Leaders in Education
Autumn Volume 50 2022
Aesthetics Practitioners Journal is the official publication of the Aesthetics Practitioners Advisory Network PTY LTD.
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Australasian College of Health & Wellness Academic | Therapeutic | Aesthetic The Australasian College of Health & Wellness offers accredited degrees in Applied Health Science to help recognise you as an expert in the dynamic, rapidly changing field of Aesthetics. The Australasian College of Health and Wellness offers a total of six qualifications, including the Associate Degree in Applied Health Science (Dermal Therapy) and the Bachelor of Applied Health Science (Clinical Aesthetics). Here are your top three reasons to study with ACHW in 2022:
1. Stand Out in a Growing Industry
2. Achievable and Meaningful Learning
3. Accessible Study Options
When it comes to elevating your existing career or applying for new jobs from the broad opportunities offered by a rapidly growing industry, a higher education degree from ACHW enables you to truly stand out from the pack.
Become equipped with the knowledge and practical skills to make a difference in the lives of your clients as you learn how to build their confidence through the treatment of conditions such as dermatitis and pigmentation.
We strive to ensure that cost is not a barrier to your study, which is why we offer a range of scholarships for registered nurses, future leaders of the industry, and passionate industry newcomers.
Our diverse faculty of experts is without equal, including qualified and respected experts in Health, Wellness, Science, Education, Aesthetics, Business Administration, and Digital Marketing.
Our mixture of online learning and practical clinics enables you to study at your preferred pace while providing invaluable hands-on experience, with dedicated student support to help you every step of the way.
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Eligible students are also able to fund part or all of their degree through FEE-Help.
We have a total of 6 programs for you to choose from: Bachelor of Applied Health Science (Clinical Aesthetics)
Associate Degree in Applied Health Science (Dermal Therapy)
Undergraduate Certificate for Cosmetic Advisors
Undergraduate Certificate in Facial Care Fundamentals
Undergraduate Certificate in Health Care Communications
Undergraduate Certificate in Laser and Dermal Therapy Essentials
New Scholarships! Available for people already working in industry, those passionate about Dermal Therapy and Clinical Aesthetics, or applicants who are registered nurses. Our new scholarships are designed to support you in furthering your health science knowledge and clinical capabilities. Scan the QR code to download our course guide and learn more about our scholarships and higher education programs:
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IN THIS ISSUE AUTUMN VOLUME 50. 2022 BUSINESS, PERSONAL AND PROFESSIONAL DEVELOPMENT
28
16-17
58
LIGHT YEARS SKIN STUDIO
TIPS ON MENTAL WELLBEING
28-31 BEAUTY & BALANCE
80-81
34-35
ENJOYING THE JOURNEY TO BUSINESS SUCCESS
BREAKING THE MOULD OF TRADITIONAL STAFFING STRUCTURES
REGULATIONS, STANDARDS AND EDUCATION 10-13
90-92
APAN AESTHETIC CONFERENCE 2022
EXPLORING THE SAFE AND EFFECTIVE PATHWAY TO ADVANCED AESTHETIC PROCEDURES
42-43 THE MISSING LINK TO MANAGING INFLAMMATORY SKIN CONDITIONS
64-65 ROSE VERSUS ROSEHIP
76-78 THE POWER OF COLOUR IN COSMETIC TATTOOING
96-97 THE ROLE OF CAROTENOIDS IN SKIN PROTECTION AND IMPROVEMENT
64
98-99 PAEDIATRIC ATOPIC DERMATITIS
INDUSTRY REPORTS, NEWS, PRODUCTS AND COSMETIC MEDICINE 8-9
74-75
CEO REPORT
APJ JOURNAL REACHES ITS 50TH ISSUE MILESTONE
60-62
DEVELOPING A TREATMENT 82-85 PLAN FOR COSMETIC HELP! I AM LOSING INJECTABLES INJECTABLE PATIENTS TO CHEAPER SKIN CLINICS
60 APJ 4
68-71 PRODUCT INNOVATIONS
100-101 AESTHETIC BULLETIN
36 SCIENTIFIC RESEARCH, TREATMENTS AND TECHNOLOGY 18-19
48-50
THE MICROCURRENT REVOLUTION
HEAT SHOCK PROTEINS AND THEIR IMPORTANT CELLPROTECTIVE ROLE
20 LIVER HEALTH IN THE SPOTLIGHT AND THE ROLE OF MILK THISTLE
22-25 GLUTATHIONE AND ITS PRECURSOR NACETYLCYSTEINE
36-38 THE MULTIPLE AND AMAZING BENEFITS OF NIACINAMIDE
46-47 WEIGHT LOSS AND THE ROLE OF FAT CELLS IN MAINTAINING A YOUTHFUL APPEARANCE
54-57 QUALITY ESSENTIAL OILS FOR HEALING AND REGENERATION
86-89 WHY YOU SHOULD ENSURE A HEALTHY LYMPHATIC SYSTEM
102-105 SCIENTIFIC NEWS
Editor Dr Giulia D’Anna (07) 5593 0360 editor@apanetwork.com www.apanetwork.com
Printed For Aesthetics Practitioners Advisory Network ACN: 136 987 169 ABN: 25 136 987 169
Typesetting & Graphics Angus Thompson TEV Group Pty Ltd
Accounts Payable Aesthetics Practitioners Advisory Network PO Box 5448, Q Super Centre QLD 4218
Advertising & Marketing Tina Viney Phone: (07) 5593 0360 info@apanetwork.com Fax: (07) 5593 0367 Mobile: 0412 177 423 Aesthetics Practitioners Advisory Network PO Box 5448, Q Super Centre QLD 4218 Australia Publisher TEV Group Pty Ltd Design & Production Artwork and Editorial TEV Group Pty Ltd Unit 7D 76-84 Robina Town Centre Drive, Robina QLD 4226 Australia Phone: (07) 5593 0360 info@apanetwork.com Mobile: 0412 177 423
Journal Advisory Board Terry Everitt - Education Features Wendy Neely - PR and Marketing Dr Douglas Grose - Scientific Content National Advisory Council John Fergusson Terry Everitt Chris Testa Gill Fish Carole Jackson Julia Grinberg ISSN: 1836-9812 Pint Post Approved [100000257] Circulation 6900
Front Cover APAN AESTHETICS CONFERENCE info@apanetwork.com www.apanconf.com For further information see pages 10-13
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. 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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Dr Giulia D’Anna
EDITOR’S LETTER Are you as excited as I am? Bloom is coming!! The APAN conference on the Gold Coast is firmly within sight, and I am so looking forward to joining you in person this time. Normality is upon us, and connecting with other like-minded skin practitioners is just around the corner. Tina and the APAN team have put together a sensational program of speakers for you all. Some of the highlights include panel discussions from industry leaders that is sure to be insightful and thoughtprovoking. I cannot wait to hear what the panels will bring to the conference as the synergy of experts is always dynamic, bringing together thought-leaders at their best. I am also looking forward to listening to the conference both live and at home. APAN has really put together a magical line-up and an event that will provide exceptional value for everyone. Come along, or watch
at home in your own time. And your team can join too - for a small fee you can also register them as well. This helps to put your entire staff on the same page, and stimulate ideas that you can help improve performance. I think that the theme of the conference is so apt for the times too. After all the disruption that we have seen over the last couple of years, being able to develop our businesses during that time, should see us all flourish and create change that we might never have been able to achieve without those disruptions. I know that I came to look at the business closures as opportunity. I never take time off work, and those downtimes allowed me to work on my business because I could not work in the business. So now is the time to bloom! In the next couple of months, there is so much to explore and unravel. The federal election, moving into winter where skin demands change with the season, and moving further along through the pandemic, which hopefully should be classified as an endemic soon. Fingers crossed. On a final note, we have some fantastic opportunities coming up related to APAN membership that we cannot wait to tell you about. We are working to improve and evolve into an even more inclusive organisation. But more about that soon. In the meantime, make sure you come along and registered for the APAN conference, and make use of the APAN resources that are available to you. You have so much support and education available at your fingertips. We will keep working hard in the background. I look forward to meeting you at the APAN Conference, let’s make it a date!
editor@apanetwork.com www.apanetwork.com APJ 6
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contributers Terry Everitt
Katherine McCann
Dr Tiina Meder
aestheticeducators@gmail.com
k_mccann@me.com
tiina.orasmae@mederbeauty.com
Professor Terry Everitt is highly regarded for his extensive knowledge in evidencebased science. He is responsible for the Scientific News segment within APJ as well as his regular well-researched articles on all things aesthetics.
Gay Wardle gay@gaywardle.com.au
Gay Wardle is a qualified dermal clinician and a passionately trainer and educatior in skin analysis, consultation and advanced skin treatments. Her articles comprehensively cover these subjects.
Katherine McCann is a highlh experienced Cosmetic tattoo practitioner and trainer. She regularly contributes to thoughtprovoking cosmetic tattoo articles in APJ.
Jacine GreenwoodDrummond jacine@roccoco.com.au Jacine Greenwood-Drummond holds qualifications in nursing, cosmetic chemistry and is an internationally recognised educator on cosmetic ingredients. Jacine contributes articles on ingredient science.
Trish Hammond
Fiona Tuck
trish@thepinkroom.com.au
fiona@fionatuck.com
Trish Hammond is an award-winning blog and social media expert and a leader in her field within the aesthetics industry and beyond. She regularly presents educational articles on Social Media.
Dr Meder is a dermatologist based in the UK. She is renowned globally as an educator in aesthetic dermatology and a regulary conference speaker. Dr Meder contributes to APJ on dermatology topics.
Deb Farnworth-Wood deb@ultimateskinandbody.com.au
Deb Farnworth-Wood as our business expert responsible for APJ’s Business Wisdom column. Deb a business development experts with amazing achievements as a seriel entrepreneur.
Fiona Tuck is a highly respected skincare and nutritional expert and a regular speaker and educator on the skin, gut and the role of nutrition in optimising skin health. She contributes to APJ through her column Nutrition for Better Skin and Health.
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CEO’S REPORT
Tina Viney APAN CEO
Dear colleagues and friends, As we come to the end of the financial year, every business will need to carefully review its expenses and take advantage of their permitted deductions, seeking to identify those that they may have omitted to include. It is useful to carefully go through these with your bookkeeper, or accountant to ensure you take full advantage of your rightful entitlements. If your APAN membership has expired this is also a great time to renew it, as it will be considered as an immediate tax deduction. Additionally, your conference registration will also qualify as a taxdeductible investment, so there is no better time to complete your registration form and take advantage of this amazing event. Our team has worked hard on this project and I know you will immensely benefit from its incredible content. Please review the information presented in our cover story where we introduce the concept of Immersion Education. Tough times require new measures, and so we carefully reviewed the content of our conference to provide you with a well-rounded educational experience that will provide you with both the macro-perspective (the bigger picture of what is happening across the industry), as well as an opportunity to explore the micro-perspective and view in greater detail some of the finer details to perfect your current services. Being part of a personal services industry, your role is to provide both human support through your care and compassion, as well as improve and enhance your clients’ appearance through positive changes delivered through your skills and knowledge, and hopefully also improve your clients’ quality of life. You are constantly giving out to others. It’s now your turn to relax and allow us to provide you with an amazing program wthat will inspire you with the very latest in education, as well as support your wellbeing. This year our program has been extended to 45 segments. We have included five panel discussions as these will provide you with an incredible and unique opportunity to view how different experts can work together through their respective disciplines for a more advanced treatment outcome. We have eight international speakers from the UK, USA, New
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Zealand, and Finland. The calibre of speakers is world-class, and the content is both diverse and in-depth. If you wish to attend in person our first day will also be staged as a face-to-face event, so please join us for an exceptional experience. All segments will however be recorded, and you will be able to access and revisit the sessions of your choice as often as you wish for up to 30 days – how good is that? We are also expanding our CPD points to 30 this year that will be supported with a Certificate of Professional Development. NEW REVISED QUALIFICATIONS As the industry continues to expand, we now have the updated Beauty Training Package with the addition of a new qualification: • SHB50321 Diploma of Cosmetic Tattooing •
SHB60221 Advanced Diploma in Skin Therapies
The Qualifications and Units of Competency were approved and have been endorsed by the State and Territory Skills Ministers and are now available on the government website training.gov.au GROWING INCIDENCES OF ADVERSE REACTIONS AND THE NEED FOR ADVANCED EDUCATION Additionally, APAN has contributed to Letters of Support for a number of Registered Training Organisations who have developed their own Advanced Diplomas in Dermal Therapies, with some including comprehensive units in laser, IPL and other body shaping and light-based technologies including HIFU. The latter is now available through an Advanced Diploma through ClinicalPro. This is a great relief to APAN as we are seeing numerous incidences of adverse reactions due to poor training. This year I have been involved with numerous legal cases to provide expert advice by reviewing burns and scarring that have resulted in court cases against the practitioner or the business. My role has been to examine the protocols, client assessment and the method of delivery of the treatment to determine whether the adverse reactions were due to operator error. In all cases the practitioners had insufficient training to assess the correct setting for their procedure. There were also cased where Informed
“Whatever will be at the centre of your life will be the source of your security, guidance and power. Choose your values wisely.” Tina Viney
Consent was only verbally discussed with the client, but not documented, while Post-Treatment instructions were only casually given verbally. These sloppy practices invariably contributed to a patient’s non-compliance of the required aftercare with no real evidence in writing of what was instructed in the first place. Everything was hearsay “I followed the instructions I was verbally given”, but without any concrete evidence of what was communicated. We are working with medical grade devices, but when major skills gaps exist and an operator error occurs, without thorough education how is the operator able to determine where they have failed if they have insufficient knowledge on which to benchmark their procedure? As an industry, we need to understand that a product supplier has a responsibility to provide you with the knowledge of how to correctly operate a device in line with their specifications. However, this does not constitute a full qualification, nor will it often provide you with sufficient knowledge on how to appropriate the treatment setting and the sequence of protocols for a specific skin condition that may have unique requirements – only a qualification can provide you with that knowledge. Qualifications, especially those that move into higher learning, such as a degree that includes critical thinking units, will provide you with the analytical skills on how to correctly assess a treatment plan. Another common problem we are seeing that is very alarming is “trained” practitioners who are too busy, and choose to hand over a HIFU or a laser treatment to a non-qualified staff member to deliver with just a few instructions, but with no formal training and without any level of personal knowledge or expertise to perform that treatment. This is highly risky and irresponsible, not to mention unethical. It not only puts the client at risk, it also exposes the staff member to potential error. We have witnessed several cases of scarring as a result of handing a device to a non-trained junior member. These incidences can not only destroy the reputation of the business, but also the confidence of the poor junior, who just “did what she was told”. We also receive calls from staff members who find themselves in a dilemma where the boss insists they perform a treatment with a device for which they have received no training. This should not happen. It not only contravenes our CODE OF ETHICS, it also violates common sense. I am happy to say that we have not experienced such incidences with our members, as we encourage them to
operate with principles of best practice and we provide them with the support to do so. SEEK ADVICE WHEN PURCHASING A DEVICE Another issue that we are identifying is the incidences of burns due to device malfunction and poor-quality devices. Just because a company states that their devices are TGA approved, or listed, there are other issues that you need to consider. Please contact APAN before purchasing a device and gain expert independent advice. We have a list of reputable companies who adhere to our five-point quality assurance standards. A device is a serious investment, and it is important that you look beyond just the pricepoint to what you are investing in. Consider quality assurance, comprehensive training, ongoing support and servicing, as well the the distributor’s reputation. Also, if you feel you can’t afford a device, we can also assist you with reputable financial services. THE REGULATORY LANDSCAPE With the ongoing adverse reactions, there is movement on the regulatory front, especially with IPL and Lasers. I am not at liberty to announce anything yet, but I can assure you that the move is for qualifications to become the prerequites within new regulatory frameworks that are currently being explored. Looking to the future, it is best to invest in the highest level of training in the modalities that you use. Where qualifications exist seek to be reviewed for recognition of prior learning and pursue to upgrade your qualification for peace of mind. In closing, I wish you all every success in your professional and business endeavours and please take advantage of all the services that we provide you with through your membership. Continue to step up your knowledge, pursue smart business strategies and move forward towards your goals. With the right knowledge and ethics, you can be unstoppable. We are standing right behind you to achieve that. TOGETHER WE ARE STRONGER. Tina Viney Chief Executive Offier
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COVER STORY
INTRODUCING IMMERSION EDUCATION
APAN AESTHETICS CONFERENCE Over the past two year we have all experienced our fair share of turmoil. This has resulted in many of us craving to live our lives with structure, certainty and predictability. However, while this is a comforting state of being it has its limitations. As our world changes, moving forward requires that we also become comfortable with flexibility and have the courage to accommodate new concepts that will better suit the everchanging expectations of consumer needs. However, according to world-renowned business strategist and educator Stephen Covey, most all creative endeavours are somewhat unpredictable. They often seem ambiguous and somewhat “trial and error” – risks that most of us do not want to take. And unless people have a high tolerance for ambiguity, they will find it unnerving and unpleasant to be involved in highly creative enterprises. So, where can we turn to, to gain our security? According to Covey, security should be drawn from our ethics and integrity, as these should be the pillars of our stability that should not be subject to change. With ethics and integrity as our foundation, we can move forward with greater security, make wise choices and embrace new innovations that will help us make our mark through successful business ventures.
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In line with these principles this year’s APAN AESTHETICS CONFERENCE is expanding its program to include an amazing 45 segments, creating a platform for industry professionals and business owners to experience IMMERSION EDUCATION within an environment whose foundation is based on ETHICAL and CREDIBLE educational content. WHAT IS IMMERSION EDUCATION The term immersion means to be completely submerged into a liquid or water. When it comes to education, it related to being engaged wholly or deeply. The term is commonly used as a successful strategy in learning a new language. Language labs are considered the fasted and most effective way of learning a language. They involve a candidate entering a learning experience where they are totally immersed into an environment that submerges them into the new language without interpreters. This exposes them to all aspects of that language, not just a slow, logical explanation of every word, but a total immersion, including the cultural experience of that language. Using the immersion technique, candidates can gain the skills to speak another language within as little as two weeks. The premise of the success of this concept is based on the observation that a child can first learn to speak through experiencing language and not necessarily only through a logical explanation of the meaning of words. To prove that immersion is the most effective and fast way of learning a language, the same child can undertake a language lesson in school for two years and still not emerge speaking that language.
A UNIQUE LEARING EXPERIENCE The APAN AESTHETIC CONFERENCE offers a truly unique learning experience unlike anything else available to you. Here is how: • 30 DAYS OF VIEWING: Through your access code that will be sent to you, you will be able to access the various lectures for up to 30 DAYS after the program is launched on Monday 18th July. This will give you the opportunity to visit and revisit any segment you wish further review at your own pace. • REWARD YOUR STAFF: By purchasing your ticket, you can then reward your staff with their own Access Code at an extremely low cost, allowing them equal opportunity to expand their knowledge and gain inspiration and confidence in their profession. You can also use the extensive content of this event to engage their feedback on how to improve standards with your current services, strengthening the team momentum.
So, how will immersion education benefit you? Most professionals and business owners that attend a conference, aim to attend lectures on topics that they are already engaged in, or delivering in their practice. The objective is to learn how to enhance or improve their results. However, while this is essential, limiting their exposure to information on other modalities will lead to missed opportunities that can also benefit them. Consider the following: •
Identify business opportunities that will best harmonise with what you are currently offering
•
Learn about a new modality and objectively assess if you could benefit from expanding your scope of practice
•
Determine new areas that you can service your existing clients or access a potential new client demographic
•
Understand the standards to which a new service that you are considering to introduce through a contractor, must comply with
•
Gain a greater understanding of how the aesthetics industry is being defined and expanded through new advances
•
Immersion education is a valuable exercise if you are seeking to rebrand your business and expand your services in a way that is beneficial to your clients and profitable to you.
•
AFFORDABLE: APAN has deliberately kept the cost of attending affordable to ensure that during these difficult times businesses are not inconvenienced from attending because of prohibitive registration costs. This event is affordable for everyone.
•
FACE-TO-FACE EXPERIENCE: If you are longing to resume a conference face-to-face experience you can attend the live event on the first day 18th July at the Legends Mantra on the Gold Coast, this is promising to be an extraordinary experience for all concerns. You will get to meet some of our amazing speakers as well as several exhibitors who are keen to meet with you face-to-face. The buffet lunch we have for you will be legendary – we really know how to look after you.
There will be prizes and lots of fun, new industry update and an amazing time of sharing and learning. We guarantee this event will not only nurture and encourage you, it will also revolutionise the way you view your profession, help you make some amazing connections with companies that will help you shape your future plans with confidence for greater success. We are often asked if you need to be an APAN member to attend? The answer is No, all are welcome to this event - it is open to the whole industry and its representatives, however, APAN MEMBERSHIP will secure you a better rate. Here is a snapshot of the program. Please prioritise to register for Australia’s leading and most comprehensive educational event. APJ
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APAN AESTHETICS CONFERENCE
Launching Monday 18th July This three-day event will be available for viewing through your ACCESS CODE for 30 days. Full program available online, with the first day Monday 18th July, also available to attend inperson at the Legends Mantra, 25 Laycock Street SURFERS PARADISE, GOLD COAST.
MONDAY 18TH JULY - 8am – 6pm DAY 1 8.00AM REGISTRATION WELCOMING ADDRESS 8.15am – 8.30am
THE EVOLUTION OF COMPOUNDING FORMULATIONS FOR HEALTH, WELLBEING AND SKIN TREATMENTS Panel: Chris Testa, Ben Eshelby, Mary-Lour Condon, Tina Viney (moderator) 12.20pm – 12.45pm
Professor Michael Roberts opening address LUNCH 12.45pm – 1.45pm
8.30am – 8.45am THE MOST POWERFUL TOOLS FOR ELIMINATING BUSINESS UNCERTAINTY Karl Margrain 8.45am – 9.00am
COSMETIC AND FUNCTIONAL USES OF BOTULINUM TOXIN TO SUPPORT SKIN HEALTH AND PROVIDE LEADING RESULTS Dr Giulia D’Anna 1.45pm – 2.15pm
DIPLOMA OF BEAUTY AS AN APPRENTICESHIP Jenni Champion 9.00am – 9.30am
PROVEN STRATEGIES TO HELP YOU ACHIEVE GROWTH IN DIFFICULT TIMES Deb Farnworth-Wood 2.15pm – 2.45pm
ADVANCES IN DERMATOLOGY Associate Professor Michael Freeman 9.30am – 10.00am A MULTIDISCIPLINARY APPROACH TO TREATING A DIAGNOSED ACNE SKIN CONDITION Panel: Dr Michael Freeman, Gay Wardle, Jacine GreenwoodDrummond, Terry Everitt (moderator) MORNING TEA BREAK 10am – 10.30am AN INTRODUCTION TO ADIPOSE TISSUE STEM CELLS Dr Phillip Bushell-Guthrie 10.30am – 10.50am THE POWER OF THE MICROBIOME – UNLOCKING THE CHALLENGES OF THE PAST Jeffrey Flood 10.50am – 11.20am ACHIEVING GROUND-BREAKING RESULTS THROUGH LEADING MULTIFUNCTIONAL TECHNOLOGY Metro-Dora Clifford 11.20am – 11.50am HARNESSING THE POWER OF THE MICROBIOME IN YOUR SKINCARE: MYTHS AND FACTS Ben Eshelby 11.50am – 12.20pm APJ 12
THE SKILLS DEMAND: WHY RECRUITMENT IS GETTING TOUGHER AND WHAT TO DO ABOUT IT Angie Gaffney 2.45pm – 3.00pm TREATING ROSACEA AND COVID-AFFECTED SKIN CONDITIONS Jacine Greenwood-Drummond 3.00pm – 3.30pm NOURISING YOUR MIND FOR RESILIENCE AND SUCCESS Nicky Wood 3.45pm – 4.15pm AFTERNOON TEA BREAK 4.15pm – 4.30pm RASING THE QUALIFICATION STANDARD IN COSMETIC TATTOOING Robert McGowan 4.30pm – 5.00pm CONFESSIONS OF A COSMETIC NURSE 5.00pm – 5.30pm Annalise Rose
DAY 2 (ONLINE ONLY) MEDICAL MICRONEEDLING FOR TREATING PIGMENTATION: PROTOCOLS FOR SUCCESS Lisa Paone THE IMPACT OF COVID-19 ON COSMETIC DERMATOLOGY Emeritus Prof. Laurence Walsh THE NEW ERA OF CONVERGENCE PROTOCOLS Gay Wardle ETHOS, PURPOSE AND PROFESSIONALSM Tina Viney THE BIOLOGY OF AGEING Mary Katsas DIVING DEEPER INTO SPF Prof. Terry Everitt MENOPAUSE, HOT FLUSHES, STRESS AND THE SKIN Dr Tiina Meder (U.K) MICROBLADING FOR MEN – THE EUROPEAN TECHNIQUE Anna Ocko MANAGING MASSETER HYPERTROPHY AND TOOTH GRIDING USING INJECTABLES – A COMMON PROBLEM DURING THE COVID-19 ERA Dr Giulia D’Anna GET REAL WITH INSTAGRAM REELS Trish Hammond THE GUT/SKIN AXIS AND ITS IMPLICATION IN ACNE Fiona Tuck BOTCHED INK: EYELINER AND COSMETIC TATTOO REMOVAL AND CORRECITONS Katherine McCann STEM CELL INTERACTION ON INTENTIONAL AND NONINTENTIONAL WOUNDS Dr Greg Maguire (USA)
MICROCURRENT: MITOCHONDRIAL FACIAL SCULPTING David Suzuki (USA) TREATING SKIN AND ENHANCING CLIENT CONNECTION THROUGH THE POLYVAGAL LENS Pia Kynoch WINNING STRATEGIES FOR BUSINESS GROWTH Panel: Andrew Lim, Darlene Ogara, Lisa Conway, Leah Coughlan ARE BIGGER LIPS BETTER? THE SIX S’s OF CREATING ATTRACTIVE LIPS WITH DERMAL FILLERS Dr Gavin Chan NEW ADVANCES IN EQUIPMENT FOR PMU AND PIGMENT SAFETY June Warry HOW TO ENSURE YOUR NEW TEAM MEMBER IS THE RIGHT FIT FOR YOUR BUSINESS Lisa Conway
KEYS TO FUTURE-PROOFING YOUR BUSINESS Matthew Williams
EVIDENCE-BASED SKINCARE INGREDIENTS FOR COMBATING SKIN INFLAMMATION Dr Donna Marcal
SCAR CAMOUFLAGING TECHNIQUES THROUGH MEDICAL MICROPIGMENTATION Jenni Maatta (Finland)
CLEAN UP YOUR MENTAL MESS Dr Caroline Leaf (USA)
UNCOVERING THE CHALLENGES FACING COSMETIC TATTOOING – RISKS AND OPPORTUNITIES Panel: Liz McGowan, Maya Ercegovac, Anna Ocko, Tina Viney, Katherine McCann (moderator) THE NEW JOURNEY IN ACHIEVING THE PERFECT EYEBROWS Michaella Messenger (New Zealand)
DAY 3 (ONLINE ONLY)
IT’S AN EYE OPENER – DESIGNING THE PERFECT EYELINER Amanda Kay Semenoff (New Zealand)
INCREASING SKINCARE SALES IN YOUR PROFESSIONAL CLINIC ENVIRONMENT Louise Thomas-Minns (UK) REJUVENATION SOLUTIONS FOR A MATURE SKIN WITH COMPLICATIONS Panel: Dr David Kosenko, Sally Park and Rebecca Habersgberger, Terry Everitt (moderator) All delegates with receive a Certificate of Professional Development as well as 30 CPD points this year. If you require accommodation, please complete the online Registration Form and receive the special discount rate of $150 per deluxe room. APAN AESTHETICS CONFERENCE 07 5593 0360 | info@apanetwork.com | www.apanconf.com
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STAR PERFORMER
GROW YOUR BUSINESS WITH
TEETH WHITENING Now is the perfect time to consider getting into the lucrative teeth whitening industry as the demand is huge and continues to grow. Teeth whitening is one of the most profitable beauty treatments you can offer your existing, as well as your potential new clients and is not time-consuming like many other treatments. The machine and the gel do most of the work for you and your clients will be thrilled with the results of 5-14 shades whiter in just one treatment. For decades dentists have been offering teeth whitening and charging up to $1,200 for a treatment. Now you can add teeth whitening to your treatment menu without being a dentist. Salons and clinics charge up to $500 for a treatment depending on their clientele demographic. Considering the product-cost of each treatment is only $16.95 the profit is massive. Most people prefer to go to a beauty professional for teeth whitening as the experience is more pleasant, while the results are the same. When choosing a teeth whitening supplier it is important to ensure the products and equipment are complaint with Australian standards. Teeth Whitening Wholesale is one of the few suppliers who are fully insured and fully compliant with Australian regulations to supply teeth whitening products to beauty professionals. We have years of experience in the industry and have mastered the art of providing both quality and affordability. Our teeth whitening products are designed to work quickly, safely and effectively on people of all ages. Over 4,000 salons and clinics in Australia are already offering our products to their clients. We are one of Australia’s largest suppliers to salons, clinics and mobile technicians and offer private-label branding and promotional material as well as comprehensive online training to get you started. The teeth whitening industry is worth an estimated $19 Billion per year worldwide and is one of the most popular cosmetic procedures today. People are becoming more aware of the great results of cosmetic teeth whitening which has become part of their regular beauty regime. You will find that most clients will want a treatment every 2-3 months, which means repeat business can be expected.
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Our teeth whitening system will give you the confidence of offering the best products available to your clients in Australia today. Even a dentist cannot create a better result for their client. TRAINING FOR YOUR ENTIRE STAFF Our teeth whitening kits come with complete online training so you and your staff can be a trained teeth whitening professional in no time. With unmatched service and quality, regulatory compliant products and equipment you will be able to achieve the best possible results. Teeth Whitening Wholesale is the leading supplier of teeth whitening products for beauty salons and clinics in Australia. This means that with just one purchase of our system, you can equip your salon or clinic and make this popular treatment available to your clients. We offer the latest in teeth whitening technology that is not only easy to use, but also affordable. By purchasing a teeth whitening system with us you will have everything you need to get started. Our products will give you amazing results and our comprehensive online training will give you the confidence to breeze through your first few clients. We are leaders in providing the latest equipment for salon and clinic professionals and our business starter kits are the easiest and most cost-effective way to introduce this lucrative business of teeth whitening. We understand our clients have different needs and objectives, so we are here to assist you every step of the way. We offer free marketing material to help you get clients. Looking after our clients is a crucial part of our business because we know if we help you create a successful business you'll keep coming back. APJ TRUST US WITH YOUR CUSTOMER’S SMILE! TEETH WHITENING WHOLESALE 0450 341 007 www.teethwhiteningwholesale.com.au
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MEMBER PROFILE
LIGHT YEARS SKIN STUDIO A New Era for Dalene O’Gara There is no greater inspiration than to hear from our members about their incredible experiences and how they overcome challenges through new innovations and advances. These stories are always appreciated, and we get numerous reports of how they encourage others within the industry to pursue their own dreams and goals.
business. It also enabled me to launch a government accredited training academy to support the expanding Medi-Aesthetic and Laser Industry.
In this issue we are delighted to feature the amazing journey of Darlene O’Gara.
I was recently offered an exciting opportunity to join the fantastic team at Light Years Skin Studio in Queensland, as Operations Manager. My roles include assisting business growth and development as well as developing and implementing training to support the business and our new and existing team members. Having enjoyed 13 years in my previous role on the Gold Coast, the timing of this new career opportunity and business partnership was just perfect, as I had planned a relocation to Brisbane and the Light Years business was expanding to a new studio location in Woolloongabba. I had been exposed to many different beauty business models and this fresh, new studio design and concept for the future of skinreally excited me.
APJ Q1: DARLENE, TELL US A LITTLE ABOUT YOUR BACKGROUND AND HOW YOU FIRST GOT INVOLVED IN THIS INDUSTRY? I was Born in Scotland, and from a very young age I loved all things beauty, hair, nails, and make-up! I followed my passion and obtained qualifications in Hairdressing, Advanced Diplomas in Beauty, Remedial Makeup, Electrology and Supervisory Management. As travel was a huge passion for me, I applied for a role with Steiner Maritime division and was successfully placed as a beauty therapist on board the luxury cruise liner QE2. Travelling the world for over two years, doing a job I just loved so much was such a fantastic experience! I couldn’t shake the travel bug, so I made plans to come to Australia for a year. That was in 1992 and I’m still here! In my 30+ years working in the beauty industry, I have been fortunate to have worked in and managed many high-end salons and day spas, treating people from all around the globe including many well-known celebrities. I then moved into the exciting world of Medi-Aesthetics and was fortunate to be given the opportunity to assist in the creation of a multi-national laser and skin franchise APJ 16
APJ Q2: WHAT DROVE YOU TO START YOUR OWN BUSINESS AND WHAT IS YOUR BUSINESS MODEL?
Light Years Skin Studios focus on offering a select menu of high performance 30-minute skin treatments combining the powerful effects of LED Light Therapy to provide quick, effective, and affordable results for everyone. The benefits extend to cosmeceutical skincare and nutraceutical internal dietary support to combine a synergistic approach to total skin health and wellness for our clients. APJ Q3: FROM YOUR PAST EXPERIENCES WHAT IS THE MOST IMPORTANT LESSON YOU HAVE LEARNED THAT WILL ALLOW YOUR BUSINESS TO BE DIFFERENTIATED FROM OTHER CLINICS? In my experience many salons offer a huge array in diverse beauty services, in fact some menus can be overwhelming for the consumer to know what is even right for them, given so many
options. At Light Years we keep the concept simple, we have an inclusive environment, where we nurture and service our client, and truly specialise in skin. Light Years have created a fresh, new approach to LED light therapy providing custom-built LED cocoons and a $55-per week subscription membership with a non-lock-in contract, to promote the highly effective results from regular medical grade LED Light therapy treatment. Through these regular visits in-studio, our experienced skin technicians can invest quality time to really know our customers well, guiding them closely on their skin journey. Our business model also provides extended trading hours over 7 days to allow clients true flexibility to choose the best times to suit their personal schedules. This is a big plus and our clients really value our extended availability. As studio appointments are on average just 15-30 minutes, these offer quick and easy commitment to achieve healthy skin, which really suits clients with busy schedules. APJ Q4: IN YOUR OPINION, HOW HAS THE AESTHETICS INDUSTRY EVOLVED OVER THE PAST SIX YEARS IN TERMS OF ADVANCES IN COSMETIC FORMULATIONS AND TECHNOLOGY? It really is such a very exciting and evolving industry; throughout this time, I have watched the trends move from a more traditional hands-on approach to more scientific equipment-based services, and more recently, the trend to a blend of both! With so much more detailed information available to consumers on the internet, social media, podcasts and blogs, our consumers are much more aware of technical advances and as a result are sourcing salons and clinics that provide both high-quality equipment and well as knowledgeable and skilled staff to help them navigate what’s best for them and be confident in explaining and delivering the various services. APJ Q5: DO YOU BELIEVE THAT THE PANDEMIC HAS IMPACTED CONSUMER SPENDING, OR DO YOU BELIEVE THAT QUALITY SERVICES WILL ALWAYS ATTRACT THE RIGHT CONSUMER WHO IS WILLING TO INVEST IN THEIR APPEARANCE AND WELLNESS? WHAT IS YOUR EXPERIENCE?
indefinitely. This was such a difficult time for everyone. We opened our new Brisbane location during this challenging COVID period, so I have experienced first-hand how the pandemic has impacted and changed regular business activities as we knew them prior to the pandemic. However, as the government restrictions eased, we observed several changes in consumer behaviour. As many clients were now doing business and interacting with family and friends via zoom meetings, they were regularly seeing themselves on screen and they started to become more self-conscious of their appearance. From our observations, clients are now clearer about achieving a more refreshed and youthful look. Another change we have observed is with our appointment diaries. Many of our clients who have transitioned to working from home, now have greater time flexibility. This has resulted in Mondays becoming one of our busiest days instead of the traditional Saturday. Additionally, we are also finding that our clients are more and more treating their visit to the clinic as valuable time-out for wellness, listening to their favourite music or podcast and just relaxing. It is no longer just about their skin treatments. APJ Q6: WHY HAVE YOU CHOSEN TO BECOME A MEMBER OF AN INDUSTRY STANDARDS BODY/ASSOCIATION AND WHAT DOES YOUR APAN MEMBERSHIP MEAN TO YOU? I believe it is important to be connected, to have the available support of APAN for up-to-date industry information, changes to industry regulation and we really enjoy the networking and education opportunities it provides. We never stop learning and that is why I love this amazing industry! You can also hear Darleen at the APAN Conference Business Panel. APJ
LIGHT YEARS SKIN STUDIO www.lightyearsskinstudio.com.au
Our industry was heavily affected by the pandemic, with many businesses closed for extended periods of time due to the government’s COVID restrictions, while other closed their doors
APJ 17
STAR PERFORMER
THE MICROCURRENT REVOLUTION
the facial treatment
OF YOUR FUTURE SKIN No technological advancement in the last 50 years has changed the face of the professional beauty industry more than microcurrent. Applauded for its transformative results, its safety and the fact that it is non-invasive, microcurrent mirrors the body’s own natural low level electrical current and in just one treatment, is able to dramatically tone facial contours, leave skin plump, hydrated and firm.
PROVIDING A DIVERSE RANGE OF TECHNOLOGIES
Established almost 50 years ago, BioTherapeutic are pioneers of microcurrent technology, innovating at the intersection of technology and the skin. It was founded by James Suzuki who is based in Seattle, Washington. Suzuki was fascinated by the electrical system and signals of the body and wanted to create a technology that could harmonise with the electrical frequencies of the human body, helping it upregulate what it was already designed to do – regenerate, renew itself and heal.
True microcurrent for aesthetics is defined as technology that uses less than 300 uA, combined with bespoke wave shapes and patented sequencing frequencies that harmonise with the electrical system of the human body, resulting in a tremendous increase in the production of cellular energy in the form of ATP.
Today we call this technology microcurrent. As President of the business, James Suzuki's son David is a licensed aesthetician, a recognised expert in medical and aesthetic devices, as well as an expert in manufacturing and regulatory issues. Bio-Therapeutic announced their partnership with Professional Beauty Solutions (PBS) in 2021, forming a partnership between two professional organisations with a focus on quality, results, and profitability. As a result of this partnership, Australian skin therapists gained access to cutting-edge, patented microcurrent technologies that would benefit their treatments by delivering effective, immediate, and long-lasting outcomes with minimal invasiveness.
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Bio-Therapeutic’s range of technologies includes microcurrent facial toning systems, wet/dry microdermabrasion, microexfoliation and a handheld line that includes microsonic cleansing and ultrasonic exfoliation tools for skin professionals and consumers. During a recent interview with Bio-Therapeutic's President David Suzuki, we spoke with him about microcurrent, the Suzuki Sequencing patented technology, and what differentiates Bio-Therapeutic from other facial devices on the market. WHAT IS TRUE MICROCURRENT?
HOW IT WORKS Microcurrent is applied to the face and neck with accessories such as probes or electric gloves, moving through a series of kinesiology techniques that lift and sculpt the face. The second step of a true microcurrent facial consists of skin work application techniques, in tandem with ampoules, serums, and saturated infusion sheet masques. True microcurrent services can be performed as a single feature service, in a mini-series of 2-4 services, or in a comprehensive series of 4-8 services for our mature clients. MICROCURRENT’S MECHANISM OF ACTION Clinical studies have proven that Bio-Therapeutic frequency specific to microcurrent has the ability to permeate the cell membrane and create a proton gradient across mitochondria, effectively allowing the mitochondria the ability to fully use this external source of energy as its own. The result is an increase of mitochondrial activity that increases ATP (adenosine triphosphate) production by as much as 500%. ATP is the single energy source of the human body that is responsible for all functions of life including membrane transport, protein synthesis, glycosaminoglycan synthesis, collagen and elastin synthesis and increased blood circulation; processes that have a profound effect on the texture, luminosity, and visual appearance of the skin. Bio-Therapeutic microcurrent services are also well known for their ability to sculpt, contour, and lift the face. As Bio-Therapeutic microcurrent uses less than 300 uA, it will not cause a contraction of the muscle via the electrical current. Sculpting, lifting and contouring is made possible by using microcurrent in tandem with physical kinesiology movements that shorten and lengthen the various muscles of the face. These physical techniques combined with the increased level of ATP help reinforce the targeted muscles to stay in their newly contoured position for a longer period of time.
WHAT ARE THE BENEFITS AND RESULTS? Because of the effect that Bio-Therapeutic microcurrent has on the mitochondria, the benefits are vast and truly go beyond the excitement of what is possible after the first service. Benefits include: •
be applied to the tissue during each service. This technology ensures that although each person is frequency unique, they will still achieve gains with Bio-Therapeutic technology.
Facial sculpting, contouring, and lifting
•
Diminished appearance of fine lines
•
Reduction of pore size
•
Improvement of skin texture, color, and luminosity
HOW IS BIO-THERAPEAUTIC MICROCURRENT DIFFERENT THAN OTHER ELECTRICAL MODALITIES, INCLUDING ELECTRICAL MUSCLE STIMULATION? As the word microcurrent is a measurement of energy, all technology that puts forth electrical energy of any type can be measured in microcurrent, allowing a wide-open pathway for a plethora of misleading marketing. Electrical Muscle Stimulation (EMS) is often disguised as true microcurrent in professional technology, and especially home use technology. EMS uses a high level of energy to shock the nerve motor points, forcing the muscle to contract and expand. As the technology continues to shock the muscle, the body perceives this unnatural surge of electrical current as damaging. To defend itself, the body locks the muscle into a contracted position. Initially this appears to be an outrageously tightened muscle, and a good result. However, using high levels of electrical current are scientifically proven to be harmful to the human body and effectively shut down the entire mitochondria cascade, eventually leaving the skin and muscles slack, flaccid and lifeless. HOW IS BIO-THERAPEUTIC TECHNOLOGY UNIQUE WITH ITS PATENTED INTELLIGENT, INTERFERENTIAL AND SUZUKI SEQUENCING TECHNOLOGY? Bio-Therapeutic is significantly different than any other microcurrent modality on the market today with its patented innovations including: •
Two independent channels of frequency specific energy that together create an interferential cross current.
•
Biofeedback smart technology that measures the level of conductivity, resistance and microcoulombs. These three precise measurements allow for Bio-Therapeutic technology to automatically recalibrate its output energy 1024 times per second, which ensures precise and accurate frequency exposure at all times.
•
Suzuki Sequencing technology, which allows for unlimited frequency combinations to
WHY IS BIO-THERAPEUTIC MICROCURRENT ONE OF THE MOST EFFICIENT AND EFFECTIVE MODALITIES FOR FORWARD-THINKING SKIN PROFESSIONALS? While there are many modalities, products, and procedures to choose from with regards to age management, there is nothing else available on the market today that has the ability to reinforce and stimulate the mitochondria. As ATP is the single energy that powers all functions of life, including those that effect the appearance of our skin, there is no other technology that is as important for us as skin therapists. Science has confirmed the “energetic theory of ageing”, which concludes that the ageing process is in fact a collection of damage that the body can no longer repair in real time, due to the deterioration of mitochondria activity as we age, and in turn a depletion of our ATP stores. In addition, there is no other technology available that has the capability to sculpt, lift, or contour the muscles of the face. While injectables, invasive technology, and surgical procedures have a place in the world of age management, BioTherapeutic must remain a constant foundational technology and services that we maintain. APJ BIO-THERAPEUTIC Distributed by Professional Beauty Solutions 1800 625 387 www.biotherapeuticaus.com.au David Suzuki will be speaking at the APAN Aesthetics Conference. APJ 19
RESEARCH
LIVER HEALTH IN THE SPOTLIGHT
and the role
OF MILK THISTLE Dr Felix Zhang Nutrition Medicine Scientist and Director, Research & Development at BYHEALTH
scientific studies to support the improvement of liver function and health.
One of the most important organs in the body is the liver. It is responsible for routinely executing hundreds of life sustaining body functions daily. The liver acts as the body's personal chemical power plant, processing everything that you eat, breathe, and absorb through your skin. Some of the activities of the liver include: •
Produces bile, a substance that allows the body to digest fats, vitamins and nutrients.
•
Creates clotting factors, which help stop cuts from excessive bleeding. Without the liver’s clotting factor, a simple paper cut could result in an ER visit!
•
Creates immune factors, which protect you from infections, and help you get well when you do get sick.
•
Regulates hormone function in the body.
Milk thistle fruit is also indicated for mild digestive disorders, with some studies showing it to possess hepatoprotective, antioxidant and cholerectic properties. It is rich in antioxidants silymarin and silybin that react with free radicals (e.g. reactive oxygen species) transforming them into more stable and less reactive compounds. MILK THISTLE AND SKIN HEALTH Research suggests that the antioxidant and anti-inflammatory potency of the milk thistle seeds and its polyphenols (flavonolignans) may make it a suitable candidate for modulating processes associated with photo-ageing., Over the last 30 years, silymarin, a standardised extract from Silybum marianum seeds, has been studied for its dermatological application, namely for its UVB-protective properties. However, given that most solar UV radiation stems from UVA radiation further studies on milk thistle are warranted. In 2018, researchers from the Czech Republic publishing their findings in Archives of Dermatological Research demonstrated that silymarin and silybin may prevent UVA-induced damage to normal human dermal fibroblasts. MILK THISTLE FOR LIVER HEALTH
•
Filters the blood, clearing away and excreting toxins like drugs, alcohol, and poisonous substances.
•
Gives you energy, by producing carbohydrates and converting glucose into glycogen that is stored in muscles.
•
The liver also acts as a storage centre for nutrients, vitamins, and carbohydrates.
Milk thistle (Silybum marianum is one of the oldest known herbal plants, and has been widely used in traditional European medicine for over two thousand years, especially for supporting liver health. It is derived from the milk thistle plant which has been shown in
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Milk thistle's traditional reputation as a liver tonic is now supported by research showing that its constituents protect liver cells from chemical damage. Liver health is one of the fastest growing wellbeing focus areas in Australia. Research shows the number of Australians facing liver health challenges is projected to increase by 25 per cent by 2030 according to medical research conducted by the University of Western Australia with experts now shining the spotlight on evidence-based natural ingredients to help support liver health to help reduce the burden on the economy. APJ Article submitted by Dr Felix Zhang - Nutrition Medicine and Science, Director, Research Development at BYHEALTH. www,by-health.com.au
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INGREDIENT SCIENCE
GLUTATHIONE AND ITS PRE-CURSOR N-ACETYLCYSTEINE
offering solutions for skin conditions Jacine Greenwood-Drummond Whether we are attempting to improve the appearance of the skin or optimise the body’s overall health, understanding the role of nutrition is of great importance to us. While vitamins play a key role, paying particular attention to components that can orchestrate activities in the body as master regulators is of paramount significance. In this article Jacine GreenwoodDrummond explains the role of Glutathione and NAcetylcysteine. As we are aware, Glutathione is the skin’s master antioxidant that protects every cell of the body, while N-Acetylcysteine is the precursor for the development of Glutathione. Oxidative stress is a process that is regularly occurring in the body and is associated with cellular death and damage to DNA, cellular proteins and lipids. Antioxidants can decrease the number of free radicals present by reducing their amount or neutralising their deleterious effects. Meanwhile, Glutathione is a potent modulator of the immune system and assists with wound healing. It is a tripeptide made up of cysteine, glycine and glutamic acid and it is found naturally in fresh leafy vegetables, fruit and nuts.
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Glutathione is so valulable to skin and overall health because of the important role it plays in the body’s detoxification process and in the reduction of inflammation – all critical factors in both skinhealing as well as skin rejuvenation. Here are some of the key roles of glutathione: 1. Neutralisation of singlet oxygen, hydroxyl radicals and superoxide radicals. 2. Regeneration of vitamins A, C and E. 3. Transportation of mercury out of cells. 4. Regulation of cellular proliferation and apoptosis. 5. Critical for mitochondrial function and maintenance. Glutathione differs from other well-known antioxidants in that it is the most concentrated intracellular antioxidant. It has a high electron-donating capacity, being able to not only regenerate itself
but also other antioxidants such as Vitamin A, C and E – this is of incredible benefit to skin health. It is also the only non-enzyme antioxidant that does not of itself become a free radical after it has neutralised a free radical – that is also significant when understanding the benefit of glutathione. OXIDATIVE STRESS - THE CONTRIBUTING FACTOR TO SKIN DISORDERS Many dermatological skin conditions have shown that oxidative stress is a key contributing factor to their development. Conditions such as rosacea, vitiligo, seborrheic dermatitis, acne and pigmentation all have oxidative stress as a contributing factor to their formation. Studies have shown that levels of plasma glutathione are significantly decreased in patients with melasma compared to control groups. Lower levels of plasma glutathione have also been seen in patients with vitiligo, acne vulgaris and alopecia areata. Exposure to UV radiation has a cytotoxic action of skin cells and damages DNA. Studies have shown that glutathione has a protective action against the damaging effects of UV radiation. Glutathione has also been shown to clinically reduce the signs of photo-ageing of the skin. According to a randomised, double-blind study by Watanabe et al on Filipino women with a baseline facial melanin index value of 200 to 350, topical application of a glutathione lotion effectively reduces wrinkle formation and increases the levels of skin moisture. GLUTATHIONE AND SKIN LIGHTENING The role of glutathione as a skin-lightening agent was an accidental discovery during treating of chronic diseases with Glutathione. Glutathione works on pigmentation in three ways: •
Tyrosinase is directly inhibited through chelation of copper
•
Glutathione interferes with the transfer of tyrosinase to premelanosomes, a prerequisite for melanin synthesis
•
Tyrosinase inhibition is affected indirectly via its antioxidant action.
In essence, glutathione shifts melanogenesis from eumelanin to phaeomelanin synthesis. The effectiveness of both topical and oral glutathione has been shown in several studies. LET’S LOOK AT THE ROLE OF N-ACETYLCYSTEINE (NAC) N-acetylcysteine is the precursor for the production of glutathione in the body. N-acetylcysteine (NAC) has been used for dermatological purposes in trials and case reports and is a safe option for the treatment of skin disorders. It has been effective as an adjuvant trichotillomania, ichthyosis, dermatitis, melasma, alopecia, connective tissue diseases, skin picking, excoriated acne, and protection against photo-ageing skin damage. N-ACETYLCYSTEINE (NAC) AND ACNE N-acetylcysteine (NAC) has been shown to play a role with reducing the severity of acne symptoms by lowering oxidative stress and lipid peroxidation. The pathogenesis of acne results in the generation of reactive oxygen species such as hydroxyl radicals and superoxide anions which cause tissue injury at the site of inflammation. These free radicals are also well known for causing oxidative damage to lipid molecules. A study by Shoabili et al (2014) investigated the levels of oxidative stress biomarkers in acne vulgaris patients with varying severities. The study involved 156 patients with acne and 46 healthy human controls. Based on clinical examination, patients were grouped into three subgroups
as follows: mild, moderate and severe acne. Oxidative stress was examined by measuring plasma levels of catalase (CAT), superoxide dismutase (SOD), total antioxidant capacity (TAC), and malondialdehyde (MDA). Plasma levels of MDA in acne patients were significantly higher as compared with that of the controls, whereas activities of the antioxidant enzymes SOD and CAT were lower. Moreover, the total antioxidant capacity was also low in acne patients as compared with that of the controls. Higher MDA levels in the severe acne subgroup as compared with that of the mild and moderate subgroups were also observed. Furthermore, in the severe acne subgroup, a significant negative correlation was observed between MDA and CAT levels. The data suggests that oxidative stress plays a key role in acne progress and may be employed as a biomarker index to assess the disease's activity and to monitor its treatment. The effectiveness of both oral and topical NAC has been assessed in studies and it has been shown to help improve inflammatory acne lesions by reducing reactive oxygen species (free radicals), inhibiting leukotrienes and prostaglandin, stabilising membranes, and inhibiting lipid peroxidation. The studies conducted on the applications and effectiveness of NAC on acne and its complications, including excoriated acne and its functional mechanisms and potential anti-fibrotic effects. It also wanted to review how NAC may be able to moderate scarring, a side-effect of acne. In reviewing the effects that NAC has in treating acne and its side-effects, the study was seeking to identify the special place that NAC could play in complementary therapy in controlling acne. In the normal follicle, the keratinocytes are shed as single cells to the lumen and then excreted. In acne however, keratinocytes hyper proliferate and are not shed as normal. They also become densely packed along with monofilaments and lipid droplets. Comedogenesis occurs when abnormally desquamated corneocytes accumulate in the sebaceous follicle. N-acetylcysteine has been shown to exert an inhibitory effect on the fibroblast cells by reversibly blocking the early phase of the cell cycle. This makes n-acetylcysteine a potential drug for preventing and reversing fibrosis. It also inhibits proliferation of human keratinocyte and has found utility in hyperproliferative diseases. The effect is due to the anti-proliferative effects of n-acetylcysteine which diminishes the hyperkeratosis. While N-acetylcysteine helps improve inflammatory lesions of acne by quenching reactive oxygen species, inhibition of leukotrienes and prostaglandins, stabilisation of membranes and inhibiting lipid peroxidation, its effect on comedones has been described as very poor, which can be due to reduced sebum or inhibition of oval Pityrosporum (a potential comedogenic organism that has been detected in comedones). A single-blind randomised study conducted in Iraq showed a significant reduction in the number of inflammatory lesions in 14 patients treated with 1200 mg of NAC compared to the placebo group. Another double-blind study showed a significant reduction in the number of comedones in a group of 65 patients receiving NAC 5% gel over eight weeks compared to the control group of 34 patients. NAC – AN AFFECTIVE DISRUPTOR OF BIOFILMS For over 40 years, the colonisation of P. acnes in patients with acne vulgaris has been treated with topical or oral antibiotics, thus leading to the increased prevalence of antibiotic-resistant P. acnes strains. In addition, P. acnes' ability to grow in a biofilm can protect it from the host's defenses and make it more resistant to antimicrobial medications, which creates the need for more effective new antimicrobial treatments, not resistant to bacteria. APJ 23
Biofilms are responsible for acute and chronic events in infections of the airways. The difficulty of eradicating biofilms with oral antibiotics has encouraged physicians to use nonantibiotic therapies. In-vitro studies have shown the potential role of NAC as an anti-biofilm agent. Indeed, there are reports on NAC's antimicrobial activity against various microorganisms and there have been suggestions of its role in various stages of biofilm formation (adhesion to surfaces, synthesis and organisation of the matrix and dispersion of biofilms). NAC's ability to disrupt the formation of biofilms was first demonstrated in 1997 by PenezGiraldo, who investigated the effect of different concentrations of NAC on bacterial development and the formation of biofilms in an S. epidermidis culture medium in their study and reported a concentration-dependent reduction in biofilms, as well as the inhibitory effect of 2 mg of NAC on matrix formation. Since then, many studies have shown the effect of NAC on the reduction of biofilms due to microorganisms (Gram-negative and Gram-positive and yeasts) and its ability to weaken the matrix structure and biofilms. Studies confirm that the antimicrobial activity of NAC is associated with: f.
The competitive inhibition of the use of cysteine,
g. The reaction of NAC's sulfhydryl group with bacterial proteins, and h. Disruption in the balance of intracellular redox through a potential indirect effect on cell metabolism and signal transmission pathways. In a study conducted in Seoul in 2018, Young assessed the antibacterial effect of NAC against biofilms, including Lactobacillus, Enterococcus, and Streptococcus mutans on 27 dental blocks and concluded that NAC has greater effects in
APJ 24
eradicating biofilms than other therapies (chlorhexidine). NAC AND WOUND HEALING The administration of oral antioxidants, vitamin C, vitamin E, and NAC, has shown beneficial effects in the treatment of burn patients, as evidenced by a reduced incidence of wound infections and the shortening of healing time. NAC, in both its oral and injectable forms, is a convenient, safe, and inexpensive medicine for burn wounds. Deniz et al. demonstrated that NAC administration via an oral or intraperitoneal route was beneficial for severe burns in a rat comb-burn model. NAC has been shown to accelerate wound healing when administered both orally or via injectable forms. In a study by Tsai et al, they examined the use of NAC topically to treat burn wounds in vitro and in vivo. In vitro, they monitored glutathione levels, cell proliferation, migration, scratch-wound healing activities and the epithelialisation-related proteins, matrixmetalloproteinase-1 (MMP-1) and proteins involved in regulating the expression of MMP-1 treated with NAC. They used various NAC concentrations (0.1, 0.5, and 1.0 mM) and it increased glutathione levels in a dosedependent manner. In addition, NAC induced collagenous expression of MMP-1. In vivo, a burn wound healing rat model was applied to assess the stimulation activity and histopathological effects of NAC, with 3.0% NAC-treated wounds being found to show better characteristics on re-epithelialisation. Our results demonstrated that NAC can potentially promote wound healing activity, and may be a promising drug to also accelerate burn wound healing. NAC AND PICKING DISORDERS Do you have clients who suffer from psychologically induced
picking disorder? NAC has shown to also benefit mood and psychological disorders. Excoriation disorder is identified with frequent and compulsory skin picking that leads to tissue damage. It affects 4% of the general population and can significantly affect the patient's quality of life. It can even cause potentially lifethreatening complications. For example, tissue damage due to removal can lead to topical infection and septicemia. The role of glutamatergic agents in skin picking has recently been investigated in open-label and controlled trials. Many studies have emphasised the role of glutamate dysfunction in the physiopathology of compulsive disorders. Glutamate is an excitatory neurotransmitter. These effects are due to the antioxidant and glutamate modulatory effects of NAC. Grant et al investigated skin picking disorder (SPD) treatment with NAC in a randomized double-blind placebo-controlled trial on 66 patients (35 patients underwent NAC therapy and 31 acted as controls). Over 12 weeks, 1200-3000 mg of NAC or placebo were administered to the patients. The desire for skin picking reduced significantly and the therapy was well-tolerated in the intervention group. Meanwhile, no significant improvement was observed in quality of life or psychosocial functioning in the cases, which may have been due to the small sample size and short follow-up period. Another clinical trial was conducted by Miller & Angulo on 35 patients with Prader-Willi syndrome and SPD comorbidity, who received 450-1200 mg/day of NAC over 12 weeks. Skin picking behavior improved in all the patients and 25 cases (71%) showed complete resolution of skin-picking. NAC AND POLYCYSTIC OVARIAN SYNDROME Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy that affects 5% to 20% of women of reproductive age contributing to excessive facial hair growth. This disorder is
usually associated with insulin resistance and infertility. Its clinical manifestations include irregular menstruation due to anovulation and skin sequel from hyperandrogenism, including hirsutism, acne vulgaris, and androgenic alopecia. The prevalence of acne is estimated as 10% - 34% in women with PCOS. Nonetheless, in post pubertal and adolescent PCOS women, it’s unclear if secondary acne is caused by increased androgens or puberty. Acne is commonplace during puberty and is due to increased adrenal androgens with adrenarche. Moderate to severe acne has been reported in over 50% of young girls. Androgens have a role in the onset and persistence of acne. In acne patients, the excessive production of sebum is mainly due to the differences in the response of androgen receptor (AR) of the sebaceous glands to the circulating androgens. The androgen AR interaction causes an increase in lipid synthesis, the proliferation of the sebum activity and inflammation. The effect of NAC on PCOS has been demonstrated to lower insulin secretion and improve hormonal profile disruption in patients. In one study, 100 patients received 1800 mg of metformin or NAC over 24 weeks. NAC had also a comparable effect to metformin and reduced free testosterone and the hirsutism score six months after the treatment. IN CONCLUSION These and several other studies have concluded that glutathione as the master antioxidant has proven skin functioning and detoxification benefits. On the other hand, its precursor NAC is also well supported through numerous studies validating the benefits of both topical and oral use for the management of complex skin conditions. Both glutathione and N-acetylcysteine are available for use as a cosmetic active commercially. APJ Jacine Greenwood-Drummond will be speaking at the APAN Aesthetics Conference.
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STAR PERFORMER
RADIANIX® FOR BRILLIANT SKIN Both men and women who have age spots or brown blemishes on their hands, face, shoulders or arms can benefit from glutathione. In fact, anyone who wants a brighter and more radiant complexion should consider the benefits of the RadianiX® Skincare Supplements.
GLUTATHIONE’S ANTI-MELANOGENETIC EFFECT
Pigmentation can be caused by several factors, including hormonal changes in the body, as well as physiological processes that produce free radicals as by-products. Other examples include oxidation reactions, energy production electron transfer process and detoxification of foreign compounds exposure to UV irradiation.
Studies have shown that oral GSH resulted in the lightening of skin colour. Interestingly, subjects aged over 40 years old experienced more pronounced skin brightening. Usually, this age group suffered more photodamage from cumulative sun exposure. Other studies have also have shown glutathione’s ability to improve wrinkles and increase skin elasticity, which is an important manifestation with sun damage, as well as chronological ageing.
Studies confirm that free radicals are reactive oxygen and nitrogen species, superoxide, hydrogen peroxide and nitric oxide. These free radicals can be highly damaging, attacking macromolecules (proteins and lipids) and may result in the pathogenesis of ageing, cardiovascular diseases, degenerative diseases and even cancer. For example, oxidative stress plays a key role in acute respiratory distress syndrome (ARDS) and glutathione was shown to have a protective effect through its ability to inhibit inflammation, reflecting away the migration of inflamed polymorphonuclear neutrophils (PMN) from lung cells (causing ARDS), towards the site of infection (microbiocidal effect). GSH is shown to reduce lung infiltration, decreasing inflammation and acute respiratory distress syndrome. There are currently new studies showing that glutathione can prevent acute respiratory distress syndrome caused by COVID-19.
When it comes to pigmentation glutathione can provide positive benefits. This is because GSH has anti-melanogenic effect by stimulating the pheomelanin synthesis rather than eumelanin synthesis, resulting in a lighter skin pigmentation. Most artificial depigmentation chemicals act by destroying melanocytes whereas GSH protects the melanocytes via its antioxidant properties.
GLUTATHIONE BIOAVAILABILITY In a healthy person, the intracellular level of GSH is between 1 to 2mm, plasma level of 2mm and brain level of 1–3mm. For depletion levels of GSH, especially in older adult, oral administration may be used to boost level. However, effective delivery of glutathione is often a problem. This is because the gastrointestinal tract is hostile to glutathione where the intestinal enzymes hydrolyse the tripeptide structure, and undergo first pass liver metabolism, resulting in an incredibly low, oral glutathione bioavailability. SUBLINGUAL GLUTATHIONE AND HOW IT WORKS To overcome this problem sublingual glutathione improves bioavailability, bypasses the intestinal degradation and the first pass metabolism. Sublingual glutathione penetrates the mucosa via passive transport through the mucosa cells or around the cells into the blood circulation. Studies showed that a rapid sublingual absorption of glutathione can reach maximum levels within 30 to 60 minutes after oral-mucosa administration. WaferiX® developed by Entity Health is a patented sublingual delivery technology, formulated for a rapidly dissolving wafer and rapid sublingual absorption of actives. These wafers are now available to salons and clinics to stock and provide glutathione support to their clients optimising the skin benefits as well as support overall wellbeing. WHY SHOULD YOU STOCK WAFERIX If you are current treating clients with pigmentation or for improving overall skin health this is the perfect complementary take-home treatment to further support overall result through their homecare. Attractively package for daily sublingual delivery, RadianiX® has become of a popular supplement due to its efficacious deliver of glutathione and its incredible benefits. It is easy to use as it simply dissolved under the tongue in approximately 30 seconds. APJ If you would like to stock RadianiX® please contact Entity Health.
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ENHANCE YOUR SKIN TREATMENT OUTCOMES THROUGH THE POWER OF RADIANIX® GLUTATHIONE The introduction of nutritional supplements that support and optimise skin health and wellbeing are one of the fastest growing categories in salon and clinics. Today’s consumers are seeking a stepped-up level of care that goes beyond basic skincare to also boost overall energy levels and immunity. Glutathione, known as the master antioxidant - is highly supported through extensive evidence-based research studies validating its antioxidant capabilities as an affective freeradical scavenger, while also boosting the utilisation and the recycling of other important antioxidants, such as vitamins C and E, alpha-lipoic acid and CoQ10. ENHANCED BIOAVAILABILITY In a healthy person, the intracellular level of glutathione is available in abundance, however stress and the ageing process extensively contribute to the rapidly depletion of our glutathione levels. In the past, glutathione levels could be boosted when administered via injections, but these can only be delivered by a medical professional or a prescribing nurse. Oral supplementation was considered ineffective due to glutathione’s poor oral bioavailability. However, now there is an effective solution:
RadianiX uses a patented technology known as WaferiX, a new advancement where glutathione is delivered by a sublingual wafer that is purpose-made to dissolve under the tongue in approximately 30 seconds for rapid absorption of glutathione into the blood circulation allow for its affective delivery of glutathione levels into the body. With Radianix Glutathione you are not only supporting your clients’ overall health, but when it comes to their skin health, studies confirm its anti-ageing benefit as well as glutathione’s activity as an effective strategy in not only preventing, but also minimising pigmentation. By introducing RadianiX to your clients you will provide them with additional support for their treatment outcomes. To learn more about Radianix® visit the Entity stand at the APAN Aesthetics Conference.
Radianix® 0421 433 660 orders@ixsyrinx.com www.ixsyrinx.com
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MEMBER PROFILE
BEAUTY & BALANCE PROVIDING A HAVEN FOR
skin therapies, healing and renewal
Eliska Graves is a passionate and dedicated practitioner who is committed to providing her clients with carefully delivered treatments, based on both the latest scientific approach to skin management, balanced with elements of nurture and care that extend to a more complete approach of whole-body treatment outcomes. Beauty & Balance is a dedicated space located in Cronulla, NSW offering its own unique brand of skin and body care. BB is a community of specialist practitioners who share a love of the therapeutic, and who take great joy in enabling wellbeing. The studio environment is thoughtfully designed and maintained to support relaxation, healing and gentle moments of sensory delight. With generous amenities, spa facilities and signature treatments, the BB space exists to facilitate care and connection. It’s a place to unwind, be uplifted, healed and restored.
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As a valued APAN member we are delighted to interview Eliska and allow her to share her treatment perspectives and how they are shaping her brand, to which more and more consumers gravitate, seeking to experience the benefits provided within her unique environment. APJ Q1: ELISKA, CAN YOU PLEASE SHARE WITH US YOUR BACKGROUND AND HOW YOU BECAME INVOLVED IN THE INDUSTRY? After I completed my diploma in Remedial Massage therapy, I joined DMK Skin Clinic in Gymea, Sydney as a massage therapist. During my breaks I would look through albums of some of the skin therapists’ work and in particular, results from the owner, Leanne Cave's work on acne skin conditions. I was so impressed with the before and after photos and this fuelled my interest to extend my training to enable me to treat skin conditions and helping people with problematic skin to improve their lives. Seeing my interest, Leanne asked me if I would be interested in moving into skin therapy - my answer was so easy. YES! I started by advancing my qualification to include skin therapies and also completed several DMK programs. I was also given the opportunity to supplement this with hands-on learning which allowed me to gain the confidence to transition into skin treatments. Today, I have my own business Beauty and Balance (BB) – an integrative skin and wellness studio where I can incorporate all my knowledge into a unique business model that combines various modalities that maximise benefits to my clients. I am forever grateful for the opportunity of meeting great teachers like Leanne Cave (Skin for Life), Debbie Dickson (DMK), Gay Wardle and Dr. Des Fernandes who have all helped shape my career path in the amazing field of skin management.
APJ Q2: WE UNDERSTAND THAT YOU ARE AN INTEGRATIVE SKIN AND WELLNESS CENTRE PROVIDING HOLISTIC CARE FOR YOUR CLIENTS, PLEASE EXLAIN THE SERVICES YOU PROVIDE AND WHO YOU ARE TARGET CLIENTS? I wish we had two more levels of space available in our premises to invite a broader range of practitioners to join us in servicing our clients at Beauty and Balance as we attract allied health care professionals who wish to co-create with our team. In the past, we shared our rooms with a naturopath, yoga teacher, meditation teacher, acupuncturist, kinesiologist and counsellor, but we just got too busy with our own clinical skincare work and unfortunately, we could not offer more space for others to grow. However, our team is big on referrals to naturopaths, integrative doctors, acupuncturists, kinesiologists, counsellors and local support groups. At this point BB has two amazing body workers providing therapeutic and healing massage and three energy healers. As we continue to work collaboratively with other practitioners, our clients are not disappointed that we don't incorporate every service under the one roof. They appreciate that we support their skincare journey through a multidisciplinary approach, even if this is delivered also through referrals. Another consideration is that we have clients who come to us from afar and it is often much easier to refer them to other practitioners within their own community. We are always on the lookout for work with other experts though collaborative referrals. I also like to mention that in our space we consistently cultivate harmonious and peaceful elements with touches of nature, appropriate lighting and healing aromas, crystals and herbal teas - ever little details is carefully thought through to surround our clients with beauty and harmony. I believe this holistic approach is so important to our brand. There is no reason why best clinical services cannot be further supported by other natural modalities. We also strongly believe in the benefit that massage can bring to every client. No matter how intensive your skin treatment is, there is always space for massage for relaxation or energy balancing. To further support our clients’ wellbeing, we extensively use our Infrared sauna. With regards to our target client, this is a hard one for me, but I will be very honest, we have never ever done any marketing, apart from our Instagram posts. So, this is an area I can afford to gain greater skills, but honestly, our business continues to flow through the ongoing referral from our existing clients who appreciate our approach and honest work, and that seems to work for us. Our client acquisition is very organic – it filters through our work, and we gain the best clients ever. Some of our clients are as young as nine years old. Their mums bring them in for skin treatments, wives send their husbands, brides bring their bridal team and the groom. Families reward their mothers with gifts of care and love. Our brand has grown through the dedication of our amazing therapists who have a strong sense of purpose in providing the best possible service, care and support - that is our best marketing tool. Every single treatment is delivered with attention to detail and to the same
standard as the client's first treatment. It’s all about focussing on the client’s priority need, giving our best, sharing our care and knowledge and the rest just flows in. If I consider who our clients are, I see people who appreciate honest service, professionalism, wisdom and expertise, exclusivity, quality products and great results. They seek value for money, attention to detail and beautiful outcomes. Their wellbeing is paramount to us and they recognise and appreciate that we focus to deliver what is best for them. iIf I was to do better in marketing, I would still choose to build on establishing relationships with people who are aligned with our values. I also love to support other practitioners with whom we work with by sharing our knowledge and passion for what we do. But if I were to expand my clientele reach, I would love to do it through interviews on topics that our clients are interested in, as I know this would create great opportunities to attract people who are in the space of holistic healthcare. My problem is that I have many ideas but little time to implement them as I am still so much of a hands-on therapist – mmm ... isn’t this the classic small business excuse? APJ Q3: WHAT BODY SERVICES DO YOU PROVIDE AND HOW ARE THESE SERVICES BENEFITING YOUR CLIENTS? We offer DMK skin revision body treatments, spa body treatments, Therapeutic Massage, Kahuna and Infrared Sauna. We do not offer body treatments using advanced devices at this stage and to be honest, it is not my vision. I would prefer APJ 29
to open a Yoga or Pilates studio first over investing into the latest body treatment devices. For body treatments delivered through technology, we prefer to refer our clients to other clinics that offer those services.
are continuing to grow as they provide stress management and support overall health and wellbeing.
With our skincare treatments we also include the neck and decollate as a more complete treatment option. We also offer skin corrective treatments for arms, hands or buttocks, but these are not accessed as frequently as facial treatments. Infrared sauna, DMK skin and body range, Venus Viva Concept device and Dermapen 4 are our core tools in skincare and technology that keep us very busy. These are complemented with our hands-on body treatments, such as massage and energy healing which we specialise in and our clients love.
Looking back to the events of the past two years, first, I wish to send my love and best wished to all our colleagues, APAN members and business owners. What a challenging time it has been for all of us and our clients. We are so grateful for being able to return to our businesses. I believe that every business has experienced the challenges of future uncertainty during the pandemic, and I sincerely empathise with you all.
APJ Q4: WHAT PERCENTAGE OF YOUR BUSINESS RELATES TO SKIN TREATTMENTS AND WHAT PERCENTAGE TO BODY TREATMENTS? ALSO, DO YOU FIND THAT COMBINING BOTH SKIN AND BODY TREATMENTS ARE POPULAR? Skin treatments are still the highest percentage of services that are accessed by our clients, however, our body treatments
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APJ Q6: HAVE YOU IDENTIFIED ANY SPECIFIC CHANGES THAT YOU HAVE OBSERVED SINCE THE PANDEMIC AND HOW ARE YOU BETTER MEETING THOSE NEEDS?
With regards to our BB team: We are an amazing mix of incredible practitioners, who have come from different backgrounds and cultures each bringing our own wisdom and strength that collectively has allowed us to remain strong and overcome the difficult times through mutual support and respect for each other. With regards to our clients: The challenge was to make sure that all our clients knew that they are in safe hands and in a safe environment. We confirmed to all our clients that we do not discriminate for the choices they have made for their health and that we will always do everything possible to make them feel welcomed, safe and cared for. Changes in health compliance: With the help of APAN, we made sure all regulatory requirements were met. During the lockdowns, our clients and our team members, had to operate in different locations, however, we were able to provide meaningful and consistent support throughout the lockdown periods, while also support both our clients and each other with care and understanding. Services: Definitely, there is a shift in people wishing to take care of their health even more than before. During these times many had the opportunity to re-evaluate life and reconsider their priorities, with health and wellbeing becoming a stronger focus. During the lockdown some clients have experimented with other products, but it was good to see
that they have returned with a greater appreciation of what we are offering them. Overall observations: Women have indicated that they are exhausted with the stress that the various aspects of the pandemic have brought, including the politics and conflicts that have arisen behind closed doors. As such, our policy has been to focus on restoring peace, care and support to them when they enter our premises. Our aim is to help them regain their equilibrium and balance through our care and nurture. This has been very much appreciated by our clients and it is a key factor as to why they visit us, even more so than before. APJ Q7: WHY DID YOU JOIN APAN AND WHAT SUPPORT AND BENEFITS HAVE YOUR RECEIVED FROM YOUR MEMBERSHIP? I fell in LOVE with APAN and Tina Viney for her dedication and life-long commitment to the professionalism and advancement of our industry. Tina and her team always consistently fight for us, and it seems that Tina never gives up in her pursuit of her mission. I have kept all my APJ journal issues and feel that I can turn to them over and over again when I need to benefit from the richness of information and the always heartfelt content. It it is very comforting and refreshing for BB to belong to a professional organisation that has our best interests at heart, that operate with integrity, supporting us with guidelines of best practice and consistently pursues to elevate the status and integrity of the industry. During the beginning of COVID, I was very lost with regulations, and I couldn't think of a more fortunate partner to have than APAN. One day, I just picked up phone and Tina was there offering me all the support and guidance I needed to move forward. The benefits of belong to APAN are endless. My only problem is that at times I am too busy to take full advantage of them all, but just knowing APAN is there for me if I need help or advice gives me peace of mind. I think after reading this interview today - you can appreciate how much more BB would benefit from accessing more of the APAN services. I hope to see you all at the Conference. If you cannot attend in person, why not connect to view the whole program online and benefit from expert knowledge and leading industry education. There is so many exciting new things we can learn and becomes stronger and more valuable to our clients. APJ Beauty & Balance 02 8544 1711 hello@beautyandbalance.com
APJ 31
STAR PERFORMER
DERMATONICS LAUNCHES NEW ENHANCED SUNSCREEN
FORMULA FOR SAFE AND PERFECT SKIN PROTECTION Recently there has been a lot of chatter about sunscreens and their potential harms and benefits. Most notably, there have been recent concerns about chemical contaminants in the manufacturing process. Benzene is a trace chemical that has been found in certain high-profile sunscreens. This is a chemical that is known to be carcinogenic, however, the actual levels that were found are unknown. There are several ingredients that are now known to be harmful that can be found in sunscreens, many of which have been banned from sunscreens. The FDA released their findings of a safety review in Sept 2021. They identified several chemicals as potentially toxic or carcinogenic. These include oxybenzone, dioxybenzone, avobenzone, sulisobenzone, octinoxate, homosalate, octisalate, cinoxate, octocrylene, ensulizole, meradimate and padimate O. This doesn’t not mean all chemical sunscreens are bad, we are just limited in ingredients we can incorporate into sunscreens that generate a safe and effective product. PHYSICAL AND CHEMICAL SUNSCREEN AND HOW THEY WORK What is the difference between a chemical and physical sunscreen? Physical sunscreens are still made of chemicals. Natural ingredients ARE chemicals, we just tend to associate negativity with anything that is called a ‘chemical’. Chemical sunscreens absorb into the skin and then absorb UV rays. This energy is then converted into heat, and the heat is released from the skin. Physical sunscreens sit on top of the skin, create a physical barrier and reflect the sun's rays. Zinc Oxide is the only ingredient the FDA has identified as being safe and effective as
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a broad-spectrum UV filter. Mineral zinc is also something that is quite beneficial for the skin. What is important is the form that it is in. Nanoparticles are potentially harmful, not only to humans, but also to our aquatic life and the environment. Zinc oxide is essentially the best ingredient we can use to create a safe and effective sunscreen. The next challenge is to get people to use the sunscreen! Yes, zinc oxide sunscreens can be a bit inconvenient, as it may be a little heavy and more difficult to apply than chemical sunscreens. However, if well manufactured, they can be easily applied, and with a tint, they can even look and feel like a foundation. One way to help achieve this is through micronized zinc, but not through nanoparticles, but microparticles. Micronised zinc sits between nano-Zinc Oxide and the chunky aggregates of Zinc Oxide we know of older formulations of Zinc Oxide that leave us looking somewhat ghost-like (think those Zinc Oxide colourful sticks that are really thick!). DERMATONICS MINERAL FACIAL SUNSCREENS The new Dermatonics Mineral Facial Sunscreens have been formulated into two beautiful products that are truly necessary in a good skincare routine. The sunscreens are TGA approved, contain micronized Zinc Oxide and rated SPF50. They also contain ingredients that are fabulous for your skin, including Hyaluronic Acid to help hydrate the skin. Our clinic partners have pursued us for a quality sunscreen that will help them provide sunprotection compliance for all their clients. We have heard you and we are thrilled to provide you with an amazing sunscreen solution you can confidently promote that is both highly effective and safe for all your clients. APJ Learn more from Dr Donna Marcal who will be speaking at the APAN Aesthetics Conference. DERMATONICS - Beautiful skin, naturally. info@dermatonics.com.au 02 9188 8819 dermatonics.com.au
Are you searching for that amazing, Australian, results-driven skincare range for your business? Australian Made Clinic exclusive Flexible opening orders Results-driven formulations Formulated by Medical Scientists Packed with ultra-pure natural actives @dermatonics_skincare @dermatonics dermatonics.com.au
BECOME A CLINIC PARTNER info@dermatonics.com.au (02) 9188 8819 APJ 33
BUSINESS WISDOM
BREAKING THE MOULD OF TRADITIONAL STAFFING STRUCTURES Deb Farnworth-Wood
Imagine returning to the days when staff stayed for a long tenure; businesses had more stability and the revolving door of employee recruitment, induction, training and exit interviews spun more slowly. Imagine what we, as business owners, could achieve if the trend of changing jobs, swapping careers and lack of commitment was no longer a thing? Sound like an impossible dream? Well, maybe not! If nothing else, the COVID years challenged even the smallest of businesses to be more resourceful than ever before. We’ve heard the words pivot, reinvent, circle back and side hustle daily (or every third scroll if you are a TikTok fan!) The great resignation must seem like the final insult to those who have carefully nurtured their businesses, suffered financial losses, and protected their staff positions while waiting for the pandemic to be over. The logic of resigning from a secure job also seems counterintuitive with a recession looming and an explosive property market which may mean most youngsters may never be able to afford to buy their own home. And yet the world’s logic seems to have changed too. The good news is there may be a way … and finally, after spending two years working on a solution for my business, I have found it! In late 2020 just after I bought Issada (and long before the great resignation), I made a promise to the teams in my two businesses (Issada and my aesthetic clinic) that I would find a way to reward them for their loyalty and commitment - not only by the usual bonus structures, but via an actual stake in the business too. It was a bold statement as I didn’t have all the answers at the time, but I was committed to developing a team that had a longer-term view of their role, and that was genuinely interested in the longterm growth and success of the company.
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Understandably this raised questions - would staff have to pay for shares? Would there be financial risks for them? What were the legalities? And so on. I didn’t start with the answers as I already knew that the typical employee share schemes didn’t stack up for anyone other than senior executives in high-level posts. Instead, I started with the determination to find a way, but provided a written undertaking that this was my goal. In the meantime, staff would share in the profits of the businesses - regardless of whether a new legal structure was in place. I made this same commitment to the teams in Issada and also my aesthetic clinic. But why? Quite simply, the world is changing, and we must change too. COVID has affected how offices function with increased homeworking, so it wasn’t too far a stretch to see that trend would be seen in beauty, and let’s face it, a home salon may seem like the ultimate side hustle! Longevity of staff tenure has always been a problem in the industry, with staff rushing from one employer to the next. Like it or not, our workforce no longer sees any job as a long-term commitment. For many, it’s not even a career anymore. It’s just something transient that will “do for now”. Social media is making the notion of “side hustles” and “nomadic working” seem attractive (probably a lot more appealing than it is), and the workforce is becoming resentful about the perceived perks of being a business owner versus being an employee. For the last 10 years our industry has suffered from skill shortages as the demand for beauty and beauty products has grown exponentially. Yet, it has taken time for the training and education of its future staff to start to catch up. Students still graduate with insufficient practical experience, client contact, understanding of sales and client service skills. Therefore, employers must commit to extensive training, which is costly in terms of loss of revenue, salaries for staff who are not earning fees, risk of customer
committed staff. The staff have a vested interest in maintaining high standards of work, ensuring profitability of the business and self-regulating their peers. Employee ownership also has other advantages for founders or owners, which can include faster scaling up, a potential exit strategy by selling down more of their shareholding to the EOT, being able to have a break knowing that other stakeholders are acting in the best interest of the business, and significantly staff job satisfaction and skill retention also improves with employee ownership. HOW DOES IT WORK? As you would imagine, there is a lot involved, and you will need advice from your accountant and lawyer to ensure that you cover all important aspects but, here is a brief summary:
dissatisfaction, and so on. However, the softer skills are just as hard to instil – it’s possible to have two experienced and technically competent staff, but with wildly different soft skills, such as communication, teamwork, cleanliness and so on. So, we may find that the amazingly experienced new therapist is great, but then discover that they are a teammate from hell who destroys the morale of everyone. You may argue that new staff also bring new ideas and new skills, which would also be true. However, in the service industry, staff leaving are often trying to take your clients and team members with them too. Just imagine how much easier life would be if the merry-go-round stopped.
“Imagine a world where staff have a vested interest in the bigger picture. Where they not only think like an owner, but act like one too? Too good to be true? No not really.” ANOTHER WAY – AN EMPLOYEE OWNERSHIP TRUST (EOT) The UK has many examples of employee-owned companies, the oldest being the John Lewis Partnership which has been co-owned since the 1920s. That said, only since 2014 has the concept become popular in the UK, with now over 750 companies boasting employee co-ownership. The UK has implemented tax incentives to make employee ownership more attractive to founders and employees alike, recognising that there are distinct advantages to the workforce. Although tax advantages are not in place in Australia (yet), the argument for employee ownership is compelling because the evidence is those co-owned companies tend to be more successful, competitive, profitable and sustainable. Independent research also suggests that a combination of shared ownership and employee participation delivers superior business performance. They are more innovative because managers go out of their way to consult, share information and give staff responsibility. Because they are co-owners, the staff tend to be more entrepreneurial and committed to the company and its success. They tend to have high employment standards, involve teams in decision-making, and give everyone a stake. Employeeowned businesses are better at recruiting and retaining talented,
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Business owner places a proportion of the company shares in an Employee Ownership Trust
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The value of the shares is determined by a valuation, and the EOT will repay the share value over time from its profits
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The employees themselves are beneficiaries of the trust, so they personally never buy or sell shares
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Only current employees benefit from the EOT, and there is an opportunity to define the qualifying beneficiaries of the trust
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Qualifying staff can include employed, casual, freelance and even offshore (these would be pre-determined at the outset)
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Company profits are distributed according to shareholding (the founder/owner who will be the majority shareholder and the EOT), and the proportion of profits that the EOT receives is passed to the beneficiaries
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A staff council ensures that staff have a voice in the business and a board presence
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Over time the EOT could purchase more shares ( eg, as an exit route for the owner)
THINK LIKE AN OWNER I believe the EOT needs to go one step further than the formalities and so I have also put into place a training program called “Think Like an Owner”. This is central to my growth strategy - the teams are fully aware that the EOT is being put into place to incentivise them to stay with the business, but also focus their attention on our scaling-up plan. They will not only benefit trading profits, but eventually on a future sale of the business. It is therefore important that they understand things like how businesses are valued, and the qualities that make a business more attractive to potential buyers. “Think Like an Owner” is a strategy to educate staff at all levels on the bigger picture so that individually they can focus on the parts of the business where they can each have the most impact. The program combines ongoing workplace mentorship, exposure to external training resources and a structured learning plan working directly with me as we navigate the growth plan together. APJ Deb Farnworth-Wood is a speaker at the APAN Aesthetic Conference.
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INGREDIENT SCIENCE
THE MULTIPLE AND
amazing benefits OF NIACINAMIDE Tina Viney
As skincare practitioners, niacinamide is an interesting nutrient that we should closely examine and investigate how it impacts the health of the skin and body, as extensive literature supports some of its impressive benefits. As far as the topical application of niacinamide for skin conditions is concerned, a quick search will reveal multiple clinical studies validating its effectiveness in treating everything from wrinkles, poor elasticity, to the prevention and treatment of hyperpigmentation.
(double blind, left-right randomised). Facial images and instrumental measures were obtained at baseline and at 4-week intervals.
WHAT IS NIACINAMIDE?
The study also confirmed that niacinamide leads to an increase in protein synthesis (e.g., keratin), has a stimulating effect on ceramide synthesis, speeding up the differentiation of keratinocytes and raising intracellular NADP levels. In ageing skin, topical application of niacinamide was shown to improve the surface structure, smoothing out wrinkles and inhibiting photocarcinogenesis.
You will find this amazing vitamin under several names - nicotinic acid (also generally known as niacin) and niacinamide (also known as nicotinamide) are common names that this nutrient comes under. However, don’t confuse niacinamide with niacin. Despite the fact they both come under the blanket term vitamin B3, they are still a different form of vitamin B3, even though they can be converted into each other within the organism. Niacinamide is a component of important coenzymes involved in hydrogen transfer. When looking for this ingredient in skincare look for it listed as “niacinamide”.
Results: Topical application of niacinamide demonstrated a stabilising effect on epidermal barrier function, a reduction in trans-epidermal water loss and an improvement in the moisture content of the horny layer.
Additionally, the study observed that niacinamide provided an antiinflammatory effect in acne, rosacea and eczema. There was significant reduction in fine lines, wrinkles and hyperpigmented spots, red blotchiness and skin sallowness (yellowing). In addition, elasticity (as measured via cytometry) was improved.
STUDIES CONFIRM MULTIPLE SKIN BENEFITS One of the first studies Nicotinic acid/Niacinamide and the Skin conducted in Germany in (2004) examined two code hydrogenases - nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP) and their impact on the skin. Here are a few details of that study: Study method: Fifty female subjects with clinical signs of facial photo-ageing (fine lines and wrinkles, poor texture and hyperpigmented spots) applied 5% niacinamide to half of the face, and its vehicle control to the other half twice daily for 12 weeks
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Analysis of the data revealed a variety of significant skin appearance improvement with topical use of niacinamide. Because of its verifiable beneficial effects, it was concluded that niacinamide would be a suitable component in cosmetic products for use in disorders of epidermal barrier function, for ageing skin, improving pigmentary disorders and for skin prone to acne. Further studies examined both internal supplementation and topical use. Here are some of the results. Improving Acne When used topically, research shows that niacinamide benefits can
include improvements in acne. For example, a 2017 scientific review highlighted multiple studies that found that both topical niacinamide, as well as internal supplements of this nutrient significantly decrease acne without any major adverse side effects. According to a 2014 review, niacinamide controls nuclear factorκB (NF-κB), a protein involved in inflammation. This antiinflammatory effect is beneficial for skin irritation and redness, making it an excellent choice for inflamed acne skin conditions. Helps Reduce Hyperpigmentation A study published in the British Journal of Dermatology found that topical application of niacinamide can help reduce hyperpigmentation and increase skin lightness. In just four weeks of usage, researchers were able to observe skin-lightening effects. Can Improve Rosacea Symptoms Improving rosacea is another one of the many niacinamide benefits. One scientific review highlighted how nicotinamide has been used in dermatology for over 40 years for a diverse range of skin conditions, including rosacea and acne. Rosacea, an inflammatory skin disease, has been successfully improved by both topical and internal use of niacinamide. CAN NIACINAMIDE BE COMBINED WITH VITAMIN C FOR TOPICAL USE? There appears to be some confusion about combining niacinamide with vitamin C, as presented within several blogs and even some beauty magazine articles stating that while the two ingredients are great on their own, combining them creates a two-fold problem: one being that it neutralises the effectiveness of both ingredients, and two, it might create a substance (nicotinic acid) that leads to skin redness. However, dermatologists advise otherwise. Research has shown that combining niacinamide and vitamin C does not lead to skin problems - in fact, the combination can lead to a wealth of skin benefits. The notion of their incompatibility was due to a study conducted back in 1960, concluding the incompatibility between niacinamide and vitamin C. This study was faulty from the start because it used non-stabilised forms of both ingredients, whereas both ingredients are typically stabilised when used in modern-day cosmetics formulations. UNIQUE CHARACTERISTICS OF NIACINAMIDE Niacinamide is a pretty “tough” ingredient; light and air don’t have the same effect on it as they do on antioxidants like vitamin C. What’s important form niacinamide is that the product must be formulated at a pH that’s close to neutral. Vitamin C (pure ascorbic acid), on the other hand, performs best at a low-pH (acidic) environment. However, nicotinic acid - the undesirable by-product of niacinamide and vitamin C - becomes an issue only when the niacinamide and vitamin C are combined in a high-temperature environment for a long time. That temperature is higher than you would find in most at-home scenarios, including leaving a box of skin care products sitting outside in the sun for a couple of days. Also, it’s important to point out that this concern applies only to pure vitamin C, not to its many other forms (such as magnesium ascorbyl phosphate, tetrahexyldecyl ascorbate, and ascorbyl glucoside). So, to reiterate, combining ascorbic or l-ascorbic acid with niacinamide is fine. In short, any studies that show a definite issue from combining niacinamide and vitamin C were conducted in an environment that does not reflect today’s required product manufacturing standards. This is a perfect example why as practitioners we need to cross-reference our studies and constantly update the data to which we base our decisions when selecting products.
In summary, we know that on its own, niacinamide is a skinrestoring ingredient that can visibly improve the appearance of enlarged pores, fine lines, and dull skin. On the other hand, vitamin C is a potent antioxidant that defends the skin against environmental assault, as well as a brightening agent that can improve the visible signs of ageing. Together, these ingredients form a powerhouse combination that synergistically addresses uneven skin tone, wrinkles, loss of firmness and dullness. All skin types will see a complexion that progressively becomes more radiant, smoother, more even and noticeably younger-looking. However, while this combination is proven effective to address various skin conditions, because the combination amplifies their results, it is important to apply caution when addressing very sensitive skin for potential irritation. WHAT DO WE KNOW ABOUT COMBINING NIACINAMIDE AND RETINOL? Niacinamide and retinol are both validated as evidence-based skincare ingredients. On their own, each ingredient can help improve skin blemishes and acne, even-out skin tone and diminish the signs of ageing. As we are aware, combining ingredients should be closely examined to ensure their compatibility, as wrong combinations can cancel out their unique benefits and when not paired well, can even cause reactions. We know the benefits of niacinamide when it comes to skin improvement. On the other hand, there is no doubt that retinol has excellent validated evidence for its efficacy. Let’s take a close look: Retinol is an over-the-counter form of retinoid. Retinoids are derived from vitamin A, an essential nutrient that your body needs for immunity, vision and cellular communication. In skincare, retinol has been proven effective for minimising or treating conditions such as acne, hyperpigmentation and signs of ageing skin. Studies confirm that it can control acne by reducing sebum production. A 2015 study also found that retinol can inhibit enzymes that destroy collagen. This in turn helps to support collagen synthesis and minimise the appearance of wrinkles. But unlike niacinamide, retinol is associated with side effects. It is known to cause irritation and inflammation, and it may result in redness, a burning sensation, tightness, dryness and peeling of the skin and photosensitivity, even though typically, these side effects are diminished over time. So, what are the studies showing when combining retinol with niacinamide? An older 2008 lab study examined the combination of niacinamide and retinoic acid (RA), which is what retinol is turned into once it’s in the skin. The study found that niacinamide actually lessens the irritation and dryness caused by RA. Additionally, a more recent 2017 study found that a retinol cream with moisturising ingredients, including niacinamide, caused less irritation than a formula with just retinol. This suggests that if you use a product that also contains niacinamide, which can protect your skin barrier, you may be able to benefit from retinol but with fewer side effects. Studies have also found that formulas containing both niacinamide and retinol can be beneficial for the skin, improving sighs of ageing. So, are there any side effects? To date, there is no specific research on the downsides of this ingredient combination, therefore, the pairing is typically considered to be safe for most skin types. However, it is possible to develop an adverse reaction, especially if one is sensitive to retinol. While adding niacinamide is known to mediate skin sensitivity it may still not be enough for some individuals with known sensitivity to retinol, so a patch test is strongly recommended.
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NIACINAMIDE FOR INTERNAL USE Energy production and DNA repair The human body uses nicotinamide to create two very important coenzymes, which are known as nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). We need NAD and NADP for functions essential to our health, including energy production and repair of DNA. Studies are now confirming that NAD can protect against telomere shortening thus protecting DNA. Helps Protect Against Skin Cancer Some research to date points toward the ability of this form of B3 to protect against skin damage caused by UV radiation and decrease the risk of developing skin cancers. A randomised trial published in the New England Journal of Medicine took 386 participants who had at least two nonmelanoma skin cancers in the past five years had them take either 500 milligrams of nicotinamide twice daily or a placebo for 12 months. Dermatologists evaluated the participants every three months for a total of 18 months. The researchers found that the high-risk participants who took the supplement for a year decreased their risk of new nonmelanoma skin cancers (including basal cell carcinoma and squamous cell carcinoma) by 23%. The study also revealed how niacinamide supplementation reduced cases of actinic keratosis by 13% within 12 months. Actinic keratosis is the most common precancer that forms on skin damaged by chronic exposure to ultraviolet rays from the sun and/or indoor tanning. Topical vs. Foods/Supplements If you’re looking to up your internal intake of this form of vitamin
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B3 you can eat foods that contain it, such as cage-free eggs, green vegetables like asparagus, wild-caught salmon and mushrooms. You can also take niacinamide supplements, which can be found in a health stores or pharmacy. Precautions Check with your healthcare provider before taking a niacinamide supplements, especially if you are pregnant, nursing or have any ongoing health concerns, including allergies, liver disease, gallbladder disease, ulcers, gout and diabetes. It’s also not recommended to take this supplement two weeks before a scheduled surgery. IN SUMMARY Niacinamide is a form of vitamin B3 that can be found in foods as well as supplements and topical products. If you’re comparing niacinamide versus niacin, it is important to remember that these are two different forms of vitamin B3. Niacinamide’s skin benefits include improvements in hyperpigmentation, signs of ageing, as well as inflammatory skin disorders such as acne, rosacea and eczema are well validated. However, skin results (such as reduced hyperpigmentation or acne) can vary by user and by the percentage of niacinamide in a topical product or supplement so it may take weeks to see improvement and full benefit. As an ingredient, niacinamide is well supported through existing and on-going studies for its efficacy and it is predicted to have a great future, particularly in skincare formulations. Niacinamide can also be successfully combined with other actives such as retinol and vitamin C to provide impressive treatment outcomes. APJ
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Cleansers can be difficult to rinse off completely, leaving behind a residue that can clog pores and lead to breakouts. If you do decide to use a powder cleanser, be sure to choose one that is gentle and nonabrasive, and make sure to follow with a moisturiser to help offset any drying effects. Powder cleansers were at one time considered to not be an “active” product and simply just to remove dirt, debris, makeup and pollution. However, cleansers have had a rise in status with many new actives being released that now allow functionality never before being able to be achieved. One of these concepts is the ability to activate a pathway in the skin known as the HIPPO pathway. This pathway is involved in stem cell renewal and also wound healing. Studies have now shown that skin cells exposed to mechanical forces of tension, activating biological signaling pathways that stimulate the HIPPO pathway in the skin, regulating skin regeneration. The APJ 40
very simple act of cleansing can now, for the first time, be an active treatment. During the cleansing process the stretching of the skin activates pathways in the skin that regulate skin regeneration. The visible result in the skin is not only a refinement in the appearance of pores and also remodeling of the skin. Other new ingredients to enter the market for cleansers are green tea saponins. Green tea saponins are a type of natural surfactant, which means they have foaming properties that can be used for cleansing. They are often used as an alternative to synthetic detergents, as they are gentle and non-irritating. Green tea saponins are derived from the Camellia sinensis plant, and they work by reducing the surface tension of water, which allows dirt and oil to be lifted away from the skin more easily. In addition, green tea saponins have antimicrobial properties that can help to kill bacteria and keep the skin clear. For these reasons, green tea saponins are an effective and natural way to cleanse the skin. Roccoco is the first company in Australia to introduce these innovative ingredients, incorporating both these ingredients into their best-selling Polishing Cleanser. An ultragentle powder exfoliant containing 11 powerhouse actives that gently deep cleans to safely dissolve dirt, sebum and impurities. Containing the world's first natural source of Salicylic Acid from Wintergreen, providing effective exfoliation deep within the pores with no irritation. Skin renewal is accelerated by up to 45% for a flawless complexion and unparalleled softness that needs to be felt to be believed. APJ
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APJ 41
NUTRITION FOR BETTER HEALTH AND SKIN
THE MISSING LINK TO
managing inflammatory SK IN CON D ITION S Fiona Tuck Guiding us through a journey to better skin and health Fiona Tuck shares her wisdom on how to optimise your skin treatment results through improved gut health that will support immunity, energy levels and ultimately skin health and vitality. The commensal microbe population living in our intestines is referred to as the gut microbiota. The gut microbiota plays an integral role in the maintenance of human health by acting as protective barrier against invading organisms and assisting with nutrient production and absorption. What we eat not only governs our nutrient intake, but also cellular changes at a biochemical level. Molecules produced by bacteria in the gut from the digestion of plant materials can affect genes in the cells of the gut lining. Postbiotic molecules, called short chain fatty acids, can move from the microbes and into our own cells. Inside our cells, they can trigger processes that change gene activity that ultimately affects how our cells behave. The best predictor of a healthy gut microbiome is the diversity of plant foods in the diet. Recent studies suggest that we need to be eating at least 30 different types of plant foods per week to support a healthy gut microbiota. Diversity of plants is important as not only does this provide an array of nutrients and phytochemicals found in various plants but also different types of fibres including prebiotics. A prebiotic is a type of plant derived fibre, resistant starch, or polyphenol. To be classified as a prebiotic it must pass through the GI tract undigested and stimulate the growth and or activity of certain beneficial bacteria in the large intestine. Prebiotics help increase numbers of beneficial gut microbes (especially bifidobacteria), increase anti-inflammatory cytokines, and decrease proinflammatory cytokines, which result in a decrease in
APJ 42
overall inflammation. Short chain fatty acids (SCFA’s) are the beneficial molecules produced by bacteria when they ferment prebiotics. Prebiotic examples – wholegrains, legumes, nuts, seeds and many fruits and vegetables such as apples, kiwi, artichoke, peas, beetroot, leafy greens to name just a few. Prebiotic benefits: •
Reduce unhealthy microbes such as Bacteroides intestinalis, B vulgatus and Propionibacterium
•
Reduce bacterial endotoxins
•
Reduce inflammatory markers such as C reactive protein, interleukins, TNF
•
Lower post-prandial blood sugar and insulin concentrations
•
Lower total cholesterol and triglycerides, increase HDL
•
Improve satiety by increasing GLP-1 and peptide YY satiety hormones
•
Improve calcium and magnesium absorption
Psychological stress and/or a diet high in processed foods, sugar and saturated fat, low in fibre and prebiotics cause alterations to
gut motility and the microbiota profile. Changes in the gut microbiota composition have been associated with disturbed gut barrier functions, increased gut permeability and increased plasma endotoxins.
•
Oily fish three times per week (omega 3)
•
The altered gut microbiota and endotoxin production promote the release of Substance P in both the gut and the skin increasing inflammation and oxidative stress. Inflammatory mediators such as CRP, interleukins, TNF, Sub P are elevated, and insulin sensitivity is decreased.
Include small amounts of fermented foods such as keffir, yoghurt, sauerkraut – be wary, fermented foods may aggravate rosacea, eczema, peri oral dermatitis.
•
Extra virgin olive oil – 30 – 40ml per day
•
Though not yet fully explored, the mechanisms by which intestinal microbiota exert their influence on skin homeostasis appear to be related to the modulatory effect of gut commensals on systemic inflammation and immunity.
Minimise animal fats, ultra-processed foods, coconut oil and processed meats
•
Minimise refined carbohydrates, sugars, soft drinks and alcohol
•
Avoid restrictive diets unless there is a medical reason to do so
•
All things in moderation
Supporting a healthy gut microbiota via a healthy diet by increasing the diversity of plant foods for prebiotic benefit tends to be overlooked yet one of the most important places to start when we are looking to support skin health holistically and lower systemic inflammation. Foundations of healthy eating for skin health: • Reduce stress •
APJ
Fiona Tuck is a skin and nutrition expert, founder of VITA-SOL Instagram @fionatucknutritionskin | www.fionatuck.com Learn more about the impact of nutrition in treating skin conditions as Fiona shares her knowledge at the APAN Aesthetics conference.
Include at least 30 different plant-based foods per week – brightly coloured fruits, vegetables, nuts, seeds, wholegrains – Diversity is key for intake of vitamins, minerals, polyphenols, phytochemicals, prebiotics and fibre
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A new approach to an old problem MEDER BEAUTY Body-Day cream is an industry first! A new-generation biological deodorant that reduces body odour, through association with the skin’s microbiome, allowing the sweat glands to breathe naturally. The battle against body odour is still dominated by two classical strategies: •
•
deodorants that often eliminate bacteria by applying alcohol bases or bactericidal actives and cover bad odour by using fragrances and perfume. And traditional antiperspirants whose strategy is based on clogging the pores with derivatives of aluminium salts, thereby depriving the bacteria in the axilla of malodour precursors.
Both these methods that are currently used are heavily criticised by experts for their potential side effects and damage to the sweat glands’ physiological function. PROTECTING THE ROLE OF THE SWEAT GLANDS Sweat glands play an essential role in the natural body's detoxification process, helping regulate body temperature and eliminate some toxins. Regular clogging of sweat glands could lead to unwanted changes in body temperature regulation, armpit skin inflammation and tiredness. Antibacterial or alcohol-based deodorants are irritating and sensitising, often causing inflammation and pigmentation problems, especially severe in darker skin types. Body-Day is a new-generation deodorant APJ 44
based on a hybrid approach by combining natural prebiotics and probiotics and using the latest plant stem cell technology addressing bacterial communication or Quorum Sensing and anti-inflammatory calming peptides. Body-Day helps to immediately reduce unpleasant sweat odour, while simultaneously helping to restore natural skin barrier protection, acting as a natural anti-inflammatory, moisturising skincare. KEY INGREDIENTS INCLUDE: •
Morinda citrifolia (Noni) plant stem cells extract: an indigenous Australian plant well known for its healing and anti-inflammatory properties.
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Probiotics of Kimchi cabbage: Lactic bacteria used for bio-fermentation of Korean kimchi reduces skin inflammation and suppresses pathogenic bacteria.
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Innovative Peptide Calmosensine This peptide calms the skin, reducing all unpleasant sensations, such as mechanical irritation or heat reaction
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Oryza sativa: This is rice starch helps absorb the excess water produced by the sweat glands.
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Shea butter: Helps to create a pleasant silky texture.
Body-Day cream acts as a deodorant, but feels like a luxurious skincare, immediately restoring skin comfort and making skin smooth and perfectly moisturised. MEDER BEAUTY SCIENCE offers two versions of Body-Day deodorant cream: one to make it comfortable to use as a traditional armpit deodorant, and one as a body cream, helping to modulate the body odour for active people looking for multifunctional body skincare. APJ Visit us at our stand at the APAN Aesthetics Conference. MEDER BEAUTY SCIENCE 0466 338 844 admin@mederbeautyscience.com.au www.mederbeautyscience.com
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APJ 45
RESEARCH
WEIGHT LOSS AND THE ROLE OF FAT CELLS IN MAINTAINING A
YOUTHFUL APPEARANCE Dr Tiina Meder
Losing weight is considered an enhancement to looking more beautiful and even more youthful, however as we age, weight loss can contribute to some undesirable side effects, namely unsightly sagging skin that may contribute to looking older. This article presented by Dr Tiina Meder, reviews the outcome of some recent studies that provide insightful and surprising evidence that challenge this notion. In exploring the activity of fat cells and fibroblasts and their role in the appearance of ageing Japanese scientists from Shiseido research centre recently published an article claiming that facial fat is the key to rejuvenation. Despite what you may think, they don’t mean surgical fat removal or injections. As it turns out, fat cells can directly affect skin cells, particularly fibroblasts. One of the key goals of the study was to determine the causes of facial tissue ptosis and gravitational changes, such as nasolabial folds characteristic. For a long time, these changes have been associated with the increased weight, burdening the facial tissue and pushing it down along with gravitational pull. However, the results of numerous experiments, including the ones in zero gravity conditions of space programs, contradicted this hypothesis: despite the lack of gravity, the astronauts’ skin did not get any firmer and wrinkles did not reduce. SKIN PTOSIS IS NOT JUST GRAVITY Japanese scientists discovered that along with the growth of fat cells, some peculiar changes in the activity of skin cells develop, and that includes the cells of the deepest dermal level, fibroblasts. Several years ago, it was established that not only are fat cells able to store and utilise fat, but they also act as part of endocrine system secreting certain hormones and hormone-like substances. When a fat cell accumulates fat and grows, it secretes cytokines, signal molecules suppressing the expression of dermal fibroblasts -
APJ 46
genes responsible for the synthesis of elastin, collagen and hyaluronic acid. Research shows, that in people with smaller fat cells, fibroblast synthesised elastin and other structural proteins are well supported. Moreover, when the size of fat cells decreased in the process of weight loss, they start to producing adiponectin, an agent enhancing the synthesis of elastin, hyaluronic acid and collagen, making the skin firmer and more elastic as a result. A study comparing elastin synthesis in people of different body mass revealed that in overweight women’s, the skin produced less elastin than women with normal BMI. The most active elastin synthesis was observed in women in the process of weight loss: their skin cells produced even more elastin that the cells of women who have never been overweight. It can be therefore theorised that skin property is adaptive. When we store fat for a rainy day, the skin becomes softer and easily stretches to accommodate the growing body mass. When the body sheds the reserved fat, the fat cells signal the skin to tighten up and it becomes firmer again. However, weight loss must be conducted cautiously and not rapidly. For example, when weight loss is quick or very significant, the skin may not be able to tighten with the same speed, as the fat reduces. However, moderate weight loss is always followed by the skin becoming thicker and more elastic, and this is true for people of all age groups, including older people. The skin firming can happen very fast in young people and slower in older age group, but the skin reacts to weight loss without fail. At the conclusion of their study the Japanese scientists proposed the following interesting conclusions: 1. Moderate weight loss is beneficial since it prevents skin ageing and can even have a mild rejuvenating effect, which applies to the face as well as the body.
2. Liposuction does not provide the same rejuvenating effect as in this case the fat cells are not reduced in volume sending chemical signals to the skin in the process, but instead they are destroyed and removed surgically. After a liposuction the skin will maintain the same volume without lifting effect, which is why liposuction is commonly combined with surgical lifting. 3. Mechanical face lifts with threads do not restore the skin’s firmness as the cause of skin folds are not as a result of the skin stretching under the weight of fat depots, but the functioning of fat cells themselves. Skin lifting does not solve the problem of gravitational changes in the long run.
of fat tissue can actually lead to loss of elasticity and the appearance of wrinkles and creases. If your weight is within normal BMI it is not recommended to attempt weight loss for anti-ageing purposes as you would risk achieving the opposite result. However, if your BMI suggests that you’re overweight, then weight loss, apart from health benefits, will make the skin on your face and body firmer. Body mass index is a value derived from the mass and height of a person. The BMI is defined as the body mass divided by the square of the body height and is universally expressed in units of kg/m², resulting from mass in kilograms and height in metres. THE SIGNIFICANCE TO AESTHETIC PRACTICE
4. All methods of aesthetic correction reducing the fat depots in the cells will simultaneously improve the skin’s firmness, elasticity and resilience. The good news is, there are plenty of such treatments, from lymphatic drainage, both by hand and machine, radiofrequency lifting, some types of ultrasound treatments and the use of various topical solutions with lipolytic effect both in clinical cosmetic treatments and in skincare. 5. The common fear that with weight loss the skin will sag is unfounded. The human body is a clever system perfectly able to stretch and contract the skin when necessary. Of course, this applies to moderate weight loss. If you are planning to lose more than 10 kg of body weight, it is a good idea to seek professional help, including cosmetic support for the skin.
The results of this study can be applied in aesthetic practice. A treatment aimed at weight loss and rejuvenation can be highly successful in a salon or clinic. Many women are wary of weight loss because they’re worried their skin will lose elasticity and sag, and instead choose liposuction or other surgical methods. The Shiseido study has demonstrated that healthy weight loss increases the skin’s firmness and resilience. However, the best solution is a combination of healthy diet with limited calorie intake and supported by aesthetic treatments aimed at firming the skin can be more effective than diet or aesthetic correction on their own. In the process of weight loss, some machine methods can be applied as well as skincare for daily use. The key, however, is progressive and moderate weight loss that is supported with skin enhancing protocols as this strategy provide the best outcome. APJ Dr Tiina Meder will be also be a speaker at the APAN Aesthetics Conference.
6. The thinning fat cells only improve the skin firmness when the cell volume is restored from large to normal. The excessive loss
APJ 47
SKIN SCIENCE
HEAT SHOCK PROTEINS
and their important
CELL-PROTECTIVE ROLE Gay Wardle
As we advance into procedures that create skin trauma for the purpose of inducing cellular renewal, understanding the role of heat shock proteins is very valuable in helping us appreciate the body’s protective mechanism. In this technical article Gay Wardle explores the role of heat shock proteins and highlights why you should guard against taking heat and other traumas too far. Heat shock proteins are also known as stress proteins. They are found in situations where there was elevated heat, hence the name heat shock proteins. For instance, plant cells when deprived of water and subjected to heat will wilt but can be revived when the stress has been alleviated, such as when the plant is watered. Stressful conditions such as inflammation, hypoxia, oxidation, starvation, hyper-osmosis and exposure to toxic chemicals are also contenders for inducing these tiny proteins which are part of a large family of molecular chaperones. These chaperones are ATP-
APJ 48
binding proteins that facilitate protein folding and degradation and are expressed constitutively in various cell types that are elevated in times of stress. For this reason, they are also described as ‘stress shock proteins’. Heat (stress) shock proteins are very low when a cell is functioning under normal physiological conditions and are elevated when the cell is under stress. Originally identified in the early 1960s by Italian researcher Ritossa. One of Ritossa’s colleagues accidentally switched the temperature of an incubator where there were cells of the fruit fly (Drosophila) growing. He noticed that there was a puffing pattern occurring within these cells caused by an increase of transcriptional activity for a family of proteins. The consequence was an exceptional increase of transcriptional activity for family of proteins. Ritossa named these proteins Heat Shock Proteins.
WHERE DO WE FIND HEAT SHOCK PROTEINS?
THE CHAPERONE FUNCTION
All organisms share a common molecular stress response that includes a dramatic change in the pattern of gene expression which elevates this family of stress induced proteins. Heat shock proteins are found in all organisms from bacteria cells, animal cells, plant cells to human cells. Many times, they may be efficiently interchanged.
Most heat stress proteins are molecular chaperones, which normally promote the self-assembly of newly synthesised polypeptide chains of proteins into a native spatial structure, as well as the assembly of their complexes, and their transport through membranes and their participation in signal transduction.
These families of chaperones play a pivotal role in cell survival and development of cells, as well as cytoskeleton organisation and ageing.
The key characteristic of chaperones is that they have an ability to recognise non-native conformations of polypeptides and protect them from aggregation. They do this by binding to hydrophobic residues that have been exposed during translation or following stress-induced damage.
Chaperones promote the self-assembly of newly synthesised polypeptide chains where they facilitate the folding of cellular proteins. In doing this they prevent protein aggregation and target proteins that have been folded incorrectly to pathways where they are degraded.
Then new synthesised polypeptides can be maintained in a foldingcompetent state. The efficient folding is achieved by cycles of controlled binding and the release of the polypeptides from the chaperone.
Chaperones, improve cellular survival by repairing denatured proteins, dissociating initial loose protein aggregates and ensuring correct folding and translocation of proteins. This function is also needed in physiological conditions during de novo protein synthesis, folding of polypeptides and transport. De novo protein synthesis refers to protein synthesis that takes place outside the boundaries of the cell body.
The correct folding of many proteins depends on a pre-existing protein machinery composed of molecular chaperones, which also function as a means of defence against protein denaturation and aggregation caused by stress. Molecular chaperones mediate folding of newly translated polypeptides in the cytosol and within the organelles themselves, they also stabilize proteins to prevent aggregation.
In the case of severe damage, HSPs direct damaged proteins for degradation within the proteasome system.
The HSP70 proteins in mitochondria have principal roles in protein translocation. HSP90 and its cochaperones are also involved in signal transduction.
The ubiquitin/Proteasome System is a highly regulated mechanism of intracellular protein degradation and turnover. Through the concerted actions of a series of enzymes, proteins are marked for proteasomal degradation by being linked to the polypeptide cofactor, ubiquitin.
SIGNAL TRANSDUCTION Signal transduction is the process by which a chemical or physical signal is transmitted through a cell as a series of molecular events.
They play a key role in facilitating immune responses, because they can bind antigenic peptides and transport them to antigenpresenting cells and T lymphocytes. They work closely with the immune system in helping to reduce inflammation.
The rough endoplasmic reticular is an organelle that is specialised in folding and assembly of polypeptides. If the proteins are not folded and accumulated correctly then this will induce a signal that selectively activates the transcription of gene encoding.
Initially, heat stress proteins were thought to be only functional in the cytoplasm and the nucleus of the cell but, studies show that they have been implicated in intercellular signalling and transport after release to extracellular space and also to the bloodstream. The heat shock response attenuates pro-inflammatory mechanisms and inducible nitric oxide synthase activity.
The assembly and modification of proteins of the secretory pathway that occur in the RER are a pr-requisite for export to the Golgi apparatus, which has a key role in monitoring protein transport through the cell.
THE STRESS RESPONSE - PROTEOSTASIS All cells are continually exposed to several sudden and potentially harmful variations of their biological milieu. To protect proteins from misfolding, denaturation and/or aggregation, the cell will trigger a fast response characterised by several events. These events occur to protect the cell from the hostile environment and restore a balanced and safe new steady-state of protein homeostasis, which is commonly referred to as ‘proteostasis’. This response builds a physiological network that shields cells and tissues from the risky challenges that they may encounter, such as heat, cold, toxics, chemicals, UV light, radiation, drugs, infections, infestations, inflammation, pH variations, osmotic changes, nutrient deprivation, oxidative stress, hypoxia-ischemia, apoptotic stimuli, and stressful conditions for individuals such as psychiatric disorders and socially traumatic experiences. The generation of new proteostasis network implies an immediate role in protein synthesis, folding, degradation, processes that encompass the translational machinery, molecular chaperones and their associated cochaperones, the u-bi-quitin-proteasome machinery, and the autophagy system. Ribosome and associated factors are also very necessary for protein biosynthesis.
If the unfolding and the assembled proteins are disrupted this will delay the action that occurs between the RER and the Golgi apparatus. Then abnormal proteins never leave the cell, and the proteins will remain in the RER until they are degraded by the ubiquitin-proteasome pathway. HEAT SHOCK PROTEIN FAMILIES HSPs have been classified into families according to their rough molecular weight and homology. This means the state of having the same or similar relation. For example, there are HSP100, HSP90, HSP70, HSP60, HSP40 and smaller HSPs. I am only going to talk here about the HSP90 and HSP70 families. Both chaperones HSPL90 and HSP70 are highly expressed in all types of cells, and they co-operate in most of the complexes with client proteins. Client proteins is a term for a protein which is manipulated or processed, as in the folding of a client protein by a chaperone. The HSP90 family comprises of HSP90α and HSP90β, which form an inactive complex with the steroid hormone receptor before agonist binding and therefore participate in steroid hormone signalling. An agonist is a chemical that binds to a receptor and activates the receptor to produce a biological response.
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HSP90 is responsible for catalysing the interaction with several substrate proteins and co-chaperones involved in cell regulation and intracellular signalling. It is a potent autoantigen and thought to have a role in various inflammatory diseases including arteriosclerosis. Even though HSP90 is one of the most abundant proteins in other tissues, it is not present in large amounts in the normal skin. Nevertheless, HSP90 is constitutively expressed in the superficial epidermis in the suprabasal keratinocytes and has been shown to be induced by heat stress and skin wounding in the superficial thickened epidermis. HSP90 AND WOUND HEALING The presence of HSP90 in the suprabasal layers during wound healing suggests a role in keratinocyte differentiation. Wound hypoxia is a consequence of alterations in systemic haemodynamics and vascular disruption associated with wound healing. Wound hypoxia promotes fibroblast migration especially in the absence of growth factors, this happens via a mechanism dependent on hypoxia-inducible factor-1alpha, which is a mediated secretion of HSP90α. The secretion is into the extracellular space. This HIF-1α-mediated pathway also controls the secretion of multiple growth factors complementing one another and is pathway dependent on signalling via reactive oxygen species. The next family is HSP70, which comprises of many different protein variants, which are different forms of HSP72, HSPA2, Grp78, HSP70B, HSP73 and Grp75. Grp75 is a chaperone glucoseregulated protein 75 and Grp78 is a stress protein that belongs to HSP 70. The different protein variants of HSP70 are located mainly in the cytosol and nucleus, but they have also been detected in the lysosomes and endoplasmic reticulum. Grp75 has also been detected in the mitochondria and HSP72 is the major inducible HSP found in the nucleus and cytosol. HSP72 requires ATP for its chaperone activity and minimizes aggregation of newly synthesised proteins. It is also capable of inhibiting stress induced apoptosis, even after the activation of effector caspases. Effector caspases cause cell-wide specific proteolysis and dysfunction. Interestingly, HSP72 is located on the luminal side of the lysosomes where it stabilises the lysosomal membrane and inhibits the release of hydrolases and subsequent mediators of cell death.
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The protein seems to act as a chaperone in non-stressed cells, and it is also likely to have a role in the formation of clathrin and several other factors involved in intracellular transportation. Clathrin is a protein that plays a major role in the formation of coated vesicles. HSPs plays an important role in generating antigen-specific T cell responses. Complexed peptides with both HSP70, HSP90 are delivered to antigen-presenting cells by receptor-mediated internalization of the HSPs. This makes them available for further processing and presentation to the major histo-compatibility complex. As much as specific receptor-mediated mechanisms exist for binding and internalisation of HSPs, it may be envisaged that the cross-presentation of HSP-derived is a realistic mechanism for cross-priming by antigen-presenting cells. Consequently, it is logical to propose that these HSPs highly induced in several types of pathologies are indeed targets of the adaptive immune response. Exported Hsp70 increases neutrophil chemotaxis, as well as macrophage phagocytosis properties, and modulation of the response of monocytes to endotoxin. Similarly, extracellular HSP70 is related to both immunestimulatory and immune-suppressive activities. This leads to cytotoxic T lymphocyte responses, which in turn stimulates tumour cells to produce their own “cellular vaccine”. In short, gene modification of HSPs for secretion could be a practical strategy to provide an exceptional beneficial approach for cancer immune therapy. Heat shock proteins are important in the cellular response to stress and in cellular homeostatic functions such as protein synthesis and protein transport across membranes. An emerging body of data supports a role for HSPs in the inflammatory response, suggesting that HSPs participate in cytokine signal transduction and in the control of cytokine gene expression, that HSPs enhance antigen presentation to T lymphocytes, and that HSPs displayed on the surface of cells are important in targeting cytotoxic cells. Because changes in HSP accumulation occur in the whole organism under physiologic conditions, understanding the role of HSPs in the immune/inflammatory response will help in understanding the organism's response to danger. LET’S TALK ABOUT HEAT STRESS PROTEINS AND THERMOTOLERANCE What will stimulate heat stress proteins? Temperature will increase stress in these cells. These could be high heat as well as very low heat. Exposure to non-lethal temperatures will protect
the cells from subsequent exposure to higher, otherwise lethal, temperatures or other stresses which induces thermotolerance.
scarring. Heat shock proteins are present in the cytoplasm and the nucleus of keratinocytes, fibroblasts and adipocytes.
The first indication that HSPs could be involved in this process was based on the correlation between their inducible synthesis and development of thermotolerance.
HSP72 is constitutively expressed in keratinocytes, especially in the upper layer of the epidermis and in fibroblasts, macrophages and endothelium. HSP72 has been proposed to have a role in the wound healing process, which is supported by the finding that its expression is rapidly induced after skin wounding in animal models. Polymer implants intended to be used in the repair of large abdominal wounds induce expression of HSP70 predominantly in macrophages and local inflammatory response dependent on the material. Interestingly HSP70 expression shows an inverse correlation with the local inflammatory response. The antiinflammatory and pro-proliferative effects of HSP72 support its potential role in wound healing.
When there is extreme stress, damaged proteins cannot be successfully refolded and destroyed. This happens mainly through a process of protein degradation known as ubiquitin - proteasome pathways. These pathways can be blocked by specific inhibitors, which results in an accumulation of abnormal and damaged proteins. This activates the heat shock response and other molecular chaperones. The protein deposition caused by the blocked pathway can implicate disease and ageing of the body and the skin. A nonlethal increase in temperature above the physiological norm for a biological species suppresses protein synthesis in the cell, it activates the heat shock factor (HSF) and enhances transcription of heat shock genes. The exposure to a lethal temperature initiates apoptosis or programmed cell death. In turn, HSPs inhibit apoptosis and provide cells with thermal stability if stress re-occurs. In so doing, chaperones prevent irreversible aggregation of unfolded proteins and assist in the restoration of their native structure and/or degradation of denatured proteins. The response to heat shock is attenuated as the cell returns to normalcy after stress has been removed, then the HSP transforms to its inactive form and is transported to the cytoplasm, and ‘bookmarked pre-initiation complexes’ are accumulated in the promoters of the genes encoding HSPs. HSP gene polymorphisms are associated with inflammatory, autoimmune, cardiovascular, and neurodegenerative diseases and, finally, ageing. The stimuli that induce the stress response may also induce apoptosis or cell death, depending on the duration and intensity of the stress signal. Apoptosis is an active form of cellular selfdestruction that is essential to maintaining homeostasis. The ability of heat shock proteins to prevent apoptosis that can be induced by several cancer medications as well as other stimuli suggests that they could enhance tumor growth in certain cancers such as breast cancer and melanoma. This may cause a resistance to cancer therapy. THE ROLE OF HEAT SHOCK PROTEINS IN AESTHETICS We have been talking about the role of heat shock proteins, so why is this important in the aesthetic world? These proteins are increased when the cells are briefly exposed to temperatures above their normal growth temperature. There are many modalities used in aesthetics that induce heat in the skin, lasers, IPL devices, RF devices, all of which are used to reduce the signs of ageing, scar reduction and so on. Heat related modalities can effectively promote skin wound healing where the main mechanism is attributed to temperature elevation. This modifies the wound healing process by inducing heat shock proteins. We know that during this time, cell repair and wound healing are initiated, and collagen re-modelling begins. During the modulating inflammation, wound debris clearance occurs, as well as cell proliferation, migration and collagen synthesis and for these processes to occur heat shock proteins are essential for normal wound healing of the skin. Heat shock proteins also play important roles in mediating death signalling, inflammation and cell proliferation during wound healing. It is also suggested there are alternative functions during
In chronic wounds, such as ulcers and in post-traumatic wounds, the expression of HSP70 protein has been found to be low. In contrast, in healing wounds with rich granulation tissue, the expression of HSP70 is high. In the granulation tissue of healing wounds, only the endothelial cells are rich in HSP72. Of note, there is an inverse correlation between HSP72 levels and the latency of the healing process and HSP72 and essential wound healing-related growth factors which are expressed in a coordinated manner during the initial phase of healing at 7–14 days. HSP72 is passively released after cell death or plasma membrane wounding, but also actively secreted via the exosome system. Subcutaneous HSP72 delivery into murine wounds accelerates the wound closure in a dose-dependent manner. This effect was attributed to improved clearance of wound debris by enhanced macrophage-dependent phagocytosis. After skin wounding there are significant differences in the expression pattern of different HSPs. Whereas HSP72 and HSP32 are expressed only in the epidermis, HSP47 is expressed in both the epidermis and dermis, and only after skin wounding has occurred. Whether exogenously applied HSP72 may stimulate wound re-epithelialisation, which remains to be proven. Increased HPS usually results in repair of damaged and misfolded proteins and survival of the cell, mainly through their chaperone function. HEAT INDUCED THERAPIES AND COLLAGENESIS Collagenase is an important enzyme that is involved with any wound repair. There is concern that if the skin temperature reaches 44 degrees and higher and is held at that temperature for some time, HSPs increase this enzyme resulting in decreased procollagen stimulation. Both these actions will degrade the skin’s own protein collagen. Studies demonstrate that these increased temperatures increase ROS and cytotoxicity, which are all contributors to the skin ageing. These are important considerations when working with heat-based technologies. IN CONCLUSION Heat shock proteins are specific proteins that are made when cells are briefly exposed to temperatures above their normal growth temperature. The synthesis of HSPs is a universal phenomenon, occurring in all plant and animal species, including humans. HSPs are also made by bacterial cells and can also be induced by oxidants, toxins, heavy metals, free radicals, viruses, and other stressors, which are sometimes called tstress proteins. Members of the extensive HSP family play a key role in cellular protein homeostasis and cyto-protection. By modulating inflammation, cell proliferation, migration and collagen synthesis, HSPs play an important function in normal skin wound healing. Gay Wardle will be also be a speaker at the APAN Aesthetics Conference.
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STAR PERFORMER
VITA-SOL Good skin starts from within Developed by nutritionist and skin expert, Fiona Tuck, the VITA-SOL nutraceutical ingestible range is designed to support the skin from within. “I advocate taking a holistic approach to skincare that embraces building the foundations of a healthy diet, complemented by premium nutraceutical wholefood supplements, and a simple yet effective topical skincare routine based on evidence-based ingredients. Simply popping vitamin pills that contain high dose isolated nutrients without getting the foundations of a healthy diet right is missing the mark, as you don’t get the same nutrients, fibres, phytochemicals and pre and post-biotics that you would get from wholefoods” explains Fiona. “At VITA-SOL we are passionate about education and provide an online training platform to ensure all practitioners are kept up to date with the latest evidence-based training in regard to skin, gut and nutritional information”. There is a strong link between what we eat, our gut health and our skin, so to truly deliver the very best results for our clients, we need to address skin concerns holistically. Each product has been carefully formulated using the very highest quality ingredients to support specific skin conditions without the use of isolated high dose vitamin pills, making the products safe and easy to recommend. This is why VITASOL is quickly becoming the number one skin professionals’ choice. The range includes pure marine collagen at therapeutic dose backed by clinical results, certified organic herbal tisanes and nutritionally dense wholefood powders based on the concept of nutrigenomics to target specific skin concerns. Free from added sugar, artificial sweeteners and additives, the formulas are comprised of organic plant derived vitamins, minerals, sprouted blends, pre and post-biotics, and phytonutrients to support gut, liver and skin health. VITASOL is soon to add a premium skin omega product to our impressive ingestible product lineup. Our most popular product is Purity
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Greens, a liver, gut and skin greens powder which contains 32 plant-based ingredients, including pre and post-biotics, sprouted ingredients, naturally sourced vitamins, minerals and antioxidants, as well as liver and digestive supporting herbs. Purity Greens contains: •
Certified Organic greens and sprout blend, including Dandelion, Milk Thistle, Broccoli Sprout and Green Kiwi Fruit powder.
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It contributes to the maintenance of normal liver function.
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Nutritionally dense formula from all vegan friendly ingredients.
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Suitable for gut health and problematic skin.
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MULTI ACTIVE CONCENTRATE – GENTLE EXTRACTION – TESTED FOR TOXIC HEAVY METAL SAFETY – NO SYNTHETICS
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RRP $63 / 210g / 30 serves
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Flavour is a refreshing greens flavour with a hint of lime.
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Industry leading mark-up for stockists. APJ
Vita-sol.com
websiteeligibility and application criteria. VITA-SOL www.vitasol.com
Good skin starts from within...
Targeted multi active nutraceuticals developed from organic wholefoods for gut, liver and skin support, organic herbal tisanes and 100% pure marine collagen peptides. We source the highest quality ingredients across the globe to ensure purity and efficacy without the use of fillers, emulsifiers, artificial colours or flavours. Online clinical support and training led by nutritional medicine practitioner and skin expert Fiona Tuck. Proudly Australian.
The professional's choice. Visit: vita-sol.com to view stockist eligibility and application criteria. APJ 53
AROMATHERAPY
In our profession, as skin therapists or clinicians, the issue of regeneration is so vital. Whether it is attempting to restore balance to a skin condition or to achieve anti-ageing benefits, essential oils can offer us an incredible tool for achieving results. As professionals, we must guard against the media hype that essential oils are purely a pampering option and pursue to better understand their powerful healing and therapeutic properties as they can be highly useful in helping you achieve results. We also need to overcome our fear of contra-indications in undertaking to select oils for use. This can easily be overcome by ensuring that for every oil that you use you have a complete therapeutic profile on its properties and benefits, what oils it will mix well with and of course, any contra-indications. That way you are assured you are working within the safety guidelines of its use. If at all in doubt for a particular client, halve the dose of essential oil within your carrier oil to ensure safety, or better still, do a patch test. Another consideration for any professional who aims to achieve credible results, is to ensure that the oils you choose are of the highest quality. This is because the properties, benefits, therapeutic constituents and safety considerations will vary significantly based on the purity and quality of the oil and therefore compromise the treatment outcome.
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Be aware that the market is full of false or diluted oils. These are often derived from different plant types or from different plant parts. For example, a cheap nerol oil may include petitgrain. Pure neroli oil comes from the flower of the bitter orange, while petitgrain comes from the leaves or young tips or twigs. The aromas are compatible and therefore you can mix the two to achieve a similar aroma, however by doing so the chemical constituents and the therapeutic benefits have been substantially altered and of course, so has the cost factor, as petitgrain is much cheaper. What you are getting may smell the same, but the therapeutic values are highly compromised. To achieve the outcomes that you want seek for genuine, pure and unadulterated oil. Expensive oils are also often extended by include a percentage of carrier oil to make them more economical. However, a dilluted oil should also has a shorter shelf life. To ensure you are getting the very best possible quality here are a few guidelines: •
Botanical name: Always check the botanical name, as common names tend to vary.
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Credible supplier: Where you purchase your oils from should be beyond reproach. If a distributor dilutes, or adulterates the essential oils to increase profit, this will adulterate the oil.
CYTOPHYLATIC AND REGENERATIVE OILS On-going research is unveiling the incredible properties of numerous essential oils for both healing and medicinal purposes. However, for the purpose of this article we will highlight some valuable oils that offer us excellent cytophylactic and regenerative properties for both face and body needs. The term cytophylactic derives from the Greek works cyto (which means cell) and phylactic which means (to preserve). Therefore, cytophylactic oils have the ability to preserve and promote cellgrowth and assist in their regenerative capacity. To a certain extent most pure essential oils have this capacity however, there are some that lead the way. Below I have included a brief profile of seven oils that we believe provide excellent benefits in this regard. Because of space restrictions we are not including their chemical constituents and in fact, not all of their benefits. However, the information I have provided should help you better understand their benefits for use within your salon. EVERLASTING Helichrysum antgustifolium A yellowy brown oil with intense rich honey-like scent, strongly woody with a hint of spice and delicate tea-like undertone. Blends well with: Geranium, Rose, Neroli, Lavender, Orange, Rosewood, Chamomile, Petitgrain and Frankinsence. Properties: anti-inflammatory, lipolytic, emollient cytophylactic, anti-coagulant, astringent, fungicidal, antispasmodic, nervine and sedative. Skin: Cell regenerator, heals scars, acne, dermatitis, abscesses, psoriasis, tinea, stretch marks, skin trauma, allergies, eczema, couperose, inflammation, skin rash, haemostatic (stops bleeding, therefore excellent after extractions).
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Chemotype: Check the chemotypes as they can substantially differ in properties. Some oils have a variety of chemotypes, this may make one type more beneficial than another e.g. Lavender Spike (lavendula spica/latifolia) is a monoterpene and cetones including camphene and limonele that make it a better choice for oily skin. Whereas Lavender angustifolia with its higher esters makes it a better choice for systemic and psychological and nervous disorders.
Circulation: Promotes cell growth, rebuilds tissue, energizes organs, boosts immunity, regulates blood pressure, detoxifying, beneficial for internal and external phlebitis (varicose veins), increases lymphatic drainage, and strengths the body against viral infections. Muscular/Skeletal: Anti-inflammatory, tendonitis, bursitis, aches and pains, rheumatism and arthritis. Nervous System: Lessons the effect of shock or fear, depression, increases dream activity, stimulates right side of the brain, helps with nervous exhaustion, neuralgia, amnesia, addictions, burnouts and mood swings. Precautions: There are no known contra-indications.
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Origin: The country of origin and climatic conditions will also affect the quality and efficacy of the oil due to varying soils and harvesting conditions.
LAVENDER Lavendula angustifolia
Wild or registered organic: For the best quality, the plant source should be guaranteed wild or registered as organicallygrown to ensure that no chemicals are used in its cultivation, therefore no pesticide residue will be in the distilled product.
Blends well with: Chamomile, Bergamot, Rosemary, Patchouli, Lemon, Palmarosa, Geranium, Nutmeg, Ylang Ylang.
Extraction method: The distillation process is an important factor to consider, if the process is cut, or redistillation occurs the chemical constituents will vary.
A colourless oil with a floral, light, herbaceous, sweet scent with balsamic, woody undertones.
Properties: Anti-depressant, anti-spasmodic, decongestant, nervine, cytophylactic, tonic, antiphlogistic and deodorant. Skin: Promotes cell growth and is beneficial for dermatitis, burns, sunburn, acne (however, Lavender Spike is the best for acne), eczema, itchy skin, psoriasis, boils, cuts, scratches, tinea, wounds and skin rashes. APJ 55
Circulation: Sedative to the heart, reduces high blood pressure, palpitations, chronic fatigue syndrome, blood thinner, increases capillary circulation, raises blood sugar level, heat exhaustion and sunstroke. Muscular/skeletal: Muscular spasms, sprains, strains, lumbago, sharp rheumatic pains, Carpal Tunnel Syndrome (great for therapists arms or office workers who do repetitive movements) and Lupus. Nervous system: Psychological disorders, relieves anger, exhaustion, calming, manic depressive states, insomnia, nervous tension, hysteria, mental distraction, irritability, burnout, panic attacks and chronic fatigue. Precautions: Avoid during pregnancy and low blood pressure. BENZOIN Styrax Benzoin A pale yellow to brown oil, with a resinous, sweet, vanilla-like scent and is one of my favourite oils. (The light colour oils is higher quality than the darker oil). This is a very pleasant oil that is not used enough. Being a base note, very little is needed to create a wonderful aromatic formula with excellent properties.
Nervous System: Tension and stress, calming effect on nervous system, comforting for sadness and loneliness, depression, warms emotions, euphoric, burnout, beneficial for post-natal depression. Precautions: Excessive amounts may cause drowsiness. Avoid with irritated, sensitive or inflamed skin and dermatitis. VIOLET viola odorata The essential oil extracted from the leaf has a dark green colour and leafy odour with a delicate floral undertone. The flower absolute is yellow with a sweet rich floral odour. Blends well with: Lemon, Orange, Grapefruit, Lavender, Sandalwood, Rose and Jasmine. Being a base note, its aroma is long-lasting. Properties: Analgesic, cytophilactic, aphrodisiac, stimulant (circ.) antiseptic, antirheumatic, sedative. Skin: In terms of the skin violet is excellent for wound healing and bruises, congested skin, inflammation, acne, eczema, broken capillaries, thread veins and refines pores. Menstrual: Menopausal symptoms, irritability and hot flushes.
Blends well with: Bergamot, Sandalwood, Orange, Juniper, Lavender, Petitgrain, Lemon, Frankincense and Myrrh. Properties: Anti-inflammatory, cytophylactic, astringent, antiseptic, antioxidant, diuretic, cicatrising (wound healing) and carminative (curing flatulence). Skin: Cracked, dry skin, improves elasticity, chapped hands and heels, rashes, wounds, sores, redness, powerful skin healing effects, bruises, scars, ulcers, cuts, acne, couperose, liver spots, regenerates skin, dermatitis and chloasma.
Circulation: Pour circulation, gout, comforts and strengthens the heart. Muscular/Skeletal: Pain relieving, rheumatism, fibrositis and gout. Nervous: Sedative, insomnia, anger, anxiety, epilepsy, dizziness and fits, congestion of the head. Precautions: There are no known contraindications for violet, however in rare instances some individual may be sensitive to high doses.
Circulation: Improves poor circulation, warms the heart and controls blood sugar levels (diabetes).
ROSEMARY Rosmarinus officinalis chemotype Camphor
Muscular/skeletal: General aches and pains, arthritis, gout, pain, rheumatism, warming of painful joints.
Rosemary has several chemotypes, but the most expensive being (verbenon) which offers incredible energy and therapeutic
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properties. However, we have chosen to profile the camphor chemotype as it is an excellent choice and slightly more affordable. Blends well with: Geranium, Peppermint, Ginger, Melissa, Petitgrain, Tea Tree, Lemon, Lavender, Lime and Bergamot. Properties: Anti-depressant, hypertensive, sudorific, tonic, antioxidant, astringent, stimulant, nervine, cytophylactic, antispasmodic, cicatrising (wound healing), diuretic, aphrodisiac and fungicidal. Skin: Sagging skin, congestion, puffiness, swelling, burns, wounds, acne, varicose veins, dermatitis, eczema, aids circulation in all layers (improves oxygen and nutrients to the skin and product absorption), regenerates tissue and aids glandular activity (sebaceous, perspiratory). Circulation: Chronic fatigue, stimulates lymph flow and tissue fluid circulation, temporarily paralysed limbs, heart tonic, cardiac stimulant, normalises low blood pressure, anaemia, high blood sugar levels, poor circulation, palpitations, adrenal cortex stimulant, fainting, cellulite, fluid retention, obesity and high cholesterol. Muscular/Skeletal: Arthritis, rheumatism, pain relieving, tired, overworked muscles, sprains, myalgia, tones muscles, pains associated with toxic elimination, cramps, sciatica, increases connective tissue regeneration (Rosemary Camphor is best for muscular conditions). Nervous: Clears the mind, aids memory, mental strain, general dullness, lethargy, mental weakness and exhaustion, multiple sclerosis, fatigue, Parkinson’s Disease, sciatica, chronic fatigue, speech impediments. Precautions: Avoid use with epilepsy, during pregnancy, where insomnia is present. PATCHOULI Pogostemon patchouli An amber dark orange liquid with a strong, earthy, exotic fragrance, yet sweet and spicy. Another base note that can be used sparingly with excellent properties. Blends well with: Lavender, Pine, Sandalwood, Lemongrass, Rock Rose, Geranium, Ginger, Neroli, Bergamot or Clove. Properties: Cytophylactic, tonic(digestive) cicatrising (wound healing) antiseptic, fungicidal, aphrodisiac and antiphlogistic-antiinflammatory. Skin: Acne, allergies, inflamed skin, seborrheic eczema, cracked skin, scar tissue, abnormal epidermis, loose skin after dieting, rough skin, sores, wounds, dermatitis, enlarged pores and wrinkles. Circulation: Low immunity, varicose veins, cellulite, offset sweating, deodorant, endocrine stimulant and fluid retention. Suppresses appetite. Menstrual: Post natal depression, eases menopausal sweats, regarded as safe to use throughout pregnancy. Nervous: Lethargy, sharpens wits, anxiety, depression, nervous exhaustion, sedative in low doses, stimulant in high doses, balance and clears the mind, cheering and contentment. Precautions: No contra-indications other than remember that it is sedative in low doses and stimulating in high doses.
LEMON Citrus limonum A pale greeny-yellow oil with a fresh sharp sweet and citrus fragrance. Blends well with: Benzoin, other citrus oils, Rosemary, Ginger, Eucalyptus, German and Roman Chamomile, Lavender, Rose, Frankincense and Bergamot. Properties: Hepatic (stimulates the liver) anti-microbial, astringent, bactericide, antispasmodic, cytophylactic, wound healing, diuretic, emollient, hypoglycaemia, anaemia, rheumatism and haemostatic. Skin: abscesses, acne, boils, greasy skin, eternal bleeding, herpes, dull, pale skin, broken capillaries, soften scars, couperose, aids epidermal function, stimulates connective tissue (collagen and elastin), aids balancing of the acid mantle, combats skin ageing, wounds and skin rashes. (See also precautions). Circulation: Vitality to red blood corpuscles, eases anaemic conditions, stimulates action of white blood cells, aids body’s defence system, toxaemia, high blood fat, cholesterol. It helps varicose veins, aids high blood pressure, heart tonic, chronic fatigue syndrome, tightens blood vessels, helps stop bleeding, purifies and stimulates glandular activity, poor circulation, reduces blood sugar levels, endocrine stimulant, oedema, cellulite and obesity. Muscular/Skeletal: Arthritis, inflamed joints, tightens smooth muscles, strengthens connective tissue. Nervous: Cooling and refreshing and clears the mind, mental fatigue, chronic fatigue, stimulates the brain and all sensory organs, stimulates the parasympathetic nervous system, assists in intellectual concentration, forgetfulness, moodiness, nightmares, Parkinson’s Disease. Precaution: May cause dermal irritation, sensitising used highly diluted 1-2% on skin. Lemon is photo-toxic so avoid sun exposure and avoid in cases of low blood pressure. IN SUMMARY As you can see the study of essential oils is a fascinating one. It is incredible to discover how many benefits are stored into just one oil, and the wonderful way they can support the skin and body. Of course, many of these conditions require the care of a qualified medical or healthcare practitioner, however essential oils can provide symptomatic relieve as a complimentary treatment. If you are serious about essential oils, it is highly recommended that you pursue formal education and training in aromatherapy essential oils, in order to use them in the most effective and professional manner. As skin therapy is moving towards addressing the body from a holistic perspective, the popularity of offering our clients spa and body treatment that also support wellness can be a natural transition. Now more than ever, essential oils are one of the most credible options to work with as they have the amazing ability to also cross the blood/brain barrier allowing a practitioner to assist their clients on multiple levels. In an age when science is searching for ways that ingredients can penetrate the skin, essential oils have always let the way with their wonderful ability to penetrate the skin to the blood stream and allow us to take treatments beyond just skincare, to supporting the body’s wellbeing. However, the key to what you can achieve will always come back to your correct knowledge of their use and the quality and purity of the products you chose to work with. APJ
TIPS ON MENTAL WELLBEING
CELEBRATING THE GIFT OF GIVING
As part of our new column Tips on Mental Wellbeing, we share with you some thoughts based on Rick Hanson, PhD on the issue of Generosity. Life gives to each one of us in so many ways. For starters, there’s the bounty of the senses – including chocolate chip cookies, jasmine, sunsets, wind singing through pine trees, and just getting your back scratched. What does life give you? Consider the kindness of friends and family, made more tangible during a holiday season, but of course, continuing throughout the year. Consider the giving of all those people in days past who figured out how to create electricity, a dishwasher, a vacuum cleaner, inventions that we take for granted, but which make our lives a little easier. Consider the giving of the natural world, the sound of rain, the sweep of sky and stars, the majesty of mountains, the song of a bird and the smell of a rose. How does nature feed you? How about your DNA? The moment of your conception presented you with the build-out instructions for becoming a human being. You don’t earn these things. You can’t. They are just given. The best you can do is to receive them. That helps fill your own cup, which is good for both you and others. It keeps the circle of giving going; when someone deflects or resists one of your own gifts, how inclined are you to give again? It draws you into a deep sense of connection with life. And if nothing else, it’s simply polite! HOW DO YOU CULTIVATE THE APPRECIATION OF A GIFT? Start with something a friend has recently given to you, such as a smile, an encouraging word, or simply some attention. Maybe a cup APJ 58
of coffee that someone made for you. Take a few moments to relish the experience, then open your heart to the feeling of you giving too. Notice any reluctance here, that may make you hesitant. A feeling of shyness or that your giving will not be appreciated. Try to open past that reluctance to accept what’s offered, to take it in – and enjoy the pleasures of this. Let it sink in that giving and receiving generosity is good experience that you should not take for granted – pause and appreciate it. Next pick something from nature. For example, open to the giving folded into an ordinary apple, including the cleverness and persistence it took, across hundreds of generations, to gradually breed something delicious from its sour and bitter wild precursors. See if you can taste their work in its rich sweetness. Open even more broadly to the nurturing benevolence in the whole web of life. Take a breath and enjoy receiving trillions of atoms of oxygen – most of them the gifts of an exploding star. Consider some of the intangibles flowing toward you from others, including goodwill, fondness, respect, and love. See if you can drink deeply from the stream coming from one person; as you recognise something positive being offered to you, try to experience it in a felt way in your body and emotions. Then see if you can do the same with other people. If you can, include your parents and other family members, friends, and key acquaintances. Try to stretch yourself further. Recall a recent interaction that was a mixed bag for you, some good in it but also some bad. Focus on whatever was accurate or useful in what the other person communicated and try to receive that as a valuable offering. Open your mind to the good that is implicit or down deep in the other person, even if you don’t like the way it has come out. Keep listening, touching, tasting, smelling, and looking for other overflowing generosity coming your way. Now practice the joy of giving from an intentional heart that seeks nothing in return – these experiences enrich our lives with the joy of our human existence. APJ
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COSMETIC MEDICINE
DEVELOPING A TREATMENT PLAN FOR COSMETIC INJECTABLES Dr Giulia D’Anna
As aesthetic medicine is becoming increasingly popular, we are now seeing dentists exploring the option of adding facial cosmetic enhancement through injectables to their scope of practice. Our editor, Dr Giulia D’Anna is a dentist, dermal therapists and a qualified cosmetic injector. In this article she addresses the different approach that is needed when developing at treatment plan when transitioning from dentistry to cosmetic injectable services. While the advice is directed at dentists, it can also be of value to other practitioners who provide injectable cosmetic treatments. Treatment planning for cosmetic injectable procedures is a challenge when we compare it with the regular medical interventions such as dental. One reason is that minimal invasive cosmetic procedures are constantly evolving and there appears to be so many different guidelines to follow. Another difference is the input of the patient. When a patient sees a dentist for an examination, the treatment planning is largely determined by the practitioner, with only minimal input from the patient. After all, this is our specialised field and most of what we do cannot be determined by the patient, as we know dental health best. This is very different when it comes to cosmetic injectable treatments, as our work is now featured externally on the face and will involve the patient’s input, as they share with us their concerns and what they would like to see corrected or enhanced. With dentistry, while there may be slightly different approaches among practitioners, when following existing guidelines, we can expect consistent and reproducible treatment outcomes, but when it comes to aesthetics and cosmetic procedures, the rules are different. COMMUNICATION IS KEY TO THE TREATMENT PLAN Communication is key when designing a treatment plan, just like in all clinical scenarios. To successfully meet the patient’s goals, it is important that the patient clearly communicates the changes they are looking for. Occasionally, a patient will offer a broad concern such as “I just don’t like my face.” In this case, the practitioner should be able to identify aspects of the face that deviate from the
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aesthetic norm and communicate their recommendations to the patient. When this happens, frequently the patient will immediately acknowledge that their observations are correct. This helps to form clarification and agreement for the treatment objectives. During the consultation process it is important that the practitioner should not feel as if he/she is leading the patient. The aim should be that both parties come to an agreement on the objectives of the treatment outcome. To some extent, the result depends on the anatomy and physiology with which the patient presents. It is important that the patient understands both the possibilities, as well as the limitations to what can be achieved before commencing any procedure. With cosmetic injectables and skin treatments, patients are more likely to take responsibility for the treatment planning. They might even try to be the decision makers of what should be treated and what kind of product should be injected. However, we cannot let the patient take the reins on that decision, as this would be the equivalent of telling an artist which paint and paintbrush to use to get the result. If you are a less experienced injector this may appear as a welcomed option, as it takes some of the pressure off you in alone designing on an accurate treatment plan. For the experienced injector however, this might pose a challenge. We need to ensure that the patient knows we are the expert and while we may welcome their input, the technical aspects are totally our responsibility. Similarly, the practitioner must be able to identify the areas of concern. One of the most crucial aspects of the aesthetic consultation is to ensure that the practitioner understands the patient’s goals and that these goals are realistic. To achieve this, photos are useful tools to help determine and discuss the patient’s goals. The practitioner must also honestly assess their ability to achieve the result. It is wise to be conservative in cosmetic injecting at the beginning of your journey. This may mean referring a difficult case to a more experienced practitioner or staying within one’s comfort zone to avoid doing irreparable harm. It is better to return for a minor revision than to create the need for a major revision.
LIMITING FACTORS Over the course of my career, I have found that dental practitioners are often confronted with a major barrier that they need to overcome. This is not because they lack the skills or knowledge in delivering the procedure that needs to be undertaken, but rather they find themselves in an uncomfortable position when pointing out to the patient areas of the face that are not aesthetically pleasing. Often, I have heard them saying phrases like: “You are so beautiful, you don't need any work”, or "Oh don't be silly. You look great already." “We only need to do a tiny bit of work, because you look so lovely already.” While these statements may be comfortable to say, you need to identify how you can best help your patient achieve what is best and important to the patient. They have sought your advice to correct their aesthetic concern, so, address the concern and whatever else your eyes see. Do not limit the patient’s result because you “feel bad” in pointing out to them any deficiencies in their appearance that you have identified. Numerous findings on the patient’s physical assessment may pose limitations to the expected outcome, irrespective of the skill of the practitioner. Despite the artistry with which the supportive tissues are manipulated, the ultimate aesthetic outcome of the face is based on how the overlying skin drapes over the supporting framework. Thick and thin skin can both predispose to different outcomes. Thick skin draped well over most well-structured skeletal and dental structures. In contract, thin skin is unforgiving in that all imperfections can be visible with filler boluses and minor irregularities can become alarmingly apparent requiring revision. ARE WE JUST COSMETIC INJECTORS, OR ARE WE DENTISTS, DOCTORS OR NURSES WHO HAVE EXPANDED OUR SCOPE OF PRACTICE TO INCLUDE COSMETIC INJECTIONS? For some reason, this seems to be a point of contention that I have never really understood. For me, you will always be your primary vocation by title. I went to dental school and will always be a dentist. That does not mean that you cannot develop skills that further assist your patients. So, I consider myself both a dentist and cosmetic injector, and these are not exclusive of one another. But let’s look at some key opinion leaders for some insight. Mauricio De Maio is a plastic surgeon and KOL for Allergan, the company that produces Botox. He has authored a textbook titled “Injectable fillers in Aesthetic Medicine” [Springer, 2014]. In this book, Dr Maio writes the following statement:
textbook, Dr Goldstein writes, “Our approach to diagnosis and treatment planning includes three major areas: the face (macroesthetics), smile (miniesthetics), and teeth (microesthetic). These serve as a framework for systematic evaluation of the aesthetic needs of each patient.” It is a disservice to our patients if we do not consider the face as a whole. Comprehensive treatment planning should include the treatment options for teeth, smile and the face overall. Choosing only one component in our treatment planning, is akin to ignoring skin health and only focussing on a skin tag. And it is in our scope to consider facial injectable treatments if we have the appropriate training and insurance. AHPRA has many published guidelines about our scope and our role as a cosmetic injector. As with any treatment, we must be trained, insured, have currency of practice and remain competent before proceeding with our treatments. This also means offering several treatment options, including no treatment and referral where necessary in our treatment plan. STEPS IN DEVELOPING THE TREATMENT PLAN The best treatment plan comes from the goal of achieving an improvement in the facial aesthetic of our patient that looks natural and untouched. Therefore, our responsibility and goals are to help them be realistic in what can be accomplished so that they can look their best. It is not about getting rid of every line and wrinkle, but rather its about helping women and men look their best at any age. To develop an aesthetic plan, we must shift from a two-dimensional focus of focussing only a particular problem, to a three-dimensional focus (recontouring and volume restoration). It is important to tailor our plan to the individual needs, which include the traditional dental treatments, alongside cosmetic injectable options. As clinical practitioners, we need to ensure that we look at many baselines before jumping right in and undertaking cosmetic treatments. As much as we all love cosmetic injecting, don’t forget to base your decision on your first vocational role, whether it be a dentist, doctor or registered nurse. The steps in developing a cosmetic injectable plan are the same as the usual healthcare steps. These are: 1. Gather data 2. Analyse data
“The physical examination is of utmost importance in lip reshaping. Both the upper and lower dental arcade promote an important role in lip augmentation. If the teeth (central and lateral incisors) are inclined backwards, lip projection is extremely difficult and sometimes impossible.”
3. Diagnosis list
So, as cosmetic injectors we are in the prime position to undertake lip augmentation by first reviewing the lip structure and architecture, while also considering the position of the teeth. I believe that this highlights how cosmetic injecting and our vocational training are intimately connected and always should be. We need to be dentists, medical doctors or nurses first and add this knowledge to enhance our treatment objectives when reviewing our injecting treatment plan.
6. Maintenance
Here is another example. I am sure some of you know of Dr Ronald Goldstein, the father of cosmetic dentistry. I had the pleasure of hearing Dr Goldstein speak in New York in 2016 about integrating facial aesthetics and dentistry for outcomes that include all the facets of the patient. Dr Goldstein has authored the textbook “Esthetics in Dentistry” [Wiley, 3rd Ed, 2018]. He has dedicated chapters to consideration and treatment of the facial tissues alongside more traditional restorative approaches. In this
• posture
4. Health restoration 5. Cosmetic improvement
Specifically, pay particular attention to: 1. The clinical examination: Look at the following attributes of your patient: • Physical examination
• speech • breathing • communication (slurs, lisps etc)
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• muscle tension
• Soft tissue attachments
2. For dentists consider the Intra-oral and extra-oral exam
5. Radiographic examination: For assessment of the skeletal structure of the face and teeth
• evaluation of head and neck • Symmetry of facial form • TMJ analysis
• Perhaps consider getting a dental report so that you can check that the patient has no active infections. This can be attained on request from the patients dentists. For the dentists reading this article, it is your role to collect this data through an OPG, or lateral cephalogram to check if the jaws are aligned, and so on.
• Eye position 6. The Facial contours • Skin health: Lesions, lumps, bumps Temples: Temporal fusion line prominent • History of sun exposure, smoking Lateral cheek: Sunken appearance, Lines evident • Lip projection Jaw line: Jowl Prominent, Angle of mandible lost into neck • Chin position Tear Trough: Orbital fat pad prominent • Facial profile: Convex, concave, flat 3. Periodontal and gum Examination • Are the gums healthy? • When was the last dental check for the patient? We need health teeth and gums for best results and to reduce the incidence of infection or other complications 4. Examination of teeth • Are there any apparent irregularities with tooth position? • Vertical dimension • Horizontal dimension • Occlusion
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Cheekbones: Flat malar apex, No definition, Medial cheek more prominent than malar apex Chin: Sucked in appearance, Convex profile, Lower lip fall back, Lower third short, Chin looks square and wide. IN SUMMARY So, to summarise, an aesthetic plan is more than just the one feature of the face,and always has been. It involves all the components of the face, and it is our role as cosmetic injecting practitioners when determining the treatment plan to assist our patients fully and comprehensively. APJ To learn more about cosmetic injecting, maintaining competency and recency of practice, please visit www.dermaldistinction.com Dr D’Anna will also be presenting two lectures on cosmetic injetable procedures at the APAN Aesthetic Conference.
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SKIN TREATMENTS
ROSE VERSUS ROSEHIP
their benefits and DIFFERENCES Tina Viney
When we think of Valentine’s Day Red Roses are undeniably the ultimate symbol of romance. Roses have captivated culture throughout history and inspired poets and art along the way. But what about rosehip, is it really related to the rose, how does it compare and are their extracts compatible with each other for health and skincare use? In this article we will examine their similarities and differences and compare roses to rosehip, as both these offer exceptional skin and health benefits. Understanding their composition will allow us to use them to their full potential. Let’s first look at the rose. There are so many different types of roses – in fact, over 150 species exist in the genus and thousands of cultivated hybrids. They come in a variety of beautiful colours, delicate white, pink or blush, to bold rich reds, vibrant yellow and oranges and every variation of colours in between. The fragrance of rose in its natural form, is instantly recognisable, delicate, intriguing with a lingering allure consisting of a mixture of sweetness and earthiness. The extract of rose essential oil is prized as the most expensive essential oil of all plants. Being such a desirable fragrance, it is often adulterated and mixed with other oils such as geranium, or petitgrain to make it more cost-effective. It is also synthetically formulated, however the artificial aroma of rose lacks the deeper aromatic complexities and of course, it also lacks the therapeutic constituents of genuine rose extract. Numerous studies on the pharmacological properties of rose oil have been conducted on both animals and in humans. Studies have observed that rose oil had physiological and psychological properties. To examine rose’s therapeutic constituents Rosa damascena or Damask Rose has primarily being used as it is considered to have the highest percentage of therapeutic properties. The most important components of rose oil being terpenes, glycosides, flavonoids, and anthocyanins. Over the past two decades numerous studies and clinical trials have investigating various species of roses, but predominantly the Damask Rose. The studies evaluated rose oil via different approaches. Rose oil has been administered as aromatherapy, or topically in these studies. The studies concluded that rose
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essential oil can be absorbed into the body via the skin or the olfactory system. Many studies found that olfactory stimulation by essential oils may produce instant changes in physiological parameters including, muscle tension, blood pressure (BP), pulse rate, skin temperature, skin blood flow, electrodermal activity, and brain activity (Diego et al., 1998; Field et al., 2005; Lorig and Schwartz, 1988 ; Tisserand, 1996; Van Toller et al., 1993). In Persian Medicine, rose oil has been alleged to have antiinflammatory, anti-infective and wound healing activities and has been used for relieving headache, haemorrhoids, inflammatory conditions of gastrointestinal tract, and muscular pain (Agili Shirazi, 2008; Ibn Sina, 2005). Pharmacological activities of rose oil have been evaluated by several in vitro and in vivo studies (Maleev et al., 1972; Boskabady et al., 2006). Some studies have demonstrated its effects on the central nervous system (CNS) including hypnotic, anti-convulsant, anti-depressant, anti-anxiety, analgesic activities as well as alleviation of morphine withdrawal signs (Abbasi Maleki et al., 2013; De Almeida et al., 2004; Naziroglu et al., 2013; Ramezani et al., 2008; Umezu et al., 2002; Boskabady et al., 2011). Rose oil has also revealed a wide spectrum of antibacterial and antifungal properties against some pathogens including Bacillus cereus, Pseudomonas aeruginosa, P. fluorescens, Penicillium notatum, Aspergillus niger and Candida albicans (Eris and Ulusoy 2013; Gochev et al., 2008; Shohayeb et al., 2014; Ulusoy et al., 2009; Uniyal et al., 2013. Rose oil also enhanced ileum contractions and gastrointestinal motility in rats (Sadraei et al., 2013). Inhalation of rose oil showed protective effects against damages caused by exposure to formaldehyde in male reproductive system (Köse et al., 2012).
There are four key areas that rose essential oil has been identified to provide benefits. These include: Psychological benefits: Rose oil can induce calmness and enhance relaxation. It has also been proven to have anti-anxiety and antidepressant properties enhancing mood and a feeling of joy. Rose essential oil is a cheering oil. Analgesic effect: Rose oil has proven effective in the management of pain as it provides a mild analgesic effect. Studies have confirmed that massage with rose oil reduces the severity of dysmenorrhea, and also reducing menstrual pain and bleeding. Another study (Marofi et al., 2015) demonstrated the reduction of postoperative pain by rose inhalation stimulating the olfactory system, increasing parasympathetic activity, releasing neurotransmitters such as enkephalin as well as reducing sympathetic activity and the release of cortisol and noradrenalin. Hormonal effects: A woman’s perimenopause period is earmarked by hot flashes, trouble sleeping, mood changes, and decreased sexual arousal, among other side effects. The natural decline in reproductive hormones is believed to be a major cause for many of these. Japanese scientists tested 10 different essential oils on women to see what effect, if any, they had on salivary estrogen levels. Rose otto and geranium boosted the levels when compared to control. Interestingly, these two, share similar chemical profiles. The other essential oils failed. Those were lavender, jasmine absolute, clary sage, ylang ylang, frankincense, neroli, orange and roman chamomile. Skin benefits: Studies have confirmed the anti-inflammatory activity of rose absolute, but not other forms of rose oil. This is great news for skincare as many creams and serums that include rose oil use rose absolute. Another study concluded that at a concentration of just 0.25%, the lab study found that rose essential oil “completely killed” Propionibacterium acnes bacteria after just five minutes. While the root causes of pimples and blackheads may have many reasons, however it’s well-known that the presence of P. acnes bacteria in the closed nodules correlates with higher inflammation and redness. So, in short, the less of it on your face, the less severe your breakouts will probably be. When it comes to the anti-ageing properties of the Bulgarian rose Rose Damascena has the most active constituents with over 40 compounds that are beneficial to the skin. It is not only antiinflammatory but also contains a combination of antioxidants like citronellol and geraniol which help diminish the signs of ageing such as wrinkles, lines and dehydration. It is also excellent for sensitive skin and broken capillaries. Now let’s compare rose oil to rosehip oil.
little like a little cherry tomato. Since it doesn’t come from the actual flower, it has more of a woodsy, earthy aroma, while rose essential oil smells more flowery. Found mostly in the mountains of Chile, Argentina, and Southern Africa, rosehips, officially known as rosa canina, are harvested primarily in the late summer and early autumn and then pressed for their oils. Insanely rich in vitamins A, C, and E, natural trans-retinoic acid, natural omega fatty acids (linolenic acid, linoleic acid, and oleic acid), antioxidants such as lycopene and tocopherol, it’s like the Swiss Army knife of skincare. Rosehip oil is cold-pressed and is rich in essential fatty acids. It contains tocopherol and carotenoids — two potent antioxidants with anti-ageing properties. Rosehip oil also contains high levels of linoleic acid, which protects the skin’s barrier and provides smoothing and balancing properties. Rosehip also is considered an excellent oil for the skin as it provides incredible benefits. There are numerous studies that confirm the analgesic and antiinflammatory properties of taking rosehip oil internally for arthritic and other system concerns, for the purpose of this article I will only share about its benefits to the skin through topical application. Here are just a few: • Rosehip oil is a fantastic moisturiser: Rosehips are chock-full of fatty acids that help the skin form a water-resistant barrier. Instead of just resting on the skin, rosehip oil penetrates the skin, essentially locking in the moisture. •
Helps fade the look of scars: Rosehip oil can help minimise the appearance of scars such as those from acne, chicken pox, pregnancy stretch marks, weight loss or anything else.
•
Has anti-ageing properties: Rosehip oil is also rich in antioxidants like beta-carotene that play a key role in skin rejuvenation and reduce lines and wrinkles.
•
It evens out skin tone: Due to is high vitamin C content, rosehip oil helps to even out skin tone and diminish the appearance of dark spots and pigmentation.
•
Moisturises the scalp: Rosehip oil is not only a great moisturiser for the face, but it’s also phenomenal for the scalp, especially if it is dry and itchy.
•
Double duty as a make-up remover: Rosehip oil is an excellent makeup remover, and it is so gentle that it will also remove waterproof mascara.
•
Rosehip oil helps minimize temporary redness: The essential fatty acids also work as an anti-inflammatory calming agent. It can minimise the appearance of temporary redness, such as after extractions or facial waxing.
THE BASIC DIFFERENCES BETWEEN ROSE AND ROSEHIP OILS
CAN YOU USE THEM TOGETHER?
Not only are these two oils extracted from different plants, but also from different parts of each plant. While there are plenty of skin benefits from both oils, rosehip oil has incredible research surrounding its benefit not just for skin, but also for overall health.
So, we come to the question “can you use rose oil and rosehip oil together?” The answer is yes. As rose oil is an essential oil, it cannot be used undiluted – it requires a carrier oil, such as almond oil or hazelnut oil. However, by blending it with rosehip oil as your carrier oil you can enhance the benefits that both oils bring to the skin and body – in fact together they provide an incredible spectrum of skin benefits. APJ
As we saw, rose oil is distilled from the petals of the botanical Rosa damascena and is classified as an essential oil. Rosehip oil, on the other hand, refers to oil extracted from the fruit of the wild botanical Rosa canina, Rosa moschata, or Rosa rubiginosa. Unlike rose essential oil, which comes from the pressed petals of a rose, rosehip oil comes from the actual fruit or rosehip of a rose plant. That’s the little bulb at the base of the flowers that looks a
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STAR PERFORMER
CLAIRDERM SKIN ANALYSER
"SEEING IS BELIEVING" The skin is much more complex than what can be seen with the naked eye, and the skin’s surface only tells half the story. However, what is happening within the skin is critical in allowing you to discover underlying factors that will help us develop an effective treatment plan, such as for pigmentation. Any skin condition that impacts the future health and appearance of one’s skin originates from deeper, invisible layers. One of the secrets to healthy skin is a customised skin management plan that effectively repairs the past, treats the present and protects the future. You can only achieve this for your clients if the skin’s overall health, both inside and out, is completely understood.
appropriate and suitable treatment options and products available in your clinic. This then becomes a great sales tool that will help you add value to your services, as well as incorporate a personal step-by-step treatment plan. The Clairderm Skin Analyser will also help you validate how your client’s skin is improving throughout the course of a treatment plan over time. With a progress evaluation at each appointment, it helps the therapist "fine-tune" individual treatments to achieve better results. It is a known fact that as time progresses, clients tend to forget the initial state of their skin and may underestimate the results achieved. A clear visible record of high-quality images and a side-by-side comparison will showcase every improvement made! Clairderm Skin Analyser does most of the explanation, convincing, promotion, and selling on your behalf. Did you know? The Clairderm Skin Analyser allows you to upload your skincare products and skin treatments and link them to the relevant skin concerns. Once the links are established, the analyser will automatically display personalised treatment recommendations based on the analysis results. This will make selling your recommend skincare to your clients a very easy process. APJ
In under 60 seconds the Clairderm Skin Analyser enables the clinician to do this. The HD camera and lens provide a superior skin analysis of both the epidermis and dermis. In addition, the 3 spectrums; PL, RGB and UV, ensure an in-depth diagnosis of 10 different skin conditions, such as enlarged pores, wrinkles, pigmentation, hydration, oil secretion, skin metabolism, UV damage and much more. Clients are often more convinced to undertake your treatments when they see their skin concerns up-close in great detail, following a skin analysis.One of the main advantages of a skin analyser is to assist you in directing your clients to the most APJ 66
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PRODUCT INNOVATIONS
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TWO HIGHLY EFFECIVE ENZYME PEELS Due to popular demand Dr Anne-Marie’s Dermal Care have recently released their two enzyme peels available in generous new packaging of 100g. Revitalise Enzyme Exfoliating Mask is an excellent choice for mature, dry and dehydrated skin conditions even the most sensitive. It has an infusion of fruit enzymes that has an exfoliating property to remove damaged cells. Contains Colloidal Oatmeal to help soothe and calm the skin. It also contains coconut milk, white and pink clays, papaya, pineapple and lavender oil. Balancing Enzyme Tea-tree Exfoliating Mask is excellent for sensitive oily and problematic skin conditions. It contains green clay and tea tree oil to help draw out any impurities, whilst also provide antibacterial properties. Pineapple enzymes and organic rice are used to remove dead skin cells deep cleansing and purifying the skin. Formulated by Dr Anne-Marie’s Dermal Care these are the perfect products to create impeccable clean and balanced skin, that is revitalised and restored to optimal health. 0403 846 622 | www.dramdermalcare.com.au
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CIRCA - HAND & SALVA - HAND Meder Beauty Science has just launces two amazing innovative hand care products combining night biohacking cream and day protection cream, both are microbiome-friendly and hypoallergenic. CHIRA-HAND is a restorative Prebiotic treatment night cream, while SALVA-HAND is a restorative hand cream providing protection from environmental damage. These amazing formulations contains new forms of hyaluronic acid, essential vitamins, new probiotics and prebiotics and natural peptides mimicking healthy 8-hour sleep effect on the skin that helps the regeneration and healing process, whilst also providing effective protection. MEDER BEAUTY SCIENCE 0466 338 844 admin@mederbeautyscience.com.au | mederbeautyscience.com.au
ISSADA LAUNCHES EPIDERMAL GROWTH FACTOR We can’t say enough about the Issada Epidermal Growth Factor formula that combines the rejuvenating activity of EGF with the hydration of hyaluronic acid. Ideal for micro-needling (the HA has excellent “slip” properties to guide your needling pen seamlessly across the skin) with the added bonus of EGF, which encourages the proliferation of cell renewal, stimulating fibroblasts to produce collagen and elastin to thicken and tighten the skin. Natural epidermal growth factor in the body decreases as we age, which partly explains the thinning and loss of laxity of the skin, but studies have shown the significant beneficial effects of EGF in skincare. If you have heard the rumours that EGF is grown from human foreskins, then please relax – Issada EGF is 100% plant-derived and like the rest of their range, Vegan and Cruelty-Free! 07 3994 2288 | www.issada.com
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STAR PERFORMER
THE ULTIMATE IN SKIN REPAIR &
renewal
A breakthrough in skin support is here! Healthy skincare with quality ingredients is just the tip of the iceberg. NeoGenesis Recovery Serum, the hero product has shown to dramatically improve the quality of skin health in various case studies across oncology-treated skin, chronic conditions, and even acne and ageing. What makes this product a major talking point for many skin enthusiasts and experts? This revolutionary serum is abundant in the NeoGenesis patented S²RM® technology to provide advanced cellular support where you need it most. Containing only nutrient-rich stem cell released molecules and nourishing proteins (no genetic material or artificial ingredients), this powerhouse serum provides therapeutic benefits to help improve the appearance of acne-prone skin and imporove tone, texture, fine lines, and wrinkles. Recovery Serum doesn't stop there! This serum has been shown to improve chronic skin conditions such as dermatitis, eczema, and psoriasis as well. Recovery Serum is a healthy, non-toxic skin solution that is safe for all skin types - even those with the most compromised barrier function. This serum quickly absorbs into the skin to prepare it for the next treatment steps. It’s beneficial to help soothe irritation, reduce redness, and naturally return the skin to a healthy state. Recovery Serum will assist in creating better results from your treatments as the skin is nourished and revitalised. Recovery Serum not only works extremely well for the skin cosmetically, it also
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provides a therapeutic benefit for wound care and scarring. Damaged skin should be treated with care utilising healthy, safe, highly effective products with zero contraindications. Recovery Serum is the perfect solution to help strengthen the skin barrier function and reduce possible scarring severity. Skin professionals trust NeoGenesis to deliver skincare products worth raving about. When product formulations are backed by quality science and research, expect to see results in your client's skin. Recovery Serum contains the full complement of adult stem cell released molecules that mimic Mother Nature and help return the skin to a healthy, radiant state. When performing various treatment modalities on your client's skin, it’s recommended to use Recovery Serum both pre and post-treatment to help strengthen the skin prior, and to nourish it afterwards. When you use this serum during microneedling, chemical peels, laser treatments, and other advanced modalities, post-treatment downtime can be reduced all while elevating the results of such treatments. It’s important that you send your clients home with Recovery Serum, alongside other customised products for each individual skin type after treatment. Recovery Serum should be used in conjunction with Barrier Renewal Cream to add hydration and revive and renew the skin barrier, locking in the benefits of Recovery Serum, plus your hard work in the treatment room. S²RM® Technology: Stem Cell Released Molecules for Rejuvenation The NeoGenesis patented S²RM® technology is a scientific breakthrough that goes beyond just aesthetics. Using healthy adult stem cell released molecules, NeoGenesis has been able to bottle up Mother Nature's response to nourishing the skin. The power and therapeutic benefit is in the molecules the stem cells release, not just the stem cells themselves, these formulas contain no genetic material and are safe for daily and longterm use. Healthy, adult human stem cells release perfectly packaged molecules that are enveloped in exosomes. These exosomes pick up signals from damaged cells. They subsequently migrate to and dock up with those damaged cells to deliver the molecules that will help cells reestablish their homeostasis. APJ NEOGENESIS neogenesis.com | info@neogenesis.com Learn more about stem cell interaction on intentional and non-intentional wounds from Dr Greg Maguire at the APAN Aesthetic Conference.
AWAKEN YOUR BODY’S NATURAL REGENERATIVE POWER. NE X T G ENE RATION STE M C ELL SCIENCE™
Giving skin + hair what it needs, when it needs it. Introducing the next generation of stem cell science for skin and hair care: NeoGenesis patented S²RM® technology. RECOVERY + HAIR THICKENING SERUM A breakthrough in skin science and abundant in stem cell released molecules, these powerhouse serums were formulated to mimic mother nature‘s method of maintaining and rejuvenating skin and the surrounding hair follicle tissue.
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ONCOLOGY SAFE
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PATENTED STEM CELL TECHNOLOGY
0011-1-858-751-4714 | neogenesis.com | info@neogenesis.com
APJ JOURNAL REACHES ITS Birthed out of an industry demand for a publication that will deliver quality educational content, the APJ Journal was launched in June 2009 and was enthusiastically embraced by professionals and business owners who were seeking support to excel in skin and age-management. Over the past 13 years the APJ Journal has been published every quarter, inspiring, educating and empowering industry professionals and their businesses to advance their knowledge and raise their standards to meet the ever-changing consumer expectations through sound, evidence-based practice. As the official journal of the Aesthetics Practitioners Advisory Network (APAN), APJ is highly committed to covering a broad section of industry topics delivered with a strong focus on education. Our primary objective has been to provide valuable educational content as the industry faces the challenges of rapid growth, technological advances and fierce competition, as cosmetic medicine merges within the aesthetic space. While APAN’s consistent dedication has been to identify, define and introduce ethical policies that contribute to raising the standards of best practice and the reputation of the profession, APJ has played a critical role as one of its strongest media arms in communicating APAN’s messages to the industry. Even though each issue may represent a seasonal theme, APJ does not steer away from its comprehensive, diverse, and robust educational content to challenge and inspire practitioners who are seeking quality scientifically-sound information to base their decisions.
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Each issue therefore aims to feature information from the following 19 categories: •
Regulations and regulatory compliance
•
Cosmetic ingredient science
•
Scientific updates and evidence-based practice
•
Advances in equipment technology
•
Advances in treatment techniques
•
Cosmetic medicine
•
Educational qualifications and training
•
Business innovations and social media
•
Nutrition for skin and age-management
•
Aromatherapy
•
Health science
•
Personal development
•
Mental hygiene/mental health
•
Professional development/conference programs
50TH ISSUE MILESTONE •
Industry updates
•
Best practice standards
•
Updates in Cosmetic tattooing
•
Global trends
•
Recognition and member profiles
A COMMUNITY TEAM EFFORT The success of APJ is also thanks to our amazing editorial contributors, who have been invited to share their knowledge and contribute to the growth of our professional community. We would like to acknowledge and thank the following: Professor Terry Everitt who is responsible for the Scientific News section of this journal, as well as on-going scientific articles. Dr Giulia D’Anna our amazing editor who provides us with excellent educational articles on cosmetic medicine. Jacine Greenwood-Drummond delivers up-to-the-minute amazing cosmetic chemistry and ingredient updates. Gay Wardle whom we are honoured to say that she is our very first APAN professional member and has consistantly supported by sharing her knowledge through articles in APJ with excellent education content in dermal therapies.
Cosmetic Tattooing advances. Fiona Tuck renowned for her extensive knowledge on nutrition for skin health and wellbeing. We are thrilled she is joining us this year to educate our readers on new scientific evidence on this important topic. Deb Farnworth-Wood – highly accomlished and renowned for her phenomenal knowledge in business success.. Despite her busy schedule Deb is committed to contribute to her Business Wisdom column and share experience and nuggets of wisdom. Trish Hammond who is renowned as a leader in the frenetic and the constantly changing world of social media, we are so blessed to also have her. Dr Tiina Meder whose knowledge in dermatology and skin management is ground-breaking. Her passion for education is phenomenal and we are thrilled that in ever issue she shares new educational information with us. We also acknolwedge and thank some of our occassional, but committed experts for their contributor of thought-provoking articles. These are: Robert McGowan, who regularly shares on pigment regulations, our lawyer Michael Bishop, senior director of Pointon Partner Lawyers who keeps us up to date with the legal issues, Maja Ercegovac and her phenomenal knowledge in cosmetic tattooing and electrolysis and Danielle Hughes who has contributed well-researched topics on all things aesthetic. Indeed, we are a community of practice, and we are honoured that through APJ we stand as one. APJ
Katherine McCann provides us with thought-provoking articles in
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TATTOO PIGMENTS
THE POWER OF COLOUR
in cosmetic tattooing P A R T II Maya Ercegovac
Our world would be a very dull place without the joy that colour brings to our life. Indeed, it is a real joy for those who are gifted in combining colours and creating amazing artwork that can transform our moods and elevate our spirits. No one would dispute the magical impact that colour can bring to our world, especially if you are the master of your canvas. However, when it comes to cosmetic tattooing our canvas is someone else’s face or body. inks or pigments are inserted into the skin with the intention of creating a specific illusion, enhancing or perfecting a feature through the use of colour. As our canvas is the skin it comes with its own elements of colour, determined by the blood present through our vascular system as well as keratin and melanin pigments that are often genetically determined, or even hormonally triggered. Getting the colour right in cosmetic tattooing is a challenge as there are several variables that we need to consider. While colour theory is a foundational requirement in understanding how to navigate getting the colour right in cosmetic tattooing, there are numerous other considerations that can influence the end result. In the spring issue of APJ (Volume 48), Maya Ercegovac covered the foundational principles of colour theory, skin colouring, how colour is perceived and how colour pigments are constructed. In this article she takes a closer look at modern organic pigments, pigment consistency, ink manufacturing and what happens in a cosmetic tattoo procedure.
pigments. The frequently used black pigment is the main source of carcinogenic polycyclic aromatic hydrocarbons (PAHs) and its purity is dependent on the source and manufacturing process. Although there is only one colour index (CI) number for black pigment, CI 77266, it has many physical variations that are all listed under the same CI number. Therefore, the CI number gives only limited information about a product and its quality. The purity and structure of a black pigment and whether it contains problematic PAHs can in no way be derived from the CI number. This information would require detailed chemical analysis, but again, no methods are mentioned in any current regulations. PIGMENT CONSISTENCY Measuring cosmetic colour pigments is essential for creating quality formulations that consumers can depend upon. The use of spectrophotometric technology not only simplifies this process but ensures replicable quality every time. Due to their water solubility, cosmetic colour pigments make up the major colorants used in decorative cosmetics. The two main types of colorants are organic and inorganic pigments, which are available in an assortment of combinations that can differ greatly in both texture and appearance. While colour perception of these pigments varies based upon individual observation, repeatable colour formulations depend on instrumental analysis to quantify colour data. Light source (natural or artificial), reflective value, and opacity all affect the visual appearance, making colour control standards imperative.
MODERN ORGANIC PIGMENTS Several different classes of organic pigments are used in tattoo and cosmetic tattooing, polycyclic pigments, and phthalocyanine
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Monitoring colour stability is also an important step, as even the slightest changes in heat or chemical formulation can affect the finished product. Spectrophotometers offer continual monitoring
throughout production to provide data on even minute changes in colour, helping avoid costly errors in final colour outcome. This information is then numerically quantified and used to aid in repeatability and formulation.
natural-looking outcomes to the face. New techniques, such as feather-stroke eyebrows can look very natural expanding the client demographic of these procures to accommodate both young and older individuals who require a more age-specific outcome.
INK MANUFACTURING
WHAT HAPPENS DURING A COSMETIC TATTOO PROCEDURE?
Historically, pigments used in tattoo inks derived from mineral or geological sources to produce certain colours and hues. For example, carbon (carbon black) and iron oxide were used to produce a black ink. Cinnabar, a mercury sulphide compound, was used to produce red hues. Cadmium compounds, such as cadmium red, or cadmium yellow were used to produce shades of red, orange, and yellow.
The procedure involves exogenous pigments that are deposited into the top layer of dermis with a fine cluster of needles by piercing the skin, causing a tiny wound. Macrophage immune cells will then rush to the site to close the wound and swallow up any foreign invaders. However, tattoo pigment particles are too large for the macrophages to destroy them, so they get lodged in the upper dermis, which permanently makes them stay in place, making the tattoo visible. However, if your immune system succeeds in breaking up some of the pigment particles, this can contribute to a patchy outcome that required a repeat visit to rectify. While cosmetic tattoos are long-lasting, they may fade over time, in which case a retouch would be necessary.
Over the past 20 years, ink manufacturers have moved away from primarily mineral-based pigments to organic ones, as a result over 80% of the colorants used today are carbon-based, and approximately 60% of these organic pigments are azo pigments. About 30% of the pigments and dyes are approved for cosmetic use, while a number of others were originally developed for industrial applications, like paints or textiles. Currently governments are investigating the potential risks of certain pigments that may be classified as carcinogenic. Tattoo inks also include several additives, such as surfactants, binding agents, fillers, and preservatives. Many of these additives are employed to keep the pigments in a uniform suspension to avoid microorganism growth in the product after opening. THE RISE IN COSMETIC TATTOO POPULARITY Cosmetic tattooing has risen in popularity over the past two decades reaching its peak in the past eight years. This is due to the advancement of techniques that offer corrective, enhancing and
Once inserted, inks remain indefinitely in the skin, possibly for a lifetime, therefore the issue of pigment safety is currently a hot topic that is undergoing investigation by several government agencies, both in Australian and in Europe. Despite their permanency, Australian regulations do not permit us to state that cosmetic tattooing is a “PERMANENT” procedure. We can refer to it as long-lasting or temporary, thus in Australia the term PERMANENT MAKEUP or PMU is often used. These rules do not apply to the US where tattoo artists are required by their industry associations to refer to the procedure as ‘permanent’. It is therefore important that as Australian artists or cosmetic tattoo practitioners that we become familiar with our local regulations and comply with them.
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anticorrosive agents to paints, primers and other surface coatings and chromic acid electroplated onto metal parts to provide a decorative or protective coating. Titanium dioxide contributes to colour alteration, due either to the abrasion of very small particles, or a chemical reaction to the ink. It should also be noted that the needles used for tattooing with ink containing titanium dioxide has higher wear than the needle use for tattooing with black ink. In terms of allergies, chromate allergy is not uncommon, and its prevalence is reported to be at 6%. This allergy is usually due to delayed hypersensitivity reaction to the chromium salts, particularly Cr(III) and Cr(VI). Both allergic and contact dermatitis are common. FACTORS THAT MAY INFLUENCE COSMETIC TATTOO OUTCOMES
SERVICES that CAN BE PROVIDED THROUGH COSMETIC TATTOOING Probably the most common reason that individuals seek cosmetic tattooing is to replace the need to constantly apply conventional makeup, or to correct a feature due to age or illness e.g. eyebrows that are fading due to hormonal changes, diminishing lip-colour or lip shape, or thinning eye-lashing making the eyes look smaller or naked. For medical reasons, cosmetic tattooing is useful for patients who are allergic to conventional makeup - disabled persons or arthritic patients who have difficulty with dexterity, poor vision, camouflage correction of scars, nipple areola complex reconstruction post-mastectomy, birthmarks, and alopecia or even vitiligo pigment loss. The opportunities to offer support and solutions for various conditions are endless. WHAT INFLUENCES OUTCOMES?
It is important to understand that a cosmetic tattoo is applied to a living organism, not to a static piece of paper, as the case with a painting. As such, there are several issues that may contribute to the outcome such as - the skin’s condition, cosmetics applied to the skin e.g. vitamin C serum may be bleaching, age and health of the individual, climate and temperature issues, outdoor activities, exfoliating procedures and picking on scabs. WHO REGULATES TATTOO PIGMENTS AND INKS? Europe has the most active and strongest commitment in investigating tattoo ink safety. Globally the key bodies are: • ECHA (European Chemical Agency) •
REACH (Registration, Evaluation, Authorization and Restriction of Chemicals regulation) this is another European Union regulator
•
FDA (Food and Drug Administration) the regulatory body of the USA
•
AICIS (Australian Industrial Chemical Introduction Scheme) is the Australian regulator for pigment safety which transitioned from the NICNAS.
There are several considerations that may influence a cosmetic tattoo outcome. The most common are: •
The type and structure of the pigments.
•
The percentage of colour, viscosity, dispersion and mixture.
•
The condition of the skin is also a determining factor.
•
Pressure applied when implementing the procedure, hand, and machine speed.
•
The use of a topical anesthetic can also influence colour stability.
•
Additionally, if there is a strong immune response where the microphages can breakdown or engulf aspects of the pigment, this can result in colour inconsistency.
POTENTIAL ADVERSE REACTIONS Certain tattoo inks may cause very small nickel particles to be abraded from the tattoo needle. This can lead to a sensitisation, or allergy to nickel, as tattoo needles contain chromium and nickel hexavalent chromium compounds including chromate pigments found also in dyes, paints, and plastics. Chromates are added as
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Currently AICIS has appointed Queensland Health Environmental Hazards Unit, to investigate the potential hazardous inks for tattooing and cosmetic tattooing of which APAN is part of the working group. WHY EDUCATION IS KEY? While Cosmetic tattooing offers attractive career options, it is important that practitioners operate on a foundation of sound education, where technique is based a strong theoretical foundation, that also includes safety considerations, limitations and risk management to ensure the safety of their clients and to uphold the reputation of the profession. APJ Maya Ercegovac holoacademy@icloud.com
L I S T YO U R B U S I N E S S T O D AY BENEFITS: We b s i t e P r o fi l e Social Media Shoutouts Be a Podcast Guest Fe a t u r e i n D i g i t a l M a g a z i n e Access Private B2C group
Scan here to learn more about how you can grow your business APJ 79
SOCIAL MEDIA
ENJOYING THE JOURNEY TO BUSINESS SUCCESS An interview with Trish Hammond Social Media Expert - ANIBODY Aesthetics
Passionate about helping businesses grow through dynamic and successful social media strategies and platforms, Trish Hammond is considered ‘the expert’ within our industry when it comes to social media marketing. Over the years we have worked with her and watched her evolve into a formidable brand that the industry recognises as a leader in her field. Social media marketing is never static – constantly evolving with different algorithms that allow the public to discover content, it can at times be difficult to identify how to best navigate this space to maximise your client acquisition. In this interview we go ‘close and personal’ with Trish as she shares with us some of her experiences. APJ Q1: TRISH WHAT DO YOU LOVE THE MOST ABOUT YOUR WORK? I love the fact that social media marketing and digital marketing is ever evolving. It's also a lot of fun when we actually get our hands dirty and develop the campaigns together. Being a part of the whole process is what makes it fun for me. I love the freedom and flexibility in digital marketing that allows me to work on-the-go and find time for my personal and professional life. APJ Q2: SHARE WITH US HOW YOUR BUSIENSS HAS EVOLVED OVER THE YEARS, BOTH AS A BRAND AND THE DEMOGRAPHICS YOU ARE NOW REACHING? We've been on quite a journey here -
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growing from a solopreneur to a team. It's been so much fun seeing all the changes along the way and meeting new people every day. Our purpose has always been the same - to help small business showcase their brand and grow their businesses. The demographics we are working with are small businesses employing 2-200 staff. I also get the opportunity to interview people from Millennials and GenZ through to Baby Boomers, and this is a highlight of what I do. APJ Q3: WHY IS IT IMPORTANT FOR A BUSINESS TO CONSTANTLY BE REACHING OUT FOR NEW CLIENT ENGAGEMENT? We're all about growing the business and that growth starts with client engagement.
To be successful, a business needs to keep the conversation flowing. Remember to always reach out and touch your clients! The more you connect with your followers, the more likely you are to get their attention for your next big thing. APJ Q4: WHAT ARE THE KEY CHANGES IN BUSINESSES THAT YOU ARE EXPERIENCING SINCE THE PANDEMIC? The pandemic has affected business in a lot of ways and I could go on for hours about this. However, at this moment, there are a few key changes that we have observed increased use of social media and digital marketing, which in turn leads to more competition. Also, the realisation that many businesses can work remotely as well as still able to find new clients through lead
generation and become an expert in handling social media marketing - which is a thing now. APJ Q5: WHAT SERVICES DO YOU PROVIDE? SHARE WITH US A SUCCESS STORY THAT YOU ARE PROUD OF? My team and I help our clients strategically curate the most effective social media posts to engage their audience, attract new followers and drive traffic to their websites. One of the funniest campaigns we have worked on this year is a local MP campaigning in this election. This has been totally different to our normal work with aesthetic businesses, but it’s been incredibly fun, varied, serious, and challenging. The success we’ve achieved is
an increase in their following over 200%, engagement up 36.2%, and growing.. APJ Q6: WHAT IS THE MOST COMMON AREA THAT YOU FIND BUSINESSES STRUGGLE WITH WHEN IT COMES TO SOCIAL MEDIA AND HOW CAN YOU HELP THEM? I think it’s the never-ending algorithms in Facebook and Instagram. This is exactly why I stress the importance of multiple surfaces of Facebook and Instagram. WHY? Each surface like Reels, Stories, and even the Feed has a different algorithm or way people discover the content. The more we post on the different algorithms (aka, 5 different surfaces of Instagram), the more likely it will reach our current audience and new users.
APJ Q7: WHAT’S NEW FOR YOU We have some exciting additions happening from the 1st of July. We will be introducing a complete advertising solution for businesses. I have partnered up with one of Australia’s biggest agencies. They are Google partners, Microsoft partners, and offer a complete software solution for business. I can’t wait to be able to offer a complete solution so you can work smarter, not harder! APJ Join Trish at the APAN Aesthetics Conference as she shares how to get the most from Instagram Reels.
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BUSINESS
HELP! I AM LOSING
injectable patients to
CHEAPER SKIN CLINICS! Dr Giulia D’Anna I hear of so many practitioners wanting to discount cosmetic injectable treatments within their practice in order to try and entice patients into receiving cosmetic injectable treatments from them. Discounting, as you probably know, is a spiral down to the bottom and practitioners need not enter that endless dive. Patients may be tempted by the allure of a cosmetic injectable clinic for many reasons, but you need to remember that they are attending your clinical practice to see you for a reason. Use that reason to encompass everything you do. Although I am writing this article with cosmetic injectable clinics in mind, you really can apply this to any cosmetic or skin component of your clinical practice. LET’S LOOK AT HOW THE PATIENTS THINK? Before we talk about the costs of treatment, let’s take a moment to look at things from your patient’s point of view. The majority of your patients won’t consider themselves a patient. They’ll consider themselves as a customer or client and treatments like muscle relaxants and lip fillers are beauty and cosmetic treatments, not medical procedures for cosmetic purposes. We are not saying this is correct or how it should be, but it is how it is, largely thanks to social media and influencers, the public are trained to think like this. Both muscle relaxants and dermal filler treatments are very much specialised medical treatments, and you must still look after each patient with a thorough examination and treatment plan before performing these treatments. Patients will not necessarily see the connection upfront, until you help them understand it. Patients are sometimes completely unaware of the risks that injectable treatments entail, but also that the cheaper clinics are cheaper for a variety of reasons that will deeply change the way the treatment and the follow-up will take place. Patients often assume that if someone is offering Botox and fillers, they have been properly trained and assessed, that providers undertake the same protocols and use the same products, no matter what. They assume it wouldn’t be allowed otherwise. But just like so many industries, there are the high turnover – churn them through - kind of clinics, and those that take time to really care and communicate for the patient.
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IT’S NOT AS IMPORTANT TO PATIENTS If you are anything like me, you live and breathe anatomy and cosmetic injectable treatments. It is literally at the centre of my universe and I am constantly reading a journal, assessing faces everywhere and absorbing information all the time. Again, if you are like me, you read a lot about the industry, all your social media is taken up with posts and pages that are related to skin and cosmetic injectables. You and I think about it a lot, we talk about it a lot, we update our skills and we work with injectable – a lot. Patients are not like us. Patients think about their face. They think about the specific things that bother them – their forehead lines, their crows feet, their thin lips … they don’t have a broad interest in any thing other than what they need and want. They don’.t care what’s happening with protocols or how you as a practitioner might follow them up. Patients generally don’t feel as passionate about cosmetic injecting industry as you and I do – and they probably never will. In the morning, they might try and fix a facial feature with makeup, but once it becomes something that is timeconsuming or not fixable, they will seek out a practitioner to ease their pain point. THE PATIENT WE WANT Once a patient decides to have treatment - whether it be for their wrinkles, thin lips or whatever, in very simple terms we can say they fall into two broad categories: the “Low-cost Lisas” and “Exclusive Elizabeths”. I know this sounds harsh, but there are some patients that just want work done for the cheapest fee possible and are not fussed by the details. These are the Lisas. Lisa will scan your website and social media and look for the fee list first. They will travel for the cheapest fee and are happy to go from clinic to clinic, practitioner to practitioner. They are not worried about quality as a primary
consideration as Lisa believes that all qualifications are the same, all products are the same and that the fee is the only definitive difference. Elizabeth is quite a different patient. Elizabeth will look at your website, consider the branding and the way it makes her feel. She wants to feel that her money will invest in the best outcome, so the fee is less important than the clinic, practitioner and the care that she will receive. She will take her time to choose a clinic, but once she trusted the “brand”, she will stay. Elizabeth has a number of key considerations. These include: 1.
Branding – The clinic and website needs to look polished.
2.
Before and after gallery – Treatment outcomes need to be natural, look cohesive and look comparable. Elizabeth can spot changes in lighting, makeup and little details
3.
Care – This type of patient will evaluate your communication style, time and consenting process. She will interact with the injector, asking questions about complication, experience and aftercare. Elizabeth wants exclusivity – no rushing, no churning, no cheap shortcuts.
4. Results – This type of patient does not want to have any complications. She wants to trust her face to you, but she needs some time to make this assessment. 5. Trust – Elizabeth sees you already as an expert and trusts in you, your staff and your experience. She will question the injectable treatment you propose, but she does this to be sure that you understand the procedure yourself and that you are confident in it, so that she may have confidence in you. If you are her dentist she trusts you with her teeth, but she needs to
know she can trust you with her face. It may take a while to get Elizabeth there, but you are many steps ahead of the cheap cosmetic clinic. ELIZABETH IS IN DEMAND You don’t want Lisa, you want Elizabeth as she is your ideal patient. Once Elizabeth starts researching cosmetic injectable treatments, she will want a reputable practitioner that makes her feel special, that she can trust and continue to care for her over the long-term – someone who has experience. Elizabeth might not fully appreciate your talent and experience yet, but she trusts the brand and the message that the brand conveys – polished, trustworthy, reliable, experienced and professional. All the little attributes that make you better than a cheaper clinic may not be fully processed – but the fact you are a doctor, dentist or nurse will be a reassuring factor that gives Elizabeth the confidence that she will be in safe hands. She knows now that she needs to see someone qualified and trustworthy, she might not acknowledge exactly what that means, but your pricing indicates to her that you have experience that she is willing to pay for. The fact that you are expensive is reassuring for Elizabeth, as she interprets this that you are a specialist. Indeed, Elizabeth dose not consider it expensive, even if you are concerned it is, Elizabeth will process it as value. Elizabeth believes that higher priced items and services are generally better quality and more reliable. Higher fees convey your experience, time that you will take, and your training. What about Lisa? Lisa doesn’t care about any of that. She hasn’t looked into it that much, it hasn’t occurred to her that not all clinics are equal, Lisa just wants her lips and she wants them now and for as little money as possible so she books the first person she sees in her area offering cheap lip fillers. She literally doesn’t care who does it, or where she goes. Price is really the only consideration.
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DON’T BE EMBARRASSED ABOUT YOUR FEES Your fees reflect you and the quality care that you offer. You have spent time and endless education getting to this point, you’ve completed a degree. Worked long hours, had years of training and learning. You have invested in your clinical space, your website, your equipment, your products. Your patients aren’t just paying for a 1m of filler or 50 unites of Botox. They are paying for your knowledge, experience and skills. They are paying for your time and effort and your commitment to safety and only acting in their best interests. They are paying for the brand that you have created and the way you make them feel. They know that you care, and that is important to them. They’re paying for your care, your accountability and your responsibility. They are paying to see you, and you, alone. They don't want just any injector, they want you. They’re paying because you’re good at what you do - don’t be too humble to recognise this. You worked for this and continue to work for this. Be proud that your patient sought you out, because she recognises your skills and knowledge. FORGET THE LISAS There are enough Elizabeths for you to run a business with. Forget the Lisas. Let them go to the cheaper clinic next door. You’re not losing them because you never wanted Lisa in the first place. That is not the brand that you stand for. Chanel doesn’t get worried that some people buy a handbag from Kmart. Kmart will never be a Chanel and Chanel knows that. They know they can charge more because their customers get a product that is exclusive, high quality and a better service with guarantees and a commitment to quality. Chanel does not mess around for being high priced when compared to Kmart, or any other brand. They are Chanel. You know when you buy a Chanel that you are buying design, style that doesn’t date and that it will stand the test of time. Kmart knows that their brand is fast fashion and relies on turnover to survive.
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You want patients who respect you for what you are charging – and they will. There are enough of them. Even if they think “Ooof, that seems like a lot of money”, they ultimately recognise that they have to pay good money for good work. Quite frankly, there’s enough Elizabeths who won’t give it a second thought – they will find a way to get treatment from you because they trust you and what you stand for – quality. DON’T WASTE YOUR TIME COMPARING It is easy to convince yourself your business is going to fall apart when you know people are going to the cheaper competitor. Perhaps you have even lost a few patients to cheaper clinics? Sometimes even an Elizabeth might leave to try a cheap clinic and save money. But they will come back because no one will look after them like you and the way you make them feel. Don’t focus on patients that are no longer yours. Focus on the Elizabeths you have. It’s worth remembering that other practitioners are thinking about you too – even the cheap clinics. They might be wishing that they could charge more to be successful like you. The cheaper clinics might be wondering why you get so many patients, why you are able to charge what you do, how they can be as good as you. They may feel envious about your success. So, it is pointless to compare. LOVE AND MAINTAIN ELIZABETH Once you have secured a patient who is happy to pay your prices and loves the service they receive, don’t become complacent about it. Don’t assume Elizabeth is yours forever. Loyalty takes time to achieve and can’t be taken for granted. However, once you’ve achieved it, you are a lot less likely to lose Elizabeth, because she trusts you and she knows how you make her feel. She is now part of your brand, part of your vibe. Here are some strategies that will ensure they remain with you:
Make it too easy for them: Send them appointment reminders and tell them when their treatment is due. For Botox and fillers, we send an automatic alert to patients, advising them that it has been x months since their last treatment and it’s time to get booked in for their next one. This works really well as it means they don’t bother looking elsewhere and just click on the link to make their appointment.
ensuring that Elizabeth will become a rich source of more Elizabeths for you. We have gained several patients in my own clinical practice because we wrote a personal message on a skincare delivery that we did. It is the simple things that matter. Attention to detail is everything!
Keep chatting to them: Ask your team to reach out or send them an SMS or email a couple of days or weeks after their treatment, check that they are happy with the results, ask them if they feel good, check that there are no concerns. If you follow them on social media give their posts the odd like or comment on how great they look in a selfie.
You don’t need to compete with cheaper clinics. They can have Lisa, you want Elizabeth. Elizabeth is not interested in the cheaper clinics, she wants quality, experience and the quality that your brand offers. She may pay a little extra for that, but she knows you will deliver the results she considers to be top tier and that is her main goal.
Make them feel special: Send them special offers, position it as a Thank You VIP deal – perhaps a free sunscreen or face mask or LED treatment with their injectable appointment. It’s different from offering all your patients a discount. This is rewarding your loyal patients, it’s a way of recognising and loving them. They’ll feel special and want to stay with you.
With all of this in mind, patients will base their decision on an emotion that they feel to begin with. Your website and social media are super important to convey that emotion from the start. After that, it is all on you and your clinic to make Elizabeth feel that she is part of your vibe and branding. That is where Elizabeth will put her money. It has never been about the fee, but about the value that you bring – remember that! APJ
Newsletters: It you’re a little bit of a wordsmith and enjoy a bit of creative writing, send out a newsletter to your patients. Tell them about new treatments or training you have been doing. Share a story you have seen about aesthetic treatments, give them some tips for glowing skin, remind them to put their serums on. There are heaps of templates on Canva or other design templates can be found on Etsy too.
SO HERE IS THE MAIN POINT
To learn more about dental cosmetic injecting, branding and cosmetic consultation, please visit www.dermaldistinctions.com Dr Giulia D’Anna will be presenting two lectures at the APAN Aesthetics Conference. Both will be available online, however, one of her lectures will be presented live at the face-to-face event. Join us and meet Giulia in person.
Essentially, you simply want Elizabeth to feel cherished and special. By doing these things you are offering extra value and subtly staying top-of-mind for Elizabeth. You are making sure that when Elizabeth’s friends decide to have a treatment, that Elizabeth recommends you – tells them how good you are, how nice you are. You want Elizabeth to become an advocate for you and all of the little gestures that you might consider irrelevant will contribute to
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HEALTH SCIENCE
WHY YOU SHOULD ENSURE A HEALTHY LYMPHATIC SYSTEM Tina Viney Whether you are treating the face or the body, ensuring the lymphatic systems is not clogged and circulating optimally is an important consideration to both skin health and for your client’s overall wellbeing. In this article Tina Viney will address why the lymphatic system is important, what are the symptoms of a clogged immune system and strategies for supporting a healthy and free-flowing lymphatic system. The lymphatic system is a network of delicate tubes throughout the body. It drains fluid (called lymph) that has leaked from the blood vessels into the tissues and empties it back into the bloodstream via the lymph nodes. It is not part of the blood circulatory system, but it runs parallel to the circulatory system. The main role of the lymphatic system includes managing the fluid levels in the body, reacting to bacteria and supporting the immune system. Therefore, a health lymphatic system is a contributing factor to a health immune system. The lymph itself is composed of a milky fluid that contains various substances including: •
Proteins
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Salt
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Glucose
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Fats
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•
Water, and most importantly
•
White blood cells
Lymph may also contain bacteria, which might be picked up by the lymphatic system and carried to the lymph nodes for destruction. In people with cancer, lymph may carry malignant cells from one site to another. That is why, for instance, in women with breast cancer, sometimes the lymph nodes in the armpit region need to be removed. The lymphatic system is a critical part of our circulatory system and immune system as it is responsible for eliminating toxins, waste, and excess fluid, as well as moving white blood cells around the body to fight infection. Unlike the blood circulatory system where the heart acts as the pump, the lymphatic system only moves one way— upward and away from gravity. As the lymph system tries to fight gravity, it can become clogged. Too many toxins is a primary factor, while poor diet and overexposure to environmental toxins can overload the lymphatic system. In addition, lack of sleep, dehydration, stress, emotional trauma, infections, and lack of movement can stagnate and sometimes even stop the lymph flow. When the lymphatic system becomes clogged, the face and body will be prone to swelling and lymphedema occurs. If toxins can’t be eliminated from the body, cells can’t properly function resulting in dysfunction and disease within the body. If the lymphatic system is
compromised, the immune system is compromised. Inflammation can occur and when chronic lymphatic congestion occurs, it can contribute to autoimmune conditions. When it comes to the skin, a slow function lymphatic system will not allow impurities to be eliminated, this can contribute to poor healing of lesions, overall puffiness in the face and even a dull complexion. During your consultation here are some symptoms you should look for that would indicate a clogged lymphatic system and a compromised immune system:
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Swollen hands and particularly the fingers
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Cold hands and feet
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Dry or itchy skin
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Sinus infections
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Brain fog
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Chronic fatigue
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Feeling stiff and sore when you wake up in the morning
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Depression
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Bloating
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Excess weight
lymphatic system and there are a few things you can do to optimise the healthy circulation of lymph in the body.
•
Food sensitivities
STRATEGIES TO SUPPORT LYMPH FLOW
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Digestive issues
There are many approaches to help support a healthy lymph flow in the body. Here are just a few simple recommendations:
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Enlarged lymph nodes (check the neck)
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Frequent colds and flu
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Parasites
WHAT CAN CONTRIBUTE TO A SLUGGISH LYMPHATIC SYSTEM? Unless you have recently experienced sudden changes to your body you can’t go to the doctor and get a test for a “sluggish lymph system.” However, if your lymphatic channels are blocked you will experience symptoms of swelling of the tissues. As we have already reviewed, unlike the blood that is stimulated by the pumping of the heart, the lymphatic system relies on body movement such as exercise or massage to move the lymph. If you have a sedentary lifestyle for example, this can contribute to a sluggish lymphatic flow with symptoms of stiffness or swelling of your hands and feet. Additionally, certain surgeries or physical trauma can also contribute to lymphatic blockages. Other instances that can contribute to lymphatic blockages are due to tumours or malignancy. Some parasites are also known to create lymphatic obstruction, leading to swelling of limbs. However, a “sluggish lymph system” as described in popular detox articles, being the source of all ailments in a wide sector of the population, does not have much science to back it up yet. Having said that, it is important to support a healthy
1. Drink Plenty of Fluids - Regularly drinking quality water, soups, vegetable juices and fresh fruit juices are all helpful in maintaining the wellbeing of the lymphatic glands. Plus, it keeps the body hydrated and fights toxins. 2. Herbs - Herbs like red roots, manjistha (an Ayurvedic herb), red clover and Echinacea accelerate lymph flow and reduce inflammation. They also reduce the swelling of lymph nodes and dissolve cysts. 3. Exercise - Regular exercise helps open the lymphatic valves and also boosts circulation. It also detoxifies the body. 4. Near Infrared Sauna - The heat of a sauna bath releases toxins through the sweat glands. 5. Brisk Walking - Walking briskly while at the same time breathing heavily is an efficient way to release toxins from the body. 6. Elevating your legs - Lying in bed with your legs up against the wall is a simple way to stimulate lymph valves. It also helps improve sleep quality. 7. Standing Desk - Movement is one basic way to keep fit. It would be an effective exercise to work at a standing desk
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rather than a sitting one. Movement would ensure activeness of the lymph nodes. 8. Hydrotherapy Shower - The switching between hot and cold water during these sessions help improve lymphatic health. 9. Deep Breathing - Your lungs pump lymphatic fluid. Deep breaths will keep your lungs strong by releasing toxins. 10. Dry Skin Brushing - This improves lymphatic flow, optimizes detoxification, boosts organ functions, and energy flow in the body. Doing at least seven of these activities for three days in a row will help reduce most toxins from your lymphatic system and improve lymph health. WHAT ABOUT LYMPHATIC DRAINAGE? Unlike the heart, the lymphatic system does not have a pump to push it around the body, so the lymph relies primarily on our body's muscle action and movement to maintain its fluid movement. Lymphatic drainage is a manual massage technique that works on the lymphatic system, stimulating it to work quickly by moving the lymph to the lymph nodes [throughout your body, but largely located in your neck, armpits, and groin]. Its main function is to accelerate the process of removing the accumulated liquid between the cells and their catabolic [aka breakdown of] residues, directing them to the capillary vessels and, through specific movements, onward so that they are eliminated. I never really included the practice into my beauty routine, but as my work progressively requires a lot of sitting and desk work, I am now systematicaly including movements and body brushing to keep my lymph flow moving. However, the ultimate is to experience a lymphatic drainage massage. According to many medical experts the benefits of lymphatic drainage are extensive, mainly in the transport and removal of stagnant fluids, but it also: •
Stimulates blood circulation and tissue regeneration
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Directs and increases lymphatic flow, promoting faster removal of excess interstitial fluid
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Reduces swelling and water retention
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Improves the immune system due to the important elimination of toxins
massage that targets the muscles to stimulate blood flow. It is a specialised technique that incorporates light, rhythmic movements that are specifically designed to move lymph through the lymphatic vessels and to the lymph nodes. It requires special training as the depth of pressure must be light and the technique involved gentle pumping movements that are strategically directed towards the lymph nodes, rather than a free-flowing effleurage and petrissage technique as in body massage. If you haven’t trained in this technique, it is worthwhile undertaking a recognised training course. The Dr Vodder Method is considered the most credible technique to learn. Once you have learned the correct way of delivering this treatment it will be useful for both body and facial treatments where you wish to improve healing, or rejuvenate the skin, particularly with clients or patients who have undergone surgery or chemotherapy. On the other hand, if you are not qualified there are several technologies that are now available that deliver compression therapy. These stimulate the venous and lymphatic flow by using sequential pressure massage delivered electronically through a “squeezing” mechanism that helps to pump the lymphatic fluid throughout the body. When activated, the pump fills the air chambers of the compression sleeves to pressurise the tissues forcing fluids, such as blood and lymph, out of the pressurised area. When the sleeves deflate, the veins will replenish with oxygen and nutrient- rich blood. By gently applying unidirectional peristaltic pressure on peripheral veins, it improves blood flow and heart function by reducing artery flow resistance. The lymphatic fluid is pumped against gravity and moved through the filtration process in the lymph nodes. Lymphatic flow is improved in both the peripheral and deep lymph nets, resulting in improved elimination of metabolic waste from the interstitial spaces. It can produce faster removal of the toxins, metabolic products and excess fluid by widening lymphatic vessels. The peristaltic movement relaxes the muscle and drains excessive fluids.From my personal experience one of the most effective technologies for affective lymphatic enhancement therapy is the SORISA PRESOR-03 available through Vogue Image Group. Their phone contact number is 03 9821 0033. This technology provides rapid results. Here is a list of just a few of the benefits of lymphatic enhancement therapy: • Decrease in lymphedema and excess fluid retention in the body •
Accelerates recovery from injury and surgery
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Immediate relief of “heavy legs”
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Decreases athletic recovery time
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Reduction/elimination of cellulite
Minimises the appearance of cellulite by reducing the amount of fluid that presses up against the cross-hatched fibers beneath your skin
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Improved shaping of legs, abdomen, buttocks and arms
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Strengthens loose skin (from pregnancy or obesity)
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Promotes body and mental relaxation
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Prevention of varicose veins
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Provides an overall lightness in the body
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Reduction in oedema from upper limbs, chest and back after mastectomy
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Energizes the body •
Improvement in immune system function
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Improved bowel movements
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Calms muscle spasms
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Moving and improving lymph flow can be achieved by a special technique known as lymphatic drainage. This is not an ordinary
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WHO CAN BENEFIT FROM COMPRESSION/LYMPH THERAPY? Although the benefits of compression therapy speak for themselves, individuals with the following health needs/conditions can especially benefit from compression therapy: •
Athletes or anyone with “tired” legs looking for recovery
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Injury recovery
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Post-surgery recovery
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Recent mastectomy
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Anyone interested in reducing/preventing cellulite
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Thinning tightening of skin (obesity, post pregnancy)
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Chronic vascular issues
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Lymphatic congestion
ADDITIONAL BENEFICIAL STRATEGIES There are several lifestyle habits that can also benefit to support a healthy lymphatic and immune system. Here are just a few considerations you can recommend:
Diet: What you eat is an important part of both your physical and mental health. A well-balanced diet makes you feel good. Eating healthy produces less waste for your lymphatic system to clean up. Avoiding processed foods that are high in salt, sugar, and preservatives will reduce your chances of lymphatic congestion. Natural foods like dark green vegetables, ginger, citrus fruits, flaxseed, and garlic are ideal for lymphatic cleansing. Herbs: Using herbs is a popular way to naturally purify your lymphatic system. Herbs such as Milk Thistle (silymarin – check the article in this journal). Dandelion, or Astragalus supported by liver enzymes will ease the stress on your liver and kidneys and lessen the amount of work your body must do to get rid of toxins from what you eat. Calendula, echinacea are also excellent herbs to promote lymphatic drainage and reduce any swelling or pain. Exercise: Regular physical exercise is a great way to get your lymphatic system pumping and detoxing your system of waste. Jumping, walking, stretching, yoga, Pilates, and other moderate exercises done daily will really improve the state of your lymph. However, for those who are too busy or who suffer from poor lymphatic flow for various reasons, providing a compression massage service in your business would allow them to gain great relief. You can provide a series of five or 10 half-hour treatments and achieve great results for fluid retention, cellulite or to support the body in recovery from any of the above-mentioned conditions. It is a technology worth considering. APJ
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QUALIFICATIONS
EXPLORING THE SAFE AND
effective pathway to
ADVANCED AESTHETIC PROCEDURES An interview with Metro-Dora Clifford
As technologies are becoming more sophisticated with consumer expectations constantly seeking a higher level of treatment outcome, salons and clinics wishing to compete in this lucrative sector of the industry are investing in advanced equipment. Meanwhile adverse reactions are also on the rise, as simply gaining supplier training on how to use a device with insufficient understanding of the full spectrum of the technology and how to implement it for safe and efficacious treatments, especially when dealing with a diverse range of skin conditions, can be a real challenge. These skills gaps however, can be easily eliminated with a government approved qualification.
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Metro-Dora Clifford holds both qualifications and has over 40 years of experience in advanced aesthetic techniques and technologies. She is both the director of ClinicalPro and the principal of a Registered Training Organisation delivering government-approved qualifications. Additionally, daily, she also takes care of corrective work on the ever-growing incidences of adverse reactions, such as burns, scars or nerve damage due to treatments delivered by operators with skills-gaps and insufficient knowledge when using advanced technologies. In this interview she shares with us some of these incidences, why they are occurring and how to avoid them.
required. Each of these hours must be completed as supervised hours. Over the years, most of the adverse reactions that I have seen have been on the darker skin types e.g. 4,5 or 6 on the Fitzpatrick scale. These are often because the operator is only going by the manufacturer’s recommendations of energy and pulse width, without a correct understanding of when and how each section of that technology’s parameters can affect the various skin types, hair colour or lesions on the skin. Another important consideration is the area that is being treated, as different areas that may be bonier, will require a different setting to avoid adverse reactions. Scars from hair removal are the most common adverse reactions I have seen, mostly on the lower parts of the leg due to inappropriately preparing the skin. Another common area of concern is that operators don’t suggest to their clients to wear loose clothing after a body treatment. I have seen excellent treatments completed with LHR or SHR turn into a nightmare for the client by the time she returned to her work. This has resulted from having pulled on stockings and tights, which only serves to intensifying heat from the laser or IPL treatment, resulting in blistering. Supplier training is focused on how to operate a device. This is often insufficient when using Advanced Light-Based Technologies designed to treat a diverse range of skin conditions. Specific health and skin considerations need to be carefully reviewed to determine how to avoid potential complications and to establish correct treatment perimeters that will deliver safe and efficacious treatment outcomes. Also, platforms that offer a varied number of treatments for all six skin types, with an array of treatments using the different laser widths, like long and short pulses in 1064nm, 1320nm plus, IPLs that come on a multi-technology platform that are currently sold, require a higher level of knowledge and training. Supplier training only is not enough, particularly in states that do not require Laser Licenses which is where we encounter most cases with adverse reactions. APJ Q2: AS YOU PROVIDE BOTH SUPPLIER TRAINING AND NATIONALLY ACCREDITED QUALIFICATIONS, HOW DO THEY COMPARE?
APJ Q1: METRO, WHAT IS YOUR EXPERIENCE WITH ADVERSE REACTIONS FROM ADVANCED LIGHT-BASED TECHNOLOGIES? Metro: Adverse reactions from the users of light-based technologies has varied from state to state. In states that have Laser Licensing laws, we see less adverse reactions, and these are often easily correctable. I believe this is because the licensee is required to complete supervised training over a required period of time. For example, in Queensland in order to secure a license, the Laser Trainee hours for hair reduction are only 25 hours, for Tattoo Removal 100 hours are required, while Skin Rejuvenation with Pigmentation, Capillary Reduction or Lesion removal 50 hours are
Metro: With our equipment, our supplier training, comes with a manual and videos of the different treatments. The manual allows the operator to start asking questions about the equipment and further videos are also sent to them, according to the level of treatment they wish to perform. However, the practical training is dependent on the number of models the purchaser invites to the training day. I have found that owners often do not want their clients to perceive them as “new” or inexperienced so, they tend to bring their relatives to be their models. Additionally, the owners don’t want to lose business on the day, so they do not include all their staff in the training. Usually, the training is concentrated on the type of treatments they wish to offer in the clinic and hence, it cannot include a great deal of theory, nor do they gain a comprehensive understanding of the terminology used in their new equipment - e.g., what does ‘pulse width’ mean? How does that impact your treatment? What does ‘spacing’ mean in HIFU and how is this different from one treatment case to another? On the other hand, a nationally approved qualification provides the practitioner with thorough and comprehensive knowledge of the theory. Knowing the ‘ins' and ‘outs’ of your theory backwards will allow you to critically analysis each potential challenge and confidently master your treatment procedures with greater precision and accuracy. I find that people in our industry often get taken in by the “latest
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invasive treatments. We live in a nation with diverse ethnic skin types and therefore one-size-fits-all treatment is both unprofessional and risky. With HIFU for example, some of the damages that I have had to repair have been - partial paralysis of jaws, crooked lips or eyebrows, burns on the forehead and corners of the mouth, areas that are specifically not supposed to be treated, swallowing problems when the wrong depth cartridges were used on the neck particularly the trachea (which is a no-go zone except for specifically designed cartridges for that depth). Another case was a client who suffered a 2-month-long headache after she had a HIFU treatment done at a well-known clinic. The owner refused to acknowledge that the client’s problem stemmed from her HIFU treatment as there were no other signs on the skin. APJQ4: HOW CAN AN EXISITNG PRACTITIONER WITH FOUNDATIONAL KNOWLEDGE ON LIGHT-BASED TECHNOLOGIES SUCH AS IPL, LASER OR HIFU UPGRADE TO A QUALIFICATION, AND WHAT ABOUT FUNDING?
thing” through advertising of that equipment or by the price alone, or what is popular. Instead, if they concentrate on updating their qualifications, they would be able to better handle the challenges presented by the diverse client needs that they will be presented with in their practice. With a qualification they are also required to complete a lot more practical supervised hours to gain their qualification. This experience alone will strengthen their confidence and support them to operate with a higher level of success in their treatment outcomes and also successfully treat some of the more challenging skin conditions. APJ Q3: WHAT CAN GO WRONG WITH A HIFU PROCEDURE AND WHY IS QUALIFICATION A WISER OPTION? Metro: Not all HIFU systems are the same as some offer many more treatment options to address contouring for face to body. There is therefore a need for both knowledge and skills for both your settings and how you navigate the delivery of the treatment with considerations of spacing, frequency, overlapping and changing the energy when treating face or body. All these factors will allow you to avoid burns and scaring that are currently very common when HIFU technology is in the hands of an insufficiently trained operator. Our Graduate Certificate in Cosmetic Lasers and Dermal Therapies qualification is considered by AQF standards as equivalent to a bachelor’s degree and is available as a postgraduate course for beauty therapists with at least two years’ experience in the industry. This course content was developed, drawing from my knowledge and skills that I have gained over my 40 years of experience in the industry. The qualification aims at helping minimise risks to clinic owners and their clients. By increasing the theoretical understanding of each technology, including HIFU, treatment outcomes can be substantially improved. Obtaining a qualification is wise as it helps to eliminate the guesswork and stress from your treatment equation and will allow you to confidently ensure the success of your treatments. Furthermore, insurance companies are more and more requiring qualifications to ensure risk minimisation. Also your local Council also may require to review qualificaions, for advanced and more
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Upskilling to a qualification will advance your knowledge and expand to career options. If you offer advanced skin treatments, such as peels, enzymes treatments, skin tightening and lifting with light-based technologies, and you are already a trained and skilled practitioner, but wish to step up your qualifications as a Dermal Therapists, you may be eligible for Recognition of Prior Learning (RPL) and gain credits towards your qualification in units you are deemed competent. This will eliminate any unnecessary repetition and also save you money in learning what you already know. For an existing practitioner who is skilled and has been delivering these modalities at their clinic for over two years, they may be able to convert their evidenced experience into a formal certificate. In some cases, they may even be able to complete the entire course by getting their well-documented skills and experience in a related workplace assessment through our RPL pathway that os specially designed for experienced practitioners. We encourage practitioners to first talk to one of our supportive education specialists to help them decide what learning pathway is best for their situation, or whether their chosen path is right for them. APJ Q5: WHAT ABOUT FUNDING PROVISION FOR SOMEONE WHO WISHES TO UPGRADE? Government-funded courses are generally limited up to the Diploma of Beauty Therapies, for advanced studies, students must arrange for their own funding. With our courses, however, students can either take advantage of the private finance options or use our “interest-free” payment plan, which is beginning to be very popular in current economic circumstances. We realised that it is hard to find a course that is relevant, affordable, and adds value to their career aspirations, and sometimes it is difficult to sort the finance side for this decision. We understand these challenges, and that’s why we offer convenient payment plan options helping students break up their course repayments into smaller installments, which are above all 100% interest-free! This is a low-cost, no-interest, and quick approval process payment option that is an excellent alternative to government-assisted funding. If you are over 18, an Australian resident, and employed in fulltime, part-time, or casual work, you could take advantage of our no-frill payment option plan. With just a 10% upfront deposit, students can get approved in less than 24 hours. The remainder fee can be converted into an easy weekly, fortnightly, or monthly payment depending on their choice and eligibility. Training in individual units also available. APJ For further information please contact 1800 628 999.
UPSKILL DID YOU KNOW THAT WITHOUT A FORMAL QUALIFICATION IN DERMAL THERAPIES YOU CANNOT CALL YOURSELF A
DERMAL THERAPIST
Become a Certified Graduate in NAT10693 Cosmetic Lasers and Dermal Therapies APAN Member Special Offer now available!
Prerequisites for individuals who wish to apply may include: Minimum of two years experience as a qualified beauty therapist;
Possess Laser Licenses or IPL Qualification in TAS, QLD & WA; or as an
Cert IV and higher qualification for the HLT training package
Experienced Laser Operator
Undergraduate degree in health science
Completed Infection Prevention for Skin Penetration Treatments HLTINF005
Enquire now to check your eligibility for the Recognition of Prior Learning (RPL) pathway.
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SKIN NUTRITION
THE ROLE OF CAROTENOIDS
in skin protection AND IMPROVEMENT Tina Viney
The role of diet and nutrition in overall health has always been an interesting topic for researches, especially in reviewing their impact in disease prevention. But in recent times studies have focused on investigating the role of specific nutrients and antioxidant in skin health, both through topically applied agents, or oral supplements. In this article I will provide an update on some of the current literature “linking” nutrition and their role in skin protection and skin ageing. Beauty comes from the inside. The connection between nutrition and skin condition or rather the effect of nutrition on skin ageing has been an interesting research field not only for scientists, but also a common field of interest for humans throughout the ages, from ancient times to nowadays. Skin ageing consists of two didactically independent, clinically and biologically, distinct processes. As we know the first is intrinsic skin ageing, which represents chronological ageing and affects skin in the same pattern it affects all internal organs, while the second is extrinsic skin ageing, which we view as aged skin and is the result of external factors and environmental influences, mainly chronic sun exposure and ultraviolet (UV) irradiation, but also smoking, pollution, sleep deprivation and poor nutrition. Prevention is the best and most effective way to work against extrinsic skin ageing effects. The best prevention strategy against the harmful action of free radicals is a well-regulated lifestyle (caloric restriction, body care and physical exercise for the body), with low stress conditions and a balanced nutritional diet, including antioxidative rich food. Frequently researched antioxidants, such as carotenoids, tocopherols and flavonoids, as well as vitamins (A, C, D and E), essential omega-3-fatty acids, some proteins and lactobacilli have been referred as agents capable of promoting skin health and optimising beauty. To find a proper balance, this review considers the beneficial “anti-ageing” effects of increased reactive oxygen
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species (ROS) signalling recently. As skin therapists we can no longer ignore the critical role that nutrition plays in skin health, as the data is now extensive. Gaining an understanding of how various nutrients contribute to skin and overall health must become a fundamental consideration to our approach for both skin protection, as well as when designing our skin corrective strategies. In this article I will examine the key role that carotenoids play in skin health, as this category of nutrients is often underestimated. So, what are carotenoids and what is their role in skin and overall health? CAROTEINOIDS (vitamin A, β-carotene, astaxanthin, retinol) Carotenoids are vitamin A derivates like β-carotene, astaxanthin, lycopene and retinol, which are all highly effective antioxidants and have been documented to possess photoprotective properties. Findings of Scarmo et al. suggest that human skin, is relatively enriched in lycopene and β-carotene, compared with lutein and zeaxanthin, possibly reflecting a specific function of hydrocarbon carotenoids in human skin photoprotection. -β-CAROTENE – ENDOGENOUS PHOTOPROTECTOR β-carotene is the most prominent member of the group of carotenoids, natural colorants that can be found in the human diet. Compared with other carotenoids, the primary role of β-carotene is its provitamin-A activity. β-carotene can be cleaved by BCMO1 enzyme into two molecules of all-trans-retinal. There is no difference between naturally occurring and chemically synthesised β-carotene. Furthermore, β-carotene can also act as a lipid radical scavenger and as a singlet oxygen quencher, as demonstrated through in vitro studies. Based on the distribution of BCMO1 in human tissues it seems that β-carotene metabolism takes place in a wide variety of organs, including the skin. Here are some natural sources of carotenoids that we can include
in our diet. These include carrots, pumpkin, sweet potatoes, mangos and papaya are just some of the examples of β-carotene containing fruits and vegetables. Upon dietary supplementation, β-carotene can be further enriched in the skin, in which it is already a major carotenoid. Studies confirm that β-carotene is an endogenous photoprotector, and its efficacy to prevent UV-induced erythema formation has been demonstrated in various studies. In a study conducted in healthy volunteers, a 12-week oral administration of β-carotene resulted in a reduction of UV-induced erythema. Similar effects have been described in volunteers receiving a lycopene-rich diet. The systemic photo-protecting effect of β-carotene depends both on dose and duration of treatment. In studies documenting protection against UV-induced erythema, supplementation with carotenoids lasted for at least seven weeks, with doses > 12 mg/d of carotenoids. With treatment periods of only 3–4 weeks, studies reported no protective effects. Furthermore, β-carotene supplementation can significantly reduce the rate of mitochondrial mutation in human dermal fibroblasts after UV irradiation. WHAT ABOUT ASTAXANTHIN? Astaxanthin, another beneficial carotenoid is found in microalgae, yeast, salmon, trout, krill, shrimp, crayfish and crustacea. Astaxanthin is biosynthesised by microalgae or phytoplankton, which are consumed by zooplankton or crustacea. They accumulate astaxanthin and, in turn are ingested by fish which then accrue astaxanthin in the food chain. Therefore, astaxanthin has considerable potential and promising applications in human health and nutrition and has been attributed an extraordinary potential for protecting the organism against a wide range of diseases. The UV protective effects of algal extract containing 14% of astaxanthin compared to synthetic astaxanthin have also been tested. The authors of one study reported that preincubation with synthetic astaxanthin or an algal extract could prevent UVAinduced alterations in cellular superoxide dismutase activity and decrease in cellular glutathione content. In a study of Camera et al. the modulation of UVA-related injury by astaxanthin, canthaxanthin, and β-carotene for systemic photoprotection in human dermal fibroblasts has been compared. Astaxanthin showed a significant photoprotective effect and counteracted UVA-induced alterations to a great extent. The uptake of astaxanthin by fibroblasts was higher than that of canthaxanthin and β-carotene, which lead to the assumption that the effect of astaxanthin toward photooxidative changes was stronger than that of the other substances. A recent study of Suganuma et al. showed that astaxanthin could interfere with UVAinduced matrix-metalloproteinase-1 and skin fibroblast elastase/ neutral endopeptidase expression. Both studies suggest that effects of UVA radiation, such as skin sagging, or wrinkling can be prevented or at least minimized by topical or oral administration of astaxanthin. LYCOPENE – GREAT FOR SUNPROTECTION Lycopene is a bright red carotene and carotenoid pigment and phytochemical found in tomatoes and other red fruits and vegetables, such as red carrots, watermelons and papayas (but not strawberries or cherries). Although lycopene is chemically a carotene, it has no vitamin A activity.
A study confirmed that the amounts of lycopene in plasma and skin are comparable to or even greater than those of β-carotene. When skin is exposed to UV light stress, more skin lycopene is destroyed compared with β-carotene, suggesting a role of lycopene in mitigating oxidative damage in tissues. Lycopene and tomato products are also mentioned for preventing cancer. RETINOL – IMPORTANT FOR MAINTENANCE OF EPITHELIAL TISSUE Retinol is important for the human body, however the body itself cannot synthesise it. Retinol, a fat-soluble unsaturated isoprenoid like its two important metabolites retinaldehyde and retinoic acid, is essential for growth, differentiation and maintenance of epithelial tissues and influences reproduction. In human skin two retinoid receptors are expressed, which can be activated by retinol and its metabolites. Retinaldehyde, additionally being important for vision, is created by in vivo oxidation of retinol in a reversible process. The normal plasma concentration of vitamin A in humans is 0.35–0.75 μg/ml. It is important that retinol be also derive from diet not just from topically applied products. Natural retinol and retinol ester are contained in liver, milk, egg yolk, cheese and fatty fish etc. Naturally occurring and synthetic vitamin A (retinol) show similar biological activities. Different retinol products, both for cosmetic (topical) and pharmaceutical (topical, systemic) use can be found on the market. In a review of topical methods to counteract skin wrinkling and irregular pigmentation of ageing skin, one study evaluated the effects of vitamin A acid derivatives, chemical peeling and bleaching agents. Also, the effects of UV protection by using sunscreens and topical antioxidants were reviewed. The topical retinoid treatments inhibit the UV-induced, MMP-mediated breakdown of collagen and protect against UV-induced decreases in procollagen expression. Endogenous retinoids cannot be linked to the pathogenesis of common skin diseases like acne and psoriasis. In several studies, oral treatment with retinol or retinal derivatives has not been proposed as a possible anti-ageing treatment. Humans require 0.8‒1 mg or 2400‒3000 IU vitamin A per day (1 IU = 0.3 µg). Unfortunately, the large CARET trial mentioned lung cancerpromoting effects of 25,000 IU retinyl palmitate combined with 30 mg β-carotene intake in smokers. Thus, the belief that chemical quenching of free radicals by natural compounds like retinyl palmitate and β-carotene exerts always beneficial effects has been challenged. Another study showed that an artificial systemic increase of oral antioxidants by dietary supplementation intended to modify UV erythema thresholds may have severe internal adverse effects which even may not only increase risk of cell ageing but of tumour promotion if administered in very high doses – especially with fatsoluble vitamins that are stored in body. However, experts still recommend dietary intake in their natural form as fruits and vegetable are highly beneficial both for skin and overall health. While the role of nutritional supplementations for better skin and health have proven beneficial, caution is required with megadoses. IN CONCLUSION
β-carotene and lycopene are usually the dominating carotenoids in human blood and tissues and are known to modulate skin properties when ingested as supplements or as dietary products. While they cannot be compared with sunscreen, there is evidence that they protect the skin against sunburn (solar erythema) by increasing the basal defence against UV light-mediated damage.
In summarising the above studies, the evidence points to the synergistic benefits of a health diet, supported by specific nutrients in recommended doses in providing sun-protective properties as well as anti-ageing benefits, especially when combined with topically applied nutrients. APJ
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DERMATOLOGY
PAEDIATRIC ATOPIC DERMATITIS Professor Terry Everitt
Atopic dermatitis (AD), more commonly known as eczema or atopic eczema, is the most common inflammatory skin disease globally. It is estimated that AD affects up to 10% of adult populations. Yet, more so 15% to 20% of the paediatric population, with about 85% of cases observed during the first five years of life, can alleviate substantially by the age of 7 (Huang & Ong, 2018). Atopic dermatitis is the most prevalent chronic skin disease seen in children, particularly before puberty. In Australia, it is estimated that 1 in 4 Australian children are affected by AD, usually starting less than 12 months of age. It frequently follows a remitting and relapsing course and tends to resolve in most children by five years. Unfortunately, not for all. Many interactions of genetic and epigenetic factors, epithelial barrier dysfunction and immunological defects are all known to play a part in the pathogenesis of the condition. AD may be confused with many other skin diseases, and careful differential diagnosis must be made with these disorders that exhibit similarities with AD, such as nummular dermatitis, psoriasis, irritant contact dermatitis or seborrheic dermatitis. While we appreciate adults with AD, children with the condition have not just physical, but also psychological concerns and these exacerbate quality of life issues. Embarrassment at school and social outings due to itching and the appearance of the lesions lead to social isolation. Additionally, itching can lead to severe sleep difficulties. Caring for children with AD can also affects the parents, who tend to have disturbed sleep and higher stress due to the demands of care needed. PATHOGENESIS The pathogenesis of AD is incredibly complex and outside the realm of this short article; however, here are some of the highlights: •
Epithelial barrier dysfunction is a significant cause of AD in children, usually due to genes encoding for proteins responsible for normal barrier function being defective, not only associated with filaggrin.
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•
Food allergies are a common concern in children and not only via the gastrointestinal tract, in fact (30% of childhood AD) have food sensitisation occurring via defective skin barrier. These changes with inhalant allergens have been demonstrated in about 65% of patients as young as six years old (Sybilski et al., 2015).
•
Skin microbiota changes with Staphylococcus aureus overgrowth occurring up to 90% of lesion sites, while it is found at lower percentages in healthy skin.
Perhaps the biggest concern is the multiple immunological mechanisms underlying AD, particularly those emanating from the keratinocytes. A host of cytokines are involved in pattern recognition receptors. However, it is the disruption of the intracellular signal molecules - intracellular cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), which increase the phosphorylation of protein kinase A (PKA) ( you can see why I did not want to get into the details). This results in proinflammatory molecules suppressing innate immunity of the epidermis, even causing changes from T helper 1 (Th1) to T helper two cells (Th2), in turn upregulating inflammatory status and causing overproduction of immunoglobulins which are known to inhibit keratinocyte differentiation. In particular, cytokines (pruritogens) are released from eczematous skin areas where they activate the relevant sensory nerves and cause pruritus, thus initiating a cascade resulting in the need to itch the area. These cause further complications with the aberrantly elongated sensory nerves in the upper layer of the skin. Due to the impaired epidermal barrier function the skin becomes dry and irritated, especially when exposed to environmental factors. Kern et al. (2021) studied 11,181 children in the UK with AD and found symptoms of depression ranged from 6.0% to 21.6%; and for internalising behaviours, from 10.4%to 16.0%, with internalising behaviour noted as early as four years of age. The child’s emotional and psychological states, including depressive behaviour, anxious behaviour, and somatic complaints) are generally not recognised as essential and remain unresolved yet need early intervention.
Overview of Atopic Dermatitis Pathogenesis. Howell et al. (2015, p.889) TREATMENT As the pathophysiology of AD is complex, so are the treatment options, as effective treatment needs to alleviate or eliminate identified triggers, while suppressing inflammation and the resulting pruritus. Additionally there is a need not to develop xerosis or dehydrated skin. In terms of treatment, it is not so tricky to work out. For example, topical moisturisers using emollients, occlusive agents, and humectants would be the first line of treatment to increase water retention, helping to prevent Trans Epidermal Water Loss (TEWL) and dehydration. If successful, this alone may be all that is needed; it at least minimises the need for pharmacological intervention. However, the moisturiser used needs to be somewhat bland with no fragrance and minimal surfactants. Daily bathing in tepid water helps hydrate the skin while removing irritants, crusts, bacteria, and allergens. Not using soaps is vital here, with gentle cleaners being advised. Gently dry the skin without rubbing and then applying moisture to the damp skin. Although it still can be done at home, more technical therapy is termed wet-wrap therapy, where topical moisturising agents are applied to the skin, then wrap a layer of tubular wet bandage and an outer layer of dry dressing over the top. This is a form of occlusion to intensify the moisture capabilities of the products applied. Bleach baths have also been a traditional treatment, with Huang et al. (2009) showing definitive proof of effectiveness, particularly in reducing Staphylococcus aureus and preventing secondary skin infections. You will, of course need some care with bleaching. For children, no more than 1/4 cup of bleach must be used within 35–40 litres of water and only have the child in the solution for 5 to 10 min. It is not recommended if there is visible laceration or tears in the skin. If bleach seems a bit much, there are a variety of antiseptic agents now also available. If AD appears to be worsening, it could be due to bacterial and viral infections. Medical help is required in the form of antibacterial or antivirals, along with anti-inflammatories and topical corticosteroids. If topical therapies appear not so effective, then systemic therapy for AD is generally recommended, this is only undertaken if the
lesions do not alleviate after using topical treatments. Again, many medications are available, including systemic antihistamines, allergen immunotherapy, and newer biological agents. APJ Professor Terry Everitt is one of our speakers at the APAN Aesthetic Conference. He will also be moderating the panel session on anti-ageing procedures.
For a list of references, please contact the editor.
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AESTHETICS INDUSTRY BULLETIN
PROFESSOR MICHAEL ROBERTS TO OPEN APAN AESTHETICS CONFERENCE 2022 We are delighted to announce that despite his busy schedule Professor Michael Roberts has accepted to official open the APAN AESTHETIC CONFERENCE. Professor Roberts is a globally renowned academic and highly respected for his expertise in therapeutics and pharmacological sciences, as well as his current studies in numerous therapeutic modalities including critical care medicine, nanotoxicology, topical delivery pharmacokinetics, drug development and cosmetology. His PhD was on structure penetration and toxicity relationships for phenolic compounds in human skin. This work is now included as core data in pharmaceutical and toxicological data bases, for example in the US Environmental Protection Agency. He is internationally renowned for his work on the absorption of chemicals, cosmetics and drugs through the skin. He has been a full professor for 25 years being initially Professor and Head of Pharmacy at the University of Otago, New Zealand and now as a Senior Principal Research Fellow of the Australian National Health and Medical Research Council. He is jointly appointed as the Chair in Therapeutics and Pharmaceutical Science in the University of South Australia and as the Professor of Clinical Pharmacology and Therapeutics
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at the University of Queensland. Professor Roberts is a visiting Professor at the University of Lyon, France and is Director of the Therapeutics Research Centre (30 staff and students), based jointly at the Queen Elizabeth Hospital in Adelaide and at and Princess Alexandria Hospital in Brisbane. He has served and currently serves on reference committees for the World Health Organisation, Europe, Health Canada and Australia and presented to regulatory forums in the US. Professor Roberts RCTs in the community led, in part, to the Australian government national implementation of medication management for nursing homes and hostels (also now an accreditation requirement), and home medicine reviews by accredited pharmacists. Most recently, he has facilitated the use of imaging and micro-dialysis techniques to study pharmacokinetics in man in vitro and in vivo, including in critical care and cancer medicine. However, more importantly for our industry, he has had extensively involvement with the direction of educational development for the aesthetics industry and in particular in the area of cosmetic sciences. If you are attending the first day of our conference, you will have the privilege of meeting him in person. APJ
PERSISTANT SKIN MANIFESTATIONS WITH COVID-19 – PROVIDING YOU WITH GUIDELINES As more and more salons and clinics are experiencing adverse reactions due either to COVID-19, or delayed sensitivity reactions due to vaccinations, the request for formal guidelines is something that APAN is frequently asked by salons and clinics. Having approached both state and federal health authorities, we have been informed to establish our own, as no formal studies have yet been released for the Government to base any recommendations. We are delighted to announce that we now have some excellent studies to base a formal Position Statement. Professor Laurence Walsh will be presenting the latest research study results at the APAN Aesthetic Conference. Professor Walsh’s lecture will feature on Tuesday 19th July where he will present information on over 100 persistent skin manifestations due to COVID-19. This information will be first presented at the APAN conference. If you are providing skin treatments this lecture is a must for you as it will present valuable evidence-based information. Our intention is to formalise our COVID-19 POSITION STATEMENT on precautionary measures for skin treatment following a full review of this study, as well as discussion with Professor Michael Roberts. APJ
This section presents the latest news, training dates and other Aesthetic Industry information
levels detected would not be expected to cause serious adverse health effects, and risks to users are considered low, the sunscreens are being recalled ensuring consumer safety. Please review the full article below and note the common brands including even one of the Cancer Council’s sunscreen brands that were recalled: https://www.tga.gov.au/alert/ multiple-sunscreens-recall-low-levelsbenzene-detected
SUNSCREEN RECALL – WHY YOU NEED TO NOTIFY YOUR CLIENTS As a skin therapist the issue of ingredient safety is something you need to be well versed in to support and advise your clients against any potential risks.
As professionals in skin therapy, we have access to quality active products that also meet with safety standards. Most of the companies that develop skincare product featured in this journal also produce safe and well-formulated sunscreens, often with multiple benefits. Please review these and include them in your clients’ recommended home care regime. We also recommend that you inform your clients of the above recall within your social media or newsletter as this is valuable information to them. APJ
Recently, the TGA released a multiple sunscreen recall having identified low levels of benzene detected. Many of these brands are very popular and even sold through salons and clinics, for example the Cancer Council Sensitive Sunscreen SPF50+. Please review details about the recall and advise your client who may be using a sunscreen that they have obtained independent of your recommendation. But let’s take a quick look at the issues with benzene: What is benzene and what are the risks? Benzene is a chemical that can cause cancer in humans, depending on the level and length of exposure. Benzene is not an ingredient in sunscreens but can be a contaminant in raw materials used in the manufacturing process. It has been detected in one batch of a raw material used in the manufacture of several products and the TGA is working with affected companies to confirm if benzene is present in their medicines and if it is, how much is there. Benzene levels in sunscreens sold in Australia must be below two parts per million (ppm). Although exposure at the
CBD OIL PARTNERING WITH RETINOL FOR GREATER EFFICACY CBD oil has gained a lot of publicity lately as it now also entering the cosmetic formulations arena. Rich in potent anti-inflammatory properties, CBD may be useful for treating many skin conditions, including acne, eczema and psoriasis. Now new studies have found that it can be very effective when combined with retinols. Both ingredients
have been extensively tested in both laboratories and human trials and the results are very encouraging as they have indicated that this combination can have a transformative on the skin. WHAT CAN CBD AND RETINOL BENEFIT THE SKIN As we know, CBD stands for cannabidiol and it’s one of the most well-known of the many natural chemicals found in the cannabis sativa plant. Extracted as an oil, in the last few years it’s been the subject of extensive research. Studies have shown that it has a long list of medicinal qualities, from anxiety relief to better sleep. But it’s the effects of CBD on the skin has now also been extensively proven. Part of its appeal lies in its antiinflammatory and anti-ageing properties. It fights free radicals that contribute to wrinkles, while also supporting collagen production, which helps to reduce the appearance of fine lines on the face. It can also help to reduce acne by restoring balance to the levels of sebum produced in the skin, while its anti-inflammatory properties are beneficial in soothing eczema and psoriasis skin conditions. Retinol is the umbrella term used to describe retinoids, of which there are five main types used in skin care. All retinoids are a slightly less potent form of a prescription-only vitamin A derivative Tretinoin. They’re only slightly milder and can be harsh on the skin when used incorrectly but when they’re applied properly, they can have dramatic effects on the complexion. One of the things that retinol creams, serums and lotions are most known for is plumping and firming the skin, thus reducing the signs of ageing. These products boost collagen production to fill out fine lines and wrinkles for a more youthful complexion. Their collagen-boosting abilities also help with treating scars, such as indented acne scars. While retinoids have excellent cellrenewal properties they need to be used with caution as they can irritate the skin. This is where CBD comes in as an excellent companion product. With its rich anti-inflammatory properties, it can provide effective synergy when combined with retinoids. APJ
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SCIENTIFIC NEWS papillomavirus (HPV) laser plume and best safety practices. International Journal of Dermatology. E-pub ahead of print. https://doi.org/10.1111/ijd.15936 I am consistently amazed at the amount of lasering that goes on in clinics without any protection in terms of plume reduction for the practitioner. Such does not bode well for the future health of so many practitioners.
able to predict overall scar appearance at the 3-month with approx—40% improvement. Linear repairs are the most common reconstruction after skin cancer excision, providing the most negligible scarring, followed by regional flaps and then grafts, with nasal and perioral scars graded the worst.
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THE DANGERS OF HUMAN PAPILLOMAVIRUS (HPV) LASER PLUM AND BEST SAFETY PRACTICES Human papillomavirus (HPV) is one of the most common viruses afflict the skin and mucosa. While it is outside the practice of aestheticians to treat warts by laser or electrocautery, it is possible to hit them in treating other conditions accidentally. The plume would contain HPV particles, a potential threat for HPV infection of the oropharynx and/or larynx when inhaled. Stetkevich & Burkhart (2021) reviewed several studies evaluating the occupational risks posed by HPV exposure from the plume, finding many dermatologists developed HPV-16– positive cancers of the oropharynx and/or larynx. Due to the HPV viral particle size of 55 nm, mask-wearing during laser procedures is ineffective for preventing infection; even N95 masks allow penetration of some particles smaller than 300 nm. Using a smoke/plume evacuator seems to be the most effective way to limit viral infection, although needed to be used within 2 inches (5 cms) of the site of HPV lesion to be effective. Stetkevich, S. A., & Burkhart, C. (2021, October 12). The dangers of human
POST SKIN CANCER SCAR AT ONE WEEK TELLS HOW IT WILL BE AT THREE MONTHS This retrospective study of 108 facial skin cancer patient scars, post full thickness to the adipose layer, muscle, or periosteum Mohs surgery, were analysed via the Patient and Observer Scar Assessment Scale (POSAS) to grade scars at two-time points (1 week and three months postoperatively) along with Analysis of variance (ANOVA) explored whether POSAS scores differed by anatomic site or reconstruction type. One week and three months, the total POSAS score improved by 36.3% and the overall opinion of the scar enhanced by 38.6%. Variations occurred in different facial cosmetic units and reconstruction scar types, with scar appearance at one week
While this was only post skin cancer healing, I think it can be extrapolated to most facial scar healing. Shao, K., Taylor, L., Miller, C., Etzkorn, J., Shin, T., Higgins, H., Giordano,C., & Sobanko, J. (2021). The Natural Evolution of Facial Surgical Scars: A Retrospective Study of Physician-Assessed Scars. Using the Patient and Observer Scar Assessment Scale Over Two Time Points. Facial Plastic Surgery & Aesthetic Medicine, 23(3), 330-338. DOI: 10.1089/ fpsam.2020.0228 We know that setting realistic expectations affects patient perceptions of outcomes, and knowledge of the surface area and cosmetic unit affected can give reliable quantification of facial scar improvement. This study joins many others in providing information that can inform your education for clients regarding scar healing post-surgery in assisting them with reconstructive decisionmaking and optimising postoperative patient counselling regarding healing expectations. APJ
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Research and Scientific New Developments In every issue of the journal, Prof. Terry Everitt our scientific educator, conveys a few items of scientific interest. In italics, are his thoughts on the subject matter of the research study.
Treatment of such has always been a big concern, and generally, much is put on the contraindicated list without scientific reasoning or validation. While there is much study on preparations used in pregnancy, these are primarily on animals, not humans, so, to be safe, almost everything is contraindicated. Due to ethical reasoning, human trials are not possible, so other extrapolations are needed.
search available at https://www.tga.gov.au/ prescribing-medicines-pregnancy-database Most topical drugs are in the A-D categories with systemic medications, usually an X, where the drug has a high risk of causing permanent damage to the foetus. While still scant, more evidence is becoming available showing the safety of many topical skincare products based on the drug counterpart. Much remains unknown, so be careful and be conservative if in any doubt. APJ
The meta-study in review furthers our knowledge, based on literature drawn from PubMed, Embase, and Cochrane Library databases, although primarily from a USA regulatory perspective and with drugs, not skincare products. TGA has listings for drugs, yet not those found in topical cosmetics.
SAFETT PROFILE OF TOPICAL PRODUCTS DURING PREGNANCY Ninety per cent of pregnant women often experience some skin changes, including physiological (hormonal) changes, worsening of pre-existing dermatoses, and specific pregnancy dermatoses, which need special care and treatment (Putra, Jusuf & Dewi, 2022).
Personally, it has always been my knowledge of cosmetic chemistry that has guided my use of topicals in pregnancy. The first thought is whether the ingredient penetrates the epidermis, causing absorption in the dermal blood supply. If not used on the abdomen, an ingredient that does not get to the blood supply will not get to the foetus. Then, the amount and frequency of use relate to the possible build-up of topical. Water or lipid-soluble is an essential factor. While the individual ingredients listed in the study are outside the scope of this writing, I would suggest reading the investigation as it does present interesting information. Yet, much remains to be tested and validated. You might be interested in an earlier study by Panchaud et al. (2012) titled Pregnancy Outcome Following Exposure to Topical Retinoids: A Multicenter Prospective Study, published in the Journal of Clinical Pharmacology that showed in a population of 235 exposed pregnant women (compared with 444 controls) found no significant differences in infants exposed to topical retinoids compared with controls on any outcome measured. Putra, I., Jusuf, N., & Dewi, N. (2022). Skin Changes and Safety Profile of Topical Products During Pregnancy. Journal of Clinical and Aesthetic Dermatology, 15(2):49–57. TGA has categories for a drug in pregnancy listed as A, B1, B2, B3, C, D and X with
HOW FAT CELLS IN THE SKIN HELP FIGHT ACNE We all know the pathophysiological factors required for the development of acne; however, new research suggests the skin cells outside of these hair follicles play a larger role. You might not believe how. Cells outside the hair follicle are at play – the fibroblasts and their secretion of an antimicrobial peptide called cathelicidin (Camp), in response to acnecausing Cutibacterium acnes. The study was triggered by knowledge of fibroblasts that become antimicrobial when triggered by TLR2 (a pattern recognition receptor known to influence the inflammatory response) to differentiate into adipocytes as an innate immune defence, particularly against Staphylococcus aureus. Without the details, analysis of inflamed skin of acne patients after retinoid treatment also
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SCIENTIFIC NEWS showed enhanced induction of cathelicidin, a previously unknown beneficial effect of retinoids in difficult-to-treat acne. While the study did show that dermal fibroblasts are involved in acne, the factors that trigger their stimulation and differentiation are relatively unknown. Overall, these data provide evidence that adipogenic fibroblasts are a critical component of the pathogenesis of acne and represent a potential target for therapy. O’Neill, A., Liggins, M., Seidman, J., Do, T., Li, F., Cavagnero, K., Dokoshi, T., Cheng, J., Shafiq, F., Hata, T., Gudjonsson, J., Modlin, R., & Gallo, R. (2022). Antimicrobial production by perifollicular dermal preadipocytes is essential to the pathophysiology of acne. Science Translational Medicine, 14(632) DOI: 10.1126/scitranslmed.abh1478 Retinoids are effective therapeutics in the treatment of acne. Their mechanism of action has been attributed to suppressive activity on the sebaceous gland or keratinocytes. Isotretinoin down-regulates TLR2 signalling in monocytes and reduces overall inflammation in acne – this appears to be in effect with topical retinoids. APJ
Interestedly, hydroquinone (4%) showed significant lightening after the fourth and sixth weeks; Azelaic acid (20%), ascorbyl palmitate (1%) and resveratrol (1%) revealed considerable lightening at the end of the third week; arbutin (5%) had significant attenuation of pigmentation by the end of week three and remained substantial in comparison to the inactive control, yet none of the agents showed significant pigmentary changes at all-time points over the six weeks. Participants did not experience any local irritation or pigmentary change with any formulations at any site. While arbutin may seem like the best ‘ depigmenting’ ingredient, the lipophilic dispersions' stability for test formulations might have been more optimal for arbutin than for actives tested. It is Important to note that all five ingredients (at usual percentage formulations) showed a marked decrease
Acquired pigmentary disorders are common distressing dermatological problems among individuals with dark skin tones, and while many ingredients are available, they tend to work better at different time frames. Hydroquinone is considered the gold standard to treat acquired pigmentary disorders, particularly melasma; however, it has adverse effects, particularly among individuals with dark skin tones, including skin irritation and allergic contact dermatitis. Arbutin (hydroquinone-O-beta-Dglucopyranoside) is a naturally occurring derivative of hydroquinone. Many products contain Beta-Arbutin, which is less effective yet can be used in higher amounts in skin products. Azelaic acid is a dicarboxylic acid derived from Pityrosporum ovale. It inhibits tyrosinase, mitochondrial oxidoreductase activation and DNA synthesis. It needs to be
COMPARATIVE STUDY ON DEPIGMENTING AGENTS IN SKIN COLOUR Found this study interesting as it was in two phases. First, it tested five commercially available OTC preparations in Sri Lanka, sold to lighten the skin on 28 subjects. The products had various ‘active’ ingredients and excipients and were found to be more effective than the control group. The products generally had more than one melanin inhibitor ingredient, so it wasn't easy to tell which specific component was more effective. More importantly, in the second phase, five single active ingredients in lipophilic dispersion (hydroquinone 4%, ascorbyl palmitate 1%, resveratrol 1%, arbutin 5% and azelaic acid 20%) were tested on a different group of 26 healthy females, using a standardised application methodology, over six weeks.
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in melanin content compared to the nonactive control. Liyanage, A., Liyanage, G., Sirimanna, G., & Schürer, N. (2022). Comparative Study on Depigmenting Agents in Skin of Colour. Journal of Clinical and Aesthetic Dermatology, 15(2):12–17.
at 20% for effectiveness. Resveratrol (3,4,5-trihydroxystilbene) is a skin-lightening flavonoid that acts by tyrosinase inhibition. APJ
Research and Scientific New Developments In every issue of the journal, Prof. Terry Everitt our scientific educator, conveys a few items of scientific interest. In italics, are his thoughts on the subject matter of the research study.
pass the formidable corneum barriers. Full details are in the study, which the DOI can access. Starr, N. J., Khan, M. H., Edney, M. K., Trindade, G. F., Kern, S., Pirkl, A., Kleine-Boymann, M., Elms, C., O'Mahony, M. M., Bell, M., Alexander, M. R., & Scurr, D. J. (2022). Elucidating the molecular landscape of the stratum corneum. Proceedings of the National Academy of Sciences, 119 (12). DOI: 10.1073/pnas.2114380119
ELUCIDATING THE MOLECULAR LANDSCAPE OF THE STRATUM CORNEUM
Information we were able to gather on the complex chemistry of this tough barrier layer has the potential to benefit research into fundamental biological processes, such as those associated with ageing and disease, and improve the efficacy of topical delivery.
inactivation of the probiotic in the product. While literature exists in the scientific world, most are direct application or ingestion of probiotics; little is on the effects with skincare products the study acknowledges. Yu, J., Ma, X., Wang, X., Cui, X., Ding, K., Wang, S., & Han, C. (2022). Application and mechanism of probiotics in skin care: A review. Journal of Cosmetic Dermatology, 21. 886–894.DOI: 10.1111/ jocd.14734R One problem is that the probiotics need to be
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I recent study has provided more detail in understanding the complex chemistry of the stratum corneum, promoting a ‘molecular map’ of the corneum’s structure that will help develop new skin products and treatments. Using new and very high-tech equipment, researchers at the University of Nottingham studied ex vivo full-thickness human skin tissue samples to generate a ‘depth profile’ showing a range of chemistries and 3D distributions within the stratum corneum. The study showed the non-homogeneity of the stratum corneum, particularly the various chemical gradients present. While aware of the varying lipid composition with epidermal depth, the previous testing has not been able to discern such differentiation in the corneum. The array of lipids such as triglycerides, cholesterol sulphate, fatty acids, ceramides and amino acids are found to differ within the stratum corneum, which again differs from those in the succeeding strata of the epidermis. Apart from the knowledge gained, the study opens the possibility of developing more specific drugs and cosmetic ingredients to better
APPLICATION AND MECHANISM OF PROBIOTICS IN SKINCARE: A REVIEW Probiotics are defined in several ways – one being as living microorganisms that give a health benefit on the host, proving a range of benefits. Having probiotics in skincare is not exactly new; however, they have been more marketing than actual benefit; however, that is rapidly changing. The specific mechanism of probiotics for skin moisturisation (p. 888) The use of probiotics can treat skin diseases by producing certain cytokine analogs that inhibit the growth of pathogenic bacteria, with this study looking at the effects of such probiotics on skin whitening, photo-ageing and moisturising. Different probiotics have effects, and it is essential to use the correct ones in sufficient quality and quantity for any effect to be apparent. The study also looked at combining some Tradition Chinese Medicine with probiotics. Progress has been made, yet there remain concerns with the
living and within a product, they frequently become inactivated. Another concern is could they cause harmful flora in skincare products to multiply, which will exceed the safety limit and have adverse effects on the skin. APJ
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STAR PERFORMER
CALM BALM PRIMER OUR CULT FAVOURITE JUST GOT BETTER!
As one of Issada’s best-selling lines we’ve always been proud of our Issada Calm Balm Primer but now it’s just got a whole lot better. Known for its anti-red, anti-shine, soothing, calming and mattifying properties, it’s no wonder that it’s fans just come back for more. In fact, Calm Balm is one of our leading products - so how did we improve on what already seemed to be perfection? It certainly wasn’t fast or easy! Our formulator is constantly researching ingredients and testing new or interesting ingredients. Not a week goes by when the staff are not trialling, and testing formulas handed to us for feedback and R&D is always high on our priority list. Not one to rest on our laurels, the whole team at Issada seek to not only widen our product range but update and keep it relevant. Throughout extended R&D periods we test new ingredients and tweaks in the formula over and over. Taking time to develop a product in a well-documented and methodical manner is essential. In addition to efficacy of formula we need to test packaging suitability, product stability and more. It’s rare, but it is possible to be months into testing and we have a formula fall apart and we need to start again. We also seek feedback from discerning group of users ranging from staff, customers and stockists as well as our own clinic where all products are tested before release. Eventually the New Calm Balm achieved an enthusiastic crescendo of approval – from some of our most particular stockists too. Our all-star line up of actives in the New Calm Balm include: •
Squalane: moisturises, reduces the appearance of fine lines, helps regulate oil production on the skin
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•
Grapefruit oil: brightens the skin, can shrink pores, and has a delicious scent
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Rose oil: moisturising, soothing and calming especially good for inflamed skin
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Witch hazel: reduces redness and irritation
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Rice Starch: anti-ageing, skin-brightening, and mattifying effect
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Pomegranate oil: anti-ageing, hydrating, and anti-inflammatory properties
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Shea Butter: anti-inflammatory and antioxidant properties Finally, the colour has slightly changed, leaning a bit more on the ‘minty’ side of green than the previous formula. Issada owner Deb Farnworth-Wood said, “The long-storyshort explanation for why we changed the colour slightly was that our formulator wanted a shade that would cancel out a wider range of inflamed skin tones, giving the skin a calmer appearance”. APJ Calm Balm Primer is ideal for rosacea, acne rosacea, oily and acne prone skin as well as oily for those who just prefer a more matte finish. www.issada.com
A complete approach to beautiful skin
Through pure, high quality, talc-free mineral makeup and advanced cosmeceutical skincare, Issada are commited to complete skin health. Formulated with clean, active ingredients to achieve flawless results for every skin type, Issada is the ultimate addition to professional aesthetic practices. AUSTRALIAN
CLEAN FORMULAS
CRUELTY FREE
ADVANCED ACTIVES
To hear more on how Issada can benefit your spa, clinic or professional salon, please call 07 3904 2288 or visit issada.com/partners
SCAN TO DOWNLOAD 37 REASONS TO BECOME AN ISSADA STOCKIST
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