomes act like little umbrellas that try to shield the body from sun exposure by producing dark spots, or pigmentation.  

References

1. Burgess, Cheryl, and Olabola Awosika. 2015. “Ethnic and Gender Considerations in the Use of Facial Injectables.” Plastic and Reconstructive Surgery 136 (November): 28S31S. https://doi.org/10.1097/prs.0000000000001813.

1. News. n.d. “Multicultural Dermatology: Treating Skin, Hair and Nail Conditions in People of Color.” News. Accessed August 17, 2023. https://health.ucdavis.edu/news/headlines/multicultural-dermatology-treating-skin-hair-and-nail-conditions-in-people-of-color/2023/02.

1. ‌Love, Porcia B, and Roopal V Kundu. 2016. Clinical Cases in Skin of Color Medical, Oncological and Hair Disorders, and Cosmetic Dermatology. Cham Springer International Publishing.

1. Ludmann, Paula. 2022. “Vitiligo: Diagnosis and Treatment.” Www.aad.org. June 29, 2022. https://www.aad.org/public/diseases/a-z/vitiligo-treatment.

\Michael Q. Pugliese, an informed educator, writer, and asset to the skin care industry, became the third-generation CEO of Circadia by Dr. Pugliese in 2006. His dedication and leadership to the brand has grown to achieve international recognition and distribution worldwide. This global expansion has created a skin care regime for every skin type in the world. Pugliese’s compelling lectures honor the tenets of modern skin science discovered originally by his grandfather. By following in his grandfather’s footsteps, he has been driven to deliver a clear message on skin care to all his clients and fellow educators in the industry. In addition to the success of the skin care line, Circadia also has the first physician-formulated pillowcase formulated to work in harmony with the body’s natural circadian rhythms which protect from environmental damage while focusing on skin repair during evening rest.