APJ Vol 25 2015

Aesthetics Practitioners Journal

AESTHETICS

PRACTITIONERS Journal The official publication of the Aesthetics Practitioners Advisory Network Pty Ltd ISSN: 1836-9812

Winter Volume 25. 2015

Winter Issue Volume 25.

BIOMIMETICS â&#x20AC;&#x201C; The Scientific Revolution in Skincare

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Biomimetic Skin Care

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INDUSTRY REPORTS, NEWS AND PRODUCTS 8-9 30-32 78-79 84-85 86-88

Heart-2-Heart Member Profile: Irena Morgenstern Product Innovations APAN Membership Moving from Strength to Strength: The power of business diversification 109-111 Aesthetic Bulletin

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REGULATIONS, EDUCATION & TRAINING 52-53 58 62-65 82 83 98-100

Industry Alert: Why a degree qualification could save the industry Medispa Management gets a makeover Breast Cancer: Treatment options and cosmetic care Bring the star quality to your treatments through new advanced education Government Funded Qualifications Are you highly employable?

SCIENTIFIC RESEARCH, TREATMENTS AND TECHNOLOGY 18-21 22-24 36-38 43 46-48 56-58

Glycation: Bad for the skin, but good for business Improving cell function through dermal needling Ingredient validity The Concise Guide to Dermal Needling Gut Health and how it controls our immunity Coconut Water: The smooth elixir for boosting hydration in the skin and body 60-61 Silica: Why it is important to the skin and body 66-67 Why Shea Butter continues to dominate in Cosmetic Formulations 70-72 Global Beauty: The new perspective in appearance enhancement 76-77 I'll drink to that: The past, present and future of Vinotherapy 80-82 Our Silent Immune System: Part 1 101-103 New Research on the role of toxins and their impact on health, obesity and Ageing 120-122 Transiting at Singapore's Changi Airport

BUSINESS AND PERSONAL AND PROFESSIONAL DEVELOPMENT 12-15 16-17 40-42 44-45 89-94 96-97

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Cover Story: The story of Omniderm: The power of imitating nature Keeping your business Tax Office Compliant Why you need to get your business on-line The latest industry Buzz: Plastic Surgery Hub and Wicked Beauty Business News Is your business commercially sound?

SEMINARS, EXPOS AND CONFERENCES 68-69

A5M Conference 15: Integrative, Preventative and AntiAgeing Medicine 104-108 Cosmetex 15: Leading the way towards new frontiers in cosmetic medical practices 123 APAN Conference – Melbourne

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EDITOR’SNOTE

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Recently I read an interesting statement that got me thinking. It was written by Henry Adams who said: A teacher affects eternity – they can never tell where their influence stops.

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When you think about it, you would define a teacher as someone who imparts knowledge or who instructs someone on how to do something. In this broader sense we are all teachers. In fact, without the quality of imparting knowledge, whether is to our staff or our clients, life would come to a standstill.

Knowledge, on a global scale, is doubling faster than we think. According to Buckminster Fuller, who created the “Knowledge Doubling Curve”, currently knowledge is doubling at an amazing pace of just 12 months. Since the advent of social media information is readily available on our ipads and mobile phones. We can access information while holding a cup of coffee in the morning still trying to wake up. Today, before most of us are up and preparing to start the day we have accessed numerous messages from our phones on topics we are interested in. So what does that mean to you and your business? It means you are no longer the only voice that influences your staff and your clients. So is that a threat and how do you overcome it? What is important is that you get in-front of those messages and make your statement richer in wisdom so they can be respected, accessed and heard. Most of us are time poor so it is important to select your information source carefully and grow your knowledge through credible means. As an industry expert seek to reference your information as much as possible from sources that are free of commercial bias. APAN's conference programs are a credible platform to gain a pure educational perspective, so invest in these events and benefit from the amazing information they can offer you. Our APJ Journal, while supporting many credible companies also focuses on delivering a high percentage of pure, credible, generic education to support you in your position as an expert. It will also allow you to be able to critically think and respond to matters that arise. Recently, a member contacted me in distress because one of her clients was touting the benefits of a great product sold over the internet that all her friends were raving about and encouraging her to also buy. “How can I compete with this?” she lamented. So I asked her to name the product and brand. I then researched the active ingredients in this product and how these ingredients were positioned in the formula. Following this, I asked her to tell me which product she was recommending to her clients and asked her to read me the ingredients. As it worked out they had a lot of similarities, but with one critical difference – the professional product had its active ingredients at a much higher strength in the formula. This gave her the confidence to go back to her client and regain her trust and her loyalty. It is important that we do not become intimidated by competition, but to achieve this we need to stay one step ahead of them, and knowledge will give us the power to do this. In this issue of APJ you will find many gold nuggets in news and education that will point to key industry changes. Look out for them and determine where you are positioned with this information.

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http://twitter.com/#!/apanetwork @apanetwork

APAN Website: http://www.apanetwork.com APAN Office Email: info@apanetwork.com

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So what areas warrant investing in if you are to stay competitive? On a technical level there are three: skin science, ingredient science and technology. In these three areas you will need to continually grow your knowledge. Additionally, you will need to advance your business and marketing skills and activities. However, as far as marketing goes you will need to invest in “Educational Marketing” as this is the era of information boom and consumers will determine whether to choose you on the basis of the knowledge you present to them. Staying current is challenging, but it is also very invigorating. Indeed, we Follow Tina on are living in exciting times with endless possibilities for those who are bold. So let us help you on this journey. Reach out and achieve your dreams. And remember, APAN is here to help you. http://www.facebook.com/APAN.page

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Editor Tina Viney Phone: (07) 5593 0360 Fax: 07 5593 0367 Email: info@apanetwork.com Web: www.apanetwork.com

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Welcome to APJ

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Typesetting & Graphics

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Mark Viney Kharis Enterprises Pty Ltd

Advertising and Marketing Tina Viney Phone: 07 5593 0360 Aesthetics Practitioners Advisory Network PO Box 5448 Q Super Centre Qld 4218 Australia Fax: 07 5593 0367 Mobile: 0412 177 423 Email: info@apanetwork.com

Publishers Kharis Enterprises Pty Ltd

Design & Production Artwork and Editorial Kharis Enterprises Pty Ltd Shop7D 76-84 Robina Town Centre Drive Robina Q 4226 Phone: 07 5593 0360 Fax: 07 5593 0367 Mobile: 0412 177 423 Email: info@kharis.com

Printed for Aesthetics Practitioners Advisory Network Pty Ltd ACN 136 987 169 ABN 25 136 987 169

Accounts Payable Aesthetics Practitioners Advisory Network PO Box 5448 Q Super Centre Qld 4218 Australia

Journal Advisory Board

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Dr Spiller Biomimetic Skin Care Distributed by OmniDerm

Terry Everitt – Education features Wendy Neely – PR and Marketing Dr Douglas Grose – Scientific content Caroline Nelson – Business Features

Phone: 1300 301 007 or email info@dr-spiller.com.au For further information see pages 12-15

National Advisory Council

The Aesthetics Practitioners Journal is the official publication of the Aesthetics Practitioners Advisory Network Pty Ltd, a network organisation established to service the needs of the aesthetics industry in the area of professional development and business networking. The Aesthetics Practitioners Journal is published quarterly for the benefit of its members and subscribers and aims to inform and educate its members on better business practices and industry advancements.

John Fergusson Terry Everitt Bill Anton Gill Fish Vanessa Kirkham Maureen Houssein-Mustafa

ISSN: 1836-981 ㈵

FRONT COVER

Print Post Approved [100000257]

Circulation 6900

All editorials and articles that are submitted for publishing remain the property of Aesthetics Practitioners Advisory Network Pty Ltd. Reproduction in part or in whole is not permitted without prior written authorisation by the publishers. Every effort has been made to ensure that all scientific and technical information presented is as accurate as possible at the time of publishing. However, members and readers are highly recommended to also seek external advice from their accountant, registered financial adviser or healthcare professional for their recommendations.

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Heart-to-Heart A message from the President and CEO Dear Colleagues and Friends As this journal goes to press most of you will be preparing your tax return and wondering how quickly the time has gone. As practitioners we are often very skilled at achieving results for our clients, but it takes a very different perspective to step back and put on the business owner's hat to evaluate how you have fared during the past 12 months and how things are looking on the business front. Having been approached and working with the Tax Office for over 18 months APAN has become aware that many within the industry are struggling particularly with their record keeping. This has concerned us and I am delighted to announce that we have a new Strategic Alliance Partner who has joined us to help solve many of these concerns. Olive Gray Business Solutions Pty Ltd is a very experienced company that is very familiar with the needs of the beauty and aesthetics industry. They provide expert bookkeeping services assisting salons and clinics in the aesthetics industry to meet their business requirements and ensuring they have peace of mind by being ATO compliant. Regardless of the State you are located in they are able to service your needs through their efficient networking system. Why struggle in this area? You can now allow an expert company to take care of you and at affordable rates. Check them out on page 16-17 and take advantage of the SPECIAL OFFER of a free introductory service, when you can have a friendly chat with them and determine if you can benefit from this service.

THREE STRATEGIC ALLIANCE PARTNERS In additional to Olive Gray Business solutions we have added two more Strategic Alliance Partners to assist our members with business support in both marketing and social media.

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Marketing and business development guru Bojan Schianetz is the CEO of Be Empowered Academy who specialise in helping practice-based salons and clinics achieve business growth and ongoing successful client engagement through the new concept of Education Marketing. This is very much a specialist area that when delivered correctly can substantially help service based businesses grow to new levels. Bojan has developed some amazing tools to help businesses master this style of marketing and so we believe that his services can be invaluable to our members to improve their cashflow in these competitive times. You can read his article on pages 40-42. We encourage you to also contact him for further information. I am also delighted to introduce to you in this issue a very special lady - Trish Hammond from Plastic Surgery Hub and Wicked

Beauty. I consider Trish another guru - this time in the area of social media. Born out of frustration of not being able to access the right practitioner for her own needs, she went on to develop an interactive new-model website for consumers to gain more information on what options are available to them for appearance enhancement and connect with the right doctor. This site is so successful that it is now accessed by approximately one million consumers. We believe that Trish has created am amazing consumer community that is proving highly successful, valuable and lucrative for all concerned. She is now including an aesthetic practitioners section and is offering our members a great opportunity to tap in to this amazing consumer/practitioner hub and grow their businesses. Read Trish’s article on page 44-45 and look at joining her community. I am sure it will benefit your business.

ANAESTHETICS THAT MEET WITH REGULATORY REQUIREMENTS Recently, we were approached by the Queensland Department of Health to discuss new proposed amendments to the Health Regulations and in particular we spoke about the need for regulatory guidelines for dermal needling and tattoo removal. One subject that came up was that many within the industry are accessing anaesthetics and using them illegally. This is of grave concern to the Health Department and poses a concern to APAN as an industry body attempting to support and foster credible practices of the industry professionals it represents. Without appropriate conduct, the industry may find itself having to bear with tough and very costly regulations. While APAN supports regulations and is heavily involved with the government with their drafting, we want to protect the industry from the potential of over-regulations that may contribute to unnecessary restrictions. As a result APAN is currently working closely with a credible compound pharmacist in research and development to determine various anaesthetic formulations and trialling them for their effectiveness. Once these have been ascertained we will be putting together a user-friendly document that clearly addresses the regulatory guidelines for purchasing, use and safety precautions for the use and application of anaesthetics. While APAN will not be selling these products to the industry, we will, however, be involved in the trialling and testing to ensure that the best possible formulations are identified and that the practice of their use is clearly spelt out to the industry. It is interesting to note that formulations can vary considerably depending on their carrier and the way the formulation is put

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“Today I will do what others won't, so tomorrow I can accomplish what others can't.” Jerry Rice together. While client comfort is important when delivering procedures that induce some level of pain, it is also important to understand that anaesthetics can cause cardiac arrest and have even contributed to deaths. It is therefore important that as professionals we abide with the necessary regulatory guidelines. I trust that by the time the next journal is released we will have further good news on this subject.

GOVERNMENT- FUNDED QUALIFICATIONS At the time of preparing this report we are putting the final touches on our first batch of businesses that are going through the APAN application with the Industry Skills Fund. The rules are definitely very different to last year; however, we are optimistic that our industry can also benefit from this amazing government-funded initiative, with several businesses hopefully qualifying for 75% of the cost of their qualifications. Subject to the success of our first batch, we will be applying once again for a further batch, providing we will be allowed to do so. If you would like further information on this please see page 83 for further details or phone 07 5593 0360.

CONFERENCES There is one more APAN Conference that will be held in Melbourne in October, so if that location suits you please support it. These events take a lot of preparation to put together and we value your support and ensure that you will gain great value from them. As usual, APAN supports and participates in other conferences so in this issue you will see the latest write-up from the COSMETEX Conference and also information on the upcoming A5M Conference in Melbourne. We highly recommend that you attend this. It is an amazing event that will leave you buzzing with incredible knowledge. ㄰ 㤵㜵

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If you are not an APAN member, please consider joining our community of practice. It will be well worth your investment.We guarantee it, and you will also be supporting an organisation that is committed and fighting for you at education and government levels. You can download an application form from our website www.apanetwork.com

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We are here for you.

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Introduce two new treatments With Cryomed innovative technologies The trend in bodyshaping is constantly on the rise as diet alone cannot always achieve the svelte physique that your clients may aspire to. The answer is in bodyshaping technology that can help you achieve a smoother body contour and help you diversify into a new and lucrative market that is growing in demand. Cryomed can provide you with the solution.

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COOLSHAPING Today's most advanced non-invasive slimming and body-contouring solution includes the integration of Vacuum, LED, Massage and Cooling technology. The system delivers versatile and customised reshaping treatments with three types of specialised applicators to choose from.

HOW COOLSHAPING WORKS Coolshaping delivers LED and real-time controlled tissue cooling under vacuum to enhance treatment outcomes. The system is specifically designed to protect the skin's surface and ensure the safe delivery of energy to target tissue while avoiding damage to the surrounding skin.

BENEFITS OF COOLSHAPING 1. 2. 3. 4. 5.

Integrated combination Technology for Better Results Controlled Vacuum and precise tissue temperature control Low Level Light Therapy and Tissue Massage for enhanced clinical outcome A choice of 3 different-sized Specialised Applicators Vacuum Pulsing pre and post treatment for Patient comfort

ACHIEVE BETTER FACIAL TREATMENT OUTCOMES WITH HYDRABEAUTY HYDROFACIAL Hydrabeauty is the complete facial skin-care and cleansing system. Using a range of specialised tips from the diamond handpiece to exfoliate and cleanse your pores, penetrate the skin with premium solutions through the electroporation handpiece, and hydro dermabrasion handpiece with unique and efficient radial tips, there is nothing to stand in the way to leaving your skin clear, hydrated and beautiful. The Hydrabeauty treatment system specialises in revitalising your face and replenishing your skin. Capable of treating all skin types, Hydrabeauty can correct any skin symptom with its unique applicators and multiple, customisable modalities.

ADVANTAGES Automatic Cleaning System – one-step cleaning system Dual Radial Tip – large and small size User-Friendly Interface – 5.7 inch LCD screen Vacuum Power Adjustment – 5 levels In-Flow Rate Adjustment – 3 levels Premium Solutions – unique to Hydrabeauty

THREE SIMPLE STEPS Step 1: Low-irritation cleansing – Water + Lactic Acid action in Solution 1 removes unwanted waste and utilizes vacuum to extract these from the skin. Use solution 1 to remove sebum and oxidised waste deep in the pores by addition of Lactic Acid. Step 2: T-zone Intensive Care – Salicylic Acid softens the outer layer of the skin and cleanses pores further especially in the T-Zone area. Use solution 2 to dissolve dead skin and calm acne, rash and other inflammatory skin conditions by addition of Salicylic Acid. Step 3: Moisturising Nutrient Supplement – Portulaca Oleracea extract contains healthy omega-3 fatty acids and numerous vitamins and minerals for skin health. Use solution 3 to provide supplementary nutrients and deep moisturising by addition of Portulaca Oleracea extract.

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For these and other innovative cutting-edge technologies please contact CRYOMED 1300 346 448 or visit cryomed.com.au

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Exclusive Genesis Pulse

Essential-6 cut off filters Allows you to use the CBL for almost every application and reduce treatment times compared to other IPLs

Personalised Presets A new feature enabling users to save and adjust presets for each patient’s skin type and application

Fast Firing Rate CBL’s rapid repetition rates enable faster treatments to optimise your clinic’s profitability

Adjustable Cooling System The CBL uses fully adjustable sapphire contact cooling giving you unparalleled safety

Long Life Handpiece Certified to last over 100,000 pulses 50% more than most IPLs on the market

“DESIGNED BY DOCTORS, USED BY DOCTORS” “Our mission is to provide beautiful, supported equipment – each device looks wonderful and works even better. We’ll work with you to have your patients feeling and looking fantastic. That’s our promise.”

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The Story of OmniDerm THE POWER OF IMITATING NATURE Going against the current trend has its challenges and benefits. In terms of challenges it is much harder to convince someone that you are right if your voice is in the minority. On the other hand, if you can prove that you are right, you have one incredible advantage – it is called the COMPETITIVE ADVANTAGE.

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Paul Fister is the Director of OmniDerm – the official Australian Distributor of Dr Spiller Skincare and Herbal Aktiv Peel®, a man who is not afraid to go against the common grain when it comes to skincare formulations, if he believes there is sufficient credible evidence for him to do so. Advocating the principles of biomimetics that believe it is better if the ingredients used in skincare are recognised by the skin and therefore guaranteed more compatible and efficacious in skin improvement, Dr Spiller Skincare is a world leading brand that believes that indeed there is a better and safer way to skin improvement. Looking at the root of the word biomimetics which comes from two Greek words – ‘bios' meaning life, and 'mimesis' meaning to imitate. Broadly speaking, biomimetics is the science that focuses on imitating nature's method, design and processes, and formulations based on these principles boast better ingredient penetration, faster and more efficient hydration and rapid restoration of epidermal barrier

function, leading to improved skin immunity and skin health. Coming up to its 19th year in Australia, despite the challenges OmniDerm has achieved consistent growth and maintained its position as one of Australia's leading cosmetic distribution companies that has survived and prospered on the strength of its credible results-driven formulations and the amazing business support that the company offers salons and clinics. Entering a new season of growth we caught up with Paul and reflected on OmniDerm's journey over the years in the Australian professional skincare market and what lies ahead for the company.

APJ Q1: Paul, how long has OmniDerm been in operation in Australia and when did you launch Spiller Skincare to the professional skincare industry? OmniDerm was founded on July 1, 1996. It all started from our travels in Europe when we came across a skincare brand with a very appealing philosophy that was backed by unique formulation technology. Their approach respected the function of the skin and its objective was to restore skin back to good health by giving it ingredients that the skin was familiar with and recognised – a technology termed biomimetic. This made a lot of sense to us so we decided to bring some products back to Australia to determine whether they would be suitable for the market here. This trial proved

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to be very successful. It was clear within a few short weeks that these products were highly compatible with many skin types and delivered great results. This led to the launch of the Spiller Skincare range to salons within Australia. However, at the time AHA-based products were all the rage. As Spiller Skincare was building the skin through a bio-compatible approach it was coming from a different angle than the current trend. We therefore experienced some resistance from salons in those early days.

APJ Q2: While several companies are experiencing hardships through growing competition, OmniDerm continues to grow. To what do you attribute your survival and continued growth? This was the late 1990s and although we were approaching skin management through a different principle we needed to prove to the salons and clinics that we could match the same rejuvenating results that glycolic peels were promising, as at the time they were flooding the market. I have to say that we did try a couple of glycolic-based peels, but found the process too aggressive so we decided against that approach. Our search for a viable alternative was finally rewarded when we came across totally natural herbal peeling. Herbal Aktiv Peel® is a natural corrective treatment that works with the skin's own natural renewal mechanism of regeneration. It is designed to support and speed up the skin's natural process, visibly improving the appearance of skin. The key benefits that we identified was that it was scientifically proven, worked with several pure plant-based ingredients, it did not use synthetic acids or chemicals and it has over 50 years of worldwide success. Furthermore, it was suitable for most skin types and conditions and its philosophy was compatible with the biomimetic ingredient principles. To answer the second part of your question – to what do we attribute the fact that we are continuing to survive and grow, salons and their clients who have been touched by our products and our philosophy stay very loyal. The reason is that we have the only truly and completely biomimetic skincare range on the market today. Once therapists and their clients experience the difference and the results that we can offer they are reluctant to change to one of the mainstream ranges. Our combination of Alex Herbal Aktiv Peel® with Dr. Spiller Biomimetic Skincare remains the gold standard for cosmetic skin treatments.

Spiller's position on acid-containing skincare would be vindicated to such an extent.

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In our salons and clinics we were constantly confronted with badly dehydrated skins. One of the obvious symptoms is diffused redness. Our biomimetic creams support the skin by quickly re-establishing the protective barrier. Redness, reactivity and sensitivity issues generally resolved very quickly. The benefits and advantages of “water-in-oil” emulsions of the kind Dr. Spiller produces have been proven in numerous studies conducted by independent scientists. A one-year study by two Italian scientists even showed that WIO creams have a significant positive impact on skin elasticity compared to regular creams. By 2005 other suppliers started to respond to skin hydration issues by turning the focus to this important issue.

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Dr. Spiller's philosophy was based on the thought that we should observe our skin, learn how it functions and then work to reproduce these natural functions as closely as possible. By the year 2000 we started to refer to this as 'biomimetic' skincare. In 2009 Florence Barrett-Hill, the well-known New Zealand dermal science educator, practitioner and author released her book Cosmetic Chemistry where she refers to biomimetic ingredients. This was the start of other Australian suppliers using the term in their marketing. OmniDerm have been leaders in the conversation around professional skincare for many years now. We were the first to talk about the importance of restoring the skin's acid mantle and optimising skin hydration for the purpose of skin health. We were first to warn about the risks of acid-containing skincare, especially when they are not correctly administered. Biomimetic, a term first introduced by us, is now becoming mainstream. Herbal peeling is unsurpassed in its safety, versatility and levels of efficacy in cosmetic-resurfacing treatments.

APJ Q4: How does the company support business growth to salons and clinics and what educational support does it offer? We don't dazzle our clients with fancy terms or big promises. Our theory builds on the basics and follows through with impeccable logic. Trainees often have 'aha-moments', times when they finally comprehend how the principles all come together and gel to a new

APJ Q3: It is interesting that the concept of biomimetics in recent times is gaining media attention as new research is identifying the benefits to this approach, which you have been advocating for several years now. Tell us about this?

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Dr. Horst Spiller made the deliberate decision not to participate in the headlong race towards acid-based skincare. Initially, this made life very difficult for us as Spiller wasn't seen as being at the forefront of skincare science. Without independent research we were reluctant to publicise Dr. Spiller's concern about the longterm viability of AHAs and glycolic acids. This changed in 2004 with the release of the book The Perricone Promise. Dr. Perricone states that 'we should work with the skin rather than against it'. He also explained that daily application of acid-containing skincare will leave the skin in a constant state of micro-inflammation. Over the next few years we found information on the Hayflick Limit and the premature shortening of the cells' telomeres. An Italian dermatologist released research claiming that constant pressure on the skin for premature exfoliation causes a loss of vital stem cells. Dr. Mark Lees and others explained that the inflammation caused by continuous exfoliation creates enzymes that break down collagen, elastin and hyaluronic acid. I was amazed that Dr.

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understanding and approach of working with the skin to achieve incredible outcomes. Most of them are inspired and can't wait to start work with our products. Aesthetic therapists are primarily caring and nurturing individuals. Their focus is on providing exceptional customer experiences and first-grade skin-treatment results. Other disciplines such as business and staff management, marketing, financial management and even retail selling are often weak points. It is in our interest to provide advice and assistance where needed. Our motto is 'we'll interfere as much or as little as you like'. In reality we often act more like business consultants than product suppliers. We have a number of clients who will confirm that our involvement gave them and their business a new lease on life.

APJ Q5: From your observation how is the industry evolving since when you first began? Since our launch in 1996 we have embarked on a very interesting journey. When looking back I am reminded of several fad terms that attracted the spotlight as the next best thing to deliver results. These included various ingredients as well as technologies. By contrast, our philosophy and our approach has essentially remained the same and had not become outdated. It fact, the principles of biomimetic skincare are increasing in popularity as science continues to validate their benefits. This is because biomimetics works with the skin by mimicking ingredients that the skin recognises and are compatible with. As a result the chances of any reaction are incredibly minimised. Furthermore, as the formulations are water-in-oil they require very little preservation, making the products safer and more skin-friendly. We not only get the results, we often hear that our products are fixing problems caused by others. I have to also say that an excellent new development is the introduction of more advanced dermal-therapy training and education. This allows beauty therapists to reach new levels of knowledge and competence with a more formal scientific approach to the skin. Training in dermal therapies seems to be very focused on corrective treatments. Both dermal therapists as well as nurses in cosmetic medical clinics working with our products are discovering that they can add a new dimension to their protocols that is scientifically based and offers them a successful tool in allowing them to create satisfactory outcomes for their clients and patients.

APJ Q6: What is your competitive advantage that you can offer salons and clinics? Our competitive advantage lies in the uniqueness of our formulas and the results that our products and treatments deliver. Dr. Spiller Biomimetic Skincare is the only brand offering light oil-based creams. Unless you have worked with these products you are unable to appreciate the effect they have on what we have identified as the five main skin concerns: dehydration, sensitivity, pigmentation, premature ageing and impure skin/acne. Just recently we received a testimonial from a client who suffers from acne and was introduced to our products many months ago, but could not see the logic in applying an oil-based cream to oily acneic skin. After 12 months of trying other approaches she came back to her Spiller therapists and was able to experience significant improvement in her condition within days. Why? Because the product delivered the skin to a much healthier state and restored balance to the oil glands so that they did not need to over-secrete.

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We know that the epidermis is lipophilic, therefore an oil-based cream is more skin-friendly and is also a more effective carrier of active ingredients. Our water-in-oil formulations, however, are not heavy or occlusive, they actually feel quite light and comfortable. They are formulated to assist in restoring the skin's protective mantle and deliver active ingredients to where they are needed to restore hydration and rebalance the skin to a healthier state. Our co-operation with our clinics and salons gives us another unique competitive advantage. We truly consider our relationship a 'win/win'. We have highly experienced beauty therapists, business owners and trainers on our team and fully understand that they also need support in business strategies. My own qualifications include a degree in Business and Marketing and I have also owned and built successful salons from the ground up, so I am aware of what is involved. We have developed unique intellectual property around salons and clinics and effective staff-management protocols, which we make available to our clients. We do this at no charge because we truly believe that for us to be successful we first need to help our clients to be successful. In terms of sales we have developed a special approach to retailing that relies on education rather than selling. This is particularly effective as our Dr. Spiller products are so different and unique. A brief explanation about the difference of biomimetic skincare quickly stimulates the client's desire to own this product. Once they

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experience our products and treatments they rarely go back to what they were using before. Educating clients followed by a positive experience through the use of our products are the keys to client loyalty for every salon or clinic. Likewise, for OmniDerm, helping our salons and clinics achieve results and client loyalty is what contributes to our success as a leading skincare brand. We also conduct a strong social media campaign and we have numerous media personalities and celebrities who have tried and vouch for our products, and this also drives business to our salons and clinics.

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APJ Q7: Share with us a success story from a salon or clinic that has introduced your products

We all like to be able to help people with their concerns. One of the most touching stories that we usually share at our trainings comes from a beauty salon in Kalgoorlie: A lady came to see the salon owner about her father's skin problem. The 84-year old gentleman was suffering from xerosis. No medical, pharmaceutical or cosmetic products had been able to give him any adequate relief from this condition. Our salon owner identified the concern and she gave the lady a sample of Dr. Spiller's Vitamin Skin Function Oil. Three days later the lady came back claiming that our product was helping. She purchased a full retail size product for her father. In just six weeks another lady visited the salon. She introduced herself as the carer of the gentleman in question, advised that our product was very effective and purchased another bottle. A further six weeks later they brought the gentleman to the salon in his wheelchair because he wanted to visit the therapist that helped 'fixed his problem'. We have numerous similar heart-warming stories that support the important role that the professional therapists have in the care of the skin. We often use these examples to emphasise the importance of an intact acid mantle and the importance of preventing moisture loss from the skin in order to retain skin hydration and pH balance at normal, healthy levels. Dehydration progresses in five stages: dehydrated skin, tight skin, rough skin, scaly skin and lastly, xerosis. It is the professional skin-therapist's job to ensure that her clients don't suffer from any of these conditions and that any deficiencies are picked up and resolved, starting with issues of dehydration. Tight skin and rough skin are signs that dehydration has progressed severely. Both conditions often manifest diffused redness, which is a sign that inflammation is present, with all its negative consequences.

APJ Q8: How do you see the future and what hope do you have that your principles will continue to gain recognition?

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Our products have generally not been of interest to medical cosmetic clinics because our biomimetic approach is not considered as effective as the cosmeceutical one. However, over the past few years we have been able to develop an excellent relationship with some leading medical clinics and have proven that our products are highly effective in delivering significant skin improvement and skin rejuvenations to their clients and patients that has contributed to outstanding loyalty. As new research comes to light on the benefit of biomimetic formulations nurses and doctors who were initially very reluctant to learn about Dr. Spiller are now some of our greatest advocates. A new book addressing the latest scientifically backed findings in skincare written by Carl R. Thornfeldt, MD titled The New Ideal in Skin Health: Separating Fact from Fiction is a further step forward in recognition of our philosophies and our approaches. Reading Dr.

Thornfeldt's book it felt as if he had written it with our products in mind. It even contains a large section on herbs and herbal extracts, explaining their active compounds and their mechanisms of action, including active secondary metabolites. His text is strongly focused on the importance of an intact stratum corneum barrier. He stresses that continual disruption of the skin barrier will lead to chronic inflammation, leading to an increase in matrix metalloproteinases. In other words, actions that will lead to on-going low-level inflammation in the skin will lead to the formation of destructive enzymes that lead to premature ageing. We acknowledge that shortterm skin trauma can help with stimulating collagen production, however, on-going inflammation is another matter. Dr Thornfeldt also covers quite extensive information on the medicinal properties of herbs and minerals. One key ingredient why we believe that the Herbal Aktiv Peel® is so successful is due also to the numerous medical- grade herbal extracts as well as the presence of Silica, which is now proven to be highly effective in the formation of collagen. Dr Jutta Oppermann has presented some of her findings on silicic acid in her book Beauty from inside out with Silicic Acid, in which she also advocates the importance of silica taken internally in a drinkable form for strengthening skin tone and elasticity as well as the elasticity of arteries. In light of the end product, while we cannot make certain claims due to TGA restrictions, we can still examine and study independent research findings on various herbs and ingredients. See also pages 60 and 61. ㄰

As new independently sourced information comes to light this will help validate our products' integrity and enable us to grow and expand our influence with both aesthetic and cosmetic medical clinics that are seeking effective solutions in improving treatment results. For further information on Dr Spiller Biomimetic Skincare contact OmniDerm 1300 301 007 or email info@dr-spiller.com.au

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APJ 15

strategicpartner ㄰

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Keeping your Business

TAX OFFICE COMPLIANT Do you find that you are guilty of not spending more time with your bookwork and keeping your financial records upto-date and this is causing you stress? Perhaps the solution is easier than you think. APAN is introducing a new Strategic Partner to assist you in this regard. Having liaised with the TAX OFFICE we are aware that this is a weak area in the aesthetics industry and we are reaching out to help identify a solution. ㄰ 㤵㜵

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Olive Gray Business Solutions Pty Ltd, our new Strategic Alliance Partner, specialises in bookkeeping for the Aesthetics Industry. They are qualified and experienced BAS agents and bookkeeping professionals and offer a complete service packages, which means that they can take care of your accounts, freeing you up to focus on your business.

Olive Gray Business Solutions provides expert bookkeeping services, assisting salons and clinics in the Aesthetics industry meet their business requirements and ensure they have peace of mind by being ATO compliant. Regardless of the State you are located in they are able to service your needs through their efficient networking system. Here is what they offer:

OUR SERVICES We are very familiar with the BEAUTY and AESTHETICS industry. We recognise that your business is unique, therefore your bookkeeping needs are specialised. As we understand your working environment we recognise that we need to work to suit your timeframe. Whether you are new to business or are firmly established we can provide a bookkeeping solution for you at affordable rates:

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Some of our more regular bookkeeping services include:

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BAS and IAS preparation and lodgement ATO Compliance General Bookkeeping Data Entry

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APJ 16

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Business registrations:

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ABN Australian Business Number GST Goods and Services Tax TFN Tax File Number for business PAYG Pay as you go withholding/instalments Payroll Tax FBT Fringe Benefits Tax Company, Partnership or Trust Payroll including commissions Superannuation Accounts Payable and Receivable Bank Reconciliation Inventory Management Budget Preparation Preparing Management Reports Preparation of Accounting Records for your Accountant Accounting Software setup and training

BOOKKEEPING GUARANTEE With 23 years experience in the Aesthetics industry working with suppliers and therapists locally and nationally we have an in-depth understanding of the special needs of this industry. We will ensure that all your deductable entitlements are included, while ensuring that your records are accurately prepared to the required standards of the Tax Office.

HOW WILL ACCURATE RECORD ASSIST YOUR BUSINESS TO GROW? By ensuring that your financial records are up to date you will not only gain peace of mind that your books are in order to comply with your Tax Department obligations, you will also gain an accurate record of your business's financial performance so that you can identify what aspects of the business is bringing the most profit and your best growth opportunities for you to move forward in. Furthermore, should you wish to sell the business, accurate records will allow you to gain the best possible selling price.

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GOOD RECORD KEEPING WILL GIVE YOU PEACE OF MIND AND HELP YOUR BUSINESS IDENTIFY ITS GROWTH OPPORTUNITIES AND ITS WORTH AS A BUSINESS ENTITY.

HOW IT ALL WORKS We provide a flexible bookkeeping service, specialising in off-site bookkeeping, you simply provide any files or paperwork via the internet, email or post. This facilitates a quick turnaround or your work.

SPECIAL OFFER Please quote this article in APJ to redeem a

COMPLEMENTARY ONE HOUR CONSULTATION.

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APJ 17

skinscience ㄰

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GLYCATION

Bad for the Skin but Good for Business By Terry Everitt ㄰ 㤵㜵

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Glycation has been a buzz word in the industry for some time, and through the years a solid body of knowledge has been established beyond the issue of 'sugar and protein', yet much knowledge about glycation still remains unknown. Terry Everitt is well known for his passion for education and in particular anything relating to ingredients and the skin. In this article, Terry Everitt lays out the purely scientific knowledge foundation for you around the subject of glycation, and provides useful hints in treatment.

I think it fair to say that two of the most important insults that the skin sustains are oxidation and glycation. Oxidation primarily, although not exclusively, is from sun damage, whereas glycation is primarily from diet. However, if only it were that simple, as the real damage is the oxidative stress that comes from glycation. From reading about glycation in the trade journals, you could be forgiven if you think glycation, and the resulting advanced glycation end products (AGEs), only harm the skin and in particular the two primary fibres of the dermis – elastin and collagen. While

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APJ 18

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this damage is true, AGEs also affect the dermal glycoproteins and glycosaminoglycans. This in turn negatively effects the dermal extracellular matrix (ECM) in terms of growth, differentiation, motility of the fibroblasts, the cytokine response, enzymatic activity, increased action of metalloproteinase production (MMP1, 2 and 9) and vascular haemostasis. This obviously is not good, however, it gets worse.

Schiff bases are common enzymatic intermediates and are reversible. This is happening throughout the body and indeed is a natural reaction process. This is not an instant reaction, taking a few hours. Essentially a Schiff base is where a double bond forms between the carbon atom of the glucose and the nitrogen atom of the lysine.

On a systemic level Simm et al (2007) conclusively showed the oxidative conditions that arise from the formation of AGEs can lead to cardiovascular disease, and a few years later Srikanth et al’s (2011) decisive paper showed how AGEs is instrumental in the development of Alzheimer's. This has built on the knowledge of AGEs directly responsible as a causative factor in cataracts, macular degeneration, diabetic neuropathy, coronary artery disease and lower-extremity skin ulcers. Quite a damage list for a bit of sugar. The short story of Glycation is that it involves non-enzymatic reactions between a sugar and a free amine group of Lysine and Arginine amino acids in proteins.

If, however there is continued exposure to the sugar [glucose], the Schiff base [glucose + protein complex] undergoes rearrangement, which is a non-enzymatic glycosylation, resulting in a more stable but much less reversible compound known as an Amadori product, which takes a few weeks to complete the reaction. At this point the reaction is not reversible. Amadori products are named after Mario Amadori, an Italian chemist (1886-1941). Chemically speaking, an Amadori product is where the hydrogen atom from the hydroxyl group adjacent to the carbon-nitrogen double bond moves to bond to the nitrogen, leaving a ketone. Amadori products undergo further change to irreversible Advanced Glycation End products [AGEs].

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HOW DOES GLYCATION AFFECT COLLAGEN AND ELASTIN? When fructose as a sugar joins up with the amino acid lysine we get something called fructoselysine, which in turn can be oxidatively cleaved to form smaller reactive compounds, such as carboxymethyl lysine (CML) and pentosidine. This is the way glycation affects collagen, as collagen fibres with Lysine and Arginine being part of the triple helix structure are easily glycated, thus reducing the elasticity and structural resilience of the collagen and elastin structure. What you may not know is that collagen can have a half-life of 15 or more years in the skin, so easily can become cross-linked, stiff and non-functioning as it cannot in this state be catabolised. This build-up of effectively 'dead' collagen is the real problem. While above is the short story, it is a massive oversimplification of a series of very complicated chemical processes. Glucose is a reactive compound because it has an aldehyde group as part of its structure. This is just a carbon atom with a double-bond oxygen and one hydrogen molecule linked to the rest of the glucose molecule. This diagram is termed a linear structure, just for ease of understanding, however glucose is generally found in a cyclic form and cannot react easily with proteins.

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In this diagram you can see the same structure as in the linear format with one major difference – the aldehyde group is no longer available.

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It is still there, yet 'locked up' in the circle and not freely available. This makes a big difference. When you have lots of glucose in your system, post that wonderful super Sunday with fudge and chocolate sauce, glucose does attract and attach itself to molecules of proteins. This reaction is termed a Schiff base, named after the German Hugo Schiff (1834-1915).

(Lopez 2009)

THE ULTRAVIOLET (UVA) FACTOR We know that ultraviolet light causes damage to the dermal extra cellular matrix and structural alterations take place. Masaki et al (1999) showed decreased dermal fibroblast cell viability due to the UVA generation of reactive oxygen species (ROS), which was accelerated in the presence of AGEs that amplified the degenerative phenomena of the skin associated with the ageing process. In addition to this damage, UVA is responsible for the up regulation of MMPs 1, 3 and 9; all enzymes that degrade collagen and elastin, not to mention the inflammatory cytokines interleukin (IL) 1 alpha and IL 6. Thus we get a double whammy of UV and glycation damage to increase the deleterious effects on the skin and other organs of the body. A recent study by Crisan et al (2013), using histological and immuno-histochemical imaging, revealed implicitly the role of UV in the modulation and accumulation of glyco-oxidation products at the dermal level, in particular the CML distribution at epidermal level, especially in the germinative layers, suggesting the impact of cytokines on glycation mechanisms. N- (carboxymethyl) lysine (CML), a known biomarker of oxidative stress, is caused by cleavage of the previously mentioned Fructoselysine (FL) and pentosidine. Simple sugars like fructose and galactose undergo glycation at about 10 times a higher rate than glucose; most sweeteners today are approximately 50% fructose or a fructose derivative. This results in glycation and free radical oxidation, which has

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APJ 19

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coined a new term named ''glycoxidation'' products; something we will be hearing much more of in the future study of glycolation.

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We do have a few enzymes that help with the breakdown of AGEs. These are known as oxidised protein degradation enzymes. Oxidised protein hydrolase (OHP) is a serine protease along with another termed glyoxidase, which works by metabolising methylglyoxal (an intermediate product in the glycation process). Unfortunately it appears to be unknown why these enzymes decrease rapidly with age, decreasing our natural ability to combat the end results of glycation.

The amount of AGEs present increases in certain situations involving hyperglycaemia and oxidative stress, such as diabetes, where ability to process glucose is at the root of the disease; diabetics have an especially difficult time with glycated sensitive skin issues, including neuropathy and scleroderma. Although the use of autofluorescence readers that can detect AGEs in the skin remains in laboratories, it will not be long before such machines will be available for clinic or salon use to accurately read the damage caused by AGEs. Until that time you can be assured that if your clients have sugar in their diet, there will be some damage caused by this approximately at 30 years of age. If they also get (or did get) UV damage, then there is an absolute guarantee that they will be suffering from glycation that negatively impacts their skin and other areas of their bodies.

RAGE AGAINST RAGES The above information would be enough to cause radical thought about your sugar intake, yet there is one more thing that I have to mention – Receptors for Advanced Glycation End-products (RAGEs). Glycation End Products would not be so bad if they just floated around in the blood or lymph, yet they don't. They get into cells where the real damage is invoked. AGEs get into cells via RAGEs, which are receptors for AGEs on the cell walls. What is even worse is that RAGEs are autocatalytic. In other words once an AGE binds to a RAGE, more RAGEs are formed to bind to even more AGEs – a positive feedback loop. RAGEs are called toll-like receptors. These receptors are used for pattern-recognition as part of the immune system and used to initiate cellular signalling programs that include activation of nuclear factor kappa beta (NF-kB), a major inflammatory agent. Generally this is good in the normal homeostatic process, however, the massive increase of activation due to the AGEs promote increased inflammation – a major factor in ageing. It is this AGEs binding to their RAGEs that cause numerous disease

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states including: inflammatory diseases such as atherosclerosis, asthma, arthritis, myocardial infarction, peripheral vascular disease, nephropathy, retinopathy, cataracts, neuropathy, Alzheimer's disease and decreased dermal volume and structure.

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(Lopez 2009)

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TREATMENT AND PREVENTION Sadly I must state that skincare alone will not be a great success. However, combining your care and their homecare (prescribed by you) with diet and exercise will help immensely.

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Did you know that about 70% of blood glucose is consumed by skeletal muscle? Reduction of muscle mass increases insulin resistance so any weight-bearing exercise will help. Eating habits that include reduction of sugar and using low glycaemic index for food choices have to be instituted. If you are not qualified in nutrition or dietetics you will not be able to be too prescriptive in food management, but you can help by suggesting the avoidance of high-sugar foods that they (your client) may not be aware of such as fruit juice and carbonated drinks, along with the obvious 'high sugar' foods.

THE SMOKING TIME BOMB So immediate treatment would be stop eating sugar – which is almost impossible, so at least cut down on sugar consumption. If you or your clients need another reason to stop cigarette smoking, then this would be it. Since the definitive study by Cerami et al (1997) that showed cigarette smoke contains high concentrations of glycotoxins that pass from the lungs into the bloodstream. Glycotoxins induce the formation of AGEs, which attach to the proteins of the vascular walls and initiate atherosclerosis. These glycotoxins react with DNA in the lungs and become a major factor in lung cancer. This same reaction of cigarette-induced AGEs are hurting the skin, apart from reducing its available oxygen supply. I have always had a hard line in never accepting a skincare client who smokes because they cannot be serious about skincare if they smoke. One thing is certain: You can promise your clients that they will have real ugly skin in five to 10 years if they continue to smoke. In general there are many helpful strategies that work to reduce the AGEs burden beyond reducing sugar and cigarette consumption; such as limiting or stop eating processed and 'browned' foods (manufacturers use techniques like caramelisation and browning to improve the taste of their products), use slow-cooking methods and avoid high-heat cooked foods (these cause a Mallard reaction which induces AGEs), don't use fructose and cut out the sugar laden soft drinks.

NATURE AND NURTURE What has shown promise from research in Japan is a mix of Anthemis nobilis (chamomile), Crataegus oxyacantha (hawthorn berry), Houttuyunia cordata (dokudami) and Vitis Vinifera (grape leaf) (Ichihashi et al 2011). I have not found such a mix from a little research in Australia. No doubt someone is working on such a blend or some other possibility coming to skincare soon. Carnosine consists of the amino acids beta-alanine and L-histidine and there is some evidence of it being helpful in inhibiting AGEs formation, as is the case with pyridoxamine (a form of Vitamin B6).

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In your skincare look for ingredients that are anti-inflammatory such as tocopherol, Salix alba (white willow), glycyrrhetinic acid (licorice root), Aesculus hippocastanum (horse chestnut), Olea europaea (olive), green tea and oat beta glucan.

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APJ 20

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General hydration in essential as is the constant use of sunblock – sunscreens just will not do in helping an AGEs-compromised skin.

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Another aspect to include in your treatment protocols is exfoliation – almost any method will do, although extra care must be taken as the skin may be thin without the underlying structure so while chemical peels and microdermabrasion can be used, you will need to think carefully about what you are doing. It may be a better option to use enzymes as your exfoliant method with these skin conditions.

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There is much work being done in pharmacology to interrupt the glycation process and generation of AGEs, or provide AGE receptor antagonists or 'decomposers' such as N-Phenacyl-4-5dimethylthiazolium, although I think they need a better name for it.

CONCLUSION (FOR NOW) As a skin condition, I would venture that glycation damage is here to stay. While not all ageing is due to glycation, it is a major contributor to what we see as ageing, not only on the skin, yet affecting the entire body. This provides a very successful business model to look at – AGEs reduction treatments.Knowing the foundational causative effects gives many insights into what can be done in the prevention or at least the amelioration of the damaging sequel of the nonenzymatic joining of two readily available compounds – sugar and protein.

Terry Everitt is an established master in the art and science of clinical aesthetics both in USA and in Australia. He maintains membership of the Society of Cosmetic Chemists, A5M antiageing society, World Society of Interdisciplinary AntiAging Medicine, USA-based Society of Dermatological Skin Care Specialist among others. He holds a Bachelor of Health Science (Aesthetics) and a Master's Degree in Education and is recognised both in Australia and the US for both his academic knowledge as well as how this information translates into the practical world.

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REFERENCES Cerami, C. Founds, H. Nicholl, I. Mitsuhashi, T. Giordano, G. Vanpatten, S. Lee, A. Al-Abed, Y. Vlassara, H. Bucala, R. Cerami, A. (1997) Tobacco smoke is a source of toxic reactive glycation products, Procedures of the National Academy of Science, 94, 1391513920. Crisan, M. Taulescu, M. Crisan, D. Cosgarea, M. Parvu, A. Catoi, C. Drugan, T. (2013) Expression of Advanced Glycation EndProducts on Sun-Exposed and Non-Exposed Cutaneous Sites during the Ageing Process in Humans, PLOS ONE, 8 (10), 1-8. Ichihashi, M. Yagi, M. Nomoto, K. Yonei, Y. (2011) Glycation Stress and Photo-Aging in Skin, Anti-Aging Medicine, 8 (3) 23-29. Lopez,R.(2009)http://www.nutridesk.com.au/index.php?advanced -glycation-endproducts-ages&highlight=glycation accessed 24 April 2015. Masaki, H. Okano, Y. Sakurai, H. (1999) Generation of active oxygen species from advanced glycation end products (AGEs) during ultraviolet light A (UVA) irradiation and a possible mechanism for cell damaging. Biochim Biophys Acta 1428: 4556. Simm, A. Wagner, J. Gursinsky, T. Nass, F. Friedrich, I. Schinzel, R. Czeslik, E. Silber, R. Scheubel, R. (2007) Advanced glycation endproducts: a biomarker for age as an outcome predictor after cardiac surgery? Experimental gerontology 42 (7) 66875. Srikanth, V. Maczurek, A. Phan, T. Steele, M. Westcott, B. Juskiw, D. Münch, G. (2011) Advanced glycation end products and their receptor RAGE in Alzheimer's disease, Neurobiology of aging, 32 (5) 76377.

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skincaretechnology

Improve Cell Function through

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DERMAL NEEDLING

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therapies that include formal training in this unit, and it is anticipated that a new Advanced Diploma will also be released at the end of this year that will include a unit in this modality.

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Dr Des Fernandes is respected worldwide, not just as a plastic surgeon, but also recognised at the pioneer of modern-day Collagen Induction Therapy, otherwise known as dermal needling. He is a devoted advocate in this procedure and is committed to on-going trials and research on both how this technique impacts cells for skin rejuvenation, as well as identifying the best protocols for achieving optimal results. In his recent visit to Australia Dr Fernandes scheduled an educational program in various States starting from June this year, where he delivered training, sharing his expert techniques and knowledge in this modality. We caught up with him to glean some of his knowledge and share it with our readers.

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In the era of age-management, skin rejuvenation has taken on a more serious role in our industry. As skin therapists we engage in activities that help to regulate cell function in order to optimise skin health. But this is easier said than done, especially when we encounter skin damage that has already occurred. One valuable tool that allows us to stimulate growth factors (substances that cause cells-to-differentiate, proliferate and grow) and cytokines (signalling molecules that are released by cells to communicate with other cells) is dermal needling.

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Currently, in Australia, various Health Departments are drafting regulatory Impact Statements that include the practise of dermal needling. Meanwhile, various qualifications are currently available in dermal

APJ Q1: Dr Fernandes, what depth of needle would you classify as cosmetic and how does the depth of needle effect the skin? Cosmetic needling can be achieved with very fine needles as little as 0.01mm to 0.02 mm as these depths are sufficient to penetrate the Stratum Cornium. According to the FDA, skin needling for cosmetic purposes should not penetrate beyond the Stratum Spinosum. With needle depths of no more than 0.2mm you can get great penetration, and because this depth does not generate pain you can tolerate a lot more intensity, while home needling procedures can be delivered on a daily basis. Just three minutes is all that is needed. As the Stratum Cornium is the obstruction for the penetration of active ingredients into the skin, needle depths of up to 0.2mm is all that is needed to allow good ingredient penetration. In fact, German research has indicated that you can achieve better enhanced penetration with daily use of 0.2mm that with greater depth needle of 0.5mm. This is because with more shallow needles you can tolerate greater frequency and intensity with needling and this will allow you to achieve more holes. At this depth I don't believe that there is a cascade of epidermal growth factors from the procedure other than those from the use of, for example, topical vitamin A, but the needling does not do it.

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APJ 22

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APJ Q2: What needle depth would you classify as “medical” and what physiological changes does this depth bring to the skin? While some say that 0.5mm can achieve medical skin needling I am of the opinion that you need at least 1mm needles. This is because with 0.5mm you do not really achieve any bleeding, and in my many years of experience with needling, without bleeding you hardly get a result with collagen induction. With 1mm you are guaranteed bleeding. It is also my opinion that rollers are the better tool, as pens remain at a more shallow depth. When dealing with conditions such as burns or acne scars you need to reach a greater depth, so needle depth can reach up to 3mms to achieve bleeding and preferably achieve a degree of anoxia, which can be viewed when skin takes on a purple colour. At that point growth factors are released. This occurs because the loss of oxygen stimulates further growth factors from platelets. The plateletderived growth factors are instrumental in achieving skin regeneration and not scarring. I am sometimes asked about needle length of 5mm, but I believe that 5mm needle depth is unexplored in terms of its outcome. My concern with this length is that the needles may bend and this would pose risks that are best avoided. In my experience you only need 1mm needle depth to get beautiful results on epidermal improvement, and up to no more than 3mm is needed for skin rejuvenation and collagen induction.

APJ Q3: Can needling correct pigmentation and how does it achieve this? From my experience I have seen less evidence of pigmentation with as little as six needling sessions and these last up to one year. Research at the Hanover University Medical School in Germany was able to identify how needling can affect two genes – MC1R gene, which is implicated in melanin receptors. Melanocortin 1 receptor (MC1R) gene variants alter pigment synthesis in vivo. They are more frequent in subjects with melanoma, and increase the risk of developing this tumour in sporadic and familial cases. MC1R variants may predispose to melanoma as a result of alterations in skin pigmentation (which affords less protection against incidents of ultraviolet radiation). It appears that needling can suppress this gene and as a result can contribute to positive effects on pigmentation reduction. Medical needling also raised the ILI0 gene, which affects interleukin levels. We now know that medical needing can impact on genes and this may explain how this procedure can instigate positive changes to the skin. There have been several studies done that support this. One person that comes to mind is Associate Professor Matthias Aust from Germany. He has worked with a team investigating how medical needling impacts genes and the skin. Their findings were published in 2010-2011 (Percutaneous collagen induction therapy as a novel therapeutic option for Striae distensae).

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the skin be prepared? Appropriate preparation pre medical skin needling will require the systematic use of oil-based Vitamins A and C for three months precollagen induction therapy. This will improve the skin's texture and it will respond better to the needling so you will get better results. However, you must use the correct Vitamin A that will not cause irritation such as you will experience with Retinoic Acid which can cause a lot of irritation. I use high doses of Environ A and C because I know these concentrations are safe yet effective. It is a mistake not to prepare the skin to optimal levels prior to doing skin needling. I recommend using both vitamins A and C morning and night. Your vitamin A should be in the form of retinol palmitate and can be safely used during the day. Did you know that retinol palmitate can give you a SPF of 20? This has been proven in laboratory tests in Geneva. In terms of when to do needling pre or after the use of serums and skincare, trials indicate that it really makes no difference. My recommendation is to perform skin needling straight after cleansing the skin before applying any serum or skincare, for the simple reason that needling on top of a skin that has been covered with products will cause further dirt accumulation within the roller and you will need to spend more time ensuring that your roller is carefully cleaned.

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APJ Q6: What about post-treatment skincare use, what protocols would you recommend and why? Post treatment I would recommend vitamins A, C and E in an oil base. Since 2009 we have also been using a selective group of peptides (not collagen). These will stimulate the formation of various collagens with amazing results. We also enhance the penetration of peptides further through currents such as iontophoresis and sonophoresis. Another great post-treatment ingredient is of course hyaluronic acid. It is wonderful in hydrating the skin and feels soothing.

APJ Q7: What are your findings on frequency of needling for best skin-rejuvenation results both for clinical application and home use? My latest treatments have been as much as 2-3 times per week over 12 to 13 days. Treatments were delivered every second or third day with the final treatment delivered by the 13th day using 1mm roller. I have tried pens but I believe that rollers are best. This can be accompanied

APJ Q4: Can you perform skin needling on the lips to improve collagen density?

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While with fraxelated laser you can't cross the vermilion border of the lips, with needling you can. With the use of needle depth of 0.05 to 0.2 mm you can improve product penetration to the skin, and you can go as far as 1mm with medical needling to help with collagen induction.

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APJ Q5: For best results when preparing a client/patient for medical needling how should

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with a home-use roller of 0.1 to 0.3mm. This combination can deliver excellent results in skin rejuvenation.

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APJ Q8: What are your thoughts on the use of anaesthetics and what would you like to see developed in terms of regulations?

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If you are delivering treatments of needle length of 1mm and above you will need to use a topical anaesthetic as it is a painful procedure. Effective anaesthetics include Tetracaine, Lignocaine and Prilocaine, The use of such anaesthetics requires strict regulatory guidelines as incorrect use can contribute to toxicity. If used in too large an area they can be a real danger. There have been cases in the US where people have died because of incorrect use of anaesthetics. High doses much be medically supervised and their use must be confided to the recommended area only. Editor note: Currently APAN is working with health regulators to determine appropriate products for use within the aesthetics industry.

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APJ Q9: Are there any contra-indications for skin needling and what precautionary measures would you recommend to skin therapists? There are no contra-indications to skin needling other than active acne and skin cancer. The reason that active acne is contraindicated is that acne involves infection and this can be transferred through needling.

APJ Q10: In your opinion what is the biggest mistake that is currently happening with the use of these devices? In my opinion, the biggest mistake is when unqualified operators do not understand the correct way to perform these treatments and work too superficially without the correct intensity. This only gives this modality a bad name because they are not able to deliver the degree of results that collagen induction therapy should be achieving with this technique. Correct training is therefore essential and a thorough understanding of the skin and how this technique will impact skin cells.

Q11 APJ: What are your thoughts on the multi-needled electronically driven device over the manual roller ones? What are the advantages and disadvantages? I still advocate that the rollers are the best option as they are more flexible especially when you are conducting medical needling with 1mm and above. Pens are not that efficient with larger areas, but are great with areas such as around the nose and lips where it may not be as easy to pass freely over these areas. Remember that needling was first introduced by cosmetic tattooists who could achieve CIT with a dry needle without colour pigments. There are a variety of different rollers with different lengths. Materials vary from titanium, which have a long-lasting sharpness, while silver and gold-plated needles act as an antimicrobial and also prevent oxidation and pitting of the needle surface. In terms of needles there is also a great variety from as little as 24 needles on a roller to as many as 540 in nine-row devices. The quality of device is important as not all rollers are created equal, so it is important to seek and work with reputable brands that guarantee well-made devices.

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For further information on Dr Fernandes's next visit to Australia or for Medical Roll-CIT contact Environ on 1300 888 708.

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POWER HYALURONIC EYES AND LASHES

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Youthful look Stronger Eyelashes

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61% Lifting of eyelashes 42% Smoothing contour wrinkles 46% Reducing circles under the eyes

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A first in global salon treatment innovations and homecare to address all aspects of an ageing eye contour, dramatically lifting eyelids, strengthening and defining lashes and intensely firming. If you are looking to restore and preserve the youth and definition of the eyes, SKEYNDOR's POWER HYALURONIC EYES + LASHES does just that. This powerful biological professional formula, with its scientifically validated concentration of plant extracts, lifts drooping eyelids, strengthens and boosts lashes and diminishes dark circles.

This is the multi-functional product for eyes and eyelashes you have been waiting for. To introduce these treatments and products contact Vogue Image Group Ph: 1 800 554 545, or visit www.vogueimage.com.au.

Imagine a year without wrinkles, dark spots, acne or scarring?

With SKEYNDOR'S METICULOUS POWER RETINOL you can

A NEW RETINOL LIKE NO OTHER

]no sensitivity ]no irritation ]just amazing results

This exacting anti-ageing facial program is synergistically formulated to stimulate the skin's natural cellular regeneration process, revealing healthier, fresher and younger-looking skin after just one session. Skin regains its smoothness, firmness, health and radiance without the usual harmful side-effects of redness and irritation that traditionally are associated with the use of Vitamin A, commonly known as retinol. ㄰ 㤵㜵

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The treatment uses concentrated levels of pure Retinol, and anti-oxidants that work together to decrease the depth of lines and wrinkles, refine and resurface. In addition, it targets acne, congestion, scarring, dark spots and environmental damage.

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SKEYNDOR's PURE RETINOL – Leading the market in retinol innovations and results Contact Vogue Image Group Ph: 1 800 554 545 or visit www.vogueimage.com.au.

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When it comes to skincare, vitamin A (Retinol)

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is the gold-standard and positioned as a leader that cannot be challenged

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POWER RETINOL

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By Skeyndor ㈵

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for INTENSIVE REPAIR and SKIN REJUVENATION

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The advancement of technology and product innovations means that the aesthetician now has the tools to deliver impressive skin improvement and long-lasting results. However, the success of any treatment can only be guaranteed if the products and protocols are based by solid, scientifically validated ingredients. When in comes to skincare vitamin A is the gold-standard and positioned as a leader that cannot be challenged. Here are just five ways that vitamin A in the form of Retinol can benefit the skin:

Retinol offers powerful skin rejuvenation: Vitamin A in the form of Retinol helps skin produce collagen, supporting skin integrity and delivering a youthful, full appearance. According to a 2007 study, published in The Archives of Dermatology, 36 participants aged 80 and older applied a formula with 0.4 percent retinol to one arm up to three times a week. After 24 weeks, these participants had dramatic improvements in their skin that were “clearly visible to the naked eye,” reports renowned dermatologist Leslie Baumann.

Retinol improves skin luminosity and healthy appearance: Retinol also works on other levels such as reducing discoloration, fine lines, wrinkles and overall skin texture. Plus, it can improve skin tone and colour for overall younger-looking, even skin.

Retinol stimulates cell turnover: As we age cell turnover decreases leaving the skin looking dull and lifeless. Retinol assists the micro-exfoliation process, helping to also speed up cell turnover for a more youthful-looking skin. The release of dead cells also assists the skin to absorb active ingredients more efficiently, allowing them to benefit the skin at the core of the problem.

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Retinol addresses acne: While retinol works to reduce telltale signs of ageing, it also treats “acne-ridden skin,” states dermatologist Heidi A. Waldorf. Adult acne is common, affecting 50 % of women. Dealing with both ageing and acenic skin can be particularly distressing. Fortunately, because of retinol's exfoliating benefits, it can help treat acne. That's because dead skin cells can clog pores and contribute to acne. By getting rid of dead skin cells, Retinol improves and prevents breakouts. Retinol is less irritating than retinoids: Vitamin A derivative, retinoids are available by prescription only from a medical practitioner. Although they're more potent than their over-thecounter counterparts, retinoids are also more irritating to the skin,

with potential side-effects like peeling and redness. Power Retinol is gentler because it gradually converts to retinoic acid, which is the active ingredient in prescription treatments. Some people simply can't tolerate retinoids. For this reason retinol is ideal for those individuals along with anyone with sensitive or easily irritated skin and those trying retinoids for the first time. Plus, retinol can pave the way to retinoids, because it helps your skin get used to retinoic acid.

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SKYNDOR'S POWER RETINOL Skeyndor's Pure Retinol formulation utilises skincare technology that delivers hardest-working retinol without the irritation. “In addition,” comments Luca Mora, CEO of Skeyndor in Australia, “they are transported and delivered deep within the cells for extraordinary results. They will not break down in the presence of sunlight, so no photo-sensitivity issues and, no irritation.”

That's why Skeyndor has enlisted its proficiency in concentrated form for their latest range, Power Retinol. This exclusive SKEYNDOR formula merges pure Retinol with actives of Bakuchiol and Soy Extract to restore the skin's individual youthful radiance. This potent anti-ageing system boosts the skin's natural cellular regeneration to reveal an infinitely smoother, more even and firmer skin. Simply put, skin looks younger. This new line-up from the masters in scientific skincare features Intensive Repairing Cream (normal to dry), Intensive Repairing Serum-inCream (all skins), Intensive Repairing Emulsion (combination + oily) and of course, a professionally based Intensive Repairing Facial. Addressing and revitalising sluggish cell turnover, Power Retinol hastens the sloughing off of the top dead layer to create a burst of new cells at the deepest level. But its prowess does not end there. Perfect for the more mature, the not-so-mature, pigmented and oilier/acneic skin conditions, the Skeyndor Power Retinol targets photo-damage, prematurely ageing skin, acne-affected complexions, and thickened skin that refuses to shed. And, it is proven to improve skin structure, reduce inflammation, inhibit collagen breakdown, while also stimulating collagen integrity. The results are a boost of skin radiance for a rejuvenated, fresher and livelier skin and fade and tone down darker spots. Skeyndor's advanced and exacting Power Retinol formulations are also supercharged with impressive top performers – anti-bacterial and talented Bakuchiol to clear the skin, anti-inflammatory and skin-whitening benefits and Soy Extract that has a diminishing, softening and smoothing effect on wrinkles, while also tackling sun damage and tightening the skin. Designed for daily use, both morning and night, Skeyndor's Power

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Retinol home-care line includes: ! Intensive Repairing Cream, an anti-ageing combination for a rejuvenating effect on wrinkles and dark spots (normal to dry) .50ml RRP $98. ! Intensive Repairing Serum-in-Cream, an anti-ageing serum cream formula to diffuse light for an immediate perfecting effect (all skins). 30ml RRP $115. ! Intensive Repairing Emulsion, a lighter-textured fluid offering a rejuvenating effect on wrinkling and dark spots for combination + oily skins. 50ml RRP $98. In a world of passing trends, be assured that the Skeyndor highpowered and innovative Power Retinol range delivers on all its promises, addressing and obliterating the most nagging beauty

complaints. Skeyndor's Power Retinol is available as a professional treatment range and home-care products to support ongoing results and boost your sales figures.

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P O W E R R E T I N O L I N T E N S I V E R E PA I R I N G PROFESSIONAL TREATMENT Skyndor's treatment protocol allows you to achieve exceptional results through a simple step-by-step system.

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To introduce these treatments and products contact Vogue Image Group Ph: 1 800 554 545, 03 9821 0033 or visit www.vogueimage.com.au

POWER RETINOL STEP BY STEP STEP 1: Skin is cleansed with appropriate Skeyndor cleanser to suit the client's skin type. Rebalance the skin's pH by applying AQUATHERM CONCENTRATED mineral-rich water. STEP 2: Remove excessive dead cells with Skeyndor Peeling. Reinforce the deep cleansing stage if necessary with the EXFOLIATING CLEANSING GEL.

STEP 3: Apply 4 ml of PURE CONCENTRATED RETINOL (4-5 SPRAYS). To help further enhance penetration use ELECTROPORATION CURRENT through the MESOSCIENCE EQUIPMENT. STEP 4: Mix one part of the AMBER EXTRACT MASK with a few drops of ORGANIC CALENDULA OIL (3 drops for oily skin and 8 for dry skin). Massage the face, neck and cleavage, remodelling the whole face. STEP 5: Apply the remaining AMBER EXTACT MASK over the face, neck and cleavage in a fine film and leave for an additional 15 minutes. ㄰

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STEP 6: To finish, smooth the skin and remove any excess product with damp sponges. Tone and finish the treatment with a small amount of INTESIVE ANTIOXIDANT CREAM.

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APJ 28

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Irena Morgenstern Director IRENA MORGENSTERN SKIN MANAGEMENT

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You could call her a “behind-the-scene person” who is not interested in publicity or self-promotion, but Irena Morgenstern is without a doubt an intelligent and committed professional who takes her practice as seriously as she does the welfare and treatment results of her long-standing and committed clients.

Mechanical Engineering. However, on coming to Australia I decided to change my career path to aesthetics having also completed a Diploma in Beauty Therapy. In order to stay abreast in the field of Paramedical Aesthetics, I have completed numerous post-graduate qualifications in Australia, England and the USA over the past 30 years.

Setting treatment outcomes to new heights, her achievements as a skin-management expert have won her the reputation by her clients and peers as a leader in the field of paramedical aesthetics and skin management. Over the past 30 years Irena has paved the way of what can be considered as treatment breakthroughs in providing solutions from some of the most challenging skin conditions. Her devotion and dedication to her profession are truly exemplary and have gained her the respect of all who come in contact with her. It is with great pleasure that we present to you highlights of her professional life.

My focus has always been on cutting-edge technology and that included the very first Low Level Intensity Lasers, which I have been using for nearly 30 years. I guess that my engineering background must have influenced my affinity to technology.

APJ Q1: Irena, how long have you been in this industry and can you share with us your background and how you got involved with skin management? I am originally from Poland where I held qualifications in

Having lived for a time in London I noticed when coming to Australia that in those days paramedical aesthetics was in its infancy. It was plainly obvious that due to the extreme sun damage in Australia, women and men needed more advanced and personalised therapies to address the effect of premature ageing and photo-induced skin damage that were prevalent at the time. In 1995 I established Irena Morgenstern Skin Management (IMSM) – a clinic based in Brisbane that is supported by the latest advanced non-invasive technologies and lasers. The

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concept of IMSM has always been a non-invasive approach to skin and age management that maximises results with no long-term side-effects and minimum, or no downtime.

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APJ Q2: You have a real passion for laser and lightbased therapies. Why did you choose to specialise using these devices and how do you believe they offered superior results to other technologies?

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When it comes to treating photo-ageing and other skin conditions traditional therapies supported by more advanced technologies achieve more advanced results. For instance, Radio Frequency for the treatment of red veins has been superseded by lasers that are faster and more effective. Laser and lightbased technologies offer me incredible tools to achieve effective skin rejuvenation and skin management with superior and long-lasting results, which is what astute consumers are looking for.

APJ Q3: Name the most important considerations to which you attribute your success in treating skin conditions? I would have to say that my success in this industry can predominantly be attributed to my on-going research and continued education that allows me to identify the best possible treatment approach. Throughout my 30 years in this industry I have also gained a great deal of experience, which also gives me the wisdom to know how to navigate around a problem and determine the most effective course of action. However, every successful practitioner also needs high-quality clinical-strength skincare coupled with the power of advanced technologies. These tools in skilled hands have the capacity to achieve incredible treatment outcomes.

APJ Q4: Compared to when you started out in skin management how is the industry different now and how have consumers changed in their expectations? The competition in the aesthetic industry has reached a point where to differentiate yourself you have to specialise and deliver a standard of work that was simply not available 20 years ago. I recognised this change very early on and provided services in my practice that were not readily available. ㄰ 㤵㜵

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Consumers today are more informed about the latest advancement in cosmetic procedures than when I started in the industry. Today's consumers expect a blend of the traditional values that beauty therapy has to offer with a clinical approach of the most sophisticated technologies that are results based.

APJ Q5: What do you look for in a potential staff member, what are the key attributes in order of their priorities? When engaging a staff member it is important to establish if

the potential candidate is able to embrace and share our vision and values. Once identified we look for the 7 Cs staff should possess: 1. Competence: This is still the first factor to consider. Does the potential employee have the necessary skills, experiences and education to successfully complete the tasks you need performed? 2. Capability: Will this person complete, not only the easy tasks, but will he or she also find ways to deliver on the functions that require more effort and creativity? For me, being capable means the employee has potential for growth and the ability and willingness to take on more responsibility. 3. Compatibility: Can this person get along with colleagues, and more importantly, can he or she get along with existing and potential clients and partners? A critical component to also remember is the person's willingness and ability to

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respect and work harmoniously with his or her manager. If the new employee can't, there will be problems. 4. Commitment: Is the candidate serious about working for the long term? Or is he or she just passing through, always looking for something better? A history of past jobs and time spent at each provides clear insight on the matter. 5. Character: Does the person have values that align with ours? Are they honest; do they tell the truth and keep promises? Are they above reproach? Are they selfless and a co-operate team player? 6. Culture: Every business has a culture or a way that people behave and interact with each other. Culture is based on certain values, expectations, policies and procedures that influence the behaviour of a leader and their employees. Workers who don't reflect a company's culture tend to be disruptive and problematic. 7. Compensation: As the employer, it is important to ensure the person hired agrees to a market-based compensation package and is satisfied with what is offered. If not, an employee may feel unappreciated and therefore, underperform. By using the above guide-lines I have developed many staff that have had great professional success with IMSM and have progressed to develop their own careers. By offering personal and professional development programs some of our staff members have been with us from five to 11+ years.

APJ Q6: Share with us a client success story that made you appreciate the value of your work in changing people's lives? This story involves a teenage girl affected by post acne scarring. The extent of the problem had inhibited her social life resulting in seclusion and depression. I noticed during the consultation that she was very unhappy and sceptical about the outcome of the prescribed laser program. After a course of laser treatments her skin improved so dramatically that the change in her demeanour was very noticeable by everyone, especially her family. Results like this give me immense professional satisfaction and also give me the impetus to continue to explore new techniques and technologies, knowing that I can make a real difference in people's lives.

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APJ Q7: What are your expectations for the future and what do you wish to achieve before your reach retirement? My expectation is that the market will continue to evolve with more medical professionals penetrating the industry and new strategic alliances forming between various practitioners. This will result in therapists needing to advance their qualifications in order to perform more specialised treatments at the higher level that consumers now demand. We will continue to see the clinical approach becoming more commonplace and also see nurses stepping into this

profession. The more routine beauty-therapy procedures that are predominantly grooming will either be lost or relegated to smaller enterprises.

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I have to say that I have achieved more than I expected throughout my professional career. My 30 years in the industry have been very rewarding and enjoyable, and have given me the opportunity to meet and treat some really remarkable people.

APJ Q8: How important is personal and professional integrity and how would you define this in your own practice?

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Personal and professional integrity forms an integral part of our business. Our 20th Anniversary this year and the multiple industry awards are a testament to our commitment to it. The best confirmation of our professionalism is the following and loyalty of a large number of our clients who have supported us for the past years.

APJ Q9: How do you split the company's responsibilities and who handles the business administration aspect of your company? While I am committed to the practice standards and treatments, my husband, Phil Morgenstern, who is also a Director of the company, is responsible for the smooth running and administration of five principle areas that support and define the practice as a business operation. These include: ! Human Resource Management ! Taxation compliance ! Marketing and Advertising ! Legislative Regulation compliance ! Standardisation of Protocols and Procedures. These are also very important pillars that support and contribute to the success of the business. Being also a qualified engineer, Phil is a meticulous systems operator and I totally trust him to ensure the efficient and smooth running of the administrative side of the business. With him at the helm I know the business is in good hands.

APJ Q10: What do you value the most from your association with APAN? As the company director and a hands-on practitioner, I have to confess I am time poor. Running a business requires many sources of information and inputs. That's where APAN comes into the big picture. With Tina Viney's thirst for constantly sourcing new developments and forming new alliances with different professional bodies, I have access to a wealth of information both from the organisation as well as from the APJ Journal at my fingertips. I have been a member of many professional bodies in the past, however, I can unequivocally vouch for APAN as a first-class, credible industry body that is a value add to my business. Irena Morgenstern Skin Management is located at 87 Albert Street, Brisbane Qld 4000 Phone: 07 3229 5484, email: imsm@bigpond.net.au

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Be in business for yourself...but not by yourself We are a forward-thinking company with a proven strategic business model and an ongoing goal of maximising the returns on your investment from day one.

Who are we?

Australian Skin Clinics has been one of the industry leaders since 1996, providing quality, affordable cosmetic treatments. We offer highly effective laser and skin treatments together with cosmetic injectables, acne programs and skin care.

Our franchise benefits • Centralised marketing • IT support and customised software • In-depth practical training programs for therapists and managers • Accredited laser safety training courses • A suite of full operations manuals, sales tools, procedures and protocols • Exceptional franchise support + many more benefits

www.ozskin.com/franchise 1300 303 014

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The Five Secrets of a

SUCCESSFUL FRANCHISE BUSINESS Nicole Wright - General Manager Australian Skin Clinics While establishing a successful business – particularly in aesthetics and/or cosmetic services – can be an exciting venture, but such a project is not without its pitfalls, particularly in today's highly competitive market. In fact, statistics in Australia confirm that over 50% of businesses fail within three years.

new clinics opening in the coming weeks of writing this article, this franchise business is an established and proven business model that is positioned for rapid and substantial growth. If this is what you are looking for, perhaps you need to take a closer look and ask yourself if you are ready for this level of business success. So what is the secret to this company's success? 1.

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These statistics reflect that while many have a good reason and a passion to start their own business, they often don't have the necessary skills to survive in the competitive world of business. With the pace of change that many industries are currently experiencing, failures often occur due to the right structures not being in place at the right time. This is why franchise models are continuing to grow as a successful and more secure business option, and particularly in the fiercely competitive market of aesthetics and cosmetic services. If you are interested in establishing a new business or converting to a successful franchise business model in the aesthetics or cosmetic industry then perhaps you need to look at one of Australia's leading med-aesthetic franchises, Australian Skin Clinics. With over 16 clinics across Victoria, New South Wales and Queensland and three

POSITIONED IN A HIGH-GROWTH INDUSTRY With consumer spend on cosmetic procedures and related treatments in Australia at over $1 billion, the business model of the Australian Skin Clinics is well positioned in an industry that is set for considerable growth, which has been predicted by analysts at 15 – 20% over the next 12 months. Of all cosmetic procedures, anti-wrinkle injections, cosmetic and dermal fillers, laser and IPL are on top of the list. Given that it is estimated that only 1% of the population have experienced cosmetic injectables, the potential in this market is guaranteed to continue to grow.

2. A STRONG BRAND IMAGE Australian Skin Clinics was founded over 18 years ago in 1996, and through the hard work and determination of the CEO, Deb Farnworth-Wood, the business has maintained

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and continued to build upon its already recognised and trustworthy brand foundation.

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This modern business understands that brand image is as important as the high-quality goods or services it provides to the market. The strong brand image of Australian Skin Clinics positions its franchises as one of the leaders in the industry to the large, growing consumer market. This has, and continues to be, a powerful asset to both the Franchisor and Franchisee. Australian Skin Clinics is an established and contemporary brand that understands the pulse of what consumers are looking for – high standard and results in a friendly, fun and professional environment that can take care of their needs.

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! ! ! ! ! !

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Simple, strong and forward-thinking system With any business you need to have solid systems t h a t a re ma x im is e d fo r e ff ic i e nc i es. Unfortunately this is not often fully established in many businesses, who develop their policies progressively as the business evolved. This can take many hours of hard work and can be a costly exercise. At Australian Skin Clinics, the business owner steps into a business model that has everything in place, eliminating this headache. This franchise system has been designed to promote performance and service excellence from day one, ensuring that systems are simple and easy-to-use for franchisees and their teams. These systems include:

support and opportunity to up-skill and develop their team members. Australian Skin Clinics further has a 'Training Ambassador' program whereby each franchise has a team member training to “trainer level” to ensure the highest level of in-clinic support and compliance.

Centralised and integrated computer systems and bespoke software Systemised accounts and payroll Benchmarking and performance – management systems Simplified administrative requirements of less than eight hours per week allowing time to focus on the performance of the business Communication, training and compliance portal Medically-approved treatment protocols for all services

TRAINING PROGRAMS THAT ARE SETTING THE BENCHMARK IN THE INDUSTRY Training is one of the unique selling points of Australian Skin Clinics. Founded in Queensland, the company commenced operation in one of the most highly regulated States for laser licensing in Australia. As such, the company made a commitment to develop standards that aimed to exceed these requirements to ensure the highestquality service standards were set for the benefit of the clients, setting the benchmark in the industry. Despite other States, including Victoria and New South Wales having no licensing regulations, Australian Skin Clinics enforces its training standards and protocols across all States to ensure consistent and high-quality service is delivered across the brand. To ensure training is delivered at the highest standard, the company has its own Training Academy. This academy conducts a range of practical and theoretical aesthetic courses and ensures our franchises have extensive

5. STRONG SUPPORT BY PROFESSIONALS While some businesses aim to reduce expense by minimising support personnel, Australian Skin Clinics truly embraces the importance of setting a strong foundation and providing quality service to franchisees and thus clients. Their support by professionals is second to none.

! ! ! ! ! ! ! !

A head office team of over 25 professionals who were selected leaders in their field of expertise Medical team, including a Medical Director, four Medical Advisors and seven-day-a-week support service Business Development Managers to drive performance, sales, profitability and growth State-of-the-art Training Academy, facilities and equipment run by a team of experienced and skilled trainers Risk and Compliance Manager to help minimise risk to the business and monitor compliance for brand protection Centralised Marketing with a team of professionals Call Centre to assist in overflow of calls from clinics Project Manager to guide you through the process of setting up new businesses and a range of other professionals in the area of IT, Recruitment, Accounting, Administration and more.

If you believe you would like to benefit from the reputation and success of the Australian Skin Clinics business model and would like to investigate more about how you can become a business owner as a franchisee of Australian Skin Clinics, please give us a call today or visit our franchise website www.laserclinicfranchise.com. Alternatively, if you would like to look into the career prosects with Australian Skin Clinics, please phone:

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AUSTRALIA SKIN CLINICS 1300 303 014 or visit www.ozskin.com

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INGREDIENT VALIDITY Six Scientifically Validated Skin-Rejuvenation Ingredients

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Article submitted by Costhetics Aesthetic professionals and consumers share a problem: information overload. With a seemingly endless parade of solutions for skin rejuvenation, it can be difficult to sort out the winners from the losers. Many new-to-market products and treatments tout amazing results, but a scratch on the surface can reveal that those results, although amazing, may be anecdotal and almost always accompanied by the caveat “your results may differ”. As an aesthetic therapist it is important that you work with scientifically validated ingredients with proven efficacy. Costhetics, Australia's leading source for news about cosmetic enhancement, agrees. They believe the answer to the confusion in skin rejuvenation can be found in choosing skincare treatments based on the use of scientifically validated ingredients with an established pedigree of success. In this article they present a brief outline of some of the most credible ingredients that fall into this category.

ALPHA-HYDROXY ACIDS (AHAs) Glycolic, lactic, tartaric and citric acid – known collectively as AHAs – remove dead and damaged skincells. This process helps to reduce fine lines and age spots, smooth acne scars, and even uneven skin tone. When used in low concentration (less than 3%), AHAs work as water-binding agents. The most effective and wellresearched AHAs are:

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Glycolic acid (the first and still most popular of the AHAs) Lactic acid

Both are available as over-the-counter and prescription-strength products.

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Higher concentration AHAs (20% and above) are used within dermatology practices for pigmentation, rejuvenation, acne and excess oil production (seborrhoea). According to 2014 research conducted by Ego Pharmaceuticals in Braeside and published in DovePress, an open access portal to scientific and medical research, anti-ageing skincare solutions that

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use alpha-hydroxy acids and vitamins have proven value in skin rejuvenation.

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Study Conclusion: An anti-ageing skincare system containing AHAs and vitamins significantly improves the biomechanical parameters of the skin, including wrinkles and skin texture as well as elasticity without significant adverse effects. (Diana Tran, Joshua P Townley, Tanya M Barnes, Kerryn A Greive, study authors) AHAs improved wrinkle depth and skin roughness 32.5% and 42.9%, respectively, in 90% of study participants after 21 days of treatment. “AHAs should be considered an essential part of every individual's daily skincare routine,” suggests Brisbane cosmetic and laser dermatologist Dr Shobhan Manoharan. “They rejuvenate by helping collagen remodelling, thus improving fine lines/wrinkles, plumping out skin and helping uneven pigmentation. Also, they are safe in pregnancy and breast-feeding, so can be an ideal rejuvenation or anti-acne option when other medications might be inappropriate. ”

ANTIOXIDANTS

Monash University in Melbourne found.

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HYDROQUINONE

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Hydroquinone is an organic compound of the Phenol family. It blocks the enzyme that triggers melanin production in the skin and has been used for over 50 years to help individuals eliminate brown skin discolorations such as freckles and “age-spots”, postinflammatory pigment and a common hormonal hyperpigmentation problem known as melasma.

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OTC skincare creams contain 2% hydroquinone, while the version that can only be prescribed by a doctor may contain 4% and above. “Topical application of hydroquinone produces a reversible depigmentation of the skin by inhibition of the enzymatic oxidation of tyrosine to 3,4-dihydroxyphenylalanine (dopa) and suppression of other melanocyte metabolic processes,” says Dr Norris.

A 2013 treatment study conducted at the Vitiligo and Pigmentation Institute of Southern California evaluated the efficacy and safety of a 12-week skincare program that included 4% hydroquinone. It concluded:

Melasma severity, melasma pigmentation intensity and melasma area and severity index score were significantly reduced from week four onward relative to baseline. In total, 85% of participants were satisfied with the overall effectiveness of the study treatment. Three (of 20) participants had adverse events probably related to treatment (dryness, erythema, peeling and stinging sensation). The 4% hydroquinone skincare system plus tretinoin cream 0.025% is effective and well-tolerated in the treatment of melasma. (Treating Epidermal Melasma skincare system Study Abstract)

Antioxidants prevent free radicals from destroying collagen, DNA and elastin, while boosting cell repair and evening out skin tone. They assist in skin repair and the strengthening of blood vessels. They turn harmful free radicals into harmless compounds. The most common antioxidants include:

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Vitamin A Vitamin C Vitamin E Beta Carotene

“An anti-ageing containing AHAs and vitamins significantly improves the biomechanical parameters of the skin, including wrinkles and skin texture as well as elasticity, without significant adverse effects.”

“Peptides have been available for about 15 years and are considered by many dermatologists as the most effective skinregeneration product available,” says Dr Norris. Peptides are chains of amino acids that serve as the building blocks of proteins in the skin. When peptides are in a short chain of amino acids they can penetrate the top layer of the skin and send signals to the cells to increase collagen and elastin production.

In 2013, the American Academy of Dermatology reported on a new study from New York University Langone Medical Center. The study found that new technology could make the use of antioxidants even more effective in skincare. It reported that antioxidants have been used as active ingredients in skincare products for years because of their anti-ageing abilities, but effectively adding these natural ingredients to skincare products has its challenges. Advances in plant stem-cell technology provide a new way to extract antioxidants from plants in their purest and most stable form, which can help products more successfully treat the signs of ageing.

Matrixyl (palmitoyl-pentapeptide 3) is the peptide that specifically stimulates collagen synthesis and skin repair. Copper peptides reduce inflammation. Acetyl Hexapeptide-8 is a neuropeptide that relaxes facial muscles, thereby reducing the appearance of fine lines and wrinkles like neurotoxin injections.

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HYALURONIC ACID (HA) Hyaluronic acid is a recent addition to the ever-growing list of effective ingredients for skin rejuvenation. “I sometimes refer to HA as Mother Nature's sponge,” says Dr Ben Norris, a plastic surgeon based in Bondi Junction. “Hyaluronic acid can hold many times its weight in water, just like a sponge.”

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“Antioxidants turn harmful free radicals into harmless compounds that are eliminated by the body,” says Dr Anh Nguyen, a plastic surgeon based in Perth. “They penetrate the skin to neutralise the effects of sun damage, pollution, wind and temperature.” Antioxidants stop free radicals from destroying collagen, DNA and elastin, while boosting cell repair and evening out skin tone.

Applied topically, hyaluronic acid plumps and hydrates skin, gently smoothing away fine lines and wrinkles a 1999 study conducted at

A synthetic collagen-like hexapeptide, developed and studied at the Vincience Research Centre in France, was tested on 20 female volunteers aged 40 to 62 with important results. The effect of the collagen-like peptide on reducing the total and average length of wrinkles was also remarkable. This effect was statistically highly significant (p < 0.003) and was observed in 75% to 80% of the replicas. The results demonstrate that the collagen-like peptide acts deeply and intensely on wrinkles; these properties are of great interest in the field of anti-ageing skincare research. (Collagen-like peptide study)

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RETINOL

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According to the Mintel Global New Products Database, nearly 300 retinol-containing cosmetics have hit the market since 2003. The

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clinical and laboratory studies have identified the benefits of an array of natural ingredients for skincare. Consequently, a number of these ingredients and compounds are today being developed, used or considered not only for anti-aging effects, but also for use in dermatologic disorders.

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Among those skin disorders and possible natural solutions currently recognised:

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Psoriasis & Atopic Dermatitis – Colloidal oatmeal and aloe vera have useful anti-inflammatory properties. Acne & Rosacea – Green tea, niacinamide and feverfew are considered effective. Hyperpigmentation – The antioxidant properties of licorice, soy, acai berry, turmeric, green tea, arbutin and pomegranate have been found to be beneficial in correcting discoloration

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FOUR ANTI-AGEING DEVELOPMENTS THAT ARE GAINING TRACTION The question for a youthful appearance and facial rejuvenation continues with new strides in the skincare industry bringing new products and treatments. In 2014 alone we have seen the emergence of: ! Fractional Carbon Dioxide Lasers for Skin Resurfacing – Provides all the benefits of laser resurfacing – an outstanding method for removing wrinkles – but without the downtime and complications. Fractional ablative and non-ablative lasers – Provide much of the benefits of traditional full ablative laser resurfacing with minimal downtime and complications.

chief benefit of retinol is a smoother-looking complexion, but retinol also pumps up circulation by increasing blood-vessel formation, so skin looks healthier. Evolving research suggests that topical retinol packs more line-fighting power than originally believed, at lower doses than were previously studied. One clinical study reported last year in the journal Skin Pharmacology and Physiology concluded that 0.1 per cent of retinol improved fine-line appearance and skin tone after 12 weeks of use (by up to 25%). Another study tested retinol formulations of only 0.075% and 0.04% on Japanese women. It concluded that even those lower doses improved the appearance of lines while causing minimal irritation even for those with sensitive skin. (Chicago Tribune)

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“Fractionation has been one of the greatest advances in laser technology over the past decade. It enables effective treatment to all skin types, with minimal downtime, less discomfort and a much higher safety-profile. Different wavelengths may be used for rejuvenation, scarring, pigmentation and even slow down the progression of pre-cancerous sun-spots.” Dr Shobhan Manoharan. Better Wrinkle Fillers – Dermatologists now have their choice of several fillers, each made with a slightly different compound. “We can use these fillers to custom-volumise skin anywhere on the face and sculpt a lifted, vibrant look without surgical treatment,” says Dr Anh Nguyen. Lip Plumpers – A new generation of lip-plumping products featuring natural enzymes and compounds that draw water into the lips, keeping them fresh and vibrant. Tested in laboratories, this new technology utilises compounds found in the body and concentrates it on the pucker. Coffee Berry Extract – Research performed by Dr David McDaniels, at the Institute of Anti-Ageing Study in Virginia, and Dr Zoe Draelos, at Dermatology Consulting Service in North Carolina, found that coffee berry extract considerably improved the look of wrinkles and fine lines. They also concluded that the extract does its work by triggering allergic responses or skin irritations.

However, “Prescription-strength retinoic acid (tretinoin) remains the gold standard for anti-ageing benefits, reducing the appearance of fine lines, wrinkles, discoloration and other sundry signs of sun damage,” says Dr Norris. “This form of Vitamin A speeds up cell turnover, sweeps away the dead cells that cause dullness, and boosts collagen and elastin by stimulating cellular repair at the deepest level of the skin.”

AMERICA'S NATIONAL INSTITUTE OF HEALTH SAYS YES TO NATURAL INGREDIENTS

With the advances in research more new-to-market solutions are currently undergoing full testing and vetting, but the preliminary news is that we have sufficient evidence of proven ingredients to ensure positive and exciting results.

Natural ingredients have been used traditionally for millennia and their application in topical creams, lotions and preparations within traditional medicines and healing traditions of many cultures has been observed. According to the National Institute of Health, over the past 20 years

Visit: www.costhetics.com.au

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Are you in need of a challenge? Kids left home? Returning to work after a career break can be confronting. We love mums! We have casual, part-time and full-time positions available now. Australian Skin Clinics is a leading cosmetic medical, laser & rejuvenation franchise specialising in dermal, laser and injectable treatments, and we are looking for people like you. If you already have a Diploma of Beauty Therapy, or a Certificate IV in Anatomy and Physiology and have a passion for people, then it is time to join a company where you can love your work. Successful candidates will be trained as a Dermal and/or Laser Technician at our advanced training academy. A career break should not prevent you from getting back to work.

REVIVE & REJUVENATE YOUR CAREER 1300 303 014 www.ozskin.com

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Why You Need To Get Your Business On-line Bojan Schianetz, CEO Be Empowered Academy Pty Ltd As a business owner your goal is to market your business the most efficient way possible. For this reason you can't afford not to be part of the digital marketing world, because a staggering 97% of your potential customers use online searches when researching products or services. 73% of online activity is related to local searches, and 82% of those searches result in an in-store visit, phone call or purchase. This means the majority of your potential clients research online and have access to an exorbitant pool of knowledge, which allows them to compare products, read reports and educate them

before they even step in the door of your business. It is a consumer decision to embrace the digital world, and if you choose to ignore this trend, you'll end up fishing in a dry pond. Unfortunately, only 44% of small businesses in Australia have a website at all. Those with websites often don't keep them updated and optimised for social media and mobile sites. Fifty per cent of small business owners invest 95% of their marketing budget in conventional marketing and don't realise how many potential customers they lose on a daily base. This is an invisible business killer at work every single day, and most small business owners don't know how bad the impact is. Think about it, if the majority of your audience is searching online for you, but your business is invisible to them, they are buying or accessing services from your competitors instead of you, every single day. Let's face it, for small business owners and entrepreneurs who did not grow up as 'digital natives', the online world can be very technical and overwhelming. If you are not tech-savvy, you should not try to build up your web presence on your own. Learning and implementing technical stuff can be very time intensive and keeps you away from your core task of working on your business. A smarter way is to get a mentor to help you to develop a smart online marketing strategy and then outsource all the tactical online development tasks to an experienced

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team member or freelancer. Having a mentor in place ensures that you follow a plan; you don't want to have a web designer or programmer with no or little marketing experience leading your marketing. Now, let me introduce you to some key elements of a successful online strategy.

FOUR KEYS TO A SUCCESSFUL ONLINE STRATEGY ㈵

Key No. 1: Stand Out With Your Website Most small business owners struggle to have a professional, userfriendly and tidy website. They invest for an internet site to get online and after that they pretty much forget about its existence. They don't realise that the real work begins once the website is published. I also see many business owners overspending on fantastic-looking websites done by graphic designers with no or little marketing experience. These sites are thrown into the Internet Ocean, where they are left to drift on their own and go unnoticed by customers, who just never find them – what a waste!

building a relationship with existing customers. Imagine if you talked to your neighbours only sporadically every couple of months. Do you think you could build up a relationship with them? Do you think they would lend you their car one day if you asked them? I don't think so. Remember, every customer who originally bought from you did it for two reasons: first, because they needed your product or service, and second, because they trusted that your product or service delivered the promised results.

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Assuming your offerings are great and provide amazing value, do you think it will be easy to make another sale to an existing client? Yes, but only if you continue to build and maintain a relationship with them. If you do this right and on a regular basis by providing great value, it is very likely that they'll buy again and again and gradually turn into long-term clients. Continuously build and take care of your database and your business will prosper.

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The most efficient and cost-effective way to contact your database is through email. Most people use the three biggest email providers:

The first step is to be clear about why you need a website. There are many misconceptions about the purpose of having a website. A website is your online presence where your audience, potential employees, business partners and perhaps even investors check out your business, products and services. In this sense, your website is like a digital representation of your business and your brand. For these reasons, your website must look professional; it must also be easy to navigate. If your current website does not look good, or is outdated and hard to navigate through, then it makes your business look bad, and you need to do something about it. Now, let's uncover what your website is not. Your website is not your primary lead-generation machine. There are exceptions if you have a local business, where it is crucial to optimise your website for local searches. The first step is to choose a domain name that reflects not only the business brand, but the location as well.

Key No. 2 List Building For Success

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After you have your professionally designed website set up, you need to think about leveraging your business by building your client list. What I mean by 'list building' is to capture the first name and email address of your audience in order to communicate with them afterwards on your own terms. I mentioned already that your website's primary function is to present your business and to build credibility and trust. In general, a website is not very good at generating a big list and making sales on its own. For this reason your website needs not have an opt-in form to record name and email.

Key No. 3 Automate Your Marketing Unfortunately, most small business owners don't capture the names and emails of their potential customers. Not only do they fail to actively grow their list – they also miss out on staying in touch and

Gmail, Yahoo and Hotmail. These free systems are great for personal use, but not for business purposes. They are not suitable for sending out hundreds or thousands of emails at once, or sequential email campaigns and automated follow-ups. So you need a system that helps you automate this process to achieve tangible results – with opt-in pages, for example. As soon a person signs up, she should immediately receive a thank you email with a download link for the gift, even if it is three in the morning. Another reason you need a professional email auto-responder is to communicate consistently with your client database to help them solve their problems.

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Key No. 4. Email Marketing Done Effectively After you have your website optimised and an opt-in form set up, an email auto-responder installed ready to send out your emails, you need to craft your emails. Before I start to help you craft emails that will get opened and read, I need to emphasise that email marketing is not a choice. It is a must! There are too many benefits for your business; you cannot afford passing on it.

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Even with the growth of social media and instant messaging services, email marketing provides the best opportunity to communicate directly with your audience. Email marketing becomes magic when you deploy Education Based Marketing as the main strategy behind it. With this your emails become clientcentred, giving the person on the other end the feeling that you care. Does it sound too simple? Believe me, too many business owners fail at this.

To learn more about the Magnetize Your Clients program please phone Be Empowered Academy on 07 3040 7527 or email: support@attractnewclients.com.au We offer you four different components to help you grow your business and to meet your needs: 1. 12 online training modules 2. 3-Day Live Event 3. 12-Month Q&A group coaching 4. Closed FB group

About Bojan Schianetz: Bojan Schianetz is the founder and CEO of Be Empowered Academy Pty Ltd, providing high-leverage training programs, events and coaching for smallbusiness owners and entrepreneurs ready to take themselves and their businesses to the next level. He has 25 years’ experience in entrepreneurial, business and corporate marketing experience in Germany, Brazil, Chile and Australia. Known as a 'Transformational Business Mentor', he helps smallbusiness owners and entrepreneurs to shift from being unseen and underpaid to expanding their reach and impact and becoming well-compensated for their products and services. His recent book Wealth Through Passion And Business is dedicated to helping small business-owners and entrepreneurs build and grow their authentic and abundant businesses.

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bookreview ㄰ 㤵㜵

The Concise Guide to

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DERMAL NEEDLING By Dr Lance Setterfield, MD

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As skin rejuvenation and anti-ageing results are increasing in consumer demand, techniques, technologies and protocols are becoming more sophisticated. As stand-alone treatments, training with clear safety and efficacious operational guidelines and protocols are often all that is needed to reach the desired treatment outcomes. However, with the push for constantly better results, the matter becomes more complex as the industry adopts a more integrative approach introducing multifunctional use of devices and techniques. One of these is dermal needling.

When it comes to dermal needling the key is to understand the healing response that the process stimulates. Until recently, the keratinocyte, which was considered less important than the fibroblast in creating healthy skin, was abused shamelessly with a variety of ablative treatments. New research, h o w e v e r, s u g g e s t s t h e h u m b l e keratinocyte is responsible for releasing several key growth factors that conduct the orchestra of cells beneath it to facilitate ideal skin rejuvenation. In his book The Concise Guide to Dermal Needling, Dr Lance Setterfield, a committed advocate and internationally renowned educator in the techniques and practices of dermal needling, presents new scientific findings that allow us to better understand the skin's responses to needling and the necessary protocols that need to be adhered to with this procedure.

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Find out why dermal needling is the only rejuvenating treatment that maximises penetration of essential cell nutrients and maximises release of growth factors associated with the positive aspects of wound healing simultaneously. Discover why dermal needling eliminates the risk for melanocyte heat injury and actually optimises cell function, making it the ideal treatment for all skin types. This expanded edition challenges the conventional wisdom of prolonging the inflammatory response in rejuvenation, and includes which product ingredients to avoid and why.

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This book provides a concise guide to this exceptional modality, explaining everything a practitioner needs to know about the hows and whys of dermal needling. The Concise Guide to Dermal Needling provides a comprehensive source of valuable information.

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To purchase the book visit: http://needlingguide.com/

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The Latest Industry Buzz PLASTIC SURGERY HUB AND WICKED BEAUTY New APAN Strategic Alliance Partner

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Not long ago I met a fascinating woman. Her name is Trish Hammond and she is the director and the brains behind a business called PLASTIC SURGERY HUB – Australia's first online support hub for those looking to undergo plastic surgery and cosmetic treatments. The Hub turned out to be a great success and as a result a sister site, WICKED BEAUTY, was launched to cater for people who were interested in the latest non-surgical cosmetic treatments. PLASTIC SURGERY HUB and WICKED BEAUTY connect people with practitioners. Visitors and members of the websites are able to research practitioners and treatments. They can arrange a consultation or appointment, and get more information about pricing or a particular procedure. The Hub has connections with thousands of people seeking information about cosmetic procedures and treatments, and has an established promotional reach approaching ONE MILLION PEOPLE through social media, direct communications, club membership and newsletter subscriptions.

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Having experienced her own frustrations when she was trying to gain information to help her make informed choices, Trish identified the need for such an on-line hub and further consumer research confirmed it. The purpose of establishing the Hub is because Trish believed in the benefits of quality aesthetic treatments being performed by quality practitioners, and she felt that there was a huge demand by consumers for a credible platform that could assist them to gain further information and connect with a credible expert practitioner. Another unique feature of Plastic Surgery Hub is that it has a

Question & Answer section where people can ask questions directly to practitioners regarding procedures that they may be considering. The questions are then reviewed and answers supplied by qualified Australian Plastic Surgeons and practitioners. Via the Q&A platform it can also connect patients with the best practitioners for the procedures that they might be considering. “The Hub has regular blogs and articles advising consumers on the latest devices, treatments, surgeries, trends and advancements in order to better inform them on what is right for them. The website also posts a regularly updated feed of real-life experiences from women and men who share their own stories of treatments and procedures. Our readers relate to stories from other readers and get stories from those readers with experiences in the procedures we share in order to ensure we are providing the most up to date and honest feedback on treatments,” says Trish. It is estimated that Australians spend up to $1 billion on cosmetic surgery annually, and this number is only increasing. With the rapid technological advancements and massive industry growth with so

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many new products, procedures and techniques being released each year, a portal like the PLASTIC SURGERY HUB and WICKED BEAUTY have never been needed more.

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The Hub was created to fulfill a need. “I wanted to create an environment where people can make informed decisions based on getting truthful and factual information, share their stories with others and get connected with the right practitioner for them,” says Trish. “All the things I wished I had when I was going through my own journey.”

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Plastic Surgery Hub is not just a wealth of information for consumers looking at cosmetic procedures or aesthetic surgery, it is a place for all people within the industry, including patients, practitioners and surgeons, to connect within this community through meaningful interactions so that the best outcomes for all parties are gained.

THE PURPOSE OF ‘PLASTIC SURGERY HUB’ AND ‘WICKED BEAUTY’

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To encourage plastic and cosmetic surgery treatments to be performed in Australia. To provide an information resource for people who are either considering or have had surgery or cosmetic beauty treatments. To connect people considering cosmetic procedures with a qualified Australian practitioner.

NEW STRATEGIC ALLIANCE PARTNER Clinics and salons today need more clients. APAN believes that PLASTIC SURGERY HUB and WICKED BEAUTY can bring amazing value to its members – both aesthetic clinics and salons as well as plastic and cosmetic physicians. We are pleased to announce that PLASTIC SURGERY HUB and WICKED BEAUTY have been added to the exclusive group of APAN STRATEGIC ALLIANCE PARTNERS for the benefit of our members.

A MESSAGE FROM TRISH HAMMOND My name is Trish and I'd like to invite you to join our growing community of Australian practitioners. We reach our readers by way of blogs, vlogs, social media, phone, email, newsletters, eblasts and articles.

OUR MESSAGE TO CONSUMERS IS SIMPLE: ‘If you are considering having a procedure, you should only consult with a qualified practitioner’

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OUR MISSION ! We believe in the benefits of quality treatments being performed in Australia ! We aim to help people get the best information and results from their procedure ! Our goal is to help raise standards and protect patients ! Each day we are connecting with people, sharing their journey and offering support ! We connect your practice with people seriously considering treatments who are looking to take the next step – consultation through to a procedure.

of Australian practitioners, and become a contributing expert on our Question & Answer Forum.

SPECIAL OFFER: We would like to offer APAN Members a Premium Platinum Package at 50% OFF. Offer is only available until 15th August.

Package includes: ! Your own mini-website within the website ! 12 Editorials (1 per month) (stories, promotions) ! Lead generation ! Social Media interaction We also provide additional services including:

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Press Releases Social Media Setup and/or Management Blog Submissions Vlogs (video blogs) Article Submission/Article Writing Directory Submissions Website Optimisation (individualised and specific) Website Creation (for you to edit and update as required)

For further information on this offer or to discuss how we can help you gain greater business exposure contact Trish on 0429 264 811 or Email info@plasticsurgeryhub.com.au to book your spot.

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We would love you to become involved in building our community

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GUT HEALTH and how it controls our In this issue of APJ Gay Wardle is introducing a three-part series of articles on the lymphatic system and why it is important to understand the role our immune system plays in our treatment outcomes.

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In the new era science is now confirming that if we are looking for real answers for health and wellness, regardless as to whether it is the skin or the body, we can no longer only look at one issue – we need to examine multiple factors and ascertain the role they play. Coincidentally, we were fortunate to gain the wisdom from an international expert on gut health and immunity. Research over the last 20 years confirms the gut and our immunity are intimately linked. Michael Ash is a world-renowned British osteopath and naturopath who holds post-graduate qualifications in nutrition and mucosal immunology. Mr Ash was recently in Australia as a keynote speaker at the 3rd BioCeuticals Research Symposium 2015, held on the 1719 April in Sydney. We were fortunate to be able to catch up with

IMMUNITY

him and gain some of his expert knowledge on the subject for the benefit of our readers.

APJ Q1: Mr Ash, tell us what are the latest research findings on gut flora and the role this plays on our overall health and immunity? There is now concrete scientific evidence published that validates that disturbed gut flora contributes and is directly linked to skin conditions, as well as diabetes, heart conditions and even cancer. We know that our body holds over two pounds of bacteria in weight that are affected by our food supply and lifestyle. Initially the ecology of interstitial tract (gut flora) was not fully understood and was considered secondary to many health conditions, however, we now know that disturbance in gut flora is actually causative and not secondary. It was once thought that infections were as a result of communicable diseases that were triggered externally. New research now has confirmed that infections may be also caused by interstitial inflammations due to internal changes.

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APJ Q2: What is the current understanding on the effects of diet on gut bacteria, transcription facts and genes to achieve systemic and local health improvement? It is generally now understood that systemic health is largely influenced by nature and nurture, and that we can amplify health risks through poor food choices as well as hereditary factors. We now know that certain foods carry molecular messages that are communicated and promoted to our immune system through transcription factors that “switch on” or “turn-off” various genes and mechanisms in our body that affect bacteria mix. For example, processed foods can interfere and mess up those connections. In fact, we now know that 50% of the populations that suffer local and systemic problems have their root cause in gut dysfunction that translates to other organs. The food we eat provides different messages to hormones and chemicals that influence our body. This is why fasting or abstinence from food or altering your food patterns with breaks from eating is better for us. In earlier times we never had instant access to food. There was no refrigeration and people walked and worked for long periods of time, often without regular food. Today, we have fast-food and we can regularly access food very easily that often is poor quality. Meanwhile, the frequency by which we now eat can create a load to our digestive system with insufficient breaks to allow for adequate digestion to take place. It is therefore a good practice to take breaks from eating as this gives the gut time to better deal with food. It is also important to understand that the food choices we make will have a significant impact on our gut flora and immunity.

APJ Q3: As a naturopath/osteopath what is the most exciting findings in immuno-therapeutics? What do we now know about how best to improve our immunity by addressing gut flora?

APJ Q6: Is it important to take probiotics and when? What about digestive enzyme? The agents that can produce anti-inflammatory cytokines are used and produced by a microflora called commernsal bacteria to maintain immune tolerance in the gastrointestinal tract. They do this by using codes in their membranes that are recognised by the innate immune system as being friends rather than foes. These codes include lipopolysaccharides and lipoteichoic acids and other substances. These are identified by many types of cells on the surface of the intestine, epithelial cells, lymphocyes, macrophages and dentric cells via what is known as Toll Like Receptors (TLRs). Both commernsal and probiotics have the necessary code to carry signals to the immune system and support it.

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While probiotics are beneficial in supporting good gut flora it is important to know that there are numerous gene species and strains of probiotics. It is therefore necessary to understand which species and strains do this in order to determine the appropriate delivery of selected bacterial for the best ecological effect. You can take probiotics pre or after eating food – there really is not a huge difference to taking them in between meals as most of the good bacteria will survive even when taken with food. The best probiotic to take is one that offers a variety of strands with a high percentage of bacteria. As for digestive enzymes, these should be taken apart from probiotics. As we age our digestive capacity does diminish so digestive enzymes are definitely beneficial. These should be taken just before a meal or during the first few minutes of eating.

APJ Q7: How is the gut connected to our immunity and what are some of the most key factors that compromise our gut health?

What we now know is that there is no such thing as the magic bullet and science is more and more distancing from that concept. With the advent of antibiotics and drugs we developed a culture that believed there was a pill to sort out any problem. We now know that the answer to good health and wellness lies is small interventions in areas of good wholesome diet and lifestyle changes that collectively better support and affect multiple systems in the body, increasing our bioenergetics. We also now understand the strong role that mitochondria plays in immune health, as previously we related mitochondria mainly to energy rather than immunity.

APJ Q4: Can you tell us any changes in scientific thought when it comes to better understanding disease and the role of gut flora? We now believe that 50% of illnesses are not due to communicable diseases as once thought. There is now clear evidence that several illnesses are due to internal gut changes and disturbance in balance of appropriate flora. These changes are responsible for many conditions, including skin disorders, depression and poor moods, lack of energy as well as metabolic issues. ㄰ 㤵㜵

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APJ Q5: What contributes to inflammation of the gut and how does this cause dysfunction to mitochondria?

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Mitochondria are small powerhouses that live in all cells and carry with them remnants of bacteria. A diet high in sugar and antibiotics damages the mitochondria as the cells register these toxins as inflammatory particle. While we may feel that we are not taking antibiotics directly they are entering our body indirectly through consumption of food such as meat from animals that have been fed antibiotics.

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The large majority of our immune system is underneath or embedded in the abdominal region and highly influenced by gut flora and is affected by the composition of bacteria in the gastrointestinal tract. Additionally, our health is compromised by poor food quality, medicines and antibiotics that cause changes to the gut flora balance. We also know that insecticides as well as other environmental toxins are contributing to the disruption of the healthy bacteria in the gut flora.

APJ Q8: What about skin diseases? Is there any research that connects gut health to skin health and skin disorders such as acne? In terms of the skin there is a correlation to gut flora and acne. There is now scientific evidence of the brain/gut health connection as well as clear evidence of a strong connection between gut health and skin health. Ten years ago there was great scientific resistance to the idea that what you eat affects your skin, however, we now know that the inflammatory chemical release in the gut are contributing to many skin conditions including acne valgaris as well as other conditions such as hypogracaemia, high incidences of diabetes and depression.

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APJ Q9: What about depression? Does it contribute to gut flora disturbance or does poor gut flora contribute to depression? Depression is the leading cause of disability worldwide. It is the third most common reason for consultation in primary care. The enhanced management of depression in primary care is central to the World Health Organisation strategy for mental health. Yet the precise definition of depression remains elusive, and other than providing advantages to pharmacological intervention it is now considered as a multifactorial “state of being”. The general consensus is that depression is a consequence of inflammation. However, it is difficult to determine which comes first. Modern psychiatry now recognises that disturbed gut flora from say sugar or grains can definitely affect mood and cognition. It is believed that our moods are influenced by an ecologically co-dependent community of bacteria and the development and maintenance of the mucosal lymphoid immune system. The greatest secreted immune protein in the body is called Sectretory Immunoglobulin A (sigA). This protein is involved in mood management as an effector and affector or mood. It is now believed that sigA deficiency is also associated with food allergy/sensitivity, and its absence or deficiency may have immunomodulatory effects on mood via food antigen stimulation. It is also linked to alterations in the microbial eco system in the gastrointenstinal tract, and may contribute or participate in the on-going production of proinflammatory cytokines. The impact of psychological, physical and immunological stressors on gastrointestinal secretion, motility, epithelial permeability and inflammation is now thoroughly documented and stress is understood to have a major influence on digestive diseases. Stress has also been implicated in the cause of psychiatric disorders. Alternations in immune-system function have been suggested to play a role in the pathophysiology of psychiatric conditions such as major depression and anxiety. As the gastrointestinal tract is the site of the greatest immune tissues, disturbances to its econ system leads to the production of proinflammatory cytokines. This then contributes to a cascade of health concerns that affect various organs, including brain cognition, depressive disorders as well as compromised immunity and skin conditions. In conclusion as practitioners we can no longer ignore such research as ultimately these new findings will allow us to gain greater insight into how best to support our clients at the various levels that our services will benefit them. ㄰ 㤵㜵

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MICHAEL ASH BSc (Hon) DO ND DipION Michael Ash received his training in osteopathy and naturopathy at the College of Osteopaths in London, UK, with further post- graduate qualifications in nutrition and mucosal immunology. He has provided continuous healthcare since 1982. For 25 years he was the founder and principal clinician at the Eldon Health Clinic, one of the largest integrated medicine clinics in the southwest of England. Mr Ash has authored hundreds of articles for mainstream, peer-reviewed and technical journals, contributed chapters to textbooks and presented to thousands of clinicians on five continents. World renowned in Functional Gastroenterology and Mucosal Immunology, Mr Michael Ash was a keynote speaker at the 3rd BioCeuticals Research Symposium 2015, which was held on April 17-19th in Sydney.

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The Dermograph™ Introducing Skin Analysis Like Never Before The Dermograph™ is the latest excusive offering from mediaesthetic specialists The Global Beauty Group and it comes packed with potential to improve the way you do business.

Unlike other skin analysers, the Dermograph™ boasts incredible transdermal technology that travels 2mm beneath the surface of the skin right down to the dermal layer, to identify skin conditions where they typically originate. So can a skin analyser alone work to grow your business? The Dermograph™ does. The Global Beauty Group developed your device specifically to suit your business so that the operating system comes completely customised to your own treatments, product and retail range. With the Dermograph™, your entire salon, spa, clinic or practice is essentially loaded on to the d e v i c e a n d recommended to your clients based on their skins needs, right down to your own photos and choice of wording. The Dermograph™ analyses all the core values of your client's skin, from redness, excessive oiliness, skin dehydration, hyperpigmentation and collagen integrity, then it generates treatment and product recommendations using your own service and product range. This makes it easier than ever to up-sell treatments and retail skincare as your clients will have all the detailed analytics in front of them to support the consultation findings. The Dermograph™ is the result of years of research and development by top skin scientists and plastic surgeons who were seeking to deliver three-tier

scientific analysis in easy to understand measurements. The system uses only natural light for the most authentic transdermal skin reading and includes a single button device capturing images of your client's skin, transporting them to the intuitive interface.

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It's a product The Global Beauty Group are very enthusiastic to share with forward-thinking businesses across Australia and New Zealand.

“We proactively search the globe for the latest and best in aesthetic technology innovations. The Global Beauty Group is very excited about this one! The Dermograph™ is the new revolution of skin analysers and we know that it will be an absolute success for our clients”, said – Kane Hammond, The Global Beauty Group CEO & CO-Founder. Taking as little as one minute for a consultation, the Dermograph™ not only customises treatments to target skin concerns, but also provides a thorough skin-analysis report for both you and your client. Case studies on the Dermograph™ have shown that this system alone has the potential to increase product sales by 52.1% and treatment upsells by 54.8%. In a recent case study, 8 out of 10 customers described their Dermograph™ experience as “unique and educative”, with 9 out of 10 trusting the device's recommendations significantly more than previous consultation experiences.

Discover more about how cutting-edge skin analysers can grow your business by calling The Global Beauty Group on 1300 006 607

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The PERFECT FIT The ultimate in consumer expectations is being assured that they are getting a tailor-made professional solution that perfectly fits their needs and restoring their skin to its optimal potential. This is the NEW TREND.

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This is why Bioelements ® new Certified training program delivers the necessary skills and knowledge in cutting-edge PRESCRIPTIVE FORMULATIONS.

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Are you ready to get empowered, create devoted clients and back it all up with over two decades of clinical results? Trust Bioelements to help you build your business, redefine your success and stand by your side every step of the way.

A COMPLETE SYSTEM BACKED BY PROVEN RESULTS Bioelements has been committed to the aesthetician, awarded by

experts and loved by clients for 25 years. Bioelements is dedicated to those who seek products that can deliver leading industry results – businesses that want to standout for their high-performance treatment and product outcomes and who wish to build a reputation around such results.

HOW WE FORMULATE Bioelements delivers what serious clients expect – the highest standards of quality and performance in treatments and products for both aesthetic therapists who seek clinical strength formulations, as well as high performing products for home use for their clients formulations that can rival the best in terms of results. Their prescriptive skincare has no hype, no gimmicks, no false claims, just results. The success of the Bioelements’ formulation is based on a fusion of scientifically validated ingredients, natural botanicals, pure nutritionally-rich oils, and aromatherapy oils. None of the products

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contain artificial colourants, synthetic fragrances, or parabens that can irritate or damage the skin, and they are never tested on animals.

HOME CARE SKINCARE ㈵

The Bioelements’ homecare formulations give clients the same professional results they expect after receiving a professional treatment in a clinic or salon. These formulations offer a complete line that can target any skincare concern, from wrinkles or sagging skin, to dark under-eye circles or problematic sensitive skin or oily and acne prone skin conditions.

P R O F E S S I O N A L U S E O N LY FORMULATIONS Why do aestheticians love, trust and rely on Bioelements - because these formulas put the control back into the therapist's hands with the unique options of customisation. Bioelements create professional formulations designed solely for the aesthetic or clinical therapist. These formulations include the Ultra-Detox Chemical Peels as well as several other advanced formulations to achieve targeted skincare results. The Bioelements Custom Blending system is one of a kind, allowing the aesthetician to become the “cosmetic chemist” who determines exactly what the skin needs at the time of the treatment and after an in-depth consultation with each client. This approach is very much appreciated by clients, who value the knowledge and expertise that their therapist is using to put together a formulation that will exactly meet their specific needs. You can't beat that! With results that can be assured, salons and clinics are gaining and retaining loyal clients who value and appreciate this level of attention and

customised service. With just a few drops of our highly concentrated formulas, the therapist can zero-in on a client's specific needs f r o m a g e i n g , s e n s i t i v i t y, pigmentation and anything in-between.

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BIOELEMENTS PROTOCOL The Bioelements protocol is an easy stepby-step procedure that will allow you to create an almost infinite number of customisable treatments. There is no need to memorise complicated instructions for every treatment on your menu. You will be taught an easy and versatile protocol that allows you to make decisions every step of the way and create an amazing number of treatments. This is the launching pad to building your entire service menu an easy system that empowers you as the therapist to design and formulate what will best suit your client and your business.

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A COMPLETE SERVICE MENU Bioelements can help you build a complete service menu that will meet the needs of your clients with in-demand treatments, chemical peels, acne treatments, lightening and brightening treatments, targeted treatments for specific needs, including body treatments, and even micro-treatments that can be added to enhance outcomes.

Ask us about the Bioelements Certified Practitioner Program and be part of the growing number of elite industry professionals who recognise the value that customised formulations brings to their clients and the incredible benefit and profits it will bring to their business. Phone: 1300 262 275. www.bioelementsprofessional.com.au

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highereducation ㄰ 㤵㜵

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There comes a time when while we are busy doing “business as usual”, something happens that has the potential to create a major shift or change in our industry. This is called a “tipping point” and it can alter the landscape and totally redefine our profession either in our favour or, against our best interests. I believe we are right in the midst of such a change that I would like to alert you to.

skin, refine its texture, improve hydration levels and minimise the appearance of pigmentation. In essence, the task of improving skin texture and luminosity was very m u c h i n t h e aesthetician's domain.

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We are all aware of the technology boom that is happening to our industry. New advanced devices are now offering more efficient capabilities to instigate positive changes in skin tissue. A skilled and highly qualified practitioner working with these devices in their hands can allow them to achieve great aesthetic artistry towards their clients' aesthetic goals. However, while this reality exists something more fundamental is happening that is actually consumer-driven. The definition of anti-ageing and aesthetics is changing to mean something quite different.

Wi t h s t r o n g m e d i a promotion and numerous TV programs aesthetic enhancement gained momentum and started to become common place and not just for the privileged and elite. This trend led to numerous medical practitioners moving from general practice to cosmetic medicine and with them followed many nurses who wished to move from the stress of a sickness model to explore a career path in cosmetic medicine. Today, there is an evergrowing trend of cosmetic medical clinics entering the market. These establishments are not just performing injectables, they are also offering procedures such as microdermabrasion peels, laser and IPL treatments as well as skin needling. In essence they are moving more and more in the realm of traditional aesthetics.

Let's look at the traditional position of plastic and cosmetic surgery. Going back just 10 years ago the medical profession conducted invasive procedures such as surgery or ablative laser resurfacing – that was their domain as these procedures were outside the scope of our qualifications and practices. A few years later a variety of new novel injectable fillers entered the market with their objective to remove deep wrinkles, volumise hollowing cheeks and sinking lips, creating a level of improvement and enhancing features, but with the potential of altering one's appearance and losing their character. Over the past eight years microdermabrasion, peels, microcurrent, IPL, dermal needling and numerous other procedures have entered the market. Their objective was to improve the appearance of the

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GLOBAL TREND IN APPEARANCE ENHANCEMENT As the common person is seeking appearance-improvement treatments the changing trend is for this to be more natural and not at all detectable. In other words ,consumers now want to look fresher, more youthful, but not at all altered or enhanced. With these expectations the definition of anti-ageing isn't necessarily totally wrinkle free, but rather fresher skin, better hydration level, clearer skin free from pigmentation and with more vibrant luminosity. The attention is moving more away from the totally wrinkle-free and the volumised, lifted look. Traditionally, this was totally in the aesthetician's domain, but no longer. ㄰

New advances in cosmetic medicine are developing a diverse range of clinical skincare, including hyaluronic acid at different molecular weight to achieve different outcomes. Some injectables are formulated to just improve the smoothness of the skin and make it look plumper and more hydrated. These are injected at just 1-3 mm deep with the objective of improving the epidermis. Others of a heavier weight can improve textural uniformity, while other weights are formulated to deliver some level of lifting. The new techniques in injectables are a lot more subtle, creating very slight enhancement in skin volume and lifting, but many are greatly focused on simply

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INDUSTRY ALERT: by Tina Viney

Why a Degree qualification could save our industry

skin improvement that will give patients a fresher, more youthful, hydrated look. At a recent cosmetic medical conference I attended one speaker said, We need to ensure we are working with scientifically-validated ingredients with proven performance. “We need to know our ingredient science, because we are not aestheticians, we are doctors.” ㄰ 㤵㜵

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So if you are an aesthetic therapist, how will you compete in this booming market that is now becoming highly competitive? Let's just look at some recent statistical highlights presented by the Australasian College of Cosmetic Surgery (ACCS) that indicated the following with regards to cosmetic procedures in Australia:

Total annual expenditure on cosmetic surgical and medical and related procedures and treatments in Australia is estimated to be $1 billion.

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Australians annually consume more than $350 million worth of wrinkle reduction procedures with botulinum toxin. There are approximately 8,000 breast augmentation surgeries performed each year in Australia and about 30,000 liposuction procedures. ㄰

Top five cosmetic procedures in Australia:

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Anti-wrinkle injections Fillers Laser and IPL Breast augmentation and reduction Liposuction

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NEW ACCREDITATION PROGRAM FOR NURSES

To provide nurses with more specific industry qualifications the

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will still not allow you to inject, as injecting is only permitted with a nursing, or a medical degree. It will however, give you the academic attributes and knowledge to think more scientifically on how you will achieve a higher level of results.

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This degree will allow you to improve your knowledge in skin biology, wound healing, cosmetic pharmacology, ingredient chemistry, physics in all the current technologies and clinical pracrices. You will gain the ability to critically think through a protocol or strategy – skills that are commonplace for a medical practitioner. With this knowledge you will be able to successfully determine how to achieve better skin penetration and faster, longerlasting results that can compete and rival cosmetic medicine in many instances.

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According to Professor Hayek, the Executive Dean of this college. “This degree is on par, and in some instances, even better than other degrees from other institutions. Some self-accrediting institutions are in an enviable position to develop programs that they can self accredit internally through their own institutions. This qualification received accreditation through the Tertiary Education Quality and Standards Agency (TEQSA) which is Australia's independent national regulator of university degree programs – in other words the higher education sector. This was a lengthy and rigorous process and once a program meets with the required standards they usually gain a three-year accreditation. I am pleased to say that we were approved for seven years largely due to the strength of the curriculum development strategies.

ACCS has launched the “New Professional Practice Standards & Scope of Practice for Aesthetic Nurses in Australia” and a Laser & IPL Safety Course – the most in-depth training available in Australia today. They indicated that this is important because nurses are increasingly involved in providing a range of treatments, under the supervision of a doctor, in the cosmetic medical practice. “The College is taking the lead in this area for the advancement of the profession and to raise standards which translates to better patient safety,” Dr John Flynn, College Censor-in-Chief, said. While many nurses have degree qualifications they are still investing in improving their education and their credentials.

WHAT THE BACHELOR OF APPLIED HEALTH SCIENCE (CLINICAL AESTHETICS) CAN DO FOR YOU

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As the aesthetics industry is gaining momentum so we are seeing higher education programs now available. Having finally received FEE Help approval for students who wish to undertake their higher learning program this year the Australasian College of Health and Wellness, which is Sydney based, has launched the new Bachelor of Applied Health Science (Clinical Aesthetics). Student now can gain government funding to pursue their degree studies. This degree program is designed to secure your future by helping you gain the skills and knowledge at a more clinical level that can allow you to operate confidently in the new era of advanced aesthetics when treatment outcomes will need to rival those of cosmetic medicine. If you don't, you may find that more and more clients seeking advanced results will choose a cosmetic nurse or cosmetic medical doctor to deliver their treatments.

While this degree will qualify you as clinical aesthetic therapist, it

From my previous experience of being on many accreditation boards for other health Degrees, in my view, having the national regulator approve our degree program has put us in a position of strength, particularly when both our degrees currently on offer received full accreditation under TEQSA's legislative authority. This is a huge bonus for the profession and a vote of confidence for our degree.

DEGREE QUALIFICATION AND THE FUTURE Cosmetic medical practitioners are seeing the opportunity to upgrade their skills and knowledge in both skincare and technologies, so what about you? I believe that unless we move to higher education we may lose the right to practise some of the treatments we are currently doing in the future. This could be either through future legislation that will predominantly align practitioner registrations to recognised qualifications to which they will determine the scope of practice, or through higher learning such as the Bachelor of Applied Health Science (Clinical Aesthetics). Furthermore, as the bar continues to rise in terms of aesthetic treatment outcomes will we be able to compete with our current knowledge? When comparing our services with cosmetic medicine will consumers still favour us as the experts in light of the new standard of results that are currently emerging? ㄰

These changes are already happening. It's time to re-evaluate our qualifications to meet the challenge of current and future developments.

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If you would like to explore the possibility of undertaking the Bachelor of Applied Health Science (Clinical Aesthetics) you can call and speak to the Head of Faculty, Associate Professor Sinan Ali on 02 8587 8888. Sinan.ali@tac.edu.au or visit www.tac.edu.au/highereducation.

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Setting a new benchmark in AESTHETICS

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Now these standards can DEFINE YOU

Bachelor of Applied Health Science (Clinical Aesthetics) THIS DEGREE BOASTS A RIGOROUS ACADEMIC PROGRAM BUILT AROUND HEALTH SCIENCE SUPPORTED BY EXTENSIVE CLINICAL PRACTICE SKILLS. IT AIMS TO DELIVER THE LATEST IN SKILLS AND KNOWLEDGE TO EQUIP GRADUATES FOR THE EXCITING AND RAPIDLY CHANGING AESTHETICS INDUSTRY. The Australasian College of Health and Wellness is now also offering PROFESSIONAL DEVELOPMENT COURSES for those who aspire for higher learning in skin science. If you would like to grow your knowledge on skin to a higher academic level why not consider undertaking a comprehensive unit in:

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Anatomy and Physiology of the Skin Pathophysiology of the Skin Skin Differential Diagnosis Clinical aesthetics and Dermal Therapy scope of practice Aesthetics Management of Common skin Disorders

These units offered as a seminar series will give graduates an opportunity to gain the benefit of knowledge on the skin at a higher academic level as well as experiencing a learning environment that will open the door to a potential university degree. Should you wish to pursue a degree qualification with the Australasian College of Health and Wellness these units will provide the benefit credit points towards your degree.To register or for further information on these units email: info@tac.edu.au or call 1800 999 963

ENROL NOW! For further information about the Degree please contact Head of Faculty Associate Professor Sinan Ali on 02 8587 8888. Sinan.ali@tac.edu.au www.tac.edu.au/highereducation

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skinnutrition ㄰

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COCONUT WATER The smooth elixir for boosting hydration in the skin and body By Tina Viney Don't you love it when science proves a simple thing that you may have taken for granted may have amazing health benefits that have only just been discovered? One of these is coconut water. While extensive research has validated the benefits of coconut oil, coconut water is a relative newcomer to the attention of health experts and in particular the commercial availability of coconut water as a common beverage. Recently a scientific study conducted by US researchers revealed that the liquid in coconut water contains five times more potassium as a popular fitness drink. Chhandashri Bhattacharya from Indiana University Southeast, who conducted the comparison, confirmed that the potassium in coconut water can benefit those who exercise as well as other individuals.

Potassium is an electrolyte (a substance that maintains your body's fluid levels). This mineral helps regulate blood pressure and heart function. Research shows that increasing your potassium intake can lower your blood pressure. Those individuals with existing hypertension, as well as those just looking to keep their blood pressure in check, can benefit from potassium.

Naturally refreshing, coconut water has a sweet, nutty taste. It contains easily digested carbohydrates in the form of sugar and electrolytes. Not to be confused with high-fat coconut milk or oil, coconut water is a clear liquid, slightly milky and is found in the fruit's centre that is tapped from young, green coconuts. It has fewer calories, less sodium and more potassium than a sports drink. Ounce per ounce, most unflavoured coconut water contains 5.45 calories, 1.3 grams sugar, 61 milligrams (mg) of potassium and 5.45 mg of sodium compared to Gatorade, which has 6.25 calories, 1.75 grams of sugar, 3.75 mg of potassium and 13.75 mg of sodium.

Potassium naturally wants to bind to something to form a potassium compound. Since the human body is very inefficient at breaking down compound minerals, only a small percentage of the potassium we consume actually gets used. To be utilised, potassium must be in elemental form and the potassium molecule needs be small enough to enter an individual cell, and it must be inside a water molecule.

In one study, people who ate foods low in potassium and high in sodium had twice the risk of death from heart disease and a 50% higher risk of death from all causes.

WHAT IS COCONUT WATER?

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BENEFITS OF POTASSIUM So what is potassium and why is it so important in the body?

A Harvard study showed that men who took a potassium supplement with a diuretic decreased their incidence of stroke by 60 %, compared to men who did not. Potassium neutralises acids and restores alkaline salts to the bloodstream. Potassium works with sodium in all cells, including at nerve synapses, to maintain or restore membrane potentials and to assist in metabolic processes. Potassium is critical to our cardiovascular and nerve functioning, regulating the transfer of nutrients into cells and facilitating muscle energy. It also regulates water balance and assists recuperative powers. Potassium aids rheumatic or arthritic conditions (causing acids to leave the joints and ease stiffness) and is crucial for the elimination of wastes. Potassium is a natural pain desensitiser; it helps control convulsions, headaches and migraines, promotes faster healing of cuts, bruises and other injuries and generally contributes to a sense of wellbeing. As it is stored in the muscles it is useful for bodybuilders to give their muscles more energy.

The typical Western diet is usually high in sodium but low in potassium, and research confirms that this imbalance is unhealthy.

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It would appear that many of the benefits of coconut water are attributed to its high and bio-available content of potassium.

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Thus, potassium must be water-soluble. Water-soluble minerals cannot build up in the body and therefore they do not reach toxic levels. This is why potassium in coconut water is so bioavailable to the body.

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WHAT ARE THE BENEFITS OF COCONUT WATER? ㈵

During a recent visit to Thailand we regularly drank chilled coconut water with a straw straight from the fruit. It was delicious, and it certainly increased our energy levels, which were depleted from the constant heat and humidity. Strangely enough this was my first experience with this drink. Interestingly enough, on my return home I noticed the constant increased availability of coconut water in supermarkets. As it gains recognition as one of the most healthy beverages to drink, it is becoming readily available in cans as well as cartons in most food stores. But, back to our research. Bhattacharya's team analysed and compared three energy drinks – coconut water, Gatorade and Powerade – and found that coconut water contained up to 1,500 mg/litre of potassium, compared to up to 300 mg/litre for Powerade and Gatorade. However, while coconut water is superior to several sports drinks it is considered inadequate for individuals who engage in strenuous exercise that produces a lot of perspiration. This is because sweat makes people lose more sodium than potassium, and coconut water, because it is low in sodium, cannot replace the lost sodium. Despite this, coconut water offers some amazing health benefits, particularly for the rest of us who are not viciously slogging it out in the gym. Low in calories and cholesterol free and with more potassium than four bananas, this smooth and delicious drink is considered mother nature's sports drink because of its amazing capacity to hydrate the body. But is coconut water capable of delivering on all the promises or is it hype? In a recent review coconut water was identifying as having less sugar than many sports drinks and much less sugar than sodas and some fruit juices. Plain coconut water could be a better choice for adults and kids looking for a beverage that is less sweet. But don't overdo it, says Lillian Cheung, DSc, RD, of Harvard School of Public Health. “One 11-ounce container has 60 calories, and if you drink several in one day the calories can add up quickly," Cheung says.

smoothness and glow. Keep it refridgerated and spray it on the face as a fantastic moisturising tonic.

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Anti-ageing Properties: The anti-ageing benefits of coconut water have been attributed to its content of cytokines and lauric acid – two important elements that are used in the process of cell growth and their regulation that also assists in balancing the skin's pH levels.

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Drinking coconut water regularly helps with keeping skin fresh, healthy and glowing.

Detoxifying scrub: To create a wonderful natural exfoliant mix

fullers earth (multani mitti) with coconut water and use this natural exfoliant for both face and body. This is a gentle yet highly effective exfoliant that helps detoxify the skin, leaving it smooth and clean.

Anti-microbial properties: Coconut water has many healing, antiviral, anti-microbial and anti-fungal properties that keep skin safe from infections. You can apply it or spray it directly onto the skin to help keep the skin both hydrated and protected. Due to its antibacterial properties coconut water is also excellent for oily skin types. Coconut water helps to control shine and provides a natural glow to the face.

OTHER HEALTH BENEFITS OF COCONUT WATER While at this point in time there is little scientific validation of several health benefits that are attributed to coconut water there are numerous anecdotal evidence of people who have experience health benefits with coconut water. Some of these include:

Cardiovascular Health: Rich in minerals such as potassium and magnesium, coconut water is beneficial for individuals who suffer from low blood pressure. It is also known to regulate the blood circulation and prevents the formation of plaque. Drinking coconut water regularly contributes to health and prevents heart strokes. It is also known to help increase good cholesterol, which makes it a wonderful drink for maintaining good cardiovascular health.

Digestion: Coconut water is composed of bioactive enzymes such as folic acid, phosphatase, catalase, dehydrogenase, diastase, peroxidase and RNA polymerases. These enzymes help in easy digestion and metabolism. The water also has more minerals like

Cheung, co-author of Savor Mindful Eating, Mindful Life, suggests being mindful about beverage choices and reading labels to choose plain coconut water and avoid those with added sugar or juices, which are no different from other sugary beverages.

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However, experts stress the importance of staying hydrated, particularly during hot, summer months or when we are physically active, and coconut water is a great choice as it is also low in carbohydrates.

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COCONUT WATER AND THE SKIN What about the skin? Does coconut water offer any benefits to the skin?

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Skin Hydration: Skin hydration is very important. Dehydration ㈵

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can contribute to ageing, lines and wrinkles. Coconut water treats dull and dry skin and imparts a glow to the face. It has natural properties that help bind moisture to the skin giving it

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calcium, manganese and zinc than some fruits like oranges. It is also a good source of Vitamin B such as riboflavin, thiamine, pyridoxine and folates.

Boosts Energy: Abundant in essential nutrients, coconut water

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makes a wonderful refreshing energy drink. Low in sugar, but rich in minerals it helps hydrate, replenish and rejuvenate the body. ㈵

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Muscle Cramps: Due to its mineral content one of the biggest

benefits of coconut water is that it prevents muscle cramps.

Manages Stress: Coconut oil consists of Vitamin B derivatives like riboflavin, thiamine and pantothenic acid, which help to reduce stress and support the body against anxiety and depression.

BEAUTY FROM WITHIN With the growing popularity of coconut water, many salons and clinics are offering it as the preferred refreshment after a treatment. Served chilled with a little mint it makes a welcoming finish to a wonderful treatment.

Below is a brief breakdown of coconut water's nutritional profile:

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Ref: http://www.stylecraze.com/articles/amazing-benefits-ofcoconut-water-for-skin-hair-and-health/ http://www.webmd.com

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skinnutrients ㄰

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SILICA AND THE SKIN

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Silica plays an important role in a number of body functions, not the least of which is the health of various tissues (including skin) in the human body. As we age, our skin begins to degenerate at a more accelerated rate due to an increasing inability to retain moisture. This loss of hydration in the lower layers of the skin is critically detrimental to collagen and elastin health. The loss of hydration and the resulting damage to collagen and elastin leaves us with dull, sagging, prematurely aged skin. Silica slows the degeneration of the skin by helping the various skin constituents (elastin, collagen, mucopolysaccharides, etc.) remain vital and able to retain moisture. Actually, collagen itself is largely made up of silica!

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S O W H AT T Y P E O F S I L I C A I S BENEFICIAL? Promoters of silica supplementation recommend aqueous extractions of vegetal silica. This is a patented method of extraction by Dr. Louis Kervran. This particular form of silica is bonded to a group of water- soluble bioflavonoids, making it a safe and easily assimilated form of silica for the human body. This form of silica is typically extracted from the spring horsetail plant.

SILICA Why is it important to the skin and body By Tina Viney As we age we lose structure integrity not just in the skin, but also in our bones and muscles. While we proceed to identify technologies and protocols for topical use there are also certain minerals and nutrients that can help support our body, particularly when it will aid the production and maintenance of collagen and connective tissue. One of these nutrients is Silica.

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Silicon is a naturally occurring element and the second-most common element in the earth's crust. It is classified in dietary guidelines as a trace mineral. Most forms of this element are not absorbable by the body, but one form in particular can be absorbed in the human body – silicon dioxide (silica). Silica is found in greater amounts in plant-based foods and is scarce in animal based foods. In 1939, Nobel Prize winner, Adolf Butenant proved that life cannot exist without silica. His research, conducted at Columbia University, proved that silica is an essential nutrient and must be supplied continuously from food.

Another, and maybe the best way, to get adequate amounts of this skin-saving nutrient into the body is through diet. Yes, we've all heard it a thousand times before, but it really is the best way to get all the good stuff – fresh fruits, fresh vegetables, and whole grains. Specifically, beets, brown rice, oats, bell peppers, green beans, leafy greens, asparagus, parsley, sunflower seeds, artichokes and grain husks from whole-grain oats, barley, millet and wheat are all rich in silica. If you're into bottled water, it's also worth mentioning that the popular Fiji Water has far more silica in it than any other major bottled-water product.

SYNERGISTIC ROLE WITH OTHER MINERALS Silica works in synergy with other minerals in the body and enhances the function of iron, boron, calcium, magnesium, potassium and ascorbic acid. It is essential for the development of bones, arteries, connective tissue, healthy hair, skin and nails. Silica "fixes" calcium into the bone matrix. It is vital to proper bone formation. Bones need silica to recalcify and for strengthening bone tissue. A silica deficiency in tissue causes a calcium deficiency which, in turn, results in a loss of tissue elasticity. If enough silica is not present, bone cannot remineralise. Ascorbic acid has been found to synergistically work with silica in retaining moisture in colloidal tissue, such as right under the skin. This is rejuvenating to the skin and prevents wrinkling. Despite its overall abundance, silica is not ordinarily easily absorbed. It is therefore important to look for the organic silica in gel form that offers greater bioavilability.

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WHERE IS IT FOUND AND HOW DOES IT WORK

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Silica is also one of the most important constituents of the body's connective tissue, including cartilage, vascular lining, tendons and

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ligaments. It is found in the thymus gland, the adrenal glands, the liver, the spleen, the pancreas and in considerable quantity also in hair. It functions as a cross-linking agent, providing strength, flexibility and resilience to collagen and elastin connective tissues. It is known to play a part in the integrity of the bones, arterial walls skin, teeth, gums, hair and nails, and has been used to alleviate eczema and psoriasis. Recently, modern research has focused on determining the role of silica in rheumatic disorders and arterial disease.

Accumulated toxins in the body inhibit the process of regenerating joints. Foods such red meat, dairy products, processed meats and highly-refined sugar promote the production of uric acid, which is bad for joints. To counteract increase your silica-rich foods or introduce supplementation. It is now considered that maintaining a healthy level of silica may overall retard the ageing process. The average adult body requires the maintenance of about 20 grams of silica to promote good health. However, the body metabolises and secretes about 10-40 mg of silica per day through urination, hair loss and nail trimming. Silica loss is constant and unavoidable and therefore supplementation should be factored into an anti-ageing program. As the body's natural level of silica declines with age the signs of ageing such as bone loss, dry, wrinkled skin, weakened teeth and gums and hair loss will occur.

Silica may be useful in preventing osteoporosis and in strengthening the musculoskeletal system, preventing injuries and speeding the healing of fractures. It does this by helping in the creation of the body's structural matrix for forming and repairing connective tissue. It also contributes to the buildup of minerals on this matrix during development. It is present in osteoblasts (bone forming cells) responsible for Strong, healthy bones, teeth and gums the deposition of calcium phosphate on the protein matrix Vertigo relief of bone. It also stimulates Accelerated wound healing chrondroblast or cartilageHair, skin, and nail integrity forming cells to deposit proteins and other structural materials on Burn relief and healing the matrix. Finally, it helps in the Collagen production building process of fibreGastrointestinal health forming cells important to the creation of collagen. Strong and flexible arteries

Silica is essential for:

Prevention and reversal of osteoporosis and arteriosclerosis

Additionally it is thought to Prevention of improve the cardiovascular system, decreasing the risk of coronary problems. It has been shown to be abundant (up to 14 times more) in the arteries of people who are free of heart disease. It is essential in maintaining the structural integrity, elasticity and permeability of the arteries, thereby regulating the blood pressure.

ASSISTS IN DETOXIFICATION There is a relationship between silica and the rate of aluminium concentration in the brains of Alzheimer's patients. Much research points to the fact that a deficiency of silica in one's diet is the causal effect of an increase of aluminium in the body, and its ultimate accumulation into the synapses of the brain. Silica plays an important role in helping the body to eliminate this accumulation of aluminium, which is a causative factor in certain forms of senility, including Alzheimer's disease.

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Research shows that skeletal diseases such as osteomalacia (soft bones) and osteoporosis (porous bones and/or spontaneous fractures, as well as shrinkage, although caused by a calcium deficiency, do not respond to calcium therapy alone. Research conducted in Paris, France by noted biophysicists Louis Kervran, and in the United States by Dr. Richard Barmakian shows that fractured bones did not heal at all when high amounts of calcium were present. They heal fair to poorly when moderate amounts of calcium were present. However, they heal extremely well when relatively low amounts of calcium were present with an abundance of silica. It has been shown that in bone demineralisation silica deficiency is a precursor to calcium deficiency.

WHEN IS SUPPLEMENTATION RECOMMENDED? ㈵

Modern processed foods tend to cause a build-up of acids in the body (a condition called acidosis). These acids destroy minerals and accelerate the development of a silicon deficiency.

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Given the importance of silica in our diet, it is surprising that more people are not aware of it. By supplementing silica levels you can potentially assist in remineralising your bones and you could aid in increasing cartilage between joints. As silica levels increase, vascular support increases and the intensity of connective tissue is restored. When available in sufficient arthritis quantities it may also retard the ageing process due to its benefit in immune system support.

All in all, our bodies need silica to keep them repaired and to maintain health and vitality.

REF: Much of the research cited herein will be found on PubMed, a service of the National Library of Medicine. PubMed includes over 15 million citations from MEDLINE and other life science journals for biomedical articles back to the 1950s. PubMed includes links to full text articles and other related resources. Some of these reference can be found below: Lassus A. Colloidal silicic acid for oral and topical treatment of aged skin, fragile hair and brittle nails in females. J Int Med Res. 1993 Jul-Aug;21(4):209-15. Lassus A. Colloidal silicic acid for the treatment of psoriatic skin lesions, arthropathy and onychopathy. A pilot study. J Int Med Res. 1997 Jul-Aug;25(4):206-9. Lassus A. The effect of silicol gel compared with placebo on papulopustular acne and sebum production. A double-blind study. J Int Med Res. 1996 Jul-Aug;24(4):340-4. Klempous J, Petruk I, Godzinski J, Helemejko M, Pospiech Z. [The influence of orthosilicon acid on traumatic edema of the skin. Introduction] Polim Med. 1998;28(3-4):71-4. Polish. Seaborn CD, Nielsen FH. Silicon deprivation decreases collagen formation in wounds and bone, and ornithine transaminase enzyme activity in liver. Biol Trace Elem Res. 2002 Dec;89(3):251-61. Bellia JP, Birchall JD, Roberts NB. The role of silicic acid in the renal excretion of aluminium. Ann Clin Lab Sci. 1996 May-Jun;26(3):227-33.

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APJ 61

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BREAST CANCER

Treatment options and cosmetic care

By Christine Comans Medical Cosmetic Tattooist As cosmetic tattooing spills over into health areas contributing to medical procedures, it is important that practitioners gain a better understanding of the broader landscape of what is involved in a patient's life and how their contribution will best fit and support confidence and selfesteem to those individuals. Christine Comans is a medical cosmetic tattooist who specialises in nipple areola tattooing for breast-cancer patients. She works with some of the leading hospitals and surgeons in Perth, Western Australia, for which she is grateful, and is also keen to liberally share her knowledge with other practitioners. In this article she discusses the experience of one of her patients and also sheds some light on the medical perspective on breast-cancer treatments and options.

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Despite the Cancer Council advocating the benefits of breast screening, breast cancer continues to remain the most common cancer affecting Australian women. In 2015, it is estimated that 15,600 women will be diagnosed with breast cancer. It is important to remember that most women survive breast cancer. The latest statistics (2011) show that the five-year survival rate for women diagnosed with breast cancer is more than 89 per cent. Of course, many women live long and healthy lives well beyond this period.

As cosmetic tattooists there is much we can do to restore self-esteem and dignity after the painful and traumatic journey that breastcancer patients must undergo. While this is an emotional experience for the patient, it is also an emotional time for the caring cosmetic tattooist. Hopefully the practitioner will be in the privileged position to be at the better end of this journey when she will be instrumental in restoring dignity and self-esteem back to her patient. This fact alone makes it very rewarding for the practitioner – knowing that she has the power to improve confidence in her patient and make their life a little better.

In this article I would like to share the journey of one of my patients and highlight that breast cancer can happen at any age and to the most unexpected moment in one's life.

JULIA'S BREAST-CANCER JOURNEY Julia has a busy life. She is a secondary school teacher and she teaches extended English to talented students. She is also a loving wife and mother of two beautiful girls. Julia's breast-cancer journey began in 2012 when she found a lump in her breast after returning home from holidays with her family. As a result she decided to get it checked out by her GP. After some tests, the results came back with devastating news. Julia was told she had breast cancer – it was the news that every woman fears. At the time Julia's little girls were only three and five years old, so she was determined to fight as hard as she could to be around for her girls. Her doctor didn't want to waste any time and Julia's first surgeon performed a lumpectomy and removed three lymph nodes. Unfortunately, tests showed that the margins were not clear and there were cancer cells in one of the three removed lymph nodes. After another operation the surgeon was still unhappy and the talk

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turned to having a mastectomy. At this point Julia was referred to breast surgeon Professor Saunders at Royal Perth Hospital. Comprehensive tests were done and came back clear, but Julia still decided to have a double mastectomy. “I felt like if I got breast cancer once I could get it again, and so I wanted to eliminate that possibility.” Although Julia hasn't had genetic testing it is something she is currently looking into. “I have an aunt and a cousin who have both had breast-cancer, and having two daughters I'd like to be as informed as I can to ensure they are safe from this disease.”

Julia's surgery consisted of a double mastectomy and implants with expanders, followed by six months of chemotherapy. Two further tumours were detected, one HR+, requiring her to take Tamoxifen for 10 years and Herceptin for 12 months. “I don't know whether it was my age, or just because I had young children, but I didn't find the effects of chemotherapy to be that unbearable. It just so happened I had already organised leave without pay for a year from my work as a high school teacher, because the kids were so little, so 2013 was devoted to getting well and being a mum,” Julia stated. “I got my girls to and from school each day, volunteered in their classes and spent time with friends watching movies and having coffee. I was surrounded by the most beautiful group of parents from my daughters' school who helped me whenever I needed, and I was totally overwhelmed by the love and support given to me during this time. The most difficult part of chemotherapy for me was the loss of my hair, even more so than the loss of my breasts. I think it is because it makes your illness so obvious when all you want to be is 'ordinary'. My husband finally shaved my head about two weeks after my first chemotherapy and that night the girls and I put on wigs and danced around the house. I tried to make it a fun experience, even though all I wanted to do was cry. I was determined not to let my daughters see me upset.”

“On a positive note,” Julia said, “my reconstructed breasts are better than I had thought they would be and it is liberating to not always need to wear a bra. The reconstruction was able to restore my dignity and to allow me to face my life ahead with optimism, and I am so grateful to be alive for my daughters' and my family's sake. I was so lucky to have a wonderful team of professionals caring for me throughout this journey. Professor Saunders is a caring and dedicated breast-cancer specialist who has consistently made me feel that my health is her top priority. Plastic Surgeon Dr Anna Goodwin-Walters did an amazing job of reconstructing my breasts, ensuring I understood each operation and was happy with the result. And finally, medical tattooist Christine Comans, who completed the process by creating nipples that make me feel 'normal'. Each of these amazing women treated me with care and respect and I am so thankful I had them on my 'team'.”

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With regards to Julia's case, I would like to state that the type of reconstruction that she had made reconstruction of her nipples with flap techniques challenging and more risky. She was therefore perfectly suited to having the 3D technique using tattooing alone. Working with breast cancer has its rewards, knowing that you can make a difference to someone's life. However, as a practitioner, it is important that you gain as much knowledge about the medical perspective and options available with this condition.

RESEARCH AND MEDICAL OPTIONS Let's now take a brief look at what is involved from the medical perspective. Did you know that breast cancer is one of the most common cancers in the world, and although women over 50 years of age are most at risk of developing this disease, it also develops in younger women, and even men in rare cases?

Months later the expanders were removed and Julia's silicone implants were inserted, followed by her nipple reconstruction in early 2014. The surgeon gave the go ahead for Julia to be able to proceed with nipple-areola tattooing, but Julia was in no hurry. “I was worried it would hurt and after so many painful procedures, I just wanted a break,” she said. It was her mother that encouraged Julia to complete the process, and thankfully that's when I had the pleasure of meeting both Julia and her mother.

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With careful 3D technique I was able to re-create a natural-looking areola to both her breasts, and despite her initial reservation she was thrilled with the outcome. “When I first met Chris I was worried about how much the tattooing would hurt as well as how it would look. I could feel Chris drawing on me so I knew I was going to feel the needle, despite being told previously that I would have little sensation in this area. Chris was friendly and caring from the moment I met her. She applied an anaesthetic cream and spoke to me for half an hour while it took effect. In all I had two sessions with Chris, which lasted for approximately two hours, and a third visit to ensure I was happy with the result. Chris never made me feel like she had to rush, and during this time we spoke to each other openly about a range of topics. By the time I was finished with my tattooing I felt that Chris had become a friend. She did an amazing job, creating nipples that appear natural, and has told me I can return to her for a touch-up if I feel I need it at a later date, which I truly appreciate.”

Rather interesting research was announced as I was writing this article that they have discovered a way to predict a woman's risk of developing breast cancer years into the future through a simple blood test. Scientists hailed the 'truly amazing' technique as better than a mammogram. They hope it will lead to earlier treatment of the disease. The new technique involves measuring all the compounds in the blood to build a 'metabolic profile' of the individual. This will analyse the pattern by which certain chemicals are processed, which changes before tumours appear. The new blood profile is able to predict the likelihood of a woman developing breast cancer within two to five years with an accuracy of 80 per cent compared to a mammogram, which can detect newly developed breast cancer with an accuracy of 75 per cent. The research, which is based on a study

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by the Danish Cancer Society, involved comparing the blood of 400 women who were initially healthy but were diagnosed with breast cancer two to seven years later, and 400 women who did not go on to develop breast cancer. Professor Rasmus Bro, of the University of Copenhagen, said that the method is better than mammography, which can only detect when the disease has already occurred. “It is not perfect, but it is truly amazing that we can predict breast cancer years into the future,” he said. He added that the method has been tested and validated only for a single population and needs to be validated more widely before it can be used practically. But it could eventually create a major shift in early diagnosis of breast cancer as well as other diseases. This is exciting news as anything that can assist in early detection is welcomed.

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CURRENT OPTIONS In the meantime surgery is considered primary treatment for early – stage breast cancer and many patients are cured with surgery alone. The goals of breast-cancer surgery include complete resection of the primary tumour with negative margins to reduce the risk of local recurrences. Adjuvant treatment of breast cancer is designed to treat micrometastatic disease. These are breast cancer cells that have escaped the breast and regional lymph nodes, but which have not yet had an

Breast Cancer Mammogram established identifiable metastasis. Adjuvant treatment for breast cancer involves radiation therapy and systemic therapy, including a variety of chemotherapeutic, hormonal and biologic agents.

SIGNS AND SYMPTOMS Early breast cancers may be asymptomatic and pain and discomfort are typically not present. If a lump is discovered the following may indicate the possible presence of breast cancer:

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Change in breast size or shape Skin dimpling or skin changes Recent nipple inversion or skin change Nipple abnormalities or discharge from nipples Lump in the breast.

DIAGNOSIS Breast cancer is often first detected as an abnormality on a mammogram before it is felt by the patient or healthcare provider. Evaluation of breast cancer may include a clinical examination, imaging or needle biopsy.

PHYSICAL EXAMINATION The following physical findings should warrant further investigation: lump or contour change, skin tethering, ulceration, nipple inversion, dilated veins, hardness or irregularity of the breast.

SCREENING Early detection remains the primary defence in preventing breast cancer. Screening includes the following modalities: Breast selfexamination, clinical breast examination, mammogram, ultrasound or magnetic resonance imaging (MRI) .

BIOPSY

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A core biopsy with image guidance is the recommended diagnostic approach for newly diagnosed breast cancers. This is a method for obtaining breast tissue without surgery and can eliminate the need for additional surgeries.

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MANAGEMENT Surgery and radiation therapy, along with hormone or chemotherapy when indicated, are now considered primary treatments for breast cancer. Surgical therapy may consist of

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lumpectomy or total mastectomy. Radiation therapy may follow surgery in an effort to eradicate residual disease while reducing recurrence rates.

These include hormone therapy and chemotherapy that are the two main interventions for treating metastatic breast cancer, and the two selective oestrogen receptor modulators often include tamoxifen and raloxifene, which are the approved drugs for reduction of breast- cancer risk in high-risk women.

A recent patient from Sir Charles Gardener Hospital in Perth explained that she had been wrapped up to sweat for several days before her surgery. This treatment is shown to be effective when combined with chemotherapy or radiation therapy for breast cancer and results when body tissue is exposed to slightly higher temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anti-cancer drugs. When combined with radiation therapy, it is called thermoradiotherapy. Hyperthermia was reserved for the most severe or recurrent cases of cancer, however, it appears as though it is being considered by the hospital as part of a primary treatment for this patient.

BREAST RECONSTRUCTION According to Dr Mark Hanikeri, Plastic and Reconstructive Surgeon in Perth, WA, most women who have either unilateral or bilateral (double) mastectomy are candidates for breast reconstruction, however, in Australia, the majority of women who could get breast reconstruction are not offered this opportunity. Of those who are offered breast reconstruction, the reconstructive procedure may be offered at the same time as the mastectomy (immediate reconstruction) or at a later date (delayed reconstruction).

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As you can imagine this is not a simple or easy journey for a breastcancer survivor. It is therefore important for the cosmetic tattooist to have as much knowledge as possible on the various facets of this journey. Being well equipped with such information will better allow her to interact with understanding and compassion and ensure a positive outcome through the all-important finishing touches of a well-designed and executed nipple-areola procedure.

“Generally women who are known to require radiotherapy would be offered a delayed reconstruction, since the radiotherapy can negatively affect the outcome from breast reconstruction. There are a number of techniques that can be employed to reconstruct breasts. Some use the patient's own tissues, moved from another part of their body such as their abdomen (TRAM flap/DIEP flap) or back (Latissimus doors flap), whilst others use only implants or tissue expanders placed into the pocket left behind after the mastectomyunderneath the chest muscle. Generally techniques that employ the patient's own tissues will produce a more natural looking and feeling breast and will also be more likely to allow the surgeon to make a new nipple on the reconstructed breast. Techniques that do not bring new tissues into the mastectomy region

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HEREDITARY BREAST CANCER

HYPERTHERMIA THERAPY

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IN CONCLUSION PHARMACOLOGICAL AGENTS

Approximately 5% of all breast cancers are attributable to a heritable mutation, including BRCA1/2 or other less common genetic mutations.

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may not look or feel as natural and may make nipple reconstruction more risky and less favourable,” Dr Hanikeri stressed.

Christine Comans is a qualified Cosmetic Tattoo practitioner and the principal of Advanced Cosmetic Tattoo and trains to Government Approved qualification standards. She is also a professional member of APAN as a Gold Member (Cosmetic Tattoo). You can contact her on: Advanced Cosmetic Tattoo 0419 965 933

A SNAPSHOT OF BREAST CANCER IN AUSTRALIA

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Australian women have a 1-in-8 lifetime risk of developing breast cancer The risk of developing breast cancer increases with age The average age of first diagnosis of breast cancer in women is 60 years 75 per cent of new cases of breast cancer develop in women over the age of 50

The graph below shows the rate of incidence of breast cancer by age for Australian women in 2010 (the most recent year for which statistics are available).

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Source: Australian Institute of Health and Welfare (AIHW) 2014. Australian Cancer Incidence and Mortality (ACIM) books: Breast cancer. Canberra: AIHW http://www.aihw.gov.au/acim-books.

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See more at: https://www.bcna.org.au/understanding-breastcancer/#sthash.BsKhDT9K.dpuf

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APJ 65

skincareingredient ㄰

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Why Shea Butter continues to Dominate in Cosmetic Formulations By Tina Viney In today's competitive cosmetic market you would think that some of the old staple ingredients would be superseded by new innovations, and this is often the case. However, some not only don't disappear, but seem to be gaining extra favour within modern formulations. As a rule, this has to do with the availability of new research that sheds light on their benefits. One such ingredient is shea butter. Popular, particularly in body-butter formulations shea butter seems to have a smoothness that feels as deliciously silky to the touch as it does when applied to the body. Nothing feels quite as good in a body product unless it contains shea butter – indeed it is one of my favourites. Shea butter has a quality similar to coconut oil – rich, hydrating, with a low melting

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point so it rapidly dissolves at skin temperature to quickly become a light fluid that sinks into the pores and delivers an immediate coolness and a feeling of complete comfort and hydration. So what do we know about its real benefits? BENEFITS AND USES OF SHEA BUTTER Shea butter is a skin superfood that comes from the seeds of the fruit of the Shea (Karite) tree and is naturally rich in vitamins A, E and F. It offers a level of UV protection (SPF6) and provides the skin with essential fatty acids and the nutrients necessary for collagen production. Shea butter has been used in Africa and other countries for years to improve skin and hair. It attributes its nurturing properties to its high content of oleic, stearic, palmitic and linolenic acids and in fact the full spectrum of omega 3, 6 and 9 fatty acids that protect and nourish the skin to prevent drying. With long-term use, shea butter is reported to improve skin texture and tone with significant wrinkle reduction. Shea butter has been used for centuries and today it is sometimes used as a base for medicinal ointments. Although there is not a huge variety of scientific studies on why shea butter is effective there are a few that have been conducted and that support that the key isolated chemical constituents are reported to have antiinflammatory, emollient and humectant properties. Shea butter has been used as a sunblocking lotion and has a limited capacity to absorb ultraviolet radiation to a certain extent, but of course it is not a complete sunscreen.

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CLASIFICATION The United States Agency for International Development and other companies have suggested a classification system for shea butter, separating it into five grades: A. Raw or unrefined, extracted using water B. Refined C. Highly refined and extracted with solvents such as hexane D. Lowest uncontaminated grade E. With contaminants.

use of shea butter is as an all-over body hydrator, and for softening cracked heels, hands, feet and cuticles.

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In summary, the key natural vitamins found in shea butter are predominantly vitamins A and E, which are abundantly present, as well as catechins and other significant plant antioxidants, which are know to also protect the skin from environmental damage, and in particular, the cinnamic acid esters in shea butter help support the skin from ultraviolet radiation.

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Commercial grades are usually the first three. The colour of raw (grade A) butter ranges from cream (like whipped butter) to greyish yellow, and has a nutty aroma that is removed in the other grades. Grade C is pure white. However, the more refined it is the less vitamins it will contain. Up to 95% of vitamin content can be removed from refined grades of shea butter, while reducing contamination levels to non-detectable levels.

SKIN INDULGENCE According to the American Shea Butter Institute, the moisturising properties of shea butter are effective because its chemical composition is very similar to those of sebum and therefore making it highly compatible and a good match for the skin, particulary dry skin.

BENEFITS TO HAIR Shea butter is used in many a haircare product and with good reason. It is said to have a number of benefits, including sealing in moisture, defining curl, conditioning the scalp, alleviating dandruff and decreasing the dreaded frizz. Also, applied to just the roots when styling can add a bit of volume to fine hair.

CHOSE THE PUREST FORM When shopping, raw, unrefined shea butter or grade A is preferred, as the product diminishes in its vitamin content the more refined it is. Also the more refined it is, it will possibly also contain more additives. Unrefined shea butter is not like a smooth, creamy lotion; it's a little harder and a little more greasy, but in a good way, and it will immediately soften to a fluid as soon as it is slightly warmed in your hands. It terms of colour, unrefined shea butter can vary in colour from a creamy off-white to yellow, but beware of white shea butter as this most likely has been highly refined.

Tests have confirmed that high-quality shea butter will diminish the appearance of wrinkles after four to six weeks of use. Other research suggests that the application of shea butter to the skin results in a brighter complexion as well as visibly reduced wrinkles. Research also confirms that shea butter has several anti-inflammatory agents, including derivatives of cinnamic acid. The study also confirmed the cemopreventive effects of shea butter. The findings of this study were published in the Journal of Oleo Science. While authorities like the Mayo Clinic and Baby Center note that the only way to really diminish stretch marks is with Retin-A, or through laser treatments, there are many testimonies of individuals who swear by the power of shea butter for helping to diminish stretch marks. This is attributed to its abundance of vitamins and essential fatty acids that support the skin's hydration levels as well as assist in improving skin tone and elasticity.

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Both eczema and acne require delicate treatments as not to exacerbate the problems; and in both cases, a pure and natural product is favorable to one with synthetic ingredients and fragrances. According to some reviews, shea butter's efficacy for eczema and acne is mixed. Some say that it doesn't work at all, but more seem to agree that shea butter does indeed help, particularly for eczema, especially when applied after a bath while skin is still damp.

There are many women's cooperatives working to produce shea butter. The United Nations notes that shea butter provides employment and income to millions of women across Africa and many come with third-party fair trade and sustainability certification. Look to buy yours from a company that supports social and environmental issues. Also, although shea nuts are usually safe, if you have a nut allergy proceed with caution, otherwise enjoy the amazing hydration and nutrient benefits of a high-quality shea butter product. Your skin will love it.

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For acne it is beneficial particularly if strong astringent and harsh products have been used to strip the skin's natural sebum and in doing so also disturb the acid mantle that is essential for the skin's immune support. As shea butter has a similar composition to sebum it can help rebalance the skin when used cautiously and in small quantities on acne or problematic skin. However, the most popular

http://digitalscholarship.tnstate.edu/cgi/viewcontent.cgi?article= 1000&context=biology_students http://www.freshradiantskin.com/skin-care-information/ shea-butter-benefits http://www.ceci.ca/assets/uploads/ PDF-FR/Karite/SheaButterRevivalAfricanWonder.pdf

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APJ 67

anti-ageingconference ㄰

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A5M Conference 2015 Integrative, Preventative and Anti-Ageing Medicine

The 2015 Conference, with the theme Research, Treatment and Prevention: Evidence-based Medicine, will be held on 1st and 2nd August in Melbourne and held at the Sofitel 25 Collins Street, Melbourne. The conference will focus on the role of Research, Treatment Protocols and Preventive approaches in evidence-based Integrative, Preventative and Anti-Ageing Medicine. This year's conference event will provide an extensive educational program spanning internal, aesthetic and complementary medicine. Once again there will be an impressive line up of Australian and international speakers who are leaders in their field. These will include: Malcolm Linsell (AU), James Wilson (US), Chiza Westcarr (AU), Ai Sears (US), Kristin Comella (US), Praveen Kumar (AU), Gina Thompson (US), Russell Knusden (AU) and Paul Taylor (AU).

Chiza Westcarr

James Wilson

Kristin Comella

Malcolm Linsell

Additionally, this year A5M will be hosting a Pre-Conference SKIN HEALTH WORKSHOP entitled:

THE SKIN TRIAD: AN INTEGRATIVE APPROACH TO SKIN HEALTH This workshop will specifically benefit Aesthetic Therapists and Dermal Therapists who wish to expand their knowledge and establish new protocols that include an integrative approach to skin health. ,

The workshop will be held on FRIDAY 31 JULY. The Skin Triad: An Integrative Approach to Skin Health will feature two world-class keynote speakers Ms Gina Thompson and Dr Andrew Heyman. Here is a brief summary of the program and its focus: The innovations of the Aesthetics industry over the past 25 years have forever changed the face of beauty. The potential options for the elusive 'fountain of youth' have grown exponentially and cannot be disputed. This billion-dollar industry is not slowing down any time soon. So, where are people going to receive the best aesthetic products and services? The answer to that question is changing and the trusted medical professional who understands wellness, health and the full spectrum of anti-ageing is becoming the NEW gold standard in aesthetics and cosmetic medicine. This Skin Health Workshop will discuss how to successfully bridge the gap between medicine and aesthetics, identify aesthetics opportunities with established patients, determine integrative treatment protocols and implements aesthetic business and marketing strategies for financial success.

GINA THOMSON Gina Thompson has over 20 years of experience in the Medical Aesthetics industry. Her diverse range of positions have included; Medical Skin Care Specialist, Aesthetic Manager, Marketing Director, Business Consultant and Health Coach. She has developed successful skincare and Aesthetics programs for various medical practices throughout the United States with her expertise in Aesthetics integration, retail planning and growth, team management and marketing strategies. Ms. Thompson earnt her certification in Medical Aesthetics from the Advanced Aesthetics Institute in Salt Lake City, Utah. She received her Spa Management Certification from the University of California, Irvine and then completed studies in Holistic Nutrition at the Institute for Integrative Nutrition. Ms. Thompson has been invited to lecture on the business of Medical Aesthetics at Plastic Surgery, Wellness, Spa and Skincare conferences internationally.

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DR ANDREW HEYMAN Dr Andrew Heyman has formal training in family and integrative medicine. He received his doctor of medicine at the University of Michigan and became the first physician to complete an integrative medicine fellowship at the University of Michigan.

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APJ 68

His diverse clinical interests include: Functional Nutrition, Traditional Chinese Medicine, Medical Acupuncture, Osteopathic Manipulative Medicine and Medical Aesthetics. This broad range of therapies allows him to develop a comprehensive treatment plan for both the acute and long-term health goals of his patients. When Dr. Heyman is not practising medicine, he utilises his administrative and business background to educate healthcare professionals and consults for companies around the world on wellness programming. He is the Medical Director for Lifetime Fitness, the Team Physician for Corvette Racing and the President of Integrative Health Resources, whose clients include: Airborne, Thorne Research, and Pfizer. Dr. Heyman is academically active and retains a clinical appointment as an Adjunct Assistant Professor at the University of Michigan and is the National Clinical Chair for the Consortium of Academic Health Centers for Integrative Medicine. He is very involved in educating medical students, residents, fellows and physicians currently in practice on most aspects of integrative medicine. In describing his approach to integrative medicine Dr Heyman stated the following: â&#x20AC;&#x153;As Program Director of Integrative Medicine at George Washington University, my primary focus has always been to help my patients become healthy. When they do get better, it is not uncommon for them to ask me what they can do to improve their appearance as well. The connection between health and beauty became more and more difficult to ignore. As their trusted physician, my opinion holds a tremendous amount of value. I now provide a combination of wellness therapies, skincare products and innovative Aesthetics treatments to create a more fully comprehensive anti-ageing experience for my patients. They are healthy and happy and the financial success of my practice continues to grow.â&#x20AC;? To benefit from the knowledge of these two amazing international speakers please register for the pre-conference workshop:

THE SKIN TRIAD: AN INTEGRATIVE APPROACH TO SKIN HEALTH (WORKSHOP) This is a full-day Workshop and topics and learning objectives will include: ! The Aesthetics evolution past, present and future ! The role of skin health in a clinical setting ! The medical advantage of modern Aesthetics ! An integrative approach to Aesthetics Medicine ! Comprehensive skin assessment ! The Skin Health Triad the combination of nutrition, pharmaceuticals and skincare for optimal skin health ! Integrative treatment protocols for common skin conditions ! Clinical integration of Aesthetics in a medical practice ! Aesthetic business and marketing strategies

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GLOBAL BEAUTY

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The new perspective in APPEARANCE ENHANCEMENT

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By Louisa McKay

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Globalisation and technological advancements have given rise to an evermore innovative and dynamic aesthetic enhancement industry. At the same time, instantaneous visual communication across online channels such as Instagram and Facebook has given rise to a one-world perspective on beauty. The changes in perspective are important to all practitioners, whether they are delivering injectables or not. Whatever the discipline that you are practising you are required to work towards specific appearance-enhancement goals. The need to interface between various aesthetic and medical cosmetic practitioners is becoming commonplace. The collaborative interaction now defines the new professional environment where results are achieved for the benefit of the client or patient. Understanding how the perception of beauty is changing is critical to the success of your end result in your treatment outcomes. In this article submitted by Costhetics, a leading source for news about cosmetic enhancement, Louisa McKay highlights what these consumer-driven changes are and how they are changing the way we define beauty and anti-ageing. There has been a major shift away from products and techniques that make it obvious cosmetic work has been done. Almost universally, cosmetic medical practitioners and consumers are finding that “less is more” and embracing the use of dermal fillers as an alternative to surgery. Rather than dramatic results, the new trend is for minimal subtle enhancements to a variety of areas. With dermal fillers, providers can avoid the unnatural “done” look and create a softer and more youthful appearance for their clients. Over-volumising, however, can make lips look like over-inflated balloons and cheeks resemble chipmunks with a mouth full of nuts.

THE NEW GLOBAL BEAUTY TREND IN COSMETIC INJECTABLES The latest surveys and research according to Costhetics confirms that the technique of over-volumising facial features to be outdated. Instead, cosmetic medicine as well as aestheticians are now moving away from the concept of dramatic enhancement with the goal now being the new global definition of beauty – NATURAL. The fresh face is a swing of the style pendulum away from the camera-ready, fully made-up look of reality TV's Kardashian sisters. Social media helped spread that look, with product-laden video tutorials on YouTube drawing millions of views. ㄰ 㤵㜵

COMPARTMENT AGEING The subcutaneous fat of the face is not a single uniform layer but is compartmentalised. Each individual compartment ages at a different rate in the same individual. This means the ageing face needs correction of these individual compartments separately, a solution expertly provided by dermal fillers as well as a combination of other technologies.

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The increased availability and variety of volumising fillers has given cosmetic physicians great flexibility in gently contouring

facial features both non-surgically and in a cost-effective way. According to the American Board of Cosmetic Surgery there are now numerous varieties of filler products that cosmetic surgeons use to achieve an individual patient’s goals. Each is uniquely formulated to have a certain texture, density and injection depth, which means that certain fillers work better for certain areas of concern.

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CONSUMER-PREFERRED DEFINITION OF BEAUTY Information gathered for a Harvard University study, The Real Truth About Beauty: A Global Report, reveals that “beautiful” is not a word women willingly associate with themselves.

In the study, women were given a list consisting only of positive or neutral adjectives to describe their looks (including; natural, average, beautiful, sexy and gorgeous) and asked to choose the one they felt most comfortable with. By an overwhelming majority, women around the world are most comfortable using the word natural to describe their looks, according to the findings of the study. When it comes to facial attractiveness, there are two concepts, symmetry, which was the older concept that was valued worldwide and theories on specific facial proportions with ratios of length and width being important in defining beauty. A study in Perception and Psychophysics suggests that symmetry adds to the attractiveness of "average" faces. In recent times, however, harmony and balance are the new standards as advocated by world renowned plastic surgeon Arthur Swift from Montreal who defined the concept of “Beautiphication”TM as the golden ration. This concept does not stick to strict symmetry, but rather follows Leonardo Da Vinci's mathematical principle of beauty and harmony through “divine” proportion. It is a medical application of the concept that ideal beauty might be a universal notion, provable by the mathematical concept of “phi” (the golden ratio) long used by artists and architects. A caliper measuring tool, similar to the one used by the Renaissance master, maps out the injection of cosmetic injectables and dermal fillers (such as injectable fillers and Botox ®) to put things simply, with the precision necessary to enhance features and restore smooth contours, with the goal being more about harmony and balance rather that strict symmetry. Another advocate of harmony and balance is Dr Steven Dayan, author of Subliminally Exposed. Dayan bring into the equation the importance of also supporting a person's confidence and self-esteem as a valuable contributor to enhancing the way they become more beautiful in the eyes of others and of course themselves.

BIODEGRADABLE DERMAL FILLERS EMERGE AS PREFERRED TREATMENT Traditionally, imperfections in the face have been camouflaged with make-up or corrected surgically, such as with a custom-designed cheek implant. More recently, dermal fillers are being used to achieve temporary, semi-permanent and even permanent solutions to asymmetry without the downtime, risks and costs associated with more invasive procedures. In a report published by The Royal Australasian College of Surgeons, it was stated in the Systematic Review: Permanent and Semi Permanent Dermal Fillers that to address the issue of materials being resorbed over time, nonbiodegradable materials have emerged as dermal-filler materials. Liquid injectable silicone (LIS), certain polyacrylamide gels ( PA A G ) , p o l y m e t h y l m e t h a c r y l a t e ( P M M A ) a n d polytetrafluoroethylene (PTFE) are non-resorbable and remain in the tissues permanently.

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APJ 71

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Permanent dermal fillers are much more technique-sensitive than temporary fillers. Used correctly, however, their chief advantage is that they do not require touch-up sessions once the expected result has been achieved.

Bio-stimulant injections are especially durable because they are replaced by the body's own collagen. The actual molecules that are stimulating the fibroblasts tend to degrade and are gone at 6-9 months, while the clinical correction lasts for several years.

BIO-STIMULANT INJECTABLES

WHAT AESTHETICIANS SHOULD KNOW ABOUT DERMAL FILLERS

Bio-stimulants are the newest face of cosmetic injectables. As their name suggests they are not classic fillers, but rather are stimulators. Bio-stimulants are effective for filling out hollow cheeks and correcting deep grooves from the nose to the mouth to restore natural facial contours. Due to complementary modes of action, biodegradable volume augmentation products such as hyaluronic acid (HA), calcium hydroxylapatite (CaHA) and poly-L-lactic acid (PLLA) are often used in combination with one another and with neurotoxins. This allows for targeting specific effects of ageing in different anatomical regions of the face.

Fillers are classified as a medical product, and there is a quality check conducted by various approval bodies in various parts of the world regulating their use. In Europe, Conformité Européenne (CE) marking is given for products complying with the laid standards. In the United States, approval by the Food and Drug Administration (FDA) is mandatory. And in Australia we have the TGA. They can only be administered by a doctor or a trained nurse who is working under medical supervision.

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According to the National Institute of Health, new fillers from China, Korea, Syria, Ukraine and ”The subcutaneous fat of the face is not a single many other places are being Injectable PLLA is a volume uniform layer, but is compartmentalised. Each introduced into the market, and in restoration product that contains individual compartment ages at a different rate many instances full knowledge biocompatible, biodegradable about the safety and approval in the same individual. This means the ageing face status may be difficult to ascertain. microparticles of PLLA. PLLA is a non-toxic, synthetic, biodegradable needs correction of these individual compartments Hence, medical practitioners lactic acid polymer. It stimulates the separately, a solution expertly provided by dermal should restrain from using lesserproduction of type 1 collagen, fillers as well as a combination of other technologies” k n o w n p r o d u c t s . I n s u c h providing gradual volume. PLLA instances, the responsibility of has been used safely as suture material treating physicians increases. for over four decades. The status of approval by FDA for any Patients treated with PLLA for filler is widely accepted in most nonsubcutaneous volume loss secondary to European countries and can be obtained ageing achieve full correction with two to online from the FDA's official website. three treatments. Results are longlasting. Gradual reabsorption occurs over FACIAL AESTHETICS TO REACH a two-to three-year period. Patients are $4 BILLION IN 2017 very satisfied with their treatment and According to Truth Centre, the global report improved quality of life. thought leadership unit of media conglomerate McCann Erickson, nearly PPL is reconstituted with sterile water 70% of women globally think that being prior to injection into the deep dermis or beautiful helps them get what they want subcutaneous space with a tunnelling or out of life. The same number believes that threading technique. In order to minimise the relationship between happiness and the possibility of granuloma formations, beauty is directly proportional. 93% of the product must be distributed evenly. women said they felt more confident With each treatment, there is stimulation overall when they knew they looked of neocollagenesis secondary to small beautiful. PLLA particles. “It is important to note that the initial studies on PLLA demonstrate an increase in skin thickness as early as six weeks after injection,” notes Dr Ben Norris, a plastic surgeon based in Bondi Junction.

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Other considerations regarding the use of volume augmentation products as published in the Journal of Drugs in Dermatology include rheologic properties, lifting capacity, and migratory ability of the product. Injectable volume restoration products are offered with a range of rheologic properties and those with a high degree of firmness, elasticity, and viscosity may be best utilised in treating the nasolabial folds and midface/lower face by creating lift and volume and resisting post-injection spreading; whereas the use of less-firm and less-viscous products may be better for treating more shallow folds and lines.

This is good news for the aesthetics industry. According to the Bloomberg Financial News the global market for facial aesthetics is forecast to reach about $4 billion in 2017. The growth is expected to be driven by minimally invasive and non-invasive procedures that offer long-term results at competitive pricing. The market for neurotoxins is expected to maintain the lead in terms of global market share. This is due to advantages such as better patient comfort, short treatments times and faster results.

Author – Louisa McKay from Costhetics www.costhetics.com.au Costhetics is Australia's leading independent information source for cosmetic surgery, non-surgical cosmetic treatments and the latest in industry advancements.

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APJ 72

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When you want the perfect fit you need an

INDUSTRY SPECIALIST INSURER Take the five point business check-up for busy salons...

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fractionaltechnology ㄰ 㤵㜵

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Fractional Radio Frequency The new technology to lead in skin rejuvenation

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While IPL and Laser have their use and benefits, Fractional Radio Frequency can allow you to extend your services and address a new dimension to your skin rejuvenation, and in particular skin tightening, which is achieved very effectively with Fractional RF. F-RF provides fractional ablation, allowing removal of damaged skin cells and resurfacing of the superficial skin layers to treat mild to moderate wrinkles and other textural irregularities, as well as red and brown spots.

W H AT R E S U L T S C A N B E EXPECTED FROM THE TREATMENT?

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After a treatment you may notice the tone and texture of the skin improving as a result of increased levels of beneficial collagen and the stimulation of new healthy skin cells that are produced. The dermal impact of the Lifton TherMatrix will notice a reduction of mild to moderate wrinkles as well as an improvement in skin discolourations.

HOW MANY TREATMENTS WILL I NEED? Simultaneously, volumetric deep dermal heating is applied to the collagen fibres causing an immediate and long-term skin tightening. This combined treatment effectively treats all skin layers for an optimal result. After repeat treatments there is a noticeable firming of the skin in the face and neck area in addition to skin-texture improvements.

HOW DOES IT WORK? The Lifton TherMatrix system's ergonomic applicator delivers radio frequency energy via a matrix Electrode in the applicator tip. The RF energy generates fractional deep dermal heating in the region of the electrode matrix to induce skin injury, thus eliciting a wound-healing response. This results in mild to moderate wrinkles and superficial skin discolouration being reduced, and skin texture becoming more smooth and elastic due to collagen stimulation.

The typical treatment protocol is three treatments 4-6 weeks apart. The total number of required treatment sessions depend on the skin condition of the client or patient.

CONTRA-INDICATIONS AND PRECAUTIONS Laser or light-based treatments should be avoided when you have a suntan or sunburn. Patients taking the drug Accutane should avoid any laser treatment until medically cleared by the physician. RetinA or bleaching creams should also be discontinued 3-7 days before treatment. During the consultation, you will need to review your client for any medication or supplements that they are currently taking to determine appropriate fluence for their treatment.

WILL IT BE UNCOMFORTABLE AND WHAT CAN I EXPECT FROM THE PROCEDURE? During treatment many patients feel a warm, prickly sensation as energy enters the skin. After treatment a pink or red “sunburn” appearance and feeling is also common. Topical anaesthetic ointment is applied for 45 minutes prior to treatment to reduce discomfort.

WHAT SHOULD I EXPECT FROM THE TREATMENT? You should expect a pink or red “sunburn” appearance with mild inflammation that can last two or more days. This is common and expected. Aftercare instructions will be given following your treatment as correct home care is important.

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WHO SHOULD BE TREATED WITH FRACTIONAL RF? ㈵

Treatment is a safe and effective solution for all skin types. This technology treats acne scarring, pigmentation and wrinkles and improves overall skin texture.

If you believe that this treatment could benefit your clients and your business, give us a call. Face Magic are the distributors of Lifton TherMatrix. In association with Beauty Therapy Training Australia, a Registered Training Organisation, they also offer several governmentapproved qualifications as well as post-graduate training. You will receive exceptional training and support from both companies.

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Phone today for further details: 07 5559 0889 or email us: contact@beautythrerapytraining.com

APJ 74

Liftron TherMatrix Complete Skin Repair Renewal Rejuvenation System no surgery

no injection

no downtime

INNOVATIVE COMBINED TREATMENT • Non invasive wrinkle treatment • Safe and effective treatment for the darker skin • Fast treatment, immediate visible results • A new category of fractional skin treatments • High dermal impact, low epidermal disruption for all skin types. • Minimal downtime, proven efficacy satisfied patients

LIFTRON NF-RF TIPS Dramatically improve texture, tone, laxity, wrinkles and skin irregularities with NFRF tips 1. Intelligently designed tips to maximize treatment options and results 2. No consumable or disposals 3. Multiple tip configurations

• The Liftron features propriety TherMatrix combined-energy technology of mono-polar and bi-polar radio frequency (RF). • Its synergistically combined mono bi-polar RF, improves safety for all skin types. • Dual heating via mono & bi-polar RF energies raises target temperature while maintaining epidermal protection. • The Liftron system consists of a single platform with a variety of treatment tips. • Treat various body areas, such as the face, eyelids, lips, abdomen, arms, hands, thighs, and buttocks. • With multiple benefits, like skin tightening, contouring, body shaping and temporary improvement in the appearance of cellulite • All with one system-just change the tip SHR PERMANENT HAIR REDUCTION

What is SHR? SHR stands for Super Hair Removal,its a step forward in permanent hair reduction. The technology was invented by Alma Lasers in Israel, it is the most advanced way of removing unwanted hair. SHR is faster than traditional IPL and Laser, its safer and its pain free in comparison. How does SHR work? How SHR works, is a revolutionary approach, rather that bombarding your skin with high amounts of Joules ( energy ), SHR fires multiple shots but at low Joules, in doing so it gently heats the hair follicle to the heat needed and the most you will feel is warmth and a tingling sensation, some clients comparing it to a warm massage. SHR also utilizes In-Motion technology, where the hand piece is always in motion over the skin. Is SHR suitable for all skin types? SHR is suitable for all skin types, even tanners, this is achievable because of the technology and techniques utilized. Unlike traditional Laser and IPL, SHR can be had all year round without having to hide from the sun. How many treatments are needed.? To fully treat the area you may require 6-10 treatments at four week intervals. A four week regime is important to maintain so that the SHR treatments get the hair at its four week re-growth. Near the end of the treatments 6-8 week intervals will be needed to finish off your course. Is there any pain? Absolutely pain free, this is achieved by SHR technology and In-Motion techniques, to give you a pain free treatment.

Includes professional training, sales enquiries Phone: (07) 5646 5583 Mobile: 0419 743 029 Email: sales@facemagicaustralia.com.au

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I'll drink to that! The past, present and future of VINOTHERAPY Article submitted by Jacqui Guinane Red and white wines, grape seeds, pulp, stems, skins and even grape vines contain high quantities of powerful antioxidants, minerals, natural sugars, tannins and vitamins that are fundamental to the skin's wellbeing. The combination of these elements serves to protect and strengthen the skin by reducing inflammation and slowing the skin's ageing process. The natural AHAs found in the wine grape are known to micro-exfoliate the surface of the skin, while other natural substances from the polyphenols improve circulation and help protect the skin's elastin and collagen fibres. Research now confirms that wine therapy also helps supports elastin and collagen fibres, and can also improve the appearance of cellulite! Additional research into wine therapy (resveratrol and proanthocyanidins, topically and internally) has shown promise in helping with skin cancers, Alzheimer's, heart disease, muscle memory, toning of muscles, reducing varicose veins (by polyphenol action, strengthening capillaries), easing allergies and also fighting stress and depression.

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Grape-seed extract, specifically, is known as a powerful antioxidant that helps to protect the body from premature ageing and disease. Grape seeds contain mainly polyphenols such as proanthocyanidins (oligomeric proanthocyanidins) as well as resveratrol. Scientific studies have shown that the antioxidant power of proanthocyanidins is 20 times greater than vitamin E and 50 times greater than vitamin C. Extensive research suggests that grape-seed extract is beneficial in many areas of health because of its antioxidant effect that bonds with collagen, promoting cell health, youthful skin and supporting skin elasticity and flexibility. Other studies have shown that proanthocyanidins may help protect the body from sun damage and may also help improve vision (even for those with diabetic retinopathy), improve flexibility in joints,

arteries and body tissues such as the heart, as well as improving blood circulation by strengthening capillaries, arteries and veins.1.

HISTORY OF WINE THERAPY Tablets from Sumerian culture and papyri from Ancient Egypt dating to 2200 BC include recipes for wine-based medicines, making wine the oldest documented man-made medicine.2 Medicinal and cosmetic qualities of grape and wine have been known since ancient times. In ancient China, Babylon, Greece and Rome grape and wine were used for health – Hippocrates (known as the Father of Modern Medicine) used wine as an antiseptic, diuretic and sedative, as well as using it to extract medicinal compounds from plants. The lack of safe drinking water during much of history may have been one reason for wine's popularity in medicine. Prohibition in the United States was a nationwide constitutional ban on the sale, production, importation and transportation of alcoholic beverages that remained in place from 1920 to 1933. During this Prohibition period, some wineries received exemption in the United States for "therapeutic wines" that were sold legally in drug stores. These wines were marketed for their medicinal benefits, but some wineries used this measure as a loophole to sell large quantities of wine for recreational consumption.3 Centuries later, 1993 in the wine-growing region of Bordeaux, France, research started that intended to verify scientifically the positive effect of grapes and wine. Then, among other things, it was discovered that grape seeds contain substances that are powerfully effective at fighting free radicals. Soon the first cosmetic preparations were made and they were based on polyphenols obtained by cold pressing the grape seeds. In 1999 the first wellness centre that offered wine therapy was opened, offering cosmetic therapies based on the beneficial healing effects of grape and wine.

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APJ 76

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A NEW TREND IN AUSTRALIA Here in Australia some of Australia's first vineyards were founded by several doctors who recognised wine as medicine, most notably Dr Christopher Rawson Penfold, of Penfold's Wines, and Dr Henry Lindeman, of Lindeman's Wines. More recently, Dr Philip Norrie has dedicated his life to the study of wine and health, as well as founding “The Wine Doctor” label. Having studied the biographies of over 180 doctors in Australia who had founded vineyards, Dr Norrie has written several books and papers including Australia's Wine Doctors, Dr Phillip Norrie's Advice on Wine and Health and A Guide to Wine and Health – a New Look at Old Medicine (which was an expansion on a paper he had previously written).

THE FRENCH PARADOX The French paradox is a catchphrase, first used in the late 1980s, which summarises the observation that French people have a relatively low incidence of coronary heart disease, while having a diet relatively high in saturated fats, in comparison to other developed nations.6 This contradicted the widely held belief that the high consumption of saturated fats is a risk factor for coronary heart disease. The French paradox implies two important possibilities. The first is that the hypothesis linking saturated fats to coronary heart disease is not completely valid (or, perhaps, is entirely invalid). The second possibility is that the link between saturated fats and in coronary heart disease is valid, but that some additional factor in the French diet or lifestyle mitigates this risk, presumably with the implication that if this factor can be identified, it can be incorporated into the diet and lifestyle of other countries with the same lifesaving implications observed in France. Both possibilities have generated considerable media interest, as well as some scientific research. Were the French really on to something? Was this something that could be replicated? Remember the book French Women Don't Get Fat?

proanthocyanidins are the most abundant flavonoid polyphenols in red wine. Two small glasses (125 ml glass) of a proanthocyanidinsrich red wine, such as a Madiran wine from south-west France, could provide this amount. However, more than 200 mg of proanthocyanidins can also be consumed by eating a Red Delicious apple.5 Other research suggests that polyphenols in wine reduce the absorption of malondialdehyde, which is implicated in arteriosclerosis, cancer, diabetes and other diseases. The future is very exciting! And in Australia we already have D'vine – a natural cosmeceutical skincare, originally formulated by Dr Mauer, created to deliver these benefits directly to the skin!

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Jacqui Guinane is the director of Dynamic Skin Solutions and the Australian distributor of D'vine Vinotherapy Skincare Ph: 02 9525 8368 email:info@dynamicskinsolutions.com.au

In the USA in 1991, 60 Minutes ran a segment on The French Paradox, following findings from French researcher Serge Renaud, Ph.D. The broadcast left the impression that France's high levels of red wine consumption accounted for much of the country's lower incidence of cardiac disease. Within a year, the consumption of red wine in the United States had increased 44%.

THE REALITY: IS IT RESVERATROL OR PROANTHOCYANIDINS? ㄰ 㤵㜵

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Although research continues on resveratrol, the concentration in wine seems too low to account for the French paradox. One would have to consume 1000 glasses of red wine DAILY to obtain the required amount of resveratrol to have this kind of effect. Professor Roger Corder and his team have identified a particular group of polyphenols, known as oligomeric proanthocyanidins, which they believe offer the greatest degree of protection to human bloodvessel cells. Tests with 165 wines showed that these are found in greatest concentration in European red wines from certain areas, which correlates with longevity in those regions.4

References: 1. 2. 3. 4.

Unlike resveratrol, proanthocyanidins are present in wine in quantities that seem to be high enough to be significant:

J Med Food. 2003 Winter;6(4):291-9. Robinson, J., ed. (2006). The Oxford Companion to Wine (3rd ed.). Oxford University Press. p. 433. ISBN 0-19-860990-6. Harding, G. (2005). A Wine Miscellany. New York: Clarkson Potter. pp. 6670, 90 & 108. ISBN 0-307-34635-8. Corder, R.; Mullen, W.; Khan, N. Q.; Marks, S. C.; Wood, E. G.; Carrier, M. J.; Crozier, A. (2006). "Oenology: Red wine procyanidins and vascular health". Nature 444 (7119): 566. Hammerstone, JF; Lazarus, SA; Schmitz, HH (2000). "Procyanidin content and variation in some commonly consumed foods". The Journal of Nutrition 130 (8S Suppl): 2086S92. George Riley Kernodle (December 1, 1989). Theatre In History. University of Arkansas Press.

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APJ 77

productinnovations

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NIGHT DEFY COLLECTION NEW RETAIL KIT FROM BIOELEMENTS

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This amazing kit features three of our most powerful and popular Age Activist® formulas.

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Power Peptide is our BEST-SELLING – Age-fighting facial tonic. It fortifies the skin with cell-renewing peptides, adding youthful radiance and revitalising skin’s appearance to a more youthful state. Power Peptide brightens, refines, tones and nourishes the skin, while restoring hydration levels. Formulated with powerful peptides and brightening liquorice root extract. Probiotic Anti-Aging Serum – Age-resistant probiotic facial serum A natural microflora balance is essential for skin to remain ageresistant and protected against irritating environmental aggressors. This advanced formula is packed with active probiotics so skin appears, younger, visibly smooth and undisturbed. Sleepwear – Overnight age activist crème for dry to combination skin Works while you sleep to smooth the appearance of lines and wrinkles as it dramatically improves moisture and tone. With Sleepwear's trusted “dream team” formula of topical calcium retinol, peptides and cranberry seed oil.

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These Retail Kits will sell fast. Contact ABSOLUTE SPA 1300 262 275

SORMÉ BB CREAM “TREAT & TINT” During winter it is still vital to provide SPF and environmental protection to the skin. This all-in-one treatment provides instant luminosity, even skin tone, hydration and sun protection (SPF 30). BB Cream contains Pure Argan Oil, which is rich in Vitamin E and essential fatty acids, which will not clog the skin but provide essential nutrients. Aloe and Chamomile calm sensitive skin and help to prevent redness. Antioxidant botanical complex of Panax Ginseng, Rosemary, Passionfruit and Papaya preserve healthy skin and is available in four shades. Contact; Dynamic Skin Solutions Phone: 02 9525 8368,

email: info@dynamicskinsolutions.com.au

NEW LIPDRINK® SPF 15 LIP BALM by jane iredale “Lips were never meant to be dry. Words were intended to glide off our lips. That is why I created LipDrink® it leaves lips soft, smooth and beautifully protected. It's refreshingly fragrant and formulated to protect lips from the damaging effects of UV while moisturising and hydrating. Go ahead, tell the stories you were born to tell! Three shades to choose from, with two new tinted shades that add a pretty hint of colour lips.” Jane Iredale Flavours include: ! NEW Crush: a sheer berry ! NEW Buff: a sheer nude ! Original, Sheer: translucent

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For more information please contact Margi Fox Distributors 1300 850 008 margifox.com.au

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APJ 78

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RAISE YOUR COCKTAIL GLASS TO AWARD-WINNING SKINCARE

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If you're seeking skincare that truly delivers on results, the bt-Cocktail 3-part energy system is proving to be the cream of the crop when it comes to professional skin nutrition and age-management solutions. This innovative skincare range recently won the Aestheticians’ Choice Award for 2015 for its exceptional ability to hydrate skin, promote cell renewal and protect cells from environmental and free radical damage – encompassing all the necessary components to slow down and even turn back the process of skin ageing. The awardwinning cocktail of ingredients includes the powerful ergothioneine antioxidant which protects skin cells against solar radiation and nucleus degradation, plus active peptides that work to enhance structural support to the cells for a healthier, firmer complexion. Its proprietary blend of ingredients has also proven to increase Adenosine Triphosphate (ATP) by up to a whopping 67%. Those lucky enough to experience bt-Cocktail either in the treatment room or as part of a home skincare regimen can enjoy a noticeable reduction in fine lines, wrinkles and pore size as well as significant improvements to skin elasticity, texture and overall luminosity and radiance. Get your hands on this award-winning anti-ageing skincare range for your salon, medispa or clinic by calling The Global Beauty Group on 1300 006 607, or visit www.TheGlobalBeautyGroup.com.au.

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D'VINE MOURVÈDRE FACIAL TREATMENT OIL A delicious antioxidant facial oil that blends grapeseed oil, jojoba seed oil, holly oil and antioxidants. Infused with wine extracts, pomegranate, mango and vitamin E. Available in professional size for facial massage and retail size for clients to use as a night-time treatment oil. Can be used for face and full body to nourish and protect during winter months.

Contact Dynamic Skin Solutions Phone: 02 9525 8368, email: info@dynamicskinsolutions.com.

SORMÉ BAKED BRONZER Give your skin instant, luminous, sunny glam, even in winter, with this micro-fine swirled bronzer. Baked on terracotta tiles, this sheer, lightreflecting powder has radiant sparkles that make the skin look dewy and radiant. Antioxidant Panax Ginseng and Vitamin E combined with soothing Aloe Vera and Chamomile to keep the skin youthful, soft and hydrated. Won't streak, fade or change colour. Sorme Baked Bronzer can be used wet or dry and available in two shades.

Contact Dynamic Skin Solutions Phone: 02 9525 8368, email: info@dynamicskinsolutions.com.au

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OUR SILENT IMMUNE SYSTEM ㄰ 㤵㜵

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Part 1

By Gay Wardle Our immune system is responsible for the repair and healing of our skin and body and therefore, as we move into procedures that address skin repair and rejuvenation, the role of the lymphatic system becomes pivotal to the success of our expected treatment outcomes.

as well as ingredient science. In this three-part series she will address the structure and function of the lymphatic system and how this knowledge will allow us to achieve a higher level of treatment outcomes.

Gay Wardle is well-known in the aesthetics industry for her passion of all areas pertaining to skin education, from advance of skin-analysis protocols, to nutrition for the skin

Without this quietly working system known as the lymphatic system our cardiovascular system would stop working and our immune system would be hopelessly impaired. The importance of understanding the lymphatic system should rate very highly for aesthetic therapists as most treatments that aesthetic therapists or

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clinicians perform will have a far better outcome if the immune system of the client they are treating is healthy.

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Treatments performed in salons/clinics often result in inflammation occurring, so if there is an impairment to the immune system the skin might not respond to correct woundhealing pathways. Therefore understanding the role that the lymphatic system plays in the issue of healing and repair is of vital importance.

LYMPH NODES

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These little soldiers produce lymphocytes that help protect the body by removing foreign material such as bacteria, viruses and tumor cells from the lymphatic stream. There are literally thousands of lymph nodes that cluster along the lymphatic vessels and the lymph will be filtered through these nodes as it moves towards the heart. There are considerably larger clusters of nodes found in the axillary, inguinal and cervical areas of the body. In fact, if the body is fighting an infection you can feel these nodes are enlarged.

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STRUCTURE AND FUNCTION

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In order to fully understand the role of the lymphatic system and how it impacts treatment outcomes results we will first need to take a quick look at some basic anatomy and physiology that will be foundational to this subject. The lymphatic system consists of lymph, lymphatic vessels, lymphatic tissues, and red bone marrow. We know that blood circulates through the body. As it is doing this there are exchanges of nutrients, wastes and gases that occur between the blood and the interstitial fluid. Approximately three litres of fluid per day remains behind in the tissue spaces that become part of the interstitial fluid. The lymph is formed when the interstitial fluid (the fluid that lies in the interstices of all body tissues) is collected through lymph capillaries. It is then transported through lymph vessels to lymph nodes before emptying ultimately into the right or the left subclavian vein, where it mixes back with blood. When we have leaked fluid and plasma proteins that have escaped from the blood it has to go somewhere. The combination of the two is carried back to the blood. This is necessary if the vascular system is to have sufficient blood volume to operate properly. If the fluid is not carried back to the blood it will accumulate in the surrounding tissue, which causes oedema. Excessive oedema impairs the ability of tissue cells to make exchanges with the interstitial fluid.

Macrophage cells are our fighters. They role is to engulf and destroy bacteria, viruses and other foreign substances in the lymph before it is returned to the blood. Along with macrophage cells, lymphocytes that respond to foreign substances are also located in the lymph nodes.

You know when you have had an infection and the glands become swollen, well what actually is happening is the lymph nodes are swollen. The swelling of the nodes occurs by the trapping functions of the nodes. The shape and size of nodes varies, although most of them are kidney shaped. A fibrous capsule surrounds the nodes with strands of trabeculae extending inward to divide the node into a number of compartments. This process creates a network of soft, reticular, connective tissue that supports a continually changing population of lymphocytes. These lymphocytes (B cells and T cells) are synthesised in red bone marrow before migrating to the lymph nodes where they develop further in numbers. So like an army these cells are on the alert to attack. The B cells generate daughter cells that are called plasma cells. These cells release antibodies. The T cells, on the other hand, circulate continuously between the blood, lymph nodes and lymphatic stream, continually surveying for foreign pathogens. Macrophage cells are located in the central part of the node waiting to attack bacteria, viruses and other foreign bodies.

LYMPHATIC VESSELS

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Lymphatic capillaries are located in the extra cellular space between the cells. If we look at blood capillaries they converge to form venules and then veins. The lymphatic capillaries form larger lymphatic vessels that have one of the ends closed. Lymphatic vessels form a drainage system whereby excess tissue fluid (lymph) is picked up and returned to the blood. These lymphatic vessels only allow lymph to flow in one direction and that is towards the heart. So from the feet it flow upwards and from the top of the head downwards.

It all works by lymph entering the node via afferent lymphatic vessels, where it flows through a number of sinuses that meander through the lymph node and finally exits from the node. The flow of lymph through the node is very slow because there are fewer efferent vessels draining the node than afferent vessels feeding the node. This action is very important as it allows time for the lymphocytes and macrophages to monitor and perform their protective functions. The whole process will incur lymph passing through a number of nodes before it is completely cleansed.

There is a resemblance between a lymphatic capillary and a small vein, although a lymphatic capillary will have thinner walls and more valves than a small vein. The formations of these valves occur by the edges of the endothelial cells forming walls that loosely overlap one and other. These flap-like mini-valves act as a one-way swinging door. As fluid pressure builds in the interstitial space these flaps gape open, allowing fluid to enter the lymphatic capillary. If it is reversed and the fluid pressure is higher on the inside of the lymphatic vessels, the endothelial cell flaps are forced together, preventing the lymph from leaking back out. The fluid is then forced along the vessel which releases this pressure buildup. Lymphatic capillaries will easily allow cell debris, protein, bacteria and viruses to enter, where they will be taken to lymph nodes.Unfortunately cancer cells will also use this method of transportation to travel through the body. The capillaries transport lymph to lymphatic vessels, known as collecting vessels, where it will be returned to the venous system via one of the two large ducts in the thoracic region.

These tiny little nodes work hard to protect the body from infections and cancer cells. Where there are large numbers of bacteria or viruses trapped in the nodes they can become very inflamed and sore to touch. When cancer cells filtrate into the nodes they become swollen, but they are not painful. This enables the identification of cancerous lymph nodes and nodes that are infected by microorganisms.

LYMPHATIC TRUNKS The final part of the journey for the lymph on its way back into the blood circulation is via lymphatic trunks. The thoracic duct is the largest lymphatic vessel. The next is the right lymphatic duct. The wall structure of these ducts is quite vascular and the valves are further apart with fewer nodes. The cleansed lymph is received into the ducts and follows the lymphatic pathways.

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We have nine large lymphatic trunks found in the trunk of the body, so there are four that are paired and one that is not. Looking at the

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pathway we have: ! Right and left jugular trunk ! Right and left subclavian trunk ! Right and left broncho-mediastinal trunk ! Right and left lumbar trunk ! Intestinal trunk

1. Drains excess interstitial fluid. Lymphatic vessels drain excess

The right and left lumbar trunk and the intestinal trunk merge together at the navel point. This forms a collecting vessel called cisterna chili, which collects lymph from the intestines, abdominal organs and the legs. After the thoracic duct has drained the left side of the body (left arm, left side of the head and the lower body) it will then be discharged into the left venous angle where both the sublcavian and internal jugular join. The right upper body, the right arm and the right side of the head discharge through the right subclavian and jugular trunk. Watersheds are notional lines drawn on the basis of different directions of lymphatic flow. So a watershed area divides two lymphatic drainage regions. For example, the watershed of the face presents a natural cone-shape from the area between the eyebrows, down lateral to the nose, to the edge of the mandible.

lipid-soluble vitamins (A, D, E, and K) absorbed by the gastrointestinal tract.

interstitial fluid from tissue spaces and return it to the blood. This function closely links it with the cardiovascular system. In fact, without this function the maintenance of circulating blood volume would not be possible.

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2. Transports dietary lipids. Lymphatic vessels transport lipids and

The upper part of the face drains lymphatic fluid outward and downward to the Perotid lymph nodes, then into the cervical lymph chain to the Terminus. The lower and centre areas of the face drains the lymph fluid to the sub-mandibular lymphatic nodes, then to the cervical lymph chain, to the Terminus back into the bloodstream at the clavicular region.

FUNCTIONS OF THE LYMPHATIC SYSTEM In short the lymphatic system has three key functions:

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3. Carries out immune responses. Lymphatic tissue initiates highly specific responses directed against particular microbes or abnormal cells.

CONCLUSION In concluding part one on this article I would like to stress that by understanding the role of the lymphatic system in fighting and keeping our bodies free of disease will allow us to recognise how important it is to determine a correctly functioning lymphatic system. As some of our treatments will involve activating the inflammatory process, it is important to understand how this will impact the lymphatic system. We therefore must consider this during the initial consultation with clients. This is because the function of the lymphatic system can have a huge effect on the outcomes of all treatments.

References: Wittlinger, H., Wittlinger, D., Wittlinger, A., Wittlinger, M., Dr. Vodder`s Manual Lymphatic Dtrainage (2011) Marieb, E. N. Esentials of Human Anatomy & Physiology, 11th Edition Tortora, Gerard J., Bryan Derrickson. Principles of Anatomy and Physiology, 14th Edition.

Bring the STAR QUALITY to your Treatments through NEW ADVANCED EDUCATION and see YOUR BUSINESS GROW

Take part in the 2015 training program with Gay Wardle

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BRISBANE: 1 Day Courses Day 1 16th November Back to Basics Day 2 17th November Advanced Skin Anatomy & Analysis Day 3 18th November Skin Disorders & Treatment Protocols

SYDNEY: 1 Day Courses Day 1 13th July Back to Basics Day 2 14th July Advanced Skin Anatomy & Analysis Day 3 15th July Skin Disorders & Treatment Protocols

MELBOURNE: 1 Day Courses Day 1 20th July Back to Basics Day 2 21st July Advanced Skin Anatomy and Analysis Day 3 22nd July Skin Disorders & Treatment Protocols Day 1 23rd November Back to Basics Day 2 24th November Advanced Skin Anatomy and Analysis Day 3 25th November Skin Disorders & Treatment Protocols

ADELAIDE: 1 Day Courses * (note date changes) Day 1 27th July Back to Basics Day 2 28th July Advanced Skin Anatomy & Analysis Day 3 29th July Skin Disorders & Treatment Protocols

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ENROL TODAY and start preparing for your best year ever!

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For further details and to book

Visit www.masterdermalacademy.com.au | Email: gay@m-da.com.au

Ph: 0418 708 455

Become An

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Government-funded qualifications – positions still available Last year APAN was approached as a lead organisation to apply for government funding on behalf of industry professionals who wish to improve their skills and knowledge through a government approved qualification. As part of the National Workforce Development Fund APAN was successful in securing funding for 125 therapists who were able to receive 64% of their training fee to complete the SIB70110 Vocational Graduate Certificate in IPL and Laser Hair Reduction.

Cosmetic Tattooing has come a long way over the years. New, more sophisticated tools, new techniques and trends can allow a skilled and welltrained practitioner to become very much in demand. Ever-growing in popularity, Cosmetic Tattooing offers an amazing and very fulfilling career with tremendous scope, both for those who are artistic and those who are compassionate and nurturing.

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Sara Naderi is a qualified beauty therapist and Cosmetic Tattooist who has international training and over 20 years’ experience in Cosmetic Tattooing. Training with Sara will allow you to benefit from her expert techniques, while you can also qualify to receive government-approved qualifications in SIBBSKS504A Design & Perform Cosmetic Tattooing.

NEW GOVERNMENT-FUNDING INITIATIVE FOR 2015 We are delighted to announce that in 2015 we are able to once again apply for funding on your behalf through a new government funded initiative with the objective to support businesses that wish to up-skill and establish a stronger commercial position. This year's program is under the INDUSTRY SKILLS FUND with it own merit criteria which is very different to last year. If you would like to be considered for this program we would like you to please apply to APAN. The good news is that this year the government is paying up to 75% towards training fees for successful applicants. The funding is available for the following qualifications:

! ! !

Sara is a APAN Corporate Platinum (Cosmetic Tattoo) Member Member of the Australasian Cosmetic Tattoo Professionals

COURSES AVAILABLE: ! Initial Training in Cosmetic Tattooing to Governmentapproved qualifications ! Refresher courses to advance your skills and knowledge in Eyeline, Lipliner, Full lip, Eyebrow techniques Sara is also a specialist in Eyebrow Threading and offers highly skilled training in her unique method. Other courses also available.

SIB50210 Diploma of Salon Management SIB70110 Graduate Certificate in Intense Pulsed Light and Laser Hair Reduction 10038NAT Graduate Certificate in Cosmetic Laser and Light Therapies (skin rejuvenation and tattoo removal)

MERIT CRITERIA This year the merit criteria require more from the candidate. Potential applicants must be: 1. Qualified beauty therapists 2. Must have an ABN number 3. Must be in business for at least three years 4. Must have a clear business plan and objective for growth through diversification ㄰ 㤵㜵

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If you are an employee and your employer meets with the merit criteria they can apply on your behalf. This is not a loan as in VET FEE Help as the Government will outright pay this fee on your behalf for your training providing you meet the merit criteria.

If you would like to apply for this funding please phone APAN on 07 5593 0360 or email info@apanetwork.com and request an application for. YOU MUST GIVE YOUR FULL NAME, PHONE NUMBER AND THE STATE YOU ARE FROM IN YOUR EMAIL.

PUREBEAU NEW GENERATION COSMETIC TATTOO PIGMENTS AND EQUIPMENT Sara is also the Exclusive Distributor of the German-made world-leading Cosmetic Tattooing pigments and equipment PUREBEAU. Sophisticated and outstanding new high-tech equipment that meets with European and Australian standards and offers state-of-the-art solutions to allow for safe, effective and precise application of cosmetic tattooing and medical pigmentation. For further information on training or to enquire about our amazing world-leading devices and pigments contact PUREBEAU Australia E: info@purebeau.com.au P: 1300 667 719 | M: 0405 463 636 W: www.purebeau.com.au | W: www.schb.com.au APJ 66

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WHY DO PROFESSIONALS AND BUSINESSES JOIN APAN?

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Experience the

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THE PREMIER BODY THAT ASTUTE PROFESSIONALS & BUSINESSES CHOOSE

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ACCESS TO LEADING INDUSTRY EXPERTS IN: ! Industrial Relations ! Wage Rates ! Best Business Solutions ! Coaching & Mentoring ! In-house Legal Advice ! Discounted Services ! Marketing Strategies

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“APAN is the professional body I turn to when I am in need of guidance and advice. It’s simple, they save me time, money and minimise my stress. Why go anywhere else when I can go to LEADING EXPERTS at no additional fees.” Jane Boyle, W.A, Salon owner

GOLD MEMBERSHIP CLASSIFICATIONS

Gold Membership for Individuals and Smaller Enterprises

Gold Membership (Degree) also has a classification for Degree-qualified Nurses and Dermal Therapists

Gold Membership (Medical) is also available to Cosmetic Medical Practitioners

Let us solve your problems, experts available 9.am-5pm five days a week.

CALL US TODAY! 07 5593 0360 ㄰

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Education | Consumer Trends | Industry innovations | Strategic thinking

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THE STRONG VOICE REPRESENTING YOU WITH GOVERNMENT

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SERVING AND SHAPING THE NEXT GENERATION OF INDUSTRY LEADERS

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DOING BUSINESS BETTER, HELP WITH: ! Regulatory compliance issues ! Best Code of Ethics ! Risk Management Strategies ! Latest Consumer Trends ! Strategies for Better Money Management ! Successful Strategies for Profit Growth

“When I need expert advice on industry intelligence, trends and regulatory issues that could affect my business I go to APAN as the preferred experts. Their information is always up-to-date and accurate.” John Jackson, NSW Practice Manager

CORPORATE PLATINUM CLASSIFICATIONS

Corporate Platinum Membership for five or more staff

Corporate Platinum Plus Membership for those who want a full business and marketing package and in-depth consultation.

This category includes a fully designed and optimised mobile website, monthly progress reports on your activities as well as a complete coaching and marketing service. We work with you to develop your marketing strategy through a comprehensive marketing plan aimed at helping businesses increase their profits and grow.

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THE ONE-STOP-SHOP FOR INDUSTRY-SPECIFIC GUIDANCE, ADVICE AND SERVICE

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APAN – AESTHETICS PRACTITIONERS ADVISORY NETWORK Please contact us for further details Ph: 07 5593 0360 | Email: info@apanetwork.com www.apanetwork.com to download an Application Form

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MOVING FROM STRENGTH TO STRENGTH The power of business diversification Kristy Ann Berg is a beauty therapist, but also an innovative entrepreneur and businesswoman, who owns an awardwinning Ella Bache salon on the Gold Coast in Queensland. She is also a supplier of niche products that help businesses grow and increase their cash flow and profits. Never short of a great idea, Kristy is constantly testing needs and introducing solutions, not just for her, but for the benefit of the industry as a whole. As a loyal APAN member we have followed and championed her success for some time and feel her story will be inspirational to others, so we invited her to share it with us.

APJ Q1: Kristy, how did you get started as a salon owner and what are some of the highlights of that journey?

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I originally qualified as a beauty therapist and makeup artist, but landed a position as accounts manager at Ella Bache in David Jones. My mother, who is a makeup artist, and I saw the opportunity to embark on our own franchise business with Ella Bache.

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When you see all the work that goes into a franchise you get quite excited that a lot of the hard work has already been done for you. In 2004 we opened our Ella Bache salon in Pacific Fair shopping centre on the Gold Coast and in 2006 we won Gold Ella Award and a trip to Paris. We held the position as No 1. franchise for three years in a row. This was very exciting for us and we then decided to move to the Robina Town Centre in 2006.

This has also been a successful business venture, especially since the shopping centre has undergone an amazing renovation. We were also excited that our salon manager, Camille, also won National Therapist of the Year last year and also won a trip to Paris. I would have to say they were amazing highlights in my professional and business journey in this exciting industry.

APJ Q2: Kristy, when did you decide to also become a product distributor and what made you choose specialist makeup products? We took on the distribution of Christian Eyebrows in 2011. Working in a shopping centre with high overheads we needed simple, easy ways to keep the revenue stream constantly increasing. It had to be able to be included in with services without the need for extra time – a niche product that would create a wow factor, at a good price range, which was quick and easy to include as an add-on service and very easy to sell. Christian Eyebrows ticked all those boxes and we were delighted to see it really take off in our salon and help improve sales and income for the business. As a makeup product it did not conflict with our Ella Bache skincare. With this experience we were able to introduce it to other businesses and help them experience the same success. In just under four years we already have 700 loyal accounts around Australia. Then in 2012 we decided to add to this the Emani makeup range. This was another niche cosmetic range that was renowned for its purity in ingredients, which were also vegan and gluten free. It had a strong social

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conscience for the environment, using only recycled packaging and is animal cruelty free. Emani has a passionate philosophy and is very much a soulful brand that believes in empowering women.

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We are delighted to be the exclusive cosmetic partner with the National Breast Cancer Foundation for their High Tea Parties around Australia that are dedicated to fundraising for Breast Cancer Research. This has been amazing for us, because we have contributed to this good cause and we also are getting our brand out there and promoted through causes that we support and believe in.

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APJ Q3: You are currently the owner of an Ella Bache Salon in a major shopping centre. What are the advantages and disadvantages that you have experienced? OK, the advantages are first that being part of a known brand that has a 60-year history we are easily recognised as a reputable brand. Being in a shopping centre we get lots of walk-in bookings through the local traffic of shoppers and tourists and it is easy to fill up your day with bookings. It is also easy to achieve sales from people who are familiar with the brand. On the negative side, we have to contend with high rents and of course it is not an environment without competition. The other challenge is that while competition would like to fight us on price, because of our overheads we are not in a position to drop our prices. This is probably a good thing because we all know that discounting can lead a business quickly to bankruptcy. On the other hand, these challenges force you to be innovative in order to maintain your business momentum and highincome sales figures.

APJ Q4: What is the ratio of grooming to anti-ageing and skin improvement consumer preferences and have you seen a shift in this trend in recent years? Because of our location a lot of clients come in for quick services, which often are grooming and maintenance services. We recently have had a huge increase in eyebrow services and lash extension, eyebrow shaping and tinting, and of course spray tanning and waxing are always very popular. I would have to say that skinmanagement services are still about 50% of our services. IPL and microdermabasion are also still very popular. The average age of our client ranges from 25 – 50 years, so skin management is also something that clients are after. If you are able to provide them with affordable packages they are not difficult to sell to clients.

APJ Q5: What are the most important qualities you look for in your staff? Getting the right staff is critical to the success of a business. While there are many attributes, we could mention the most important of all is a good attitude. A happy, positive employee is a real asset to a

business. Someone who always looks at ways to make things better, to be a supportive member of a team with a happy, positive attitude, ready and willing to find solutions to problems. Negativity brings the team down. It is important that they are always looking at ways towards their self-improvement, are well presented and groomed and have a quiet inner confidence. In today's market it is also important that they are not pushy at sales, but promote products through education on ingredients and through professional recommendation. That works much better in today's market. It is also important to have the right manager with leadership qualities who is willing to guide, inspire and lead by example. These are valuable qualities to a successful staff team.

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APJ Q6: Tell us how social media has contributed to your business success?

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We do a lot of Facebook promotions, keeping consumers informed of news and constantly connecting with them. However, we have found that while FB is the popular media platform for those under 35 the rest of our clients, particularly our skin treatment clients, still respond better to email newsletters.

APJ Q7: Do you find that owning a salon has allowed you to better understand business owners in this industry and how? Absolutely! As a distributor who is also very familiar with the realities of the salon environment I known the time pressures they are under and understand how to communicate with salons. I also can guide them with simple strategies on how to quickly increase their cash flow as I can show them when and how to do it. We understand when not to bother them on busy days and the best time and way to approach them having an understanding of the daily

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challenges they face in identifying ways to introduce niche products that don't cost much but are very easy to sell.

APJ Q8: You are an APAN member, how has your membership benefited you over the years? I have to say that I owe a lot to APAN as their constant support and wealth of knowledge has been invaluable to me. From the beginning my frequent discussions and meetings with Tina have been so beneficial and I found her advice always inspirational. I also owe the success of our distribution business to advertising in APJ, which is extremely valuable to us. At the beginning of our launch with Christian Eyebrows we took out the front cover and that was hugely successful. It is always good to have a strong supportive organisation that you can turn to for wisdom and advice.

APJ Q9: What are your plans for the future? As the distribution business grows one day I would love to sell the salon to focus more on new product development and business growth as the potential in this area is huge. The salon is very successful and would make a great business for someone who would like to step into a business that is well established.

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What I enjoy about the distribution business is that it allows me to meet interesting people and to be part of a community. The experience with the High Tea Parties has been amazing. I love mixing with diverse women in business and getting to know them. Emani has been so well received and it is great to know you can help other women in so many ways. I know life ahead will be even more exciting.

You can contact Kristy Ann Berg on email kristy@bebeauty.com.au If you would like to become a stockist of Christian Eyebrows or Emani Makeup you can also contact 1300 885 101 for further details.

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BUSINESS NEWS

Business & Legislation, New Tools and Research Outcomes HOW AN EMPLOYEE WHO ACCIDENTALLY TEXTED HER BOSS WITH A SWEAR WORD GOT SACKED AND LOST THE UNFAIR DISMISSAL CASE An employee of a Perth mining company who accidentally sent a text message to her boss calling him a “complete dick” has lost a claim for unfair dismissal before the Fair Work Commission. Louise Nesbitt had been employed as an office administrator and bookkeeper for ASX-listed metals and minerals company Dragon Mountain Gold since 2007, but was dismissed by the company for “gross misconduct” in January 2014.

describing him as “a complete dick”. The text message went on to say: “... we know this already so please try your best not to tell him that regardless of how you feel the need…” Having realised she had sent the text to the wrong person, Nesbitt sent another message to her boss reading, “Rob [Mr Gardner] please delete without reading. I am so so so sorry, xxx”. Nesbitt sent another subsequent message explaining she felt “frustrated” and “ignored” by Gardner on certain workplace issues and urged him to not take the message out of context. “Please forget it and just go on as normal. I am very, very sorry. It is not how I feel,” said Nesbitt. But Commissioner Danny Cloghan found the content of the message trumped any context put forward by Nesbitt. “To call a person a 'dick' is a derogatory term to describe them as an idiot or fool. The word 'complete' is used to convey the message that the person is, without exception, an idiot or fool – they are nothing less than a 'dick',” said Cloghan. He rejected Nesbitt's application for unfair dismissal, instead finding her employment was terminated on reasonable grounds. Employment lawyer and M+K Lawyers partner Andrew Douglas stated that the courts will consider the content of electronic media because context is hard to determine in such communications. “Electronic media doesn't have a context, it only has substance,” Douglas says. “How it is received will stand on its own in the eyes of the recipient because they have no understanding of the context of the sender. Even if accidentally you send a message attacking your boss in a manner which is utterly derogatory, you can't expect to keep your job.”

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As part of her role, Nesbitt organised plumbing work to be carried out in the company's office. She arranged for the work to be done by her daughter's boyfriend, Robert Guy. On January 12, Nesbitt sent a text message intended for Guy to the company's chairman and managing director, Robert Gardner,

But Douglas says employers should be careful not to overreact to such situations and should perhaps consider managing the issue through a discussion or a warning. “Generally, I think people should listen carefully and act sensible rather than reach for their gun,” he adds.

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CUTTING MINIMUM WAGES AND PENALTY RATES COULD HAVE MORE WINNERS THAN LOSERS

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One of the issues to be assessed by the Productivity Commission's inquiry into the Workforce Relations Framework is the option of lower minimum wages and penalty rates for weekends and public holidays. A major challenge within the current debate is that while lower wages create some winners, at the same time they create some losers. When assessing the claims of the winners and losers it seems sensible to recognise the different structure of the economy in the 21st century against the structure of the early 20th century when the framework of the current system of regulated wages was designed.

UNRESOLVED DEBATE ON EMPLOYMENT LINK

low- skill and penalty rate labour inputs. Personal services industries such as the beauty industry are highly competitive, and most of any cost reduction, including lower labour costs, is passed forward to buyers as lower product prices. These benefits of lower prices and greater choice are spread across most citizens.

CHANGED CIRCUMSTANCES

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A major reason for establishment of the minimum wage in Australia, and in particular the Harvester judgement of 1907, was as a minimum-income support. This was a time where almost all employment was full-time male bread-winners, and there was very little in the way of a social security system and no income tax system. Australian Bureau of Statistics and HILDA data show that

It's clear that the immediate losers would be those now employed at regulated minimum wages and penalty rates who would experience a reduction in their labour income if these rates fell to a lower rate set by market forces of labour supply and demand. The losses are explicit and easily documented. But at least two groups of citizens will gain from a reduction in minimum wages or penalty rates – namely those now unemployed and who gain employment, and buyers of products, which are intensive users of low-wage employees and of weekend and holiday labour inputs. Many of those who shift from unemployed to employment, or work more hours, magnify the initial benefits as they acquire additional experience and human capital which, in time, speeds their progression to higher-paying employment in the future. There is an important unresolved debate about the magnitude of the increase in employment if minimum wages or penalty rates were to be reduced. In terms of aggregate employment and average wages, there is compelling evidence of a significant labour-demand response. However, the magnitude of the estimated response, or demand elasticity, varies from one study to another depending on model, data series and estimation method.

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There are fewer studies, and in particular for Australia, of the response of employment of the low-skilled to changes in minimum wages and penalty rates. Logic suggests a larger employment response for the low-skilled than the average worker because of greater substitution options between low-skilled labour with machines and technology. In the beauty industry there are significantly more businesses that employ staff who have a Level 3 qualification to do waxing, tinting, manicures and pedicure or who engage in traineeship programs and the key issue for the purpose of lower wages. Another set of benefits of lower minimum wages and penalty rates flow to consumers as a combination of lower prices and greater availability and choice for products, which are intensive users of

about a half of low-wage employees are in middle and high-income families. Now, over 30% of the workforce is part-time employees, and the share is larger for those on minimum wages and receiving penalty rates on weekends. Today, a sophisticated social security system and progressive income tax provides a more direct and effective policy for achieving society equity goals than regulated minimum wages. The magnitude of penalty rates for weekends and holidays established last century likely is out of date with the 21st century. Changes in social attitudes and higher incomes have contributed to a massive increase in demand for services 24/7. At the same time, changes in social attitudes, in female and part-time employment, and especially in employment of several family members, has boosted the supply of people willing to work on weekends. It is likely that market forces of labour demand and supply would equate at much lower weekend versus weekday wage rates than the current penalty rates. In the context of modern circumstances, lower minimum wages and weekend penalty rates likely would raise national wellbeing. But, the political challenges for change are formidable because the losers are far more visible than the winners. Ref: The Conversation and SmartCompany.

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APJ 90

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AUSTRALIAN EMPLOYERS LOSE BILLIONS OF DOLLARS EACH YEAR DUE TO HIRING THE WRONG STAFF Achieving a great working environment that can help counteract employee churn and reduce the cost and time associated with finding and training new staff is a real worthwhile skill to gain. A happy team is a productive team, so here are four tips for fostering a positive culture in your workplace.

1. Hire the right people and put them in the right positions

HR expert Margaret Harrison says a good workplace culture is something business owners have to get right from the get-go. She suggested that the staff turnover question can be reduced by recruiting the right people in the first place. In this day and age, you can assume people have the skills, but you can't assume they're going to fit your business. Harrison says she is amazed at how much a business' problems can be solved when the right hiring processes are put in place. “The big question is what can you do to help me in my company, and a lot of people don't ask that during a recruitment process either, which I find quite extraordinary as it's one of the things I ask all the time,” she said. “The skills on paper are usually quite correct and you don't need to worry about that. But getting it right in the beginning saves an awful lot of angst and pain later on. So recruit carefully.”

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In the aesthetics industry, which is predominantly a service industry, hiring staff with the right values and enthusiasm is critical to most businesses. “This is very much a constantly evolving business,” says salon manager Jane McGregor. “We need staff with the right attitude towards ongoing flexible learning and a willingness to be part of a strong team where we all share our experiences and knowledge,” she adds. “Highly competitive staff who are secretive about what works for them are not a good fit for our business. We look for positive people who are passionate about their work and can't wait to learn something new every day. This is the dominant attitude that works for us,” she confirms.

2. Give your employees flexibility Harrison says one of the magical ingredients to a positive workplace culture is flexibility. While it may seem like a simple solution, a lot of businesses have a natural aversion to flexibility.

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“One of the greatest things that I used to do in corporate life was give someone who had done something really well a day off,” she said. “Go get your hair done, play with your kids, have – fun.” Some salons chose to close early on days such as Melbourne Cup day and take all staff out to lunch to celebrate. Attitudes like this go a long way to help your staff feel appreciated. It also demonstrates to them that work can also include fun times as well, not just reaching sales targets.

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3. Show leadership and let people know when you are grateful “It is important to show your staff that you know what it's like to work hard, but joining them from time to time with tasks that need to be completed. If you have a good work ethics you are giving them something to follow and aspire to”. Tracy Smith salon manager from WA, said. Tracey also stressed the importance of building on your personal relationship with your staff. Surprising them with a small thank you card or gift for a job well done is so important. There is nothing like a thank you to boost morale. According to Harrison, another nice thing to do is to give an employee flowers, but have them delivered to their home rather than the office. “That's really important because the whole family sees they're appreciated and wanted,” Harrison said. “It's the whole thing of feeling good in your family, which is more important than feeling good at work.” ㄰

4. Celebrate and build friendships According to Jane McGregor, a happy team is always based on strong, appreciative relationships. “Once a week we take the first hour in the day off, go to our favourite coffee shop and grab a cappuccino and talk about issues that have made our week special. Usually this is on a Friday morning. It is such a special time that everyone looks forward to and it really leaves everyone with a “feel good” note to finish the week. It is amazing what stories are shared and it is a special time of bonding with each other that we all look forward to,” Jane confirmed.

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APJ 91

over can set the time frame and the owner quickly reaps the benefits," Boulton says.

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AIBB chairman Graham Long says management buyouts are one way forward, but business owners can sell outright; become investors with others in management roles and/or elect to transfer to family members.

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"The view that all Baby Boomers will elect to sell reflects a more narrow view of the options available to business owners," Long says. While the AIBB barometer is swinging heavily towards too many sellers and not enough buyers, Long says certain markets segments are enjoying the reverse.

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The middle and top ends of the SME market are selling well but there are "a lot of businesses trying to sell, which are poorly priced or just not viable or saleable".

CAN THE BOOMERS SELL THEIR BUSINESSES? If you are in your 50s and 60s and trying to sell your small business, join the ever-lengthening queue. Never before have so many tried to sell so many nest eggs at such short notice. There are a record 41,200 businesses for sale across Australia as at October 2014 the BizExchange Index shows; a 23 per cent rise on the preceding quarter. Many point the finger at one group: ageing business owners. There's an oversupply of desperate "seniorpreneurs" flooding the market with the nest egg they created and nurtured over 30 years, with retirement as the overwhelming reason for selling businesses. "No other reason comes close to this," says the Australian Institute of Business Brokers, which publishes quarterly trends on business sales. Its September report says there are $8 billion worth of prequalified businesses available for immediate purchase. Kerry Boulton, chief executive of The Exit Strategy Group, says the demographics don't lie: there is a bubble of Baby Boomer buyers trying to shift their small businesses and "nowhere near enough Gen Y coming through to buy them out".

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"They're all trying to cash out and attract the same pool of buyers, resulting in massive downward pressure on price. It's a sad outcome for many business owners," Boulton says. Boulton believes the answer is to revive the management and leveraged buyout methods which proliferated in the 1980s and 1990s.

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Buyouts almost invariably come with vendor finance attached, allowing the buyer to pay parts of the purchase price on completion of the contract and the balance afterwards. Boulton says she had originally run a division of conglomerate Mayne Nickless and instituted her own buyout afterwards. It took about 18 months to achieve. "It doesn't have to be stretched out. The employees taking

So what are the top and bottom ends? Tony Arena, of Sydneybased BCI Business Brokers, rejects the notion that it's a buyers' market. There are always more buyers than sellers, he says. "Some of the most successful ones can name their price," Arena says. In the beauty industry many successful salons are securing a buyer from an aspiring employee who loves the business and is ready to take the reins as an owner. “We deal with this issue with our members regularly,” Tina Viney of APAN says. “It is always wise to nurture someone within your staff who has faith in the business to take it on to a new level, and our experience is that this has led to several successful sales,” Tina says. “The problem with our industry when wishing to retire is that they are often burnt out and lose their passion. As a result they fail to see the value of what they have developed as a sellable commodity and this is such a disappointment, as many businesses are going to the wall when they can be of value to someone with dreams and aspirations,” she stressed. The advice that APAN is giving is that every business should have an exit strategy and build the business accordingly to ensure that when you wish to leave you have a viable business to offer someone and achieve a sale that can benefit your nest egg. It's all about good management. Currently it is estimated that each year over 20,000 students graduate and are entering the market looking for career options and business opportunities. That is a high number when you consider that currently there are approximately 9,000 salon businesses nation-wide. Where will all these graduates going? APAN offers support in assisting businesses to prepare in this regard. They also recommend excellent business coaches who can assist you if you need a more hands on approach. For more information phone APAN on 07 55930360. This service is available free of charge to financial members only.

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APJ 92

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FOUR UNEXPECTED HIDING PLACES FOR GREAT MARKETING IDEAS When it comes to crafting winning marketing messages you can often find inspiration in the most unexpected places. According to the Smart Company here are four places to start looking to uncover marketing messages and product or service developments to help you strike marketing gold. 1. Frequently Asked Questions Frequently asked questions give you an insight into what is important to your clients, the potential limitations of your products and services, the features or elements customers don't understand and what may be missing from your marketing messages. Why not introduce a questionnaire with your emails welcoming client feedback on what they would like further information or better clarification. You could also include a suggestion or Question flyers in your reception area for clients who are waiting to give you their feedback. Have a box for these included with the opportunity to win something.

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If you keep getting the same question numerous times and there is a positive answer, try to identify if there is a key selling point you can draw out of it. If not, is there an innovation you could make that will fill the need and give you a competitive edge? 2. No – Monitor how many you get Nothing causes us to stand up and listen like a "no", although in order to learn from each "no" the important question to ask is "why?" Was it because they couldn't see the value? Was it the price? Did it lack a key benefit, feature or inclusion? Was it the sales message or process? Was it just this particular customer

(one "no") or are changes needed to suit the needs of your larger customer base (more than one "no")? Examine the scenario yourself and solicit feedback from your staff. It could be as simple as needing to change your message to demonstrate your value from a client's perspective. 3. Objections – not just yet Objections are often seen as the first step towards rejection, but it's not the case. A client who is objecting is still engaged. They are still interacting, listening and evaluating. Objections aren't a "no", they're a "not yet" or "I need more information". Just like frequently asked questions, objections uncover the priorities of your target market and, when you listen closely, can give you the information you need to customise your sales pitch so they see the value for them personally. They can also show you what case studies and testimonials you need and what information you should include in your marketing material and sales process to overcome objections before they're even verbalised. By doing so you'll show your customers you 'get' them. 4. Feedback and Testimonials While this is a more obvious place to find marketing gold, if you're like most businesses it's unlikely you are using them to your full advantage. While they can help you 'prove' your value through your marketing material and overcome common objections of customers (provided you get the right testimonials), they can also tell you what to prioritise in your marketing message. Your clients may love a particular product, service, feature or result more than those you are currently pushing, and chances are what your future customers love about you will be the same thing your future clients will want from you. You can also uncover the true frustrations of your customers through your testimonials. Often you will solve a problem your client didn't know they had. Testimonials are a great way to capture valuable feedback and give you the gift of hindsight for your potential new clients. Why not offer a surprise gift to the best “Testimonial” of the month.

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Ref: Startup Smart and Smart Company.

APJ 93

technology and better education. For those salons and clinics business is booming and we are delighted to be supporting the industry in this direction through our own mentoring and consulting services, as well as accessing government funding to assist them financially to gain the necessary qualifications,” Tina confirmed.

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While APAN is encouraging businesses to take the plunge and diversify from traditional services, some are fearful of the change of direction and choose to downsize or even leave the industry.

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FOREVER YOUNG: WHY BUSINESSES IN THE AESTHETICS INDUSTRY ARE DIVERSIFYING When economic times are difficult businesses need to reevaluate their current positions. This is happening extensively to many salons that are seeing the opportunity for growth. This year the government has established the Industry Skills Fund and is inviting businesses to apply for government-funded training. APAN has once again been approached to represent businesses in the aesthetics industry who wish to take advantage of this funding. As a lead organisation APAN has taken the challenge and is inviting businesses to contact them for potential consideration for funding for specific qualifications. “What we are finding is that many businesses have stagnated in their growth as a result of providing conventional services and operating in business practices that have become outdated,” Tina Viney said.

Advances in technologies is also necessitating the need to also up-skill in business practising, and for that reason another qualification that is gaining momentum is the Diploma of Salon Management. While a business coach can offer great assistance and support, it is now possible for business owners and managers to gain qualifications in management with specific units that pertain to the salon, spa or clinic environment. “We believe that business coaches will still have their place as a business support service, however, the depth of knowledge that the Diploma of Salon Management offers is invaluable as it will offer businesses the skills and knowledge on how to better manage staff performance, embrace modern marketing and promotional strategies and learn how to best plan and manage finances to achieve business growth,” Tina explained. If you have identified a growth opportunity and would like to increase your qualification and gain new confidence on how to gain new clients and position yourself more competitively in the current market, please contact APAN by emailing info@apanetwork.com. Please include your full name, State and contact details and request an application form, or phone 07 55930360 to speak with Tina Viney for further details. This is a great opportunity to gain up to 75% of the cost of a new qualification.

“Through our consultation we are encouraging businesses to conduct consumer research in their region and identify growth opportunities. Most of these fall within the domain of light-based technologies. However, with these come risks, and so our recommendation is to upskill their staff through Governmentapproved qualifications,” Tina stressed

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Tina went on to say that businesses don't have to lament when times are tough. In most instances it is not the “economy” that is the concern. “We have evidence of numerous examples of businesses that are experiencing substantial growth because they have reviewed their services and embarking on age-management treatments in a more targetted and advanced way through new

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APJ 94

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treatment works by selectively heating skin tissue at a controlled depth via a head that delivers an electric current to create a thermal micro injury in the skin tissue and trigger the body's healing response: stimulation of the fibroblasts and the production of new collagen. This energy form allows different depths of penetration and spares melanin, which means it can be used on all skin types, including ethnic skin types that may fall into types 4 and 5 on the Fitzpatrick Scale.

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ONGOING ADVANCES

The first generation of radiofrequency skin remodelling devices were mono-polar and worked mainly on a superficial level, but subsequent refinements have led to bi-polar and even multi-polar devices with multiple contact pins that act on the deeper skin structure. At the same time the discomfort involved has been significantly reduced.

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Hybrid devices combining pulsed light and RF energy were developed, with the two protocols each using lower levels of energy to achieve an optimum outcome with less discomfort and downtime. Further refinements enabled limitation of the size of the microinjury at the surface of the skin, with the main effect occurring at precisely targeted levels in the deep dermal and sub-dermal strata. Yet another variation combines RF energy delivery with mesotherapy in a mechanised skin needling treatment head.

COMBINING THE APPLICATIONS

CATCH THE WAVE Radiofrequency electrical energy has been used in medical applications for more than 75 years. Today it has an important role in appearance medicine. Along with the intrinsic factors that affect skin ageing, such as hormonal changes and the cellular metabolism, ultraviolet damage has an enormous impact in Australia. Sun damage also accelerates epidermal skin cell senescence and decreases the quantity and activity of fibroblasts, the dermal cell responsible for the production of skin matrix components. UV damage also affects transforming growth factor-beta collagen deposition, which provides the scaffolding in our skins. The negative effects range from pigmentation and vascular blemishes to pronounced wrinkles and loss of tonicity with visible drooping or sagging. Owing to our extreme climate the demand for treatment protocols to address these problems is unlimited. Some of the solutions have included topical retinoids and ablative techniques using chemical peels and microdermabrasion for resurfacing, and the use of noninvasive electromagnetic radiation (EMR) devices such as lasers, light-emitting diodes, intense pulsed light and ultrasound for skin remodelling. ㄰ 㤵㜵

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THE FRACTIONAL REVOLUTION Of these, the protocols based on the controlled creation of microinjuries by using fractionated energy have emerged as providing the best cosmetic results while limiting downtime and the risk of infection. Discomfort during and post procedure remained an issue, however, and treating the delicate eye area was tricky, with only some specialised devices providing this capability. Using radiofrequency as an energy source has evolved as a strong alternative to laser-based fractional protocols. Like laser, the

The key and unique feature of the Spectrum device, and why it stands out among competition, is the combination of invasive and non-invasive bi-polar RF handpieces achieves the optimal result. The invasive handpiece contains 49 gold plated pins that can be applied with controlled entry of up to 4mm. The operator can choose the invasive handpiece for the first 3 of the 4 treatment protocol, typically recommended 2-3 weeks apart. The last treatment is generally the non-invasive option. as the electrodes create a resurfacing or disencrustation effect on the epidermal layer. The effects are generally well tolerated; the Spectrum team have discovered only few patients require any topical pain relief, and the after effects are the usual redness and minor swelling.

PRACTICAL APPLICATIONS The applications for RF devices include wrinkle reduction, hair removal, pigmentation and redness, stretchmarks, scar revision and improvement in drooping and sagging. Most notably, fractional RF can be used to improve sagging and the appearance of wrinkles on the upper and lower eyelids. Improvement in skin quality is usually visible immediately and incremental over a further six months, and downtime can be as little as a few hours, depending on the device used. Contraindications are mainly discretionary: people who have had recent skin-resurfacing procedures or surgery, are pregnant, taking anticoagulants such as Warfarin, suffering severe heart condition or connective tissue diseases, or who have a pacemaker or metal pins in the treatment area. Computer controlled, simple to operate and effective, fractional RF devices have earnt their place in skin-quality improvement protocols.

Call Spectrum Science & Beauty on 1300 766 198 or visit www.spectrumsciencebeauty.com.au to find out how you can grow your business with the full training and support necessary

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APJ 95

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Is Your Business Commercially Sound? By Caroline Nelson The commercial reality of businesses is changing, with an ever-growing need for detailed evaluation and analysis of your management strategies. If a business is no longer sustainable and growing the answer could be that the current business strategies are no longer working. Before admitting defeat why not look at potential weakness that may be contributing to your failure. In this article Caroline Nelson uncovers some of the most common areas why businesses are failing and makes some wise recommendations.

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Today's highly competitive marketplace has resulted in some brutal price wars between salons and clinics, making it difficult to keep financially viable for some businesses. Slashing prices might work in the short term to get a few extra clients through the door, but if the business is not operating on a sound commercial base it will not be the 'fix' most businesses need. In an ever-changing business landscape you need to have a competitive edge to stay ahead. Unfortunately, many business owners are still burying their heads in the sand in the hope things will improve. While this is happening, another phenomenon is also

emerging – more competitors are coming into their marketplace, often competitors who have business skills and acumen. Businesses therefore need to take stock and consider what they can improve, change or what new strategies could be implemented that are more suited to today's commercial reality. Failure to adapt will leave a business in danger of low profits, or worse still, cause them to go out of business. On a positive side, many steps can be taken to strengthen a business well before this occurs, but first you have to know the current 'state of affairs'.

IDENTIFYING CURRENT WEAKNESSES Once you have identified the factors that could be damaging, or may be holding your business back, you will be in a position to make any necessary changes. Below is a list of what I have found to be some of the main areas of concern. 1.

Lack of commercial planning is one of the main reasons businesses get into difficulty. This industry is heavy on passion. And passionate people often go into business letting their 'heart rule instead of their head'. But for a business to be successful this passion needs to be combined with sound business principles. If you lack

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APJ 96

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experience or expertise get yourself booked into a business development course, attend seminars or seek an experts help. Consider every move you take by putting it to the “commercial reality” test – will this support my business, turn a profit or get my cash register ringing? If the answer is no, maybe, or I don't know – don't do it.

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service, but through natural attrition – people move away from the area, lose their job or have their hours reduced, or their priorities change. Whatever the reason the client base will reduce, necessitating the need for acquiring new clients just to keep pace. In addition you want the business to grow, so more sales means more clients. But getting or acquiring new clients costs money. Marketing and advertising is an expense that needs to deliver results. Finding new business is important, but so too is keeping existing customers. My advice is to develop a leading market strategy by offering treatments or products that are different or better than your competitors, so it's important to find a niche.

No Business Plan or written Goal Plan. A Business Plan does not have to be a 30 to 50 page undertaking – even a three or four page plan will have enormous value. It makes you focus on your business, not just the lovely décor, but the operationally elements, your goals and what will need to be implemented to accomplish them. Wrong Location. The wrong location can and will play a big part in the level of success. While it will be more expensive to be situated in a good location, it will often save marketing costs. For a business to be successful it needs to be seen, it needs good parking, good walk-by and/or drive-by traffic and a little competition to keep you on your toes. If the location is wrong then if possible relocate. If this is not possible then try to renegotiate your rental fees to reduce fixed outgoings. Many landlords would rather have the premises occupied than vacant. The Wrong People. The wrong people can cause the most devastating impact on any business, but particularly in a service industry. And yet I can tell you from the experience of working with hundreds of businesses that it's the single biggest issue most underperforming salons and spas face. While picking the right people at the onset is best, if that didn't happen then getting rid of them as quickly and painlessly as possible is essential. And never hire a friend. Hire right and train hard. Lack of Record Keeping and Financial Controls. It's not just a 'poor economy' that causes businesses to fail, it's more common that it is due to poor financial control and poor strategic management. Many businesses just simply run out of money! Do you know exactly how much revenue you need to cover commitments? Can you read a Profit and Loss Statement or even understand what one is and how it affects your business? In a nutshell, a profit and loss statement summarises the income (for a period of time monthly, quarterly or annually) and subtracts expenses to calculate the profit and loss for your business. From this you will know exactly how much money you are making, if any, or how much you may be losing. Ineffective Management Systems. Poor management, the lack of quality systems, the inability to manage staff effectively, poor organisational and time-management skills, the lack of quality staff training and loss prevention will impact productivity and profit potential. In the Aesthetics industry we not only need to prevent loss through pilfering and shoplifting, but also loss of sales through lack of up-selling and retailing. It is essential to implement measures to safeguard your business assets, equipment, stock, supplies, and lack of sales. And every business needs a staff policies manual so that each team member knows what is expected of them, and this in turn will keep standards maintained at a high level.

Lack of skills and knowledge. It's not just your employees who could be lacking skills and knowledge. You may need to improve your management skills, while your team their technical, customer service and retail skills. And never give the excuse “I haven't got time”; or “I can't afford to train”. It is your responsibility to train. That having been said, I would agree a lot of money can be wasted if you don't manage “training to profit” outcomes and implement targets for your team to strive to reach. Where possible get the support from your suppliers, have employees attend regular product and treatment technique training. In addition, many suppliers and learning institutions now provide exceptional longdistance learning and DVDs.

Management burnout. You don't have to be Superwoman. It is important to learn to delegate, seek experts help and keep your passion alive by giving yourself time to dream.

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If while going through the above list you have identified any area or areas that your business is lacking or falling behind I would strongly recommend you address these issues as soon as possible. Please do not try ignoring or putting them into the 'too hard basket'. Do this and the problems will intensify and some day in the future could implode. Every single one of the above nine factors you as the business owner can influence, change or correct. Make a commitment to do something today! © Copyright Caroline Nelson 2015

Caroline Nelson is a beauty industry expert who specialises in helping businesses develop their brand, improve productivity and increase bottom-line profit. To learn more about her step-by-step program for salon spa success visit www.SalonSpaBusiness.com or phone 0410 600 440.

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Marketing that fails to deliver. Every business needs to continually attract new customers. Why? Because you will always be losing clients not necessarily due to poor

APJ 97

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Are you HIGHLY EMPLOYABLE? By Julie Hyne

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Competitive pressures and growing consumer expectations mean that salons and clinics need to constantly elevate the level of results and the standard of service they provide. To achieve this staff selection must meet a certain criteria as this is critical to the success of the business. While there are numerous students entering the industry, why are so few achieving employment? In this article Julie Hyne explores the reasons and defines the attributes that are now needed for every successful business.

For beauty graduates wanting to be seen as highly employable to salon and spa owners, and who are dissatisfied with the limited number of opportunities available and offered to them on entering the industry, there is a need to radically review what's missing and why salon and spa owners are so reluctant to invest in the people who could well be our entrepreneurs of the future.

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The concept is to raise the employability scope of all graduates by training them in the essential soft skills they need to meet the evergrowing demands and needs of industry consumers. Employability skills are identified as those skills outside of basic skills taught at school, but which are essential to business growth and sustainability. They are the skills that cannot be taught from a textbook, but rather from quality training.

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APJ 98

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CURRENT SKILLS GAP There is a global consensus arising from conversations between industry leaders in Australia and overseas of a huge gap existing in how individuals are being trained and what value they bring to the table when contributing to a salon's business. On the other hand, graduates are frustrated and confused as to why they are unable to secure employment when fresh out of college. Looking at the statistics, the number of beauty therapists in Australia in 2013 was over 20,000, and this number will have increased by 17% by 2017. Where are these individuals going to find employment if salon and spa owners are not prepared to give them a chance to prove themselves? What skills are missing that will elevate their chances of success? Feedback from graduates clearly highlights their desire to understand how they can increase their chances of securing the dream job they have worked so hard to pursue. The disillusionment they feel by achieving a certification and experiencing limited to no opportunities to begin their chosen career is overwhelming.

underpin excellent customer service. With the emergence of advanced treatments in all areas of this industry, I cannot stress enough the importance of therapists adopting a more integrated consultative approach to how they work with their clients.

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In order to be confident and successful, a therapist does need to have more refined skills that strengthen their communication and interpersonal interactions with not just clients, but their peers as well. But how and where will they learn these skills?

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The biggest issues that salon and spa owners complain about in relation to staff are their lack or inexperience in skills that help them: ! Build rapport and meaningful relationships with clients ! Sell retail and re-book clients ! Create a strong reputation that attracts new clients and retains existing ones ! Present professionally ! Be part of a team

They are desperate for quality staff who have compassion, empathy, a positive attitude and great communication and presentation skills, and who don't need to be trained in these areas. They simply don't have time to do that.

Having also been a salon owner, I can appreciate the dilemma of this situation. Competition is fierce, and with the ever-increasing costs associated with running a business, salon and spa owners need staff who are not only fully trained in the knowledge and practical skills that certification gives them, they also want staff who can exhibit the skills and character traits that will sustain and grow their business. The risk of losing customers or not being able to attract new clients because of inexperienced staff is just not an option.

Salon owners know that the secret to their success lie in the staff they employ. 70% of clients attending salons and spas are reportedly 35 years and above who not only seek solutions to their health, wellbeing and appearance, but who also seek a premium service they know they are entitled to. This emphasises the need for more mature, wellrounded therapists who can relate and show empathy to this consumer category and win them as loyal clients.

Is it any wonder then that 40% of employers across nine countries have vacancies due to the perceived lack of the right skills in graduates? (McKinsey Centre for Government report 2012.)

WHAT IS THE CONSUMER LOOKING FOR IN A THERAPIST?

In Australia, the very latest environmental scan done for the hair, beauty and retail sectors by Service Skills Australia, reports that new entrants frequently lack critical employability skills that

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Clients too have a say in this debate. Research completed by review site WOMOW reports that the most important attributes they want to see in a therapist are: ! Listening skills

PROFESSIONALS VERSUS AMATEURS

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PROFESSIONAL

AMATEUR

! Learns every aspect of a job ! Carefully discovers what is needed/wanted ! Looks, peaks, acts and dresses as a professional ! Keeps their work area clean and tidy ! Is focused and clear-minded ! Does not let mistakes slide by ! Accepts difficult clients ! Completes paperwork on time ! Remains level-headed and optimistic ! Is in control of their feelings ! Handles money and accounts carefully ! Faces up to other people's upsets and problems ! Admits errors and learnt from them ! Uses higher emotional tones: enthusiasm,

! Skips the learning process whenever possible ! Assumes what others need and want ! Is sloppy in appearance and speech ! Has a messy, disorganised or unclean work area ! Gets confused, goes off on tangents and is easily

cheerfulness, interest and contentment

! Is careful about gossip and sensitive company information

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! Earns high pay and incentives ! Has a promising future

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! Ignores or hides mistakes ! Tries to get out of difficult work ! Is surrounded by unfinished work ! Gets upset and assumes the worst ! Cries or loses control of temper ! Is sloppy with money and accounts ! Hides mistakes, blames others and repeats them ! Uses lower emotional tones: anger, hostility,

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resentment, fear and victimhood ! Spreads gossip and leaks sensitive company information ! Earns low pay and thinks it’s unfair ! Has an uncertain future

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Presentation, ie looking the part Great communication skills that don't come across as sales Good grooming and personal hygiene The ability to make a woman feel beautiful

There is a strong correlation between what skills salon owners want to see in therapists and what clients expect.

EMPLOYABILITY SKILLS These skills are called employability skills, and are otherwise known as interpersonal or soft skills. Possessing these skills will demonstrate to a prospective employer that you have ! Dependability and responsibility ! A positive attitude to work, a passion for what you do ! Efficiency ! Punctuality ! Enthusiasm

! ! ! ! ! ! ! !

Self-discipline Polished, professional and appropriate dress and grooming Honesty and integrity Ability to work without supervision Self-confidence Excellent team spirit Good communication skills with your peers and with clients Accountability

Now while these cannot always be demonstrated in a resume, a good candidate can elude to possessing these qualities through how professionally they present their personal brand to a salon or spa owner. In essence, every therapist is their own personal brand and has unique qualities that can make her stand out from the crowd. Being aware of what these are can make the difference to their application being placed in the pile or being put to one side for an interview. It is all about what value you bring to the table, how can you deliver results for the salon or spa that you aspire to work in?

that position her as exceptional. How you look, talk, write, act and work determines whether you will be seen as a professional or an amateur. Modern society in general does not emphasise the importance of professionalism, so people tend to perform at an amateur level and many salons and salon owners accept substandard results. Near enough is an attitude many people accept, but this is the attitude of amateurs, and can result in high staff turnover. Often salon owners in this space have difficulty attracting and retaining good-quality staff. If you really want to be an attractive candidate to salon and spa owners some basic principles need to be adhered to: (taken from the online Business4Beauty Professional training program for salons):

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THOUGHTS TO LIVE AND WORK BY:

! ! ! ! !

Don't do anything as though you are an amateur. Anything you do, do it as a professional and to professional standards. Develop the frame of mind that whatever you do you are doing it as a professional and move up to professional standards in it. Never let anyone say that you lived an amateur life – , work and live with passion. Professionals see situations and they handle what they see.

Remember, making your mark in this industry, or any industry for that matter, is not about what an employer can do for you, but rather what you can do for them. In that instance, with the right attitude and demonstration of your skill sets and personality traits, you can pursue and succeed your dream job and career.

Julie Hyne is the founder of Business4Beauty: a unique and professional online training program that teaches salon individuals the essential soft skills they need to build business and success. She is the author of Invaluable: What every salon owner wanting success needs to know. To purchase the book and for further information: T: 0433 114 841 info@business4beauty.com

IDENTIFYING YOUR ALIGNMENT TO YOUR DREAM JOB As a potential employee you need to determine the values that are important to you and look for them in your potential employer. For example, what are the values, mission and goals of the salon I wish to work in? What products do they work with and how do the promises they make align with my own values? Can I see myself working there; building a business within the salon business that enhances their reputation and image, and ultimately mine too? ㄰

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There will be times in your life when you have demonstrated some or all of the above traits, and these examples are what salon and spa owners want to know about. There's an old saying, “you can teach practical skills, but you can't teach attitude”. Employers will hear your words, but they will sense your attitude when talking to you and read it in the written words on your resume. It can be like a red flag to a salon or spa owner if they cannot find anything that aligns with their values or goals in your application or interview.

A true professional owns her space and has certain characteristics

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New Research on the role of

TOXINS

and their impact on Health, Obesity and Ageing An interview with Dr Joseph Pizzorno

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As aesthetic enhancement and age management are reaching a new level of consumer expectation, the need to take a more scientific and systemic approach to skin and body improvement is becoming essential. There is no doubt that internal health has a direct correlation to skin health, as skin predominantly gets its nutrients and oxygen from the blood. There is therefore no question that a toxic body will compromise any attempts for skin improvement. In recent years the issue of toxicity and its impact on health has attracted attention. For many years mainstream medicine scoffed at the need for external detoxification protocols, stating that our bodies have sufficient mechanism to ensure that wastes are eliminated and the body naturally detoxifies. However, evidence of the impact of toxicity on human health and ageing is no longer anecdotal, as there is now emerging scientific proof that is validating how toxicity is impacting our bodies and identifying ways to manage and even eliminate toxic impact.

Australians are being exposed to a toxic soup of heavy metals and chemicals and their health is suffering as a result, according to a world-renowned naturopathic physician. Co-author of the best-selling Encyclopedia of Natural Medicine and founder of Bastyr University, Dr Joseph Pizzorno says this toxic soup is overwhelming our normal protective detoxification systems, leading to chronic disease and ill health. Dr Pizzorno was recently in Australia as a keynote speaker at the 3rd BioCeuticals Research Symposium 2015. Titled the Interrelated Drivers of Health and Disease, the three-day Symposium on 17-19 April specifically focused on functional medicine, oxidative stress and immune dysfunction.

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It was our privilege to catch up with Dr Pizzorno to gain insight into some of the latest scientific findings on this subject for the benefit of our industry. Here are some highlights of our interview with Dr Pizzorno.

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APJ Q1: Dr Pizzorno, can you tell us what are the three groups of toxins that we are exposed to and how does toxicity affect our health, and why is the issue of toxicity important to our health? In the past 50 years we are seeing remarkable changes in health, particularly with the increase of diabetes. In Australia diabetes has increased from 1% of the population to 9%. We now know that a huge contributing factor to this is more than just sugar, it is due to the persistent organic pollutants such as bromadine, chlorine and fluorine that are resistant to environmental degradation. These chemicals contribute to our metabolic receptors binding to insulin receptors, causing insulin resistance. This forces the pancreas to produce more insulin that contributes to diabetes. There is now evidence that confirms that the higher the levels of chemical exposure the higher the likelihood of getting diabetes. I am convinced that the toxic load of modern civilisation is now probably even more important than nutritional deficiencies in terms of causing disease in our patients. The scientific evidence confirms that toxins are proven endocrine disruptors that contribute to diabetes, obesity, cardiovascular disease and cancer. More specifically, toxins can be broken into three key categories – exogenous, endogenous and toxins that we choose to ingest. Exogenous toxins come from the environment, like heavy metals, persistent organic pollutants (POPs), solvents and other such chemicals such as heavy metals like lead and mercury. As we have mentioned above, we now believe that environmental toxins increase the chance of developing most chronic diseases such as type II diabetes. Research indicates that people in the top 10% of toxic exposure have as much as a twentyfold increased risk for diabetes. Endogenous toxins, such as homocysteine, antibiotics and biotoxins, are known to change the nature of the gut through the impact of wrong bacteria. Ingestible toxins, through poor food choices. Examples are excessive salt in the diet, alcohol and wheat. Studies reveal that the problem with wheat is that it contributes to increased intestinal permeability, such as leaky gut syndrome where the intestines lose control and substances are reabsorbed into the bloodstream. People with celiac disease and Crohn's disease experience this. (We asked Dr Pizzorno as to whether this problem is due to GMO wheat, however, he did not have any specific study results that looked at that issue.)

APJ Q2: What role does mercury pay in toxic overload and where can we find it in our diet?

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We know that mercury is highly toxic to the body, particularly to the nervous system, and high levels of mercury in the body contribute to dementia, memory loss and brain fogginess. They can also contribute to dry hair and skin. I have numerous instances where treating patients with detoxification protocols contributed to all these symptoms disappearing. However, in some cases it can take up to 18 months to achieve full detoxification of heavy metals. The primary contributing factor to mercury toxicity is usually silver teeth fillings. Silver fillings can leach out one microgram of mercury every day into the blood and brain tissue. Other ways that we can get mercury in the body is through fish. The larger the fish the more mercury they contain. Fish that live longer are more likely to accumulate more pollutants over their lifetime. If you eat large fish select wild caught as they tend to have more omega3.

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MERCURY LEVELS IN FISH LEAST MERCURY:

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Guideline: Eat no more than six servings per month Anchovies, Butterfish, Catfish, Clam, Crab, Crowfish, Flounder, Haddock (Atlantic), Hake, Herring, Mackerel (N. Atlantic, Chub), Mullet, Oyster, Perch (Ocean), Salmon, canned and fresh, Sardine, Scallop, Shrimp, Sole, Squid (Calamari), Trout (freshwater), Whitefish and Whiting.

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MODERATE MERCURY: Guideline: Eat no more than six servings per month Bass (Striped, Black), Cod (Alaskan), Croaker (White Pacific), Lobster, Monkfish, Perch (Freshwater), Sablefish, Skate, Snapper, Tuna (Canned, chunk light), Tuna Skipjack), Weakfish (Sea trout).

HIGH MERCURY: Guideline: Eat no more than three servings per month Bluefish, Grouper, Mackerel (Spanish Gulf), Sea Bass (Chilean), Tuna (Canned Albacore), Tuna (Yellow Fin).

HIGHEST MERCURY: Guideline: Avoid eating Mackerel (King), Marlin, Orange roughy, Shark, Swordfish, Tilefish, Tuna (Bigeye, Ahi). Source: The Natural Resources Defence Council

APJ Q3: Glutathione is a master antioxidant. What role does it play in detoxification? I cannot overemphasis the critical role of glutathione in the detoxification and excretion of mercury. As the most important intracellular antioxidant, it directly neutralises the oxidative effect of mercury by binding to mercury and transporting it out of the cell and across the blood – brain-barrier. Additionally, glutathione binds to mercury in the liver and transports it into the bile for excretion in the stool. Therefore, a key strategy for mercury detoxification is to support glutathione production. There are several ways to do this: 1. Decrease glutathione depletion, 2. Administer direct glutathione through supplements or injections, and 3. Promote glutathione production. Toxins and anything that increases oxidative stress depletes glutathione. Thus cleaning up the diet and taking antioxidants helps to maintain the body's natural glutathione levels and decreased depletion. As oral glutathione apparently does not survive the digestive process, direct administration is only possible through oral liposomic glutathione, intranasal spray, and intravenous IV injection – the first two of which are available in health-food stores. Effective measures to promote glutathione are to decrease alcohol consumption and supplement with alpha lipoic acid and melatonin, both which decrease oxidative stress, thus protecting glutathione from depletion. Finally there is promotion of glutathione production by resveratrol and milk thistle. It's important to note that the rate-limiting step in glutathione is cysteine availability. While oral cysteine does not work, N-acetylcysteine (NAC) and/or whey are very effective in increasing cysteine availability.

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APJ Q4: What simple strategies would you recommend for people to practise to minimise toxic overload and to support the body in detoxifying? There are several simple strategies that benefit in minimising toxicity in the body. Eating organic fruit and vegetables is very helpful. Pesticide sprays as we know are very toxic and accumulate in the body, so organically grown food is also the better choice. It is also important to increase fibre. If there is not sufficient fibre in the diet toxins will reabsorb and remain in the body. Fibre helps to both mop up toxins and also assist in their elimination. Natural fax seed or oat bran are all good fibres. Supplement with glutathione. Nacetylcystein, milk thistle and alpha lipoic acid are also very useful.

APJ Q5: What role does emotional stress play in the body retaining toxins? Personally, I have no data on this, but there is no doubt that emotional stress has a detrimental effect on the nervous system that affects organs such as the heart and digestive system. Our body does not work optimally when under emotional stress, especially if it is chronic.

APJ Q6: What about genetics, are some of us genetically predisposed to retaining toxins? There is sufficient evidence that genetics do play a role in how we handle toxins. In fact there are 1000 variations as to how we get rid of toxins and one of the determining factors is our genetic predisposition. Each individual needs to personally monitor their own body and their particular sensitivity and determine the best strategy for them in getting rid of toxins.

APJ Q7: What is research indicating about the use of alcohol? Is it healthy or is it toxic? The research is very clear, showing that light to moderate alcohol consumption is healthful and excessive alcohol is extremely damaging to health. The challenge is that the border between healthful and toxic has huge variations based on genetics, nutritional status and environmental toxic load. I believe that one of the reasons for benefit from light to moderate alcohol consumption (separate from the antioxidant benefits of wine and the HDL elevation from ethanol) is the increased levels of glutathione that occurs with light to moderate alcohol consumption. However, too much alcohol will totally deplete the body of all of its glutathione, but this will vary from individual to individual.

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Research confirms that in 10% of cases wines did not produce glutathione, so each individual is different. No, I am not saying drink alcohol to increase glutathione. As soon as the alcohol breaches a threshold that appears to vary according to diet and genetics, cytoplasmic and mitochondrial glutathione levels plunge, resulting in metabolic dysfunction and disease. Bottom line: it's safest to follow the general guidelines of one drink per day for women and two per day for men. It is interesting, but research indicates that teetotallers do not live as long and have a higher incidence of several diseases as those who consume light to moderate amounts of alcohol, suggesting that some alcohol is beneficial. The best alcohol is fermented – red wine and beer. The thing to look for is organic grapes for the best choice, because grapes that are heavily sprayed with pesticides are obviously not a good choice.

APJ Q8: What about wheat, is it the GMO factor that contributes to its toxicity or are there other factors? As I have stated previously the problem with wheat is that it contributes to compromised intestinal permeability and can result in

leaky gut syndrome. It is not clear whether genetic modification contributes to this. At this point there are no studies that I know that have examined that. What we do know is that many of today's wheat grains have double the gluten factor that they used to have. This may have something to do with wheat now having a problem. I also regularly hear that in other places such as Europe often they are better tolerated, so possibly they have a lower gluten factor. However, research in the US clearly indicated that wheat is problematic.

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APJ Q9: How does toxicity affect metabolism and weight gain? What about insulin resistance?

The issue of toxic overload is clearly a strong contributing factor to disease and in particular to diabetes. Metabolic syndrome is a very common phenomenon today, and while in the past if was often associated with poor diet, the research is now clear that major contributing factors also include elevated exposure to chemicals, especially persistent organic pollutants and several prescription drugs, including antibiotics. We know that individuals who have taken extensive doses of antibiotics can often suffer from persistent weight gain later in life due to the changes in the intestinal flora. Heavy metals, mercury load also contribute to chronic toxicity, insulin resistance and diabetes – one of the common reasons for metabolic syndrome and weight gain. Up to one-third of the nonprotein molecules in the blood come from bacteria in our gut. Some of these chemicals are good for us, like B-vitamins, but most are metabolic poisons. There are 10 times more bacteria in our gut and 100 times more genes in these gut bacteria than we have in our body. The balance of good and bad bacteria is essential for maintaining good health, and permeability has a role in all toxicity. Normally, in the healthy gut, we have good permeability control, which means we keep out the bad stuff and let in the good stuff. Today up to 35 per cent of people have excess gut permeability because of our modern diet, food allergies and inappropriate gut bacteria.

ABOUT DR JOSEPH PIZZORNO Joseph E. Pizzorno is one of the world's leading authorities on science-based natural/integrative medicine. He was appointed by President Clinton in December 2000 to the W h i t e H o u s e Commission on Complementary and Alternative Medicine Policy and by President Bush's administration in 2002 to the Medicare Coverage Advisory Committee. A naturopathic physician, educator and researcher, Dr Pizzorno is founding president of Bastyr University. Dr Pizzorno is also the co-author of the Encyclopaedia of Natural Medicine and also the Textbook and Handbook of Natural Medicine with Dr Michael Murray. He is the editor in chief of Integrative Medicine, A Clinicians Journal (IMCJ) and is also the board chair of Bioclinic Naturals and treasurer of the Board of the Institute of Functional Medicine (IFM).

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COSMETEX15

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Leading the way towards new frontiers in cosmetic medical practice

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The Australasian College of Cosmetic Surgery once again staged its annual conference COSMETEX on 30 April – 2 May, this year in Melbourne at the Pullman, Albert Park. With the theme Leading the way towards new frontiers in cosmetic medical practice it delivered on its promise with an amazing and diverse range of topics from local and international speakers. Academics, scientists, psychologists and cosmetic medical practitioners from a range of disciplines presented compelling education with topics ranging from beauty concepts across cultures, to advances in facial rejuvenation, cosmeceuticals, face lifting, dermal fillers, tattoo removal, laser skin rejuvenation, body contouring and lifting. How people see themselves, is itself an intriguing concept explored in depth at Cosmetex 15. Professor Richard Boyd, a key researcher from Monash University opened the session on Stem Cells stating that research and treatment is beginning to show the potential for changing fundamentally the way doctors are approaching the treatment of conditions associated with ageing.

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“With an ageing population, it is exciting to hold a key to slowing down, and potentially even reversing, damage at a cellular level,” Professor Boyd said. “Ongoing collaboration between researchers in the labs and practitioners working in the field is vital for the advances and broadening of applications,” Professor Boyd said. The conference speakers explored the hurdles, hopes and applications in both regenerative and “rejuvenating” medicine. College Censor-in-Chief Dr John Flynn agrees that there certainly are a lot of ways stem cells can impact cosmetic medicine. “Putting stem cells in a fat graft means it will last better and be more reliable. Stem cells help in revision of surgical scars and traumatic defects and for the effect of facial volume enhancement. Along with regenerative medicine this holds great promise for the way we treat our patients in the future,” Dr Flynn said. “However, the language surrounding stem cells can be very misleading. The work to date in this exciting field has focused on regeneration of joints in areas such as osteoarthritis, however, it is interesting to also explore the potential for these developments in stem cell therapies also in cosmetic applications,” Dr Flynn said. This year's program touched on the need to consider regenerative medicine playing a key role in aesthetics medicine. Dermatologist Dr Vivian Bucay from Texas, who presented at several of the sessions stated that health and beauty are not mutually exclusive. Aesthetics is also medicine and ageing of the skin needs to be assessed at various layers – skin deterioration, fat displacement, muscle deterioration and bone

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desorption leading to skeletal remodelling and loss of structural support. Dr Bucay presented several non-surgical lifting techniques of the brows, chin and neck and discussed the combination of fillers with micro-focused ultrasound. She also compared various lightbased modalities such as IPL, laser and Radio Frequency and identified their various capabilities.

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Dr David Castle, psychiatrist from St Vincent's Hospital in Melbourne presented a confronting lecture on image perception and how the media drives the aesthetic patient world. He present several examples of media impact subjected images with quite a bit of “doctoring” creating images of bodies that were substantially different to the original person. He stressed the dangers of photo-shopping that is creating a “beauty celebrity culture” that is putting pressure on women and leading to eating disorders and Body Dysmorphic Disorders. One of the images he presented was of the actor, Kate Winslet on the cover of GQ Magazine who appeared incredibly elongated - much taller and with longer legs than in real life. It was reported that Kate was very angry at the changes stating that she didn't look like that, however the magazine gave it no thought as they felt it sold more copies. Dr Castle stressed that today's models are expected to be walking clothes hangers, whose bodies do not interfere with the projection of the garments. He also critiqued Barbie dolls as being not a feasible human look. “For example, Barbie's waist is actually the size of her head,” he said. These media-driven distortions are having a detrimental effect in women's morale and over the years are leading to an increased number of body dissatisfaction by over 70% of women who were recently questioned. Dr Castle warned about the danger or unrealistic expectations by some patients and encouraged practitioners to say “no”

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if they believe their treatments would not meet with client expectations. He also encouraged that should BDD be identified not to hesitate to refer clients or patients to a psychologist or psychiatrist.

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There were several sessions that looked at the full-face approach to sculpturing with dermal fillers. Substantial information was presented not just on the emerging new fillers but also the

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new and very different approach to creating a more natural, subtle and youthful look rather than extensive volumising with excessive cheek lifting that becomes weird as one ages. ㄰ 㤵㜵

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Dr Kate Goldie, Medical Director of the Advanced Rejuvenation Clinic from London (but with a thick Scottish accent), and also the Medical Director of European Medical Aesthetics and trainer presented the new way of assessing anatomical features to make treatments as natural as possible. She presented various techniques and also discussed a variety of injectable products that would allow changes to be blended to create seamless harmony and balance that does not appear artificial in any way. The strategies for improving features often involved not working locally at the problem by creating balance in another side of the face that will draw the attention away from the perceived identified problem.

There was quite a lot of information presented on scientifically validated skincare and which ones appeared to offer the best results. These included various types of Retinol/retinoic acid and various formulations of vitamin C, such as l-ascorbic acid, magnesium ascorbyl phosphate and ascorbyl tetraisopalmitate as well as microbal peptides and growth factor activators. Hyaluronic acids were covered at length with a variety of molecular weights being discussed and how they can provide different treatment outcomes such as effective lifting, smoothing or firming depending on the formulation. Injectable HA through the use of multiple needles (five needles) injecting at just 2-3 mm depths was presented as a novel way of improving overall skin conditions and enhancing hydration and skin freshness.

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Another novel ingredient targeting dermal epidermal junction that was praised was acetyl hexapeptide-37 which delivers great results in a 2% cream. As we age, the decline of Glycosaminoglycans GAGs was something that needed to be addressed and a formulation of 1% GAGs proved promising in minimising water loss and improving skin barrier function.

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There were numerous speakers who presented a variety of treatment outcomes through the use of CO2 ablative lasers as well as nonablative RF with amazing results. Some severe scarring and pigmentations were able to achieve very impressive results. The necessity to work interactively with various technologies as well as scientifically-validated ingredients was able to demonstrate incredible outcomes. I could not finish my report without mentioning Dr Dianne Quibell, Assistant Clinical Professor, Harvard Medical School who presented at amazing speed some of the most advanced techniques and outcomes that can be achieved through various new laser technologies. Dr Quibell was quite robustly endowed and her presentation was also spiced with a great deal of humour, mainly aimed at her own physique and her love of carbs and fats, to which she has no intention of holding back in their consumption. Adding to the humour, she decided to show off her beautiful crystal shoes which, as she stated, redeemed the lower half of her, but she did advise us to only look at her from the waist up. Her witty humour was well received as she had the conference room roaring with laughter, however this did not at all take away from her amazing knowledge and the incredible technical information that she presented. ㄰ 㤵㜵

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I have to say while this year COSMETEX was not as large as other years I felt the information presented was of a very high quality and very valuable. The event was well organized and structured and I am sure was worth while for all who attended. Congratulations to the conference organisers, International Conferences & Events (ICE) Blanche Wilkie PR officer and ACCS for another very successful event. For additional information about the ACCS, please visit: http://www.accs.org.au/

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AESTHETIC INDUSTRY BULLETIN

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This section presents the latest news, training dates and other Aesthetic Industry information.

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COSMETEX15, the Australasian College of Cosmetic Surgery (ACCS) released the new Professional Practice Standards and Scope of Practice for Aesthetic Nursing Practice in Australia. This draft consultation standard is the first of its kind in Australia, setting the benchmark for nursing care in the rapidly evolving field of cosmetic medicine and surgery.

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ACCS nursing representative Nurse Practitioner Elissa O'Keefe said that the practice standard would improve standards of care and could be used for recruiting new staff, developing position descriptions, professional development planning and performance appraisal.

COSMETIC NURSES RELEASE NEW DRAFT PRACTICE STANDARD Nurses and doctors work together to raise the standards of cosmetic medical practice and improve patient care. Recently at

ALPHA-H CELEBRATES 15 YEARS OF LIQUID GOLD This year Alpha-H's iconic Liquid Gold turns 15 and to celebrate Alpha-H recently hosted an exclusive Liquid Gold Cocktail Party on March 25 at Doltone House, Hyde Park, Sydney. The extravagant event oozed Gatsby-style glamour and gestures of gold from crystal chandeliers, to a champagne tower and gold-dusted, chocolatedipped strawberries. The event was supported by key media. ㄰ 㤵㜵

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Once media had mingled Alpha-H owners Michelle and Dean Doherty took to the floor to thank everyone for being part of the Liquid Gold journey. Proudly Australian owned (and manufactured), Michelle Doherty explained how as the pioneers of the acid toner, people were initially hesitant about putting acid on their face as it was such a new concept. But once they noticed the astounding results Liquid Gold's following quickly grew. Designed to bridge between the beauty counter and invasive treatments, Michelle says, “We wanted to bring salon results to the bathroom at home for those without access to therapists, three nights a week.”

ACCS President Dr Soo-Keat Lim said the practice standard was a key reform in the nationwide effort to raise the standards of care and protect patients. “Nurses are an integral part of the health team and this gives clear guidance for nurses, doctors and their patients about what an expected standard of care is,” Dr Lim Said.

Copies of the Professional Practice Standards and Scope of Practice for Aesthetic Nursing Practice in Australia are available from the ACCS www.accs.org.au

The success of Liquid Gold has not been without its struggles. Going up against beauty heavyweights with huge marketing budgets presented a major challenge. As Michelle Doherty put it, “We are just a family business going up against faceless multinational companies”. But the battle has paid off with Liquid Gold now being deemed a 'musthave' beauty product. Today one bottle of Liquid Gold is sold every 60 seconds and this year to date the brand has created seven tonnes of the product to cater to the UK market alone. It's not hard to see why Liquid Gold has proven so popular, with the no-rinse resurfacing treatment showing results in just 20 minutes. The combination of glycolic acid and licorice extract and low pH delivery system is key to its success. In recent clinical studies, participants had a 23 per cent reduction in skin roughness, a 20 per cent reduction in wrinkle depth and a 22 per cent increase in skin hydration after just one application. Liquid Gold has been called many things, from a magic bullet to a miracle in a bottle, but put simply it works. Harpers Bazaar recently called it “bottled brilliance” adding, “We will search hard and global for off-Richter radiance. We've polled dermatologists, facialists and backstage model-maintenance crews and, know what? The big-rater remains Alpha-H Liquid Gold, a cult Australian no-rinse, all-in-one exfoliant, toner and serum”.

Alpha-H can be contacted on 1800 659 777 or Ph: 07 55294866.

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5 WAYS THAT AESTHETICS PROFESSIONAL CAN CONTRIBUTE TO SKIN CANCER PREVENTION As the threat of skin cancer continues to grow, the Australian Cancer Council is urging skin therapists and practitioners to spend more time with their clients and patients educating them on preventative measures and the dangers of skin cancer. Recommendations include encouraging checkups to educating the public on prevention, the aesthetic and medical community is serious about skin cancer. Here are just a few ways that aesthetic and medical professionals are encouraged to get more about vigilant with strategies for skincare prevention.

NEW HEIGHTS IN THE FIELD OF DERMAL THERAPIES In December 2014, The Australasian Academy of Cosmetic Dermal Science (AACDS) has unveiled the highest Australian qualification available in the field of Dermal Therapies The Graduate Diploma of Dermal Therapies. This new course is classified as a level 8 in the Australian Qualification Framework under the Vocational Education and Training sector (VET), which thus places it above an Advanced Diploma or Bachelor Degree.

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This qualification also features an exciting unit, which resulted from the partnership of AACDS and the Australasian Academy of AntiAgeing Medicine (A5M). This unit, titled 'Analyse the Principles of Anti-Ageing Medicine' provides graduates with credit into the A5M Certificate in Anti-ageing Medicine for Allied Health Professionals.

For further information on this new AACDS qualification, please visit www.aacds.edu.au

CHECKUPS As a practitioner, during checkups, take extra time to fully examine the client's or patient's skin condition. Check for suspicious moles and even discoloration where the texture of the skin in changes. If this is the case, recommend your client or patient see a dermatologist. In addition, encourage clients to examine their skin regularly and schedule checkups whenever they find an area of concern.

SELF-EXAM TECHNIQUES The medical and aesthetics world are urge to spreading the word about self-exam techniques that can help the public detect signs of skin cancer early. From the ABCDEs of Melanoma exam to the Ugly Duckling Sign technique used to determine which spots are cancerous and which aren't, dermatologists are getting the public on board with skin cancer awareness.

SKINCARE ABLE TO ACHIEVE SELL-TO-SELL COMMUNICATION We are aware that regulating bodies do not permit certain claims to be made regarding the capability of skincare to actually create changes to the skin, meanwhile technological advances are proving otherwise with same interesting discoveries.

SPF PROTECTION

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Recent research has identified that while people are stating they are applying sunscreen, they often are leaving gaps that leave the skin unprotected. It is advisable to first blend the sunscreen thoroughly to ensure that the warmth of the hands has fliudified it sufficiently to create a thin liquid and then encourage your clients to take their time to ensure proper coverage. A quick slap of sunscreen could mean that areas of the skin are left unprotected. Appropriate application is the key. Also it is important to recommend a UVA and UVB sunscreen.

VITAMIN AND ANTIOXIDANTS There is sufficient research that supports the properties of certain vitamins and nutrients. The combination of vitamins C and E are considered supportive of photo-protection. Additionally vitamin B3 (Niacinamide) and green and red tea extracts have proven activity in protecting the skin against free-radical damage. Make sure your clients homecare products adequately cover against sun damage and ensure your instructions for use are thorough experts advise.

Influenced by the latest discoveries in reconstructive tissue engineering for the treatment of burn injuries, the SWT-7™ never-seen before mechanism of action is based on stem cell technology with a cell-to-cell communication between adipose-derived stem cells (ADSC) and keratinocytes through growth factors action. SWT-7™ has demonstrated its efficacy on vertical wrinkles, skin texture, lip contour wrinkles and roughness, lipstick migration. SWT-7™ is a patented liposoluble ingredient based on a highly innovative technology using phospholipids as inverse emulsion provider. Coupled with trans-dermal delivery technologies such as RadioFrequency, Electroporation and even dermal needling the aesthetics industry is able to achieve a great deal more than previously possible. However, with every new invention or innovation there is always those who will take advantage of the market opportunities with unsubstantiated claims. This is why practitioners need to ensure they seek evidence-based research to ensure what they embrace and promote has strong, credible scientific backing. Furthermore, the need for higher education has never been more important.

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International Aesthetic Show Calendar

CELEBRATING 10 YEARS OF BEAUTY AND LASER TRAINING! 10 years ago Ilse Taumberger entered the laser industry at a time when there was little or no IPL and Laser training available in Australia. Laser Technicians gained their experience and knowledge through on-the-job training, sometimes making mistakes and hopefully learning from them. Ilse realised that there was the potential for influencing the direction of the Laser industry with quality training and education and through her passion and dedication she developed Government accredited courses in IPL and Laser Hair Reduction and Skin Rejuvenation to help lift the standard of a rapidly growing industry. In 2005 Ilse purchased Fuss Beauty College in Edgecliff and founded her business on the principles of trust, honesty, delivering quality training, ethical business values and support for the student. Over the years the business has grown, and new courses have developed to meet the growing needs of a constantly changing industry. Reaching this pinnacle and with the constant evolution of the college it was appropriate to change the name of the

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In a unique joint venture the Australasian College of Cosmetic Surgery (ACCS), and Laser Safety Australia have launched two brand new laser and intense pulsed light safety courses to support doctors, nurses and other providers of cosmetic laser treatments.

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Produced by Terry Everitt 㜵

July 12-14 COSMOPROF North America Mandalay Bay Las Vegas T: + 1 480.281.0424 x 3445 Email: info@cosmoprofnorthamerica.com

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college and in celebrating the college's 10th year Fuss Beauty College has become Sydney Beauty and Dermal Institute. “The name change reflects the core of where we came from, who we are and where we are going,” says the principal Ilse Taumberger. SBDI has a team of highly experienced and skilful trainers who are dedicated to consistently deliver excellent training from entry level short courses right through to Graduate Certificate level. “We are proud to be part of the learning journey of each one of our students and excited about what the future will bring for Sydney Beauty & Dermal Institute in the next 10 years,” Ilse said. Thank you to all our clients, students and team members past and present for being part of an extraordinary 10 years.

Sydney Beauty & Dermal Institute can be contacted on 02 9326 2211 Email: info@sbdi.com.au

ACCS Fellow Dr David Topchian said, “This course is unique because it has been specifically developed with busy clinicians in mind. It is online, rapidly accessible and participants are able to learn at their own pace and in their own time.”

COSMETIC LASER COURSE LAUNCHED SAFER LASER AND IPL TREATMENTS FOR AUSTRALIANS

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The partners recognised the need for evidence-based and contemporary courses that are able to adapt and change with a fast-paced industry. Complaints about adverse outcomes to laser and intense pulsed light treatments are becoming more common and ACCS and Laser Safety Australia believe that this new partnership will help to raise the standards of clinical education and improve outcomes for cosmetic patients.

For more information on the courses go to http://www.accs.org.au/cosmeticmedicine-training or www.lasersafetyaustralia.com

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9th Annual Anti-Ageing & Aesthetic Medicine Conference Sofitel Melbourne T: 03 98130439 F: 03 98130649 Email: enquiries@a5m.net

Aug 13-15 New Zealand Society of Cosmetic Medicine Annual Conference T: +61 9 4365 829 F: + 61 9 4370 487 E-mail: nzscm@clear.net.nz www.nzscm.co.nz Aug 22-24 Face & Body Northern California McEnery Convention Center San Jose, CA T: +1-630-653-2155 F: +1-630-653-2192 Email: FBNC@allured.com Aug 22-23 Sydney International Spa Beauty Expo – Sydney Convention and Exhibition Centre Darling Harbour T: 02 9422 2535 Email: visit@internationalbeautyexpo.com.au

Aug 22-24 Face & Body Northern California – McEnery Convention Center San Jose T: + 1-630-653-2155 F: + 1-630-653-2192 FBNC@allured.com Aug 30-31 Professional Beauty Johannesburg Gallagher Convention Centre Johannesburg, South Africa www.probeauty.co.za/jhb.htm Sept 7-8

International Congress of Esthetics & Spa Long Beach Convention Center Long Beach, California T: +1 305 443-2322 F: +1 305 443-1664 Email: registration@lneonline.com

Sept18-19 3rd Aesthetic & Anti-Aging Medicine World Congress Eastern Europe World Trade Centre, Moscow T: + 33 (0)1 56 83 78 00 F: +33 (0)1 56 837 805 E-mail: registration@euromedicom.com

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Sept 20-21 International Congress of Esthetics & Spa Long Beach Convention Center Long Beach, California T: +1 305 443-2322 F: +1 305 443-1664 Email: registration@lneonline.com

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SCIENTIFIC NEWS

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COMPUTER-ASSISTED DIAGNOSIS TOOL HELPS PHYSICIANS ASSESS SKIN CONDITIONS In the first major study to examine the use of a computer-assisted, photo-driven differential diagnosis generator for skin conditions, researchers at the Perelman School of Medicine at the University of Pennsylvania found physicians routinely used the tool, without an increase in calling for inpatient dermatology consultations. The software diagnostic tool, VisualDx, aids in diagnosing dermatologic conditions by allowing physicians to enter information such as the type and location of a rash, and associated symptoms such as pain or itching, and then generating a range of possible diagnoses accompanied by photographs. This enables users to rapidly compare the rash of an individual patient to a database of more than 1,300 pediatric and adult skin conditions represented by nearly 30,000 images, with the aim of improving diagnostic accuracy reducing misdiagnosisrelated harm.

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The study, published early online in Diagnosis, found that the rate of dermatologic consultations at the Hospital of the University of Pennsylvania, the flagship hospital of Penn Medicine, did not change for the 18 months after VisualDx was introduced compared to the 12 months before it was introduced. "This is important because these tools by design suggest numerous potential diagnoses, which could result in an increase in unnecessary testing and specialty

consultation, and associated costs and harms, particularly in the hands of less experienced clinicians," says the study's senior author, Craig A. Umscheid, MD, MSCE, assistant professor of Medicine and Epidemiology and director of the Penn Medicine Center for Evidence-based Practice. "Conversely, if there were a significant reduction in dermatologic consultations, it would have suggested that general internists, emergency-room physicians, family doctors and pediatricians, all of whom by definition are not specialists in dermatology, may have relied on the tool to make dermatologic diagnoses rather than consulting a dermatologist for help.”

we found that it is – most often on mobile devices and by inpatient providers.” Differential diagnosis generators have been suggested as a potential way of reducing misdiagnosis, which is estimated to result in 40,000 to 80,000 deaths in U.S. hospitals annually. "The technology can help users overcome cognitive shortcomings such as availability bias, in which providers diagnose patients with conditions they've recently seen or can easily recall, rather than those conditions that are most likely to occur. It can also reduce fund of knowledge deficiencies by directing users to diagnoses they might not have otherwise considered," commented the study's lead author’ John Barbieri, MD, MBA, a 2014 graduate of the Perelman School of Medicine and The Wharton School. Ref: University of Pennsylvania School of Medicine

The Penn team examined the use of VisualDx throughout the University of Pennsylvania Health System by month for the 18 months following its introduction in September 2012. Researchers found a median of 474 unique monthly VisualDx sessions by users, a rate that continued throughout the time period under study. The researchers found that, overall, VisualDx was accessed through mobile devices (35 per cent); inpatient (34 per cent), outpatient (11 per cent), and emergency department (1 per cent) electronic health records; and via searches in UpToDate, a point-of-care evidence summary resource (19 per cent). "Technology like this has great promise, but it can't help patients unless it's actually used," says Umscheid. "Previous studies have been primarily simulations, where researchers take variables from case studies and input them into the software to retroactively assess the diagnostic accuracy of the software. However, our purpose was to determine if a differential diagnosis generator like VisualDx would actually be used by providers if implemented in a hospital, and

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SPIRONOLACTONE AFFECTS STEROID SKIN DAMAGE It might seem unlikely, but researchers have found the antihypertensive drug

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spironolactone reduces skin atrophy from topical corticosteroid use.

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In a study published online February in the Journal of Investigative Dermatology, researchers from Inserm report on their hypothesis that skin atrophy, which results from corticosteroid-based dermatological creams, might be related to these topicals' activation of mineralocorticoid receptors in the epidermis. “These receptors, which are present in the kidney, heart, eye, and certain neurons in particular, reacted with aldosterone, a hormone that regulates the blood pressure. Moreover, previous studies also showed them to be highly sensitive to corticosteroids,” according to a release. They found that corticosteroid application to cultured skin results in skin thinning. In six days, the epidermis's thickness was reduced by one-third. To remedy the side-effect, researchers induced a pharmacological receptor blockade by adding an antagonist to corticosteroid treatment. Spironolactone is a mineralocorticoid receptor antagonist.

skin diseases requiring short-term glucocorticoid application, as in some patients with eczema or psoriasis. “We did not see any side-effects after onemonth treatment of healthy volunteers; however, there is a need for extensive toxicity (local at the level of the skin surface, and, general, because of possibility of percutaneous absorption) in normal and diseased skin,” Dr. Farman writes. “The use of topical spironolactone to limit glucocorticoid-induced skin atrophy is not approved yet for dermatologists. We provided a proof of concept of efficacy, but much is still required before human use. It is necessary to reformulate spironolactone for topical use, to do toxicology assessments, and to perform clinical evaluation in patients with skin diseases. We have deposited a patent application, and we are now exploring the possibilities to progress towards future use of this kind of drug for patients.” Ref: Dermatology Today

he's removed recent tattoos from patients from 14 years old to senior citizens. Regarding tattoo locations, Dr. Hruza says that as tattoos have grown more mainstream, he increasingly zaps them from highly visible areas such as the neck, once the wearers rethink their ink.

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Roy Geronemus, M.D., adds that as people become more aware that lasers can safely and effectively remove tattoos, he sees growing numbers of patients with lip and eyeliner tattoos they want removed. He is director of the Laser & Skin Surgery Center of New York and clinical professor of dermatology at New York University Medical Center.

Treating tattooed-on cosmetics can be tricky, however. Frequently, explains Dr. Hruza, they contain iron oxide (for tan and rust tones) or titanium dioxide (for pastels and flesh tones). Immediately after Q-switched or picosecond laser treatment, he says, both materials often irreversibly darken to grey or pitch-black tones as refractory as genuine black ink. Dr. Bernstein says the darkened pigment can take double or triple the usual number of Q-switched laser treatments. When using such lasers for facial cosmetic tattoos, particularly with rusty hues, Dr. Hruza recommends first treating a small test spot – which one can surgically excise if it darkens. Alternatively, Dr. Geronemus uses an ablative CO2 or fractional ablative CO2 laser for tattoos containing iron oxide or titanium dioxide.

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They tested a spironolactone-based treatment for 28 days in 23 healthy volunteers, applying creams of different compositions to four areas of the volunteers' arms. The researchers applied a cream containing a corticosteroid used in dermatology; a cream containing spironolactone; a combination of both drugs; and a placebo. They found that by adding spironolactone to the corticosteroid, they significantly limited skin atrophy. Inserm Research Director Nicolette Farman, M.D., Ph.D., writes in an email to Dermatology Times that, if the drug is eventually approved for topical use (because oral absorption is not efficient for this reason), dermatologists might use spironolactone topically in patients with

TATTOO REMOVAL IS A BOOMING BUSINESS As Americans’ taste for tattoos has grown, experts say, so have many tattoo wearers' regrets. Nationally, says Eric F. Bernstein, M.D., M.S.E., "There's a total epidemic of people wanting their tattoos removed." He is clinical professor, Department of Dermatology, University of Pennsylvania School of Medicine. George Hruza, M.D., M.B.A., says he commonly sees parents who want tattoos removed from children – who got them without permission – as young as 16. He is a Chesterfield, Missouri-based dermatologist in private practice. Dr. Bernstein adds that

Dr. Bernstein says that although he has not yet treated cosmetic tattoos with the PicoWay 532/1064 nm picosecond laser (Syneron & Candela), he hopes that it simplifies the task. For now, he says that as tattooed Americans get older and perhaps wiser, "The tattoo-removal business is booming – and it's only going to keep booming as time goes on”. Australian trends are not far behind the US, with studies confirming that tattoo removal is considered one of the largest growth opportunities in the aesthetic and medical cosmetic industry. Meanwhile, there is an urgent need for regulations to be introduced for this practice, which poses risks when performed by an unqualified and inadequately trained person. “With some formal qualification currently available and with national regulations soon to be introduced in the area of laser and IPL for cosmetic purposes, we believe that in the not-too-distant future Australia will be better positioned to provide safe practices in the area of tattoo removal,” a representative of APAN stated.

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At higher-power densities, achieved adjacent to an RF emitter, plentiful physical interactions can occur.

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FRACTIONATED BIPOLAR RADIOFREQUENCY DEVICES REJUVENATE SKIN

In Australia, both Radiofrequency and Fractionated monopolar and bipolar RF are now gaining momentum as the next generation “preferred” technology following laser and IPL. As with every technology, correct training and qualifications will ensure the delivery not only of safe, but also efficacious treatment outcomes. At the end of the day it's all about results that are consumer-driven. Safety is only one end of the spectrum. This is why licensing alone (which is not a qualification) is in itself inadequate.

Psychodermatology Over 2,000 years ago, the Greek physician Hippocrates described people who tore their hair out in response to emotional turmoil. To d a y, w e c a l l t h i s c o n d i t i o n trichotillomania. The ancient traditions from Greece to China to India highlighted the interdependence between the mind and the body. Somewhere along the lines in Western medicine we lost this connection, focusing instead on philosophies that treated the body as a separate entity from the mind. Only in the past several decades have we seen the resurgence of mind-body awareness in medicine – and only in the past decade or so have we seen an emphasis on understanding the interaction between the nervous system and skin diseases. Psychodermatology is a new medical subspecialty emerging from the combination of psychiatry and dermatology. Psychiatry treats mental processes

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The clinical utility of radiofrequency (RF) devices is to deliver various morphologies of energy to biologic tissue, with objectives ranging from destruction to denaturing and rejuvenation. In the context of dermatology, three fundamental types of RF devices exist: monopolar, unipolar and bipolar. These are differentiated by the configuration of electrodes and corresponding electromagnetic fields. Fractionated RF is a variant of bipolar RF, wherein an electrode array is patterned to divide the treatment field into multiple RF thermal zones (RFTZs) with intervening areas of untreated tissue. The application of these technologies include tightening of the skin, rhytid reduction, striae reduction, as well as heating of adipose tissue used in body contouring and cellulite reduction. Fractionated bipolar RF creates superficial RFTZs, and it is most commonly used today for rejuvenation of the skin. Because RF devices function independent of chromophores, they can be used on all skin types with little to no risk of pigment alteration.

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Radiofrequency refers to oscillating electromagnetic waves within the range of 3 kHz to 300 GHz. To provide perspective, cellular telephone signals operate from 800 MHz to 2.69 GHz, and there is rarely a moment a person in the industrialised world is not being infinitesimally irradiated by one source or another, such as these cellular carrier signals WiFi or Bluetooth. These signals are typically distant from the transmitter and have low-power density, and thus a presumed negligible biological effect.

THE BRAIN-SKIN CONNECTION Does our skin really reveal our innermost feelings, calling us out on our guilt, shame or panic? Yes, when coupled with the microexpressions we make with our muscles. But another part is our actual skin acting as a telltale sign of emotional turmoil. Take a look at political figureheads – pre-term and postterm. Notice the greying hair, the dark undereye circles, the lines and wrinkles. These are not just effects of chronological ageing; these are (sometimes) also the long-term effects of stress and anxiety on skin, hair and nails. And it's this very brain-skin connection that's been a focus of studies over the past several years. But is this a new phenomenon? Or are we just beginning to understand the very real effects stress has on our minds and bodies?

manifested internally, while dermatology treats skin diseases manifested externally. In essence, psychodermatology is a holistic view of skin disease within the medical world. Stress is more than skin deep Imagine any of these scenarios: back-toback exams, a messy divorce, unexpected health issues, even being stuck in traffic when you're already late. Does the mere thought of these send stress signals down your spine? It doesn't take scientific evidence for us to realise that the kind of stress driving us to the nearest pub – or reaching for the bowl of chocolate-covered nuts – isn't good for our skin (and neither are those coping choices!). But the effects of psychological stress on our skin may be more serious than we realise. Scientific evidence has shown us that stress equates to

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inflammation, and this can cause havoc on the skin. From acne breakouts, to rosacea flushes to eczema flare-ups, stress is the fuel to the fire of inflammation lurking in these conditions. What's more, stress not only triggers or exacerbates particular skin diseases, it can also lead to dehydration, lines, blotchiness, hair loss and brittle nails for those without an inherent condition.

On the flip side, the distress these "stressrelated" skin conditions causes is also very real, feeding a vicious cycle. Getting that awful pimple before your date, or the significant hair loss after a traumatic event – these can in turn cause psychological

(comprised of heavy hitters like prostaglandins, cytokines, neuropeptides, immune cells and hormones) that could lead to devastation on skin tissue, to put it kindly. There is much to learn about this topic, but scientific evidence points to a very real neuroendocrine system in the skin that is particularly sensitive to psychological stress. Lucky for us, the solution is not an elaborate and labor-intensive one. In fact, it's quite simple if we stick to it. Experts advise the importance of taking 10, sticking to a whole-food diet, enjoy a walk in nature and your skin will thank you for it, or should we say this is only the beginning of a healthy and well-nurtured skin.

PENSIONERS IN THE UK ARE SEVEN TIMES MORE LIKELY TO GET MALIGNANT MELANOMA

distress, even to the point of creating a psychiatric condition such as depression and anxiety. The statistics are telling: People with the most visible skin conditions (vitiligo, psoriasis) have much higher risk factor for developing anxiety, depression and even suicidal thoughts.

A Mind-Body Approach

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Sure, the creams, lotions and potions you spend your hard-earnt money on can offer surface benefits. But if the problem stems in the mind, slather on as much retinol as you want, but the tension lines will remain if your heart rate is reminiscent of the jackhammer pounding on the sidewalk. I'm not saying you can ohm your pimples away, but taking a look at the root cause, and certainly decreasing stress levels, could be a secret ingredient to your arsenal of skin-clearing techniques. In reducing cortisol, you're putting an end to a molecular pathway

People over 65 are around seven times more likely to develop malignant melanoma compared to 40 years ago, according to new figures released by Cancer Research UK. Older men in Great Britain are around 10 times more likely to be diagnosed with this kind of life-threatening skin cancer than their parents' generation, while older women are around five times more likely to develop this disease. The most recent figures show that on average around 5,700 pensioners are now diagnosed with melanoma each year compared with just 600 in the mid 1970s. While age is one of the biggest risk factors for melanoma, the huge increase in pensioners being diagnosed with the disease is likely to be linked to the cheap package holiday boom dating from the 1960s, and the desirability of having a tanned appearance even at the expense of painful sunburn. Getting sunburnt just once every two years can triple your risk of developing malignant melanoma, and even reddening of the skin is a sign of damage. Sue Deans, a 69-year-old retired teacher and mother of three, was first diagnosed in 2000 with malignant melanoma after the doctor removed a mole, and re-diagnosed in 2007 after she discovered a lump under her armpit.

"I was part of the generation where package holidays became affordable and you could go abroad nearly every year," she said. "I don't think there was much understanding at the time about the impact that too much sun can have on your risk of getting skin cancer. And I loved the sun, but suffered quite a bit of sunburn over the years.

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"I've always been quite body aware so my cancer was spotted early. I had successful surgery and have been healthy since – but I'm always vigilant in keeping an eye out for anything unusual or persistent that might need to be checked. Now I make sure my grandson knows the dangers of getting caught out in the sun."

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Around 13,300 people are diagnosed with malignant melanoma in the UK each year, making it the fifth most common cancer overall in the UK and the second most common cancer in young adults (aged 1534). Each year 2,100 people die from the disease. Professor Richard Marais, Cancer Research UK's skin cancer expert based in Manchester, said: "It's worrying to see melanoma rates increasing at such a fast pace, and across all age groups. It is very important for people to take care of their skin in the sun. It is also important for them to keep an eye on their skin and seek medical opinion if they see any changes to their moles, or even to normal areas of skin. Melanoma is often detected on men's backs and women's legs, but can appear on any part of the body." Cancer Research UK and NIVEA SUN are working in partnership to encourage people to enjoy the sun safely this summer. The partnership offers simple advice that people can follow to make sure they have a great summer while protecting their skin. Dr Julie Sharp, Cancer Research UK's head of health information, said: "Many cases of malignant melanoma, the most serious form of skin cancer, are preventable by taking precautions in the sun and making sure you don't burn. "Sun damage accumulates over time, so avoiding sunburn – and sunbeds – is key, as well as getting to know your skin type so you don't overdo it on the beach or even in the garden. You can burn at home just as easily as you can on holiday, so remember to spend time in the shade, wear a T-shirt and a hat to protect your skin and regularly apply sunscreen that is at least Factor 15 and has four stars. Swapping bad sun habits for good ones could save your life.”

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on those disease processes,” Dr. Bhatia says.

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RETINOIDS, VITAMIN D USEFUL FOR HYPERPROLIFERATIVE SKIN DISORDERS “Topical vitamin D and retinoids impact c e l l d i f f e re n t i a t i o n r a t h e r t h a n keritinisation,” experts say. Dermatologists could be making greater use of topical retinoids and vitamin D preparations in treating a variety of hyperproliferative and other skin disorders, an expert says. Topical vitamin D and retinoids impact cell differentiation rather than keratinisation, says Neal Bhatia, M.D., a dermatologist in private practice in Long Beach, Calif., and an associate professor of dermatology at the Harbor University of California Los Angeles Medical Center. In the early days of psoriasis treatment, he explains, the “sandwich theory” focused on epidermal turnover and inflammation, with one drug or strategy for each layer.

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“And the recipe of using salicylic acid and urea to stimulate epidermal turnover led to using steroids to reduce inflammation and keratolytics to achieve sloughing,” Dr. Bhatia says. Vitamin D products and retinoids initially fell into the latter pigeonhole, he says. However, “Their mechanism is not keratolytic. Those two drugs are meant to restore cell differentiation, which plays a more significant role in modifying psoriasis”. As such, he says that topical vitamin D and retinoids are underutilised not only in psoriasis, but also in other hyperproliferative disorders such as ichthyosis and acanthosis nigricans. “Whether that's because of cost, irritation or other reasons, those two classes of drugs, based on their mechanisms, will have impact

Vitamin D's role in promoting differentiation also explains its efficacy in reducing the risk of steroidinduced skin a t r o p h y, D r. Bhatia says. Case reports of m o r p h e a 1 exemplify this problem, he says. “Steroid overuse can create more atrophy, and the use of vitamin D can reduce that risk,” Dr. Bhatia says. Many recent case reports and small studies also highlight the role of topical retinoids in chronic hand dermatitis, 2 warts, 3 and chemoprevention.4

world of noninvasive cosmetic surgery advances. The traditional way to treat a double chin has been with a full-on face lift. But that may be about to change. An injection called ATX-101, which targets double chins, is nearing approval by the U.S. Food and Drug Administration (FDA). Recently the drug was backed by an independent panel to the FDA, which brings it one step closer to full approval. ATX-101 consists of deoxycholic acid that's injected into the skin to target and eliminate fat cells under the chin without spreading to surrounding tissue. Its maker, Kythera Biopharmaceuticals Inc., hopes to make the injections available in the back half of 2015.

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“This drug is going to be a game-changer, no question about it,” Nashville dermatologist Michael Gold, MD, tells Yahoo Health. Gold participated in clinical studies of the drug. “It worked incredibly well in patients who were treated, as shown by results versus placebo. It's indicated for the neck, but I won't be surprised if people use this off-label with other areas of the

“All those applications are based on retinoids' i m p a c t o n differentiation over time, whether the initial insult comes from UV, the human papilloma virus or other inflammation triggers,” Dr. Bhatia says. “That's where the application of a retinoid is important.” D i s c l o s u r e s : D r. Bhatia is a consultant, investigator and/or speaker for Anacor, Aqua, Bayer, DUSA, Ferndale, Galderma, Leo, Novartis, Promius, Quinnova and Valeant.

AN INJECTION THAT MAKES DOUBLE CHINS DISAPPEAR IS PROBABLY COMING SOON A new injection called ATX-101 is nearing FDA approval which, for the first time, targets the fat cells in the neck area to smooth away double chins. We can freeze our wrinkles, smooth our fine lines and zap away our skin imperfections. But the biggest cosmetic complaint of many – the double chin – has been neglected in the

body, like we saw with Botox,” he adds. While double chins may be caused by natural genetics, advancing age and weight gain, experts say ATX-101 currently works best on a certain case type. “The ideal candidate is a younger individual with good skin elasticity and a milder double chin – it's not going to replace a lift yet,” says New York facial plastic surgeon and presidentelect of the Facial Plastic Surgery & R e c o n s t r u c t i v e S u rg e r y A c a d e m y (AAFPRS) Edwin Williams, MD. Ref: Dermatology Today

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Sunscreens Enter a NEW ERA By Tina Viney

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While sunscreens have a great deal of responsibility to shield us from damaging sun rays, they often fail to achieve the full protection for which they were used. At the recent COSMETEX Conference a new technology called superfluids in sunscreen formulations was presented that is set to establish a new benchmark in sunscreens. I found this lecture quite exciting, so here are some highlights. The lecture was presented by Richard Parker, who is the formulator of Rationale – the company that developed a new sunscreen B3-T with superfluids. In this lecture Richard presented the science behind this formulation and started by sharing some of the current challenges in sunscreen formulations. Despite statements from the Cancer Council about the importance of adequate sun protection it would appear that the warnings are still going unheeded, as the incidents of skin cancer continue to grow each year. In a bid to prove greater protection some companies have moved to producing sunscreens with an SPF of 50+. However, this has introduced other problems, namely sensitivities and reactions to the rise in chemicals within these formulas. In some instance up to triple levels of chemicals are needed to raise the SPF factor to 50 and above, leading in many cases to sunscreen-induced dermatitis. Further trials concluded that the problem is not that consumers are not applying sunscreen, but that it is poorly applied, leaving areas uncovered. This indicated that the appropriate application is even more important than the amount of UV active in the product. High SPF therefore is clearly not the answer. Another concern is that many formulations are sticky and leave a thick layer on the skin. As a result, consumers are significantly under-dosing because the products are cosmetically unacceptable. The answer in theory is a formula that can more easily be spread on the skin and with lower levels of chemicals. This product would need to be lightweight, silky feeling, non-sticky and without the characteristic odour.

B3-T superfluid

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After extensive research a new sunscreen technology has been launched called B3-T, based on superfluids. This is a new class of its own and with superior photo-protective properties. B3-T is an entirely new technology that goes beyond standard sunscreens in that it protects against visible light plus infra-red. Additionally B3T has the ability to deliver a perfect uniform film and this is because it is a near zero viscosity micro-emulsion. The unique feature of superfluids is that they have an amazing ability to provide 100% protection with an incredibly thin, yet uniform coverage. In sunscreen chemistry there is a term called contact angle that measures the rate by which a product can spread on application. While current sunscreens congregate as irregular drops, superfluids provide very fast, uniform and excellent spread on the surface. This

allows them to provide superior SPF protection with the need for much less actives, so less chemicals are need to provide superior protection. Tests confirm an amazing 110% SPF protection yet with less chemicals. Superfluids have been proven to provide total protection with no gap yet with superior cover. And that is not all. Superfluids provide an excellent vehicle for the penetration of several non-photoprotective ingredients such as:

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Niacinamide (B3) – known for its immuneboosting properties, barrier restoration and skin-lightening properties for conditions such as pigmentation. Studies also confirm that niacinamide has the capacity to prevent photoimmunosupression, which is a precursor t o s k i n c a n c e r. A l s o niacinamide enhances c e l l - t o - c e l l communication. This explains why niacinamide can maintain langerhans cell viability during UV radiation as well as its ability to prevent transfer of melanocytes. It is therefore useful in treating hyper-pigmentary disorders as well as supporting stratum corneum integrity and reducing skin sensitivity. Red and Green Tea – Polyphenols found in red and green tea extracts have been shown to deliver amazing photoprotective properties as well as antioxidant and anti-carcenogenic properties. The polyphenolic compounds found in red and green tea have been showed in studies to reduce photosensitivity as well as UV-induced erythema. Furthermore, these polyphenols are also protective against visible light and infra-red, both which contribute to melasma. Vitamin C+E – Numerous studies confirm the photo-protective properties of Vitamins C and E as well as their rejuvenating effects on the skin.

BASED ON THIS RESEARCH B3T TINTED SUPERFLUID SPF50+ CONTAINS THE FOLLOWING ACTIVES: BROADSPECTRUM: Zinc Oxide, Titanium Dioxide, BisEthylhexyloxphenol, Methoxyphenyl Triazine, Methylene BisBenzotriazolyn UVA: Bytyl Methoxydibenzenzoylmethane UVB: Ethylhexyl Salicylate, Momosolate, Octocrylene ANTIOXIDANTS: 4% Niacinamide, Green and Red tea

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extracts, Vitamin C+E

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B3-T Tinted Superfluid SPF 50+ has an amazingly light, non-sticky texture that makes it pleasant to use. It is believed that superfluids will usher a new era in sunscreen with amazing superior results.

B3-T Tinted Superfluid SPF 50+ is available through medical cosmetic clinics. For further details information visit Rationale® at www.rationale.com.

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APJ 117

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MAGNESIUM The Master Mineral

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Examining the different types of magnesium and how they differ in their benefits By Tina Viney

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As a constantly evolving industry with the bar for improved skin management being constantly raised, we can no longer afford to address the skin just on a superficial level. The need to take a more integrative approach with elements of wellness included in our

protocols is now becoming paramount. One simple way of achieving this is through the use of minerals such as magnesium used transdermally, or as a supplement. However, there are many different types of magnesium and understanding each one can make a huge difference to achieving optimal results. In this article I will present some interesting information that researchers have

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identified on the various types of magnesium and their benefits so that you can identify which ones will best suit you.

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WHY MAGNESIUM? Whether to ease pain, counteract fatigue, improve sleep or minimise the impact of inflammation in systemic or skin conditions, magnesium can be a very useful tool.

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Magnesium researchers have referred to it as “the miracle, or the anti-stress mineral” because of the amazing benefits to the nervous system in aiding the body to relax, however, master mineral would also be a good description as it offers numerous other benefits. Did you know that magnesium contributes to over 325 different biochemical processes in the body and coordinates, or co-factors, many other nutrients, making them more efficient in supporting health within the body? In aesthetics, magnesium can play a key role as a natural antiinflammatory to help quell pain, swelling and soothe skin conditions that are characterised by inflammation. Magnesium also helps blood flow more smoothly and supports the delivery of oxygen to the tissues, and for this reason is vitally important to skin health. As magnesium can also be delivered quite effectively through transdermal means it is often used topically in the form of magnesium oil as a massage medium or foot soak. Transdermal delivery as we know can only be effectively achieved as long as a molecule or ion is small enough to pass through the porous surface of the skin, and if it can, it will eventually end up in your bloodstream.

THE BEST MAGNESIUM FOR ORAL AND TRANSDERMAL USE Let's look at which ones will work the best. For topical use the best magnesium for transdermal delivery is magnesium chloride, the other forms are not as good. So if you are looking for one as a soak, or to use as magnesium oil for topical application look for magnesium chloride.

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What about taking magnesium orally? As the benefits of magnesium are become widely advocated an increasing number of people are turning to magnesium supplements to boost their intake of this vital nutrient, particularly to help them relax at night and improve quality of sleep. However, since magnesium must be bound to another substance before it can be adequately absorbed, magnesium supplements come in a number of different forms that provide different, or targeted, health benefits. This article takes a closer look at the best (and worst) forms of magnesium on the market today. Let's first look at the best forms of magnesium as a supplement:

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Magnesium citrate – Magnesium citrate is the most popular magnesium supplement, probably because it is inexpensive and easily absorbed. Since citric acid is a mild laxative, magnesium citrate functions as a constipation aid as well as a magnesium source. It is a great choice for individuals with rectal or colon problems, but is unsuitable for those with loose bowel movements. Magnesium taurate – Magnesium taurate is the best choice of

magnesium supplement for people with cardiovascular issues, since it is known to prevent arrhythmias and guard the heart from damage caused by heart attacks. Magnesium taurate is easily absorbed (magnesium and taurine stabilise cell membranes together), and it contains no laxative properties Magnesium malate – Magnesium malate is a fantastic choice for people suffering from fatigue, since malic acid – a natural fruit acid present in most cells in the body – is a vital component of enzymes that play a key role in ATP synthesis and energy production. Since the ionic bonds of magnesium and malic acid are easily broken, magnesium malate is also highly soluble.

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Magnesium glycinate – Magnesium glycinate (magnesium bound with glycine, a non-essential amino acid) is one of the most bioavailable and absorbable forms of magnesium, and also the least likely to induce diarrhoea. It is the safest option for correcting a long-term deficiency. Magnesium chloride – Though magnesium chloride only contains around 12 per cent elemental magnesium, it has an impressive absorption rate and is the best form of magnesium to take for detoxing the cells and tissues. Moreover, chloride (not to be confused with chlorine, the toxic gas) aids kidney function and can boost a sluggish metabolism. Magnesium chloride is also the best form to apply topically as an oil. Magnesium carbonate – Magnesium carbonate is another popular, bioavailable form of magnesium that actually turns into magnesium chloride when it mixes with the hydrochloric acid in our stomachs. It is a good choice for people suffering from indigestion and acid reflux, since it contains antacid properties.

THE WORST FORMS OF MAGNESIUM Magnesium oxide – Magnesium oxide is the most common form of magnesium sold in pharmacies, but it is non-chelated and possesses a poor absorption rate compared to those listed above. Magnesium sulfate – Magnesium sulfate, also called Epsom salt, is a fantastic constipation aid, but an unsafe source of dietary magnesium, since overdosing on it is easy. Magnesium glutamate and aspartate – Avoid these two forms of magnesium completely. Glutamic acid and aspartic acid are components of the dangerous artificial sweetener aspartame, and both of them become neurotoxic when unbound to other amino acids. ㄰

Knowing how the various types of magnesium affect the body will allow you to access the right one for the specific purpose you need it for. In my personal experience, I benefit both from topical as well as supplementing, as it is too valuable a nutrient to allow myself to become deficient. In terms of research, there are numerous academic papers that validate the role magnesium plays in health and disease prevention.

Ref: http://www.acatoday.org

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APJ 119

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Transiting at Singapore's Changi Airport By Mark Viney

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Internet services (15 mins) Enjoy a stroll in the world's first Butterfly Garden in an airport at Terminal 3 (20 mins) Get a FREE foot massage at the Foot and Calf Massage Stations across all terminals (15 minutes) Pick up fantastic gifts from a wide selection of accessories, cosmetics, fragrances, souvenirs, toys, fashion and books (30 mins) Grab a light and healthy meal at Quick Bites (30 mins)

3 to 4 hours Last month I found myself at Singapore's Changi Airport waiting eight hours for a connection. Normally I, like most people, try and limit the time taken for transit, as being stuck in an airport for eight hours is not my idea of fun. However, Changi Airport has the reputation as the world's best airport to spend time in, with an incredible list of things and places designed for the transit passengers. I searched Dr Google and came up with this site http://www.changiairport.com/in-transit/recommended-transferexperiences. By the way, there are numerous sites giving you this information and much more, with comments by former visitors. ㄰ 㤵㜵

RECOMMENDED TRANSFER EXPERIENCES With the exciting array of facilities, services, shops and dining offerings, you will definitely find something that meets your needs and guarantee an unforgettable transfer experience. Here's our recommendations based on your transit dwell time at Changi Airport.

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2 to 3 hours

Surf the Internet or send out some emails with FREE

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Try out a fish micro-massage therapy at the Fish Spa & Reflexology at Terminal 1 (30 mins) Try out the Signature Crystal Foot Mud with Oriental Foot Reflexology and Deep Tissue Massage (full body scrub + shower) at My Foot Reflexology at Terminal 3 (120 mins) Refresh with a quick shower at our Rainforest or Ambassador Transit pay-per-use lounges (20 mins) Have a go at the FREE Xbox 360 and PlayStation® 3 games at the Entertainment Deck at Terminal 2 (30 mins) Shop at the wide selection of fashion labels, gift choices and lifestyle brands (1 hour) Enjoy delicious gourmet dining at the wide range of restaurants (45 mins)

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4 to 5 hours

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Soak up the sun and take a refreshing dip in the rooftop swimming pool at Terminal 1 (30 mins) Get a new hairdo or manicure across all terminals (45 mins) Catch a blockbuster movie for FREE at the Movie Theatre at Terminals 2 & 3 (2 hours)

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ability to lose yourself in and behind these wonderful flowers. The indoor gardens had to be seen to be believed. With the gardens spread out over the various terminals, I decided to walk to stretch my legs, so by the time I had visited all of them and checkout the free movies playing in the two cinemas I had chewed through almost four hours. For those who don't want to walk between the terminals there is a free and very good light rail system. With tired legs and feet I ended up in Terminal 1 at the Fish Spa & Reflexology centre which is aptly known as the Airport Wellness Oasis. There I checkout their menu and settled on a combination treatment involving a 30 minute fish micromassage therapy, followed by a 30 minute foot reflexology and then a relaxing 90 minute

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Rediscover the beauty of nature at one of Changi's themed gardens across all terminals (15 mins) Tuck into a hearty meal and chill out at Harry's Bar or Hard Rock Cafe at Terminal 3 (45 mins)

More than 5 hours

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Sign up for a FREE Singapore Tour at Terminals 2 & 3 and take in the sights and sounds of Singapore, as well as get a glimpse into Singapore's ethnic heritage and tourist attractions. (2 hours) Try out the various cuisine from local, Asian and international dining outlets in the airport (45 mins) Don't miss out on some great buys from our wide range of duty-free products (1 hour) Catch a nap at one of our quiet Rest Areas or check into a napping facility (1 hour)

As you can see there is so much to do; and most of the things to do will not cost you anything but time. And all of them are inside the airport; through security and immigration. I would have loved to do the free Singapore Tour but my connection started after the last one departed for the day. So I decided to visit all the indoor and outdoor gardens, check out the free movies, browse the endless shops and take in a fish micro-massage therapy at the Fish Spa & Reflexology in Terminal 1.

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THE INDOOR AND OUTDOOR GARDENS

Although the afternoon was a little wet the outdoor gardens were spectacular. My favourite was the Sunflower Garden, with the

massage. The cost in Australian dollars was about $160.

30 MINUTE FISH MICRO-MASSAGE THERAPY I have been wanting to try fish micro-massage therapy for a long time but have had some questions about hygiene and other issues. However as part of my reading about Changi Airport on Dr Google, I had seen the fish micro-massage therapy being offered, so had researched the Singapore regulations and how they keep the tank and fish hygienic. This information reassured me that they were a safe option so had planned to have that treatment. As I was heading onto a cold Europe I had long pants on, so I had to roll the legs up to first wash my feet and legs with a special soap and then sit on the edge of the pool and put my legs into the water. It was OK but I would suggest that if you were wanting to try this you dress for the occasion.

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APJ 121

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My feet are not in the best condition when it comes to pedicures and I have strange toenails that I inherited from my mother, so there was lots of dead skin for the fish to nibble on. As soon as I put my feet and legs in the water I was swarmed by the tiny fish. If I moved my legs, all but a few determined ones would flee. So by keeping my legs and feet still I was able to get the maximum number of fish feeding.

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How do you describe the feeling? It is not unpleasant. Most of the time you just feel the flittering of the fish as they brush against your legs and feet. Then occasionally you feel a tingle

where they are chewing. This is not a treatment for those who have ticklish feet. The results on my feet was like they had been filed well with a fine file. All the roughness had been smoothed out and they were nice and smooth to touch. Was 30 minutes enough? Yes. By then I was getting bored and wanted to proceed to the next treatment.

30-MINUTE FOOT REFLEXOLOGY Asian foot reflexology is not about relaxing and pleasure. Having had a few I still remember the pain associated with them, especially with the swelling of your feet that accompanies air travel. The benefits are found afterwards, when you urinate out litres of fluid and your feet go back to their normal size and shape. The beginning was a pleasant soak in a Flower Essence. The produce blurb said, “The special formulation is suitable for all types of skin, especially porous and chemically treated, enhance your skin with extra moisture while keeping it healthy, soften”. Just what I needed after the fish! The result was a very relaxing foot bath with the water having gelatine-type particles in it. Then came the massage using the reflex points, and as much as my ㄰ 㤵㜵

therapist tried to be gentle, it still hurt as he hit the points. I tried not to jump around too much. The end result was the swelling in my feet went and my feet went back to their normal size.

RELAXING 90MINUTE MASSAGE The best was saved for last. I would like to wax eloquently and expound the finer details of this relaxing massage but, well, I relaxed very early on and slept through most of it, only being woken to turn over. I am not one to normally sleep during a massage. Did it relax me? Absolutely! The same male therapist that did the foot reflexology did the massage. I was presented with a very loose-fitting pair of shorts to change into and a sarong to cover myself. What I remember of his technique showed he was skilled in massaging. The 90 minutes were up way too soon. After fully enjoying my time at the Airport Wellness Oasis I headed to the Qantas lounge and had a light meal and then walked some more looking at electronics before it was time for my flight to Europe. How was my eight hour transit? Well it didn't seem longer than usual two to three hours, thanks to the great features offered by Singapore's Changi Airport.

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APJ 122

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