Hyperpigmentation takes much longer to address than most other skin issues, but approaching treatment from a holistic base can ensure long-term success, not necessarily perfection. This mindset can take some getting used to for most. Mostly due to society’s unattainable beauty standards made popular by media consumption, it should be said that healthy skin does not equal flawless skin.  

“Holistic” is an ambiguous term used as a part of a shift in consciousness to return to nature. However, a holistic aesthetics practice is much more than “natural” products. A holistic approach looks at the whole being working together to support harmony and homeostasis. In the treatment room, it can include symptom management with ingredients that work to support the entire body but generally address the root cause of an imbalance. Often, products with specific ingredients (or without particular ingredients) are chosen to avoid other disruptions elsewhere. In addition, holism generally implies a look at how all the other systems in the body affect skin, even emotional and energetic effects.

Emily Davis is the founder of Stratum Aesthetics, a veteran aesthetician, holistic health connoisseur, and budding herbalist. She has spent the last 15 years as both an educator in the aesthetics industry and her private practice, creating unique facial experiences that support the mind, body, and spirit of her clients. She integrates plant medicine, nutrition, old-world holistic spa techniques, and modern modalities to stimulate the body's natural ability to heal and thrive. Davis has a long-standing passion for health, wellness, and skin care. She is thrilled to intersect that passion with her love for plant medicine.

Hormonal pigmentation is an often missed or misdiagnosed skin condition. Known as melasma, hormonally affected pigmentation affects over five million Americans, particularly women of all ethnicities and skin types. Internal hormonal fluctuations can linger outside the scope of practice for skin care professionals, but there are many ways to establish an effective plan to balance and maintain skin health. 

Elizabeth Brasher has been a licensed aesthetician since 2011 and has been practicing with a strive for advanced skin care education ever since. Brasher is an aesthetician at Premier Med Spa in Richardson, Texas. She continues to devote herself to helping her colleagues offering expert training, heading online aesthetics forums, and writing contributions to industry magazines. At the beginning of 2020, Brasher became DERMASCOPE Magazine’s lead in-house aesthetician.

Pigmentary disorders have long been among the top concerns that cosmeceutical advancements in formulations and technology address. Among the most common pigmentary disorders are melasma (pregnancy mask), solar lentigines (sunspots), and post-inflammatory hyperpigmentation (PIH) – which remains the least discussed in textbooks and training resources.

All ethnicities, genders, and skin tones can experience the woes of hyperpigmentation, but it is arguably the most common and foremost significant concern for clients with higher Fitzpatrick classifications. Skin care professionals must have the wherewithal to answer the battery of questions, concerns, and inquiries made around treating post-inflammatory hyperpigmentation in all clients regardless of skin tone to achieve tangible and sustainable results.

TAKE NOTES

Post-inflammatory hyperpigmentation commonly involves hyperpigmentation scarring following acne lesions but not exclusively. Post-inflammatory hyperpigmentation can also occur after thermal insult or injury, bug bites, abrasions, inflammatory skin disorders, and viral illnesses such as chicken pox. 

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, but most importantly the inherent worth in every skin professional. 

 A thorough understanding of pigmentation disorders and causes is paramount for long-term success in the treatment room. By understanding various causes of hyperpigmentation and skin discoloration, along with a deep knowledge of ingredients that both lighten and brighten skin (and their sequential level of importance in the client care plan), skin care professionals can effectively treat these conditions and provide their clients with the visible results they deserve.  

Hyperpigmentation is characterized by dark patches or spots on skin. This can look like freckles or lentigos but also like larger, irregular patches of discoloration on various areas of the body. There are numerous intrinsic and extrinsic causes of skin discoloration, and the underlying causes require different levels of treatment plans. 

CONTRIBUTORS 

Excessive exposure to ultraviolet (UV) radiation from the sun is one of the most common causes of hyperpigmentation, along with being an extrinsic factor of aging. Ultraviolet radiation triggers an increase in melanin production, resulting in darkening of skin. While some amount of exposure to sunlight is necessary for healthy skin and vitamin D production, too much sun exposure has detrimental and long-term cellular aging effects. For this reason, it is important that clients apply sunscreen with a sun protection factor of 30 or higher daily. Additionally, wearing protective clothing, such as wide-brimmed hats and sunglasses, can help protect clients’ skin from overexposure to ultraviolet rays. The consistent advocacy for sun protection by skin care professionals is key to engraving this understanding into the minds of clients. 

Intrinsic factors that cause hyperpigmentation have to do with hormonal imbalances. Cells need food, oxygen, and water to survive and perform properly. Improper nutrition, such as consuming excessive amounts of sugar and dairy products, does not fortify organelles on a cellular level. Glucose ingested in excessive amounts causes a lining in the gut that is impenetrable to nutrients from fruits and vegetables. Lactose in dairy products can be broken down into galactose as well as glucose and cause the same reaction to occur.  

Courtney Sykes is the chief administrativeoOfficer of Southeastern Esthetics Institute and a licensed aesthetics instructor in South Carolina. Sykes is also the creator of Courtney Sykes Molecular Anti-Aging, a clinical skin care line for consumers and professionals. Her passion lies in creating real change in the aesthetics industry, assisting her students to obtain gainful employment, and making a difference in the lives of their clients. Sykes specializes in a science-based approach to skin health and education. Her primary focus is chemical peels, laser treatments, eyelash extensions, micropigmentation, and cosmetic lasers. Her background in medical spa management has led her to nationally accredit the largest, licensed aesthetics school in South Carolina – Southeastern Esthetics Institute.  

In “A Tale of Two Cities,” Charles Dickens famously wrote, “It was the best of times, it was the worst of times,” and for the global medical spa industry, this couldn’t be a truer statement. People across the globe are tightening their purse strings and closely watching where their money goes. Yet, the global medical spa market is projecting a 14.6% compound annual growth rate (CAGR) through 2032, making this the best of times. According to Global Industry Analysts, Inc., the United States medical spa market is projected to grow at 13.5% over the next decade. China’s market is forecast at a compound annual growth rate of 18.2% through 2027 while Japan is forecast at 10.3% and Canada at 12.2%. Germany’s growth is a standout in Europe with an estimated compound annual growth rate of 11.2%.

MEDSPA MONEY FLOW

The 2023 trends show people are investing their money in themselves and in small indulgences rather than larger ticket items. For the medical spa industry this is excellent news, especially as medical spas are focused more on complete client health and wellness journeys. Advances in skin care technology and increased awareness of antiaging products among potential clients are helping drive medical spa growth. Prevention is a big market, and skin care professionals are in the right place at the right time. Make educated decisions when it comes to purchasing expensive equipment and survey clients first when necessary.

Internationally recognized aesthetic business development expert, Cheryl Whitman, is the founder and CEO of Beautiful Forever Consulting. She is a sought-after speaker and industry marketing specialist who assists physicians and medical spas in creating new profit centers, developing profitable private label product lines, ghost writing articles and eBooks, and identifying and executing new business strategies aimed at improving their bottom line. A celebrated author, Whitman’s turnkey educational system, “Aesthetic Medical Success System,” has assisted clients in opening or jumpstarting their current businesses. Her second book, “Beautifully Profitable, Forever Profitable,” provides solid, practical information on how to create, launch, and grow successful aesthetic medical practices and related businesses.

The aesthetics industry was hit hard by the COVID-19 pandemic. It took a sharp and unexpected turn that most were not prepared for, leaving service providers with no choice but to deal with the fallout. Lockdowns, phased reopening, and regulations on social distancing caused businesses to come to a screeching halt. In turn, we were forced to get creative or risk losing everything.

There are many people in the industry who struggled, those who lost, those who fought, and those who survived and succeeded. Skin care professionals created new options and opportunities for their clients and took active measures to think on their feet, step outside the box, and hang on to their business – it was nothing less than astounding and inspiring. There are still so many mixed emotions, and what happened during the pandemic can only be summed up by the words devastation, adaptability, perseverance, strength, and endurance. 

DEVASTATION

Every industry has been impacted by coronavirus shutdowns, but the beauty industry was one of the hardest hit due to the nature of our jobs – touching people, a thing that obviously can’t be done from a six-foot social distance. 

Updates on COVID-19 closures, reopenings, and mandates were the daily obsession. Some states closed for months, some states opened early, other states had professionals working outside in tents, and some survived by illegally servicing clients. Unfortunately, none of the temporary solutions solved the loss of income, and many beauty businesses did not reopen. 

Shawna Rocha is the owner of Awaken Day Spa in California and Washington. She has a love for helping clients with compromised and sensitive skin and constantly strives to gain additional knowledge and education. Since becoming an aesthetician, she has completed multiple advanced courses in oncology aesthetics, immuno-aesthetics, and specialized training in sensitive skin and holistic therapies. Rocha holds several certifications, including a NCEA certification and has recently become the director of education for Hale and Hush Skincare. Rocha’s current passion is writing blogs and articles about the skin care industry, and she has recently become a DERMASCOPE Ambassador.  

The world of human resources changed dramatically after the pandemic. We’ve dealt with shutdowns, quiet quitting, quiet hiring, and far more as a result. We’re seeing trends in the aesthetics industry across the country that are certainly different from before. In case you think you’re alone, you’re not.

RECESSION PANIC

Practices are figuring out the balance between being in full swing with plans to expand and handling a recession that could cause a decrease in client appointments and increase the potential need for layoffs. 

Taking the lessons from the last recession in 2008, this is the time to solidify your protocols, systems for rebooking clients, membership program offerings, and autopay, evaluating every expense in your practice and reviewing every contract you are currently engaged in. Perform a strong profit and loss statement analysis. Getting your financial affairs in order now will better prepare you for a downturn.

How does this match up with human resources? The first fear is often layoffs. Don’t fall into that trap; your strong team members should be the last to go. Still, make sure that each hiring decision is based on clean financial projections with multiple what if scenarios. Do the homework ahead of time.

GETTING GHOSTED

After posting a job description and help wanted ad online, it is common to receive an influx of resumes that have nothing to do with your posted position, or no applications at all. This could be due to the law of supply and demand being in full force with more positions open than strong candidates to fill them. People are applying for jobs they know they are unqualified for, not reading the descriptions to the fullest, and, if you aren’t quick to respond to the candidate during every point in the interview process, then another equally amazing opportunity with another practice may beat you to the punch.

Get crystal clear with the job description, including daily and weekly duties, experience needs, rate of pay, and benefits. Note that in some states, this is becoming a law. In addition, make sure that you get back to strong candidates as soon as possible to avoid losing them to another practice that acts quicker.

THREE-WEEK NOTICE

While several hypotheses can be the reason for the three-week trend, the same average timeline is present in practices across the country. To combat this, make sure you aren’t overselling the position during job postings and the interview process. Be honest about the pay range for the position, whether the hours are flexible, the level of stress and workload expected out of the position, and the current workplace environment. If a new team member is hired and realizes there was any misrepresentation, they will leave. 

Remember, team members have more options for positions than in 2020, and if they are unsatisfied, they will walk. Practices often hype up the job and accept far less than when it comes to qualifying for the positions. In addition, undertraining and improper initial onboarding also results in new team members feeling overwhelmed and quitting for another job.

MENTAL HEALTH MATTERS

The past three years have done a doozy on the mental health of our society. Your team members are not exempt from the struggles the rest of the world has faced. More time off requests and illnesses have resulted from this.

Remember that legally, you cannot screen for mental health issues or ask questions regarding your current or prospective team members’ physical or mental health. You can ask them if they have any concerns about meeting the hours needed for employment. However, this is where the term quiet hiring has come into play; businesses are looking at how they can increase coverage when someone calls out of work or needs to decrease their hours. In addition, ensure your team has the proper time off to decompress. The days of only giving team members the bare minimum in terms of paid time off are long gone. When your team members are granted time off, remember to respect that they are out of the office. Allowing them that downtime is key to allowing them to recharge.  Finally, if an outsourced human resources specialist needs to be integrated to assist your team members in conflict resolution, consider this as an additional solution.

The pandemic and fear of a looming recession have made spa ownership and hiring team members more challenging. It is important to be forthright with prospective employees and offer fair treatment to attract quality help long-term.

Jay A. Shorr is the CEO and founder of Shorr Solutions, a national award-winning consulting firm assisting aesthetics practices with their operational, administrative, and financial health. Shorr served as the vice president of operations and practice administrator for a leading board-certified dermatologist and cosmetic surgeon in South Florida and has previously held partnerships in two leading South Florida plastic surgery centers. A veteran in the conference lecture circuit, Shorr serves as an adjunct faculty member at Florida Atlantic University, teaching a medical business management course. He is also a contributing author for the American IV Association.

One of the most frustrating hurdles to deal with as a skin care professional, whether new or veteran is understanding and educating clients on their skin conditions that are caused by hormonal imbalances. For clients who have given years to understand why they keep breaking out or are dealing with pigmentation without resolution, it can be discouraging. As a student or new professional, having an understanding of how the fluctuation of hormones and different types of hormones impact skin is crucial. If you aren’t seeing the results both you and your client want, it isn’t necessarily something you are doing wrong; after all, you can’t fight biology. 

Skin care professionals’ goal is to guide clients to find the best solution and help. Whether it is something to balance their hormonal acne, lighten their hormone-influenced pigmentation, or keep their collagen levels healthy, professionals need to see things that may not be in plain sight. We must ask questions about personal matters, such as health history and medications, and make clients feel comfortable at all times sharing such personal matters. 

THE BODY’S GUIDE

Hormones are chemical messengers within every part of the body that are responsible for, or have a direct impact on, most functions within the body, including metabolism and energy levels, how the immune system functions, and the growth and repair of cells. Although there is an abundance of hormones in the body, all which play a vital role in the day-to-day functioning of everything that keeps the body moving and healthy, the key hormones that tend to contribute to skin issues are estrogen, progesterone, and testosterone. 

It is important to remember and recognize the good that these hormones do for the human body, like keeping skin soft, supple, and balanced. A drop or disruption of any of these hormones can impact the condition of skin by affecting the oiliness, dryness, pigment, and a variety of other conditions. 

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 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.

The way you set up your spa’s payroll is a foundational cornerstone upon which the spa’s culture is built. This decision deserves serious consideration. Whether commission, hourly, or team-based pay, 1099 or W2, or selecting the best payroll provider, the choices can seem endless and lead to decision paralysis. Clarity of vision is vital in all areas of running a successful spa, including payroll. Choosing the desired team culture of the spa is always preferred to falling into a default culture determined by uninformed decisions. 

SPA CULTURE

The Competition Culture

Commission-based pay is the compensation model most spa professionals are familiar with, receiving a percentage of the revenue generated from the services they provide to clients. It is particularly beneficial for high-performing professionals with an established clientele; they may earn a higher income than they would with an hourly rate. However, it can also lead to a lack of stability for employees because their income may fluctuate monthly based on the revenue generated. This can make it difficult to budget and create stress and uncertainty. Also, it may not be suitable for newer spa professionals who are still building their books; they may need help, guidance, and time to earn a consistent income. Additionally, this type of compensation can lead to competition instead of teamwork and perpetuate the misconception of client ownership. 

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 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 focusing on mentoring and guiding the next generation of thinking skin care professionals and spa owners.

Nature has many beauty cures. Plants, herbs, and flowers are the foundation, main ingredient, or synthetic ingredient in some of the best skin care products on the market. Many herbs are underutilized. This article covers some plant-based skin-regenerating ingredients as well as the underappreciated benefits of plant power.

ROSEMARY 

Rosemary grows almost everywhere, making it a plant that is widely sustainable. An ingredient is beneficial when it can be easily replaced once removed. For centuries, rosemary has been used to treat wounds and acne. It is an underutilized antioxidant with anti-inflammatory properties derived from carnosol or carnosic and ursolic acids. These acids are used in traditional medicine, pharmacy, and cosmetics, which is why many do not think of rosemary as anything other than a natural preservative, atmospheric scent, or kitchen ingredient. With inflammation at the root of almost every skin condition and concern, an anti-inflammatory ingredient like rosemary is critical to any practice. Historically, rosemary has been used to treat inflammatory diseases, wounds, skin cancer, and mycoses. Rosemary has also been implemented to treat cellulite, baldness, ultraviolet ray damage, aging, and a variety of other pathological and nonpathological conditions. It is currently being studied as a treatment for a variety of cancers, including skin cancer, with promising results. Rosemary contains polyphenols, diterpenes, and flavonoids, all of which play important roles in fighting both extrinsic and intrinsic aging. According to some studies, the diterpenes carnosol and carnosic acid account for up to 90% of rosemary’s antioxidant activity. In vivo studies have shown that rosemary reduces oxidative stress and inflammation in the gastrointestinal tract, which aids in skin health by removing inflammation that can transfer from the gut to skin through the circulatory system. Rosemary has also been linked to the treatment of fungal skin conditions and acne due to its antifungal, antiviral, antibacterial, and anti-inflammatory properties. Rosemary has been used successfully in both eastern and western medicine to treat neurological, cardiovascular, gastrointestinal, genitourinary, menstrual, hepatic, reproductive, respiratory, and other skin disorders. Rosemary’s antiplatelet activity regulates sebum and skin and protects and soothes skin conditions such as impaired barrier, eczema, psoriasis, acne, atopic dermatitis, and other chronic inflammatory conditions. 

Sash Moreaux has been a licensed aesthetician since 2006, a licensed aesthetics instructor since 2017, and CEO and founder of Meaux Co Pro LLC. In this phase of her aesthetics journey, Moreaux leads a team of licensed aestheticians providing free and low-cost advanced skin care education and mentoring to other licensed professionals. A big believer in supporting the aesthetician community and respecting all humans and mother earth, Moreaux supports the aesthetics community with wholesale pricing and no minimum orders, including free mentoring and small batch, handmade skin care that is earth loving and sustainable. All her mentors and educators are licensed as well; she believes skin care advice should come from a professional. Moreaux holds college education from Missouri State University and Arizona State University as well as licensing and certification from Missouri College of Esthetics.