It most certainly requires an adept eye, ingredient knowledge and a customized approach. Fortunately there are a number of tools at our disposal to help clients achieve healthy skin.
Simply put, UVA and UVB rays destroy the skin. UVB rays are shorter and cause burns while UVA rays, which have longer wavelengths, are responsible for photo-aging damage.
Sun exposure depletes the tissue of all moisture and hydration, and its rays penetrate the dermis – affecting it at the cellular level – causing long-term damage. Collagen fibers are also disrupted and begin to form abnormal amounts of elastin and increase metalloproteinases production. Collagen then begins to malfunction and decompose; incorrectly rebuilding the skin and forming wrinkles. Over time, the skin's ability to regenerate is compromised, dead cells build up on the surface, and the production of new cells decreases resulting in an aged appearance.
Most sun damage occurs in early childhood, but damage continues throughout our lifetime. Its effects are cumulative and gradual, yet brutal. Prevention is key, and recent research has shown that chemical and laser peels, as well as retinoids actually help prevent skin cancer. These methods have the ability remove precancerous cells, such as actinic keratosis, which reside in the epidermis, by literally burning off the damaged cells.
This is exciting news for skin care professionals, because it means we have the tools available to help prevent a potential long-term battle with skin cancer. However, keep in mind when the cellular damage has already been done, our role as aestheticians is to know how to properly diagnose the damage, develop a treatment plan, or make a physician referral.
A Note about Sun Damage
Sun damage can range in severity from mild discoloration and visual signs of aging to the most extreme – skin cancer and deep burns. If a client falls into the more severe end of the spectrum, always refer them to a physician. While there are a number of ingredients and treatments that may provide them some relief, extreme caution must be exercised. The skin could be in such a sensitive state that even touch could elicit an undesired response.
Skin cancer is the most common form of cancer in the United States. It is estimated that one in five Americans will develop skin cancer in the course of a lifetime. It can present itself in many different forms. Basal cell carcinoma is the most common form with squamous cell carcinoma the second. Melanoma however, is the most serious form of cancer. Knowing what to look for in skin abnormalities and catching skin cancer early on is absolutely essential in preventing the proliferation of cancerous cells. In many cases it can be stopped in its tracks.
For basal cell carcinoma, some signs include: non-healing open sores; reddish patches; shiny pink, red or tan nodules; pink, elevated growths; and scar-like tissue. Squamous cell carcinomas will often appear as persistent rough, thick, scaly patches that may easily bleed. They can also look like warts or open sores with a crusted surface.
Always refer clients to a doctor for abnormal spots and never administer any active treatments on the area without first knowing the diagnosis. The same is true with severe burns. It is always better to err on the side of safety.
Visual Signs: Burns
When a burn occurs, what is the safest way to work with skin? And is it possible to accelerate healing?
In many cases, it is possible to speed the healing process – or at the very least help prevent clients from doing further damage. However, there are a few things to keep in mind when working with superficial burns and wounds.
For starters, depending on the severity of the burn, you may need to refer the client to a physician. Otherwise, if it is at the superficial level, we can help soothe, nourish and rebuild the skin.
With minor burns that have not caused any major trauma, use formulas with ingredients like hydrocortisone, bisabolol, arnica, thermus thermophilus ferment, and mugwort as these have potent anti-inflammatory capabilities and decrease pain. The thermos thermophilus ferment can also help take the heat out of the skin.
For deeper burns that have reached the dermis, you will want to avoid using any occlusive topicals. These will trap in heat and seal in moisture.
In the Treatment Room
If the skin is particularly tender, inflamed or pink, keep in mind that less is more. The goal is to accelerate the healing process. Steer clear of enzymes, acids and harsh scrubs. Instead focus on gently cleansing, soothing and nourishing the skin.
Start with a gentle milk-based cleanser, followed by a layer of lubricating ointment and a skin-calming formula using ingredients like hydrocortisone, bisabolol, aloe, or arnica, to name a few. A chilled milk-based mask and Ice Globes gently rolled over the skin will provide instant relief to irritated skin as well. After gently removing the mask, bathe the skin with oxygen and vitamin spray. Finish with an epidermal growth factor serum and mineral-based SPF 30.
If the skin is further along in the healing process and is not tender or inflamed, you can begin to slowly reintroduce enzymes and exfoliation. But again, the emphasis is on nourishing, soothing and protecting.
The goal with the home care regimen is to continue the rebuilding and healing process with nourishing ingredients and protection from damaging elements. Of course customization will be key but a few key home care formulas and ingredients that generally aid the healing process include:
- Gentle milk cleanser or an antioxidant-rich pumpkin cleanser
- Grape seed oil
- Epidermal growth factors
- Omega-6 essential fatty acids
- Vitamins E and C
- Sun protection
Everyone will have a unique set of needs and conditions, but do keep in mind that less is more.
Visual Signs: Discoloration
Excessive production of melanin can be brought on by a number of internal and external factors, but the primary extrinsic cause is the sun. There are many solutions from melanin suppressants to peels and more mild home care systems. Treatment results vary greatly depending on discoloration level (cellular or superficial). Through a combination of home care and professional treatments, there can be significant change and correction.
Ingredients that help correct discoloration include bellis perennis flower (daisy flower), L-arbutin, kojic acid, L-lactic acid, and azelaic acid. These will work to inhibit melanin synthesis, brighten, and reduce hyperigmentation. In the treatment room, you will want to combine both brightening and skin-building ingredients, as the goal is to correct the issue and reset the skin on the right path.
In the Treatment Room
There are a number of enzymes, acids and modalities that may be used to address hyperpigmented skin. Some brightening formulas that work well include AHAs and TCAs, vitamin A peel formulas boosted with peptide support to correct the skin and also rebuild it, and melanin suppressant formulas. For melanin suppressants, look for a formula with daisy flower, L-arbutin, kojic acid, L-lactic acid and azelaic acids. These will work in tandem to brighten, provide antioxidant and anti-inflammatory support, and improve texture overall.
Prepare the skin with a brightening cleanser followed by a scrub. To breakdown dead surface cells, increase regeneration, soften fine lines, reduce hyperpigmentation, and improve skin tone, apply a TCA/AHA blend followed by the melanin suppressant formula. Finish the treatment with an application of the vitamin A and peptide peel formula to improve uneven pigmentation and produce radiant skin. The peptide action in the formula helps rebuild the skin.
Send clients home with a brightening cleanser and scrub, a potent pigment control serum containing daisy flower, and a hydrating brightening complex with lighteners and moisture support.
A formula with hydroquinone will also be effective in lightening pigmented skin, but it must be used in moderation and the client's skin should be monitored for irritation. Remember with any brightening program you will want to incorporate a growth factor and daily sunscreen.
Visual Signs: Aging
Skin damage and aging occur when oxidative stressors like the sun penetrate skin cells where they break down collagen and impact the DNA structure of the cell. As damage occurs over time, the cell is more likely to replicate it – the damaged cells multiply.
If a client's skin is wearing the signs of aging induced by overexposure to the sun, focus on boosting the skin's antioxidant defenses, as these typically decrease with age. This can be achieved through diet, as well as topicals.
Antioxidants are vital in fighting the signs of aging, internally and externally. Getting these nutrients naturally from super foods is always the best option, but supplements and topicals applied to the skin also provide benefits.
In the Treatment Room
Topicals rich in antioxidants will help firm, tone, tighten, refine lines, and give skin an overall glow. Active corrective ingredients like ascorbic acid, tocopherols, retinoids, and L-lactic acid will also help stimulate the regeneration process.
In the treatment room, you can help clients restore the skin and get them started on the right track with antioxidant-rich treatments beginning with a pumpkin cleanser, followed by a mist of liquid lotion containing Shea butter, resveratrol and raspberry.
To exfoliate, reduce keratinocytes, stimulate cell turnover, and infuse the skin with antioxidants, use a pepsin and papain enzyme followed by a salicylic formula blended with a mix of herbs such as oregano, thyme and basil, which help to restore the skin. Finish with an antioxidant mask, a vitamin C serum, omega-6 EFAs, growth factors and sun protection.
Continue the re-youth program between treatments by sending clients home with a good cleanser, a vitamin C and peptide complex, a retinol serum, and a deep-sea formula with thermos thermophilus ferment.
Vitamin C will work well to improve skin elasticity, decrease wrinkles by stimulating collagen synthesis, boost the skin's immune system, and repair damages caused by the sun's harmful rays.
While the best defense for sun-related skin damage is prevention, the reality is most clients have some degree of sun damage. While we cannot jump in a time machine to reverse the harmful effects, we can do the next best thing to correct, rebuild and protect their skin from future damage.