Leaders in Education
Spring Volume 44 2020
Aesthetics Practitioners Journal is the official publication of the Aesthetics Practitioners Advisory Network PTY LTD.
We pledge Safety for all
Pandemic Infection Control Program
APJ 1
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IN THIS ISSUE SPRING VOLUME 44. 2020 REGULATIONS, STANDARDS AND EDUCATION
82
19
CONCISE GUIDE TO DERMAL NEEDLING
26
PROVIDING NEW LEVELS OF EDUCATIONAL SUPPORT DURING CHALLENGING TIMES
50-53
SCIENTIFIC RESEARCH, TREATMENTS AND TECHNOLOGY 20-22
THE GUT-BRAIN SKIN AXIS
74-77
92-93
TARGETTED APROACH FOR SKIN REJUVENATION
UNDESTANDING THE CAPABILITIES AND CHARACTERISTICS OF VARIOUS COSMETIC TATTOO NEEDLES
94-95
82-84
LED THERAPY FOR EYE SAFETY CONSIDERATIONS
CLARY SAGE ESSENTIAL OIL FOR HORMONAL BALANCING
86-87
AUSTRALIAN NATIVES RICH IN VITAMIN C
88-90
UPDATE ON THE BENEFITS OF SPIRULINA FOR SKIN AND HEALTH
56
THE ARCHITECTURE OF FACIAL AGEING
STUDY CONFIRMS COVID-19 IS MUTATING - WHAT DOES THAT MEAN TO YOU?
56-58
NON-IONIZING RADIATION FOR COSMETIC PURPOSES 59 REVIEWING ADVANCES IN THE NON-SURGICAL AND SURGICAL LANDSCAPE
20
TREATMENT OPTIONS FOR SYSTEMIC AND LOCALISED SWEATING DISORDERS
96-97
98-100
THE HEALTH BENEFITS OF CHIA SEEDS
BUSINESS, PERSONAL AND PROFESSIONAL DEVELOPMENT 22
BUSINESS WISDOM SURVIVAL OF THE FITTEST
24-25
RESILIENCE, BODY.MIND. SOUL
38-41
HOW SKINCARE IS LEADING THE WAY IN THE PANDEMIC ERA
44
HOW TO ACHIEVE BUSINESS SUCCESS IN THE NEW DECADE
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54-55
62
THE WORLD’S SMARTEST SOFETWARE FOR APPOINTMENT BOOKINGS
72-73
SOLUTIONS FOR COVID DOWNTIME - RAISING STRONGER DURING THE DISRUPTION
96
INDUSTRY REPORTS, NEWS, PRODUCTS AND COSMETIC MEDICINE 8-9
68-71
8-15
78-81
CEO’S REPORT COVER STORY
32-35
PRODUCT INNOVATIONS
64-65
REJUVENATION THAT RESTORES CONFIDENCE SKINMED SEATTLE
66-67
ACHIEVING AN ACADEMIC MILESTONE
AESTHETIC BULLETIN
BUSINESS TIPS
104-106
SCIENTIFIC NEWS
Editor Dr Giulia D’Anna (07) 5593 0360 editor@apanetwork.com www.apanetwork.com
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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 Fax:(07) 5593 0367 Mobile: 0412 177 423
Journal Advisory Board Terry Everitt - Education Features Wendy Neely - PR and Marketing Dr Douglas Grose Scientific Content Caroline Nelson - Business Features National Advisory Council John Fergusson Terry Everitt Chris Testa Gill Fish Vanessa Kirkham Carole Jackson Julia Grinberg ISSN: 1836-9812 Pint Post Approved [100000257] Circulation 6900
42 Spring Volume 44 2020
Front Cover INTERNATIONAL INFECTION CONTROL CHARTER 07 5593 0360 www.apanetwork.com For further information see pages 10-14
Aesthetics Practitioners Journal is the official publication of the Aesthetics Practitioners Advisory Network PTY LTD.
We pledge Safety for all
Pandemic Infection Control Program
APJ 1
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. APJ 5
Dr Giulia D’Anna
EDITOR’S LETTER I JUST LOVE SPRING. It is all about renewal, warmer weather, longer days and celebrations. This spring is certainly different with the current COVID pandemic. I have found that a really positive element of having more time to focus, is that I have taken the time to enjoy the little things that I never noticed before. I have actually watched the blossoms bloom, and found that there are a few Kookaburras that live really close to my home. Who knew? My dogs are loving all the attention they are getting and my step count is so high every day. Australia is doing so well, and I am really encouraged by the improving numbers here in Victoria too. Hopefully we can all get back to doing what we love and working with our clients soon. The Spring edition of the APJ has a number of focusses that are really apt for the current moment. In this edition we are focussing on stress and business management strategies. If this pandemic has shown us anything, it is that we need to strategise and position
ourselves in the market in a totally different way than we might have done before. There are so many disruptors to our clinics and salons, not only from the health aspect, but also our interaction with our clients - it is good to stay ahead of the game. This edition of the APJ also takes a good look at the advances in ingredients and skincare formulations. This is perfect, as our clients are getting really savvy with what they expect from us and from their skincare. All of our inboxes are filled with promises of great skin and products, but the average consumer needs to wade through all of this and find the real science. And this is where we can all really shine. I think each one of us has something truly unique to offer our clients. Our knowledge and expertise are truly stunning and I love that our education in ingredients, formulations and skin science really does set us apart from the supermarket aisles. So, I hope that you will gain further insight into this everexpanding area from this APJ edition. 2020 has been certainly interesting, and it has shown the true strength and determination that many of us have had to rise to, in order to stay focussed and motivated. APAN is definitely leading the way. I am excited to see APAN and Tina working on setting industry standards, not only here in Australia, but on a global level in many areas of our industry. There is so much positive action going on here at APAN that I think you will be truly blown away by some of the work being done. So, as I settle into my new role as editor of APJ, please take the time to reach out and connect with me. I cannot wait to meet you soon face-to-face, and work together on collaborative efforts in education, networking and business processes. Stand strong industry friends. We have got this!
editor@apanetwork.com www.apanetwork.com APJ 6
APJ Contributers
Terry Everitt
Katherine McCann
Gay Wardle
Terry Everitt is regarded as a ‘Master Skincare Professional’ due to his extensive knowledge in the art and science of skincare. A very competent educator and regular lecturer on aesthetic and medical conferences where he presents up-to-date information from an evidence-based scientific perspective. Terry is the Director of Aesthetic Educators Pty Ltd.
Katherine McCann has moved to her new dual position within APAN. Her new title will now be Regulations and Standards Advisor and Press and Media Liaison. Additionally, Katherine will continue to contribute to APJ through articles on Cosmetic Tattooing as this is an area in which she is truly an expert.
Gay Wardle is a well-known multiawarding winning industry expert and a renowned lecturer who conducts advanced skin analysis training for businesses and their staff on all issue pertaining to skin science.
aestheticeducators@gmail.com.
0405 069 311 k_mccann@me.com
Jacine GreenwoodDrummond
Deb FarnworthWood
Jacine Greenwood is an internationally recognised educator who is known within the industry for her up-to-date knowledge and her ability to deliver training in an easy to understand method. Jacine holds six Diplomas, including a Diploma of Cosmetic Chemistry and a Bachelor of Nursing. Her knowledge is highly respected in the cosmetic industry. With over 22 years experience in the industry and a background of cosmetic formulation, Jacine has an immense knowledge of current trends in research and new developments in the industry.
We are delighted to welcome Deb Farnworth-Wood as our new business expert. Deb will be sharing her wealth of knowledge in each issue of APJ.Her column - Wisdom in Business will present valuable, business-boosting tips. Deb is a leading figurehead and business development expert with amazing achievements, also within our industry. She has an incredible reputation as a serial entrepreneur. Expect to gain winning strategies from this amazing woman. deb@ultimateskinandbody.com.au
0418 708 455 gay@gaywardle.com.au.
Trish Hammond Trish Hammond is an award-winning blog and social media expert and the director of Plastic Surgery Hub. She is renowned for her skilful writing and interviews in all facets of the social media space. Her company specialises in the Aesthetics, Cosmetic Surgery and Cosmetic Medicine industry sectors for which she provides personalised and comprehensive services to help businesses communicate powerfully, grow their brand and capture new clients and patients. 0429 264 811 info@plasticsurgeryhub.com.au.
07 3807 1429 jacine@roccoco.com.au. APJ 7
Tina Viney CEO APAN
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Dear Colleagues and Friends, WHAT A TURBULANT YEAR we have had so far and going by the predictions, both here and around the world, COVID-19 is determined to be with us for a long time – calming down and then peaking at seasonal intervals, particularly during winter. We are living in unpredictable times right now and one area we need to guard against, is discouragement, as this will lead us to defeat, which none of us can afford. As the saying goes – “when the going gets tough, the tough get going,” and so this has been our experience here at APAN. By March, we stepped back and reviewed all our operations, searching for the most meaningful ways to support and help the industry, as businesses considered their options and making serious decisions about their future. As an organisation we made many changes, some of these we will be reporting in the Cover Story of this issue. Please take a few moments to read these new developments. I can assure you that our efforts are aimed at bringing you hope and helping you stay above the roar of chaos that seems to be coming in waves. PAUSE AND RESET There is so much talk about pause and reset, but what does that mean and how can we make the most of it? We hear a lot about how this disruption has impacted lives and businesses. There is no doubt it forced all of us to stop and re-evaluate our identity, our operations and ultimately our future direction. Many decided to downsize and minimise their risks, while others expanded their current knowledge, refined their business practices and are planning for growth. From the very beginning, the awareness for the need for change was very evident. For APAN we saw a fury of expired members who decided it was time to reconnect, reassess their values and determine what they stood for. There was a huge shift in revisiting their business fundamentals by first starting with asking some serious and sobering questions. Who are we and what do we stand for? What are we really doing here? Cliché statements with their prime objective to just flatter and gain the commercial transaction were identified as insincere, phony and no longer working. ETHICS – REVISITING OUR VALUES I have to say we are seeing a real shift in the industry re-establishing a strong focus on ethics and values. Businesses are taking time to review and seek to understand the honest truth about their identity and their brand and this has been very refreshing. Superficial layers are being pulled back to make room for a greater degree of honesty and integrity. Who are we? What do we stand for? What are our values? What really matters to us and to our clients? Are we honest and sincere in what we do, or just going through the motions? Good Ethics is a fundamental requirement of any profession. It is integral to the success of the business as well. Ethics is a system of moral principles governing the appropriate conduct of a person or a group. Maintaining good ethics is being consistent with the principles of correct moral conduct on a continuous basis. This is not only good for the reputation of the business, but also helps uphold the reputation of the profession as a whole, of
which you are an important part. Good ethics is good business and is fast becoming the “it” word. Ethical conduct not only contributes to the business’s success, it also provides many ways for growth and development by leaving a good impression about an organisation in the market. Agreeing to abide by a set of professional ethics enables us to establish order, respect and credibility. Ethical individuals bring calm and trust to their business dealings and personal relationships. In essence, ethics is about doing the right thing. The APAN Code of Ethics covers five areas of conduct. It is amazing that members are now pulling these out, orientating their staff and redefining their standards. Looking at our Code of Ethics will allow you to establish uniform behaviour in the following areas: •
Practitioner/Client relations
•
Referrals
•
Education and Compliance
•
Business Dealings
•
Professional Conduct
It is incredible how much conflict and misunderstandings can be prevented just by living up to the requirements of an industry’s Code of Ethics, as a guide and measurement of conduct. Another way to understand ethics is to consider it as a plumb line. A plumb line is a weight suspended from a string used as a vertical reference line to ensure a structure is centred. It is used in construction to ensure accuracy. It is also used to denote righteous conduct. It is a yardstick that helps to determine if you are consistent with the agreed standards of behaviour. Ethics are so effective because they advocate and foster honesty, integrity, respect for self and others and the universal moral code which is to do no harm. An ethical code requires that you operate within the bounds of your qualifications and scope of practice and to take it upon yourself to know and abide by the required regulations and standards. It places responsibility, not just on an organisation, but more importantly, on the individual to do the right thing. One of the ways that APAN is helping to elevate the standards of the industry is through our 48 Standards and Regulatory Resource documents that also includes our Code of Ethics. These documents can be accessed from us by businesses. They are designed to enable you to streamline your back end and put in place a strong foundation of ethical behaviour, based on principles of best practice so that you can build a reputation of excellence. These are currently some of our most popular documents to be accessed by businesses and we are thrilled to be able to support you in this way, with many more initiatives to come. I believe that the current pandemic has also brought home the important issue of ethically abiding by appropriate hygiene and infection control standards. These are not only central to professional conduct, but are also paramount to the prevention and transmission of a life-threatening virus. However, with mutual respect and collaboration we can do our part to contribute to a safer world. APJ 9
COVERSTORY
It’s Time for the New Order "There is nothing more difficult to undertake, more perilous to conduct than to take the lead in the introduction of a new order of things. But if it provides virtue, it must be pursued." - Tina Viney AS CARETAKERS OF OUR INDUSTRY, APAN has a responsibility to examine what can negatively impact our industry and your businesses and take the initiative to come up with solutions. At this present time, the potential for lockdowns is still a major threat of disruption for our industry and we took this very seriously as we witnessed the devastation these uncertainties brought to many businesses and their staff. At this point in time, COVID-19 is already mutating and a second wave is hitting Europe. In discussions with the government, the single deciding factor for the lockdowns is the issue of containing the infection breakouts. STAYING ABOVE THE ROAR OF CHAOS While we have made it very clear to the Government the important support that our services bring to the wellbeing of the community, the infection control measures could not be proven to be uniform throughout the industry. Part of the problem lies in the diversity of our industry and their activities that span over four different classifications: General beauty services – Certificate III qualifications Beauty Therapy – Certificate IV and Diploma qualifications
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Dermal therapists, aesthetic clinicians and cosmetic nurses – Advanced Diploma and Degrees qualifications Cosmetic Tattooists who hold a qualification. Each of these categories has varying levels of risk. Practitioners who perform advanced procedures including skin needling, laser and IPL procedures are usually required to complete a skin penetration license and/or an infection control qualification. However, this is not the case with general beauty, which predominantly consists of grooming services with minimal risk factors compared to the more advanced procedures. From our interaction with the Government, they required tighter measures of safety. So, let's go back and look at what we have developed and where we currently stand. COVID-19 CLINICAL SAFETY POLICY KIT In March this year, during the early stages when COVID-19 was first announced as a global pandemic, APAN identified an immediate need to support the industry by acting swiftly to develop the COVID-19 CLINICAL SAFETY POLICY KIT – a collection of eight documents including policies and procedures to help educate the industry on how to best prepare for a safe working environment and to protect
also contributed to uncertainty to many businesses in other states. Currently, many businesses are concerned and taking a cautious approach in investing in expanding their business operations through further debt, as the future remains unknown, with the potential that this could also happen in their State. When speaking with the Government they raised their concern that allowing ALL the Beauty Industry to return to work carried a level of risk as there was insufficient evidence of compliance. We needed to step-up what we had previously introduced to a new more-stringent level. Further in-depth research, meetings with academics and government agencies, we identified how we could achieve this through the development of a new clinical safety program that would meet the most stringent criteria of safety. THE LAUNCH OF THE PANDEMIC INFECTION CONTROL PROGRAM Subsequently, we approached a world-renowned expert in the field of infections and viruses who is also an active member of numerous regulatory panels in the development of evidence-based infection control regulations. Professor Laurence Walsh collaborated with us as we identified the best way to move forward in supporting the industry on a higher level. As a result, he developed the PANDEMIC INFECTION CONTROL PROGRAM. This program includes further robust academic content including two comprehensive units on the pathophysiology of viruses. It does not just address COVID-19 but covers other viruses and global pandemics, their behaviour and how they potentially can mutate and return to re-infect the population.
against the risk of cross-contamination against the virus. This program was launched in early April and was highly successful in bringing a level of calm to business owners. Over 2500 businesses reached out to us to access the kit, with APAN members receiving these documents for free, while non-members paid a small fee. We presented this initiative to the Federal Government who encouraged us and supported our efforts. Meanwhile, with the constant rise of infections occurring, lockdown measures were introduced in every state. As the number of infections declined the lockdown measures were slowly eased starting in June with a State-by-State checklist of infection control procedures required by the various health departments to be implemented by businesses owners. While initially, these disruptions brought a lot of panic and confusion, it also gave businesses and practitioners alike the opportunity to review their direction, upgrade their skills and refine their policies and procedures, as well as their business operations. As the online platforms became the most effective means of communication, many businesses expanded their skills in this area, improving their online presence and adapting to communicate in this way with their clients and patients through zoom meetings and social media. Then with a fury, came the second lockdown in Victoria. The severity and duration of these lockdowns, which extended to several months, took many by surprise. We realised that this virus was unpredictable and could return at any given time without warning. From our interaction with the industry, this not only brought a great deal of pain to Victorians, but it
It also includes updated protocols and procedures using the latest evidence-based information that goes far beyond what was previously available to us. While the course covers important scientific information, it is presented in an easyto-understand systematic manner in order to allow a nonacademic person to understand it and enable a high uptake within the industry to be best prepared for the future. WE PLEDGE SAFETY FOR ALL To further support the project and to underpin its purpose, we supported it with the INTERNATIONAL SAFETY AND INFECTION CONTROL CHARTER strengthening and uniting us all through a pledge – we pledge safety for all. I am sure most of you are familiar with the United Nation's Human Rights Charter. Charters are valuable position statements that define the goals and objectives of the people who are participating in a project. A charter unifies an industry or a body of people who pledge to uphold the objectives of the charter, bringing a new level of commitment and ethics to the project. THE POWER OF UNITY - INTERNATIONAL CONNECTION THROUGH A COMMON OBJECTIVE While COVID-19 has created massive disruptions globally, it has also provided us with an opportunity to connect with other countries through a common objective - establishing effective standards that specifically address how we can best protect our industries, the consumers, as well as support businesses from the need of excessive lockdowns and further financial disaster. In this regard, we have become a global community.
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In speaking with other peak bodies and industry representatives we can confirm that what we are experiencing in Australia is a common phenomenon in other countries as well, particularly in Europe. Currently, Governments are overwhelmed as their citizens are reaching out to them for answers. They, therefore, welcome any support they can receive from industry leaders. Through our interaction with other nations we all agree that industry peak bodies have a duty-of-care to demonstrate leadership through initiatives that can help minimise risk for consumers to access our services with greater assurance of safety. We are part of a service-based industry and our members can offer much-needed care, compassion and support to the public during these turbulent times helping them to ease some of their stress and support their wellbeing and mental health. We are pleased to report that at this time we have seven nations that have committed to introducing both the PANDEMIC INFECTION CONTROL PROGRAM and the INTERNATIONAL SAFETY AND INFECTION CONTROL CHARTER to their industry colleagues. They recognise the integrity and quality assurance of this program and see the value of uniting globally through our common objective - to establish evidence-based safety measures that are internationally uniform. Our ultimate aim is to establish agents for this program in 25 countries, making it a truly international program, as together we pledge safety for all, as well as the survival of our businesses. Together, we can contribute to a safer world. We are indeed humbled to gain international support and it is wonderful that Australia can help other countries secure safer measures through this program. HOW CAN THIS PROGRAM BENEFIT YOU? It is important to note that our main focus is to help our industry here in Australia. Both the PANDEMIC INFECTION CONTROL PROGRAM and the INTERNATIONAL SAFETY AND INFECTION CONTROL CHARTER have been developed to help clinics and salons establish a new level of clinical safety. This program will be available from the end of October as an online study unit and graduates will receive an international certificate signed also by Professor Laurence Walsh as the author of this program. GOVERNMENT RECOGNITION We, therefore, invite all industry professional to invest in this program. We are currently pursuing government recognition of the PANDEMIC INFECTION CONTROL PROGRAM. We believe those who have completed this course will be able to confirm their competence in understanding the behaviour of pandemics, as well as adhering to strict, evidence-based infection control protocols of the highest standard. As such, we will pursue that graduates of this programm, both individuals and businesses, be given greater leniency against future lockdowns. WHAT ABOUT YOUR CLIENTS? This program being also part of an Iternational Charter of Safety will allow businesses to provide their clients with an additional assurance of evidence-based safety. Be part of a global movement and let's stand together for a safer world! This course is now available as an online course. We urge individuals and businesses to register and complete program online www.apanetwork.com If you require further details please contact APAN on info@apanetwork.com or 07 5593 0360.
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WHO IS PROFESSOR LAURENCE J. WALSH AO? Professor Laurence J. Walsh OA, a highly respected academic and specialist clinician based at the University of Queensland, in Brisbane Australia. Professor Walsh holds extensive credentials from several universities, having undertaken training both in Australia and internationally, including the University of Pennsylvania Medical School as a post-doctorate as well as Stanford and Harvard universities. Most notably, his PhD is in Immunopathology and he is involved in lecturing in infection control and clinical microbiology, which he has done for over 25 years. He is also an active contributor on several regulatory and standards bodies within Australia. In his long list of achievements, Professor Walsh was also awarded the Order of Australia for his contribution to scientific research. The Order of Australia is an order of chivalry established on 14 February 1975 by Queen Elizabeth II, in recognition of Australian citizens and other persons for outstanding achievement or meritorious service. Professor Walsh is highly esteemed for his extensive knowledge on immunopathology and pandemics and we are honoured he is the author of our program.
APAN'S achievements As an industry standards body APAN's focus is to support you in the area of industry best-practice, regulations, standards, business and professional development. For the purpose of accountability here is a brief outline of just some of the activities that we have undertaken in the past 12 months. We would like to take the opportunity to thank our financial members for their support in enabling us to serve them and the industry. 1. COMBINED THREE CONFERENCE PROGRAMS – LAUNCHED THE FIRST INDUSTRY ONLINE CONFERENCE EVENT – 40 world-class speakers In support of COVID-19 financial restrictions, delegates were able to register at the price of one day, but also gain access to the remaining two days for free. Registrations for this event reached 438 delegates, including international delegates from 15 countries. This was a highly successful event. 2. COVID-19 CLINICAL SAFETY PROGRAM Launched prior to the lockdown - an eight-document program helping business put in place appropriate COVID specific clinical safety policies and procedures. This program was available free-of-charge to members and a small fee for non-members. Over 2500 accessed these documents. 3. UPDATED OUR RESOURCE DOCUMENTS – REGULATORY COMPLIANCE AND BEST PRACTICES TEMPLATES Many in the industry were keen to step up their backend and refine their policies, procedures, consent forms, privacy policy, HR Staff Manuals, KPI documents stocktake templates etc. To assist businesses to refine their operations we expanded our resource documents to over 48 templates that business could purchase at a very modest fee. These resources were of great help to many businesses. 4. DEVELOPED THE NEW PANDEMIC INFECTION CONTROL PROGRAM Developed a totally new infection control program with comprehensive and robust scientific and evidence-based content, that is also supported by the INTERNATIONAL SAFETY AND INFECTION CONTROL CHARTER. To establish these two programs we allocated a comprehensive budget towards their development as they need to be of a high standard. 5. ESTABLISHED A REFERRAL ALLIANCE WITH THE AUSTRALIAN ECZEMA ASSOCIATION To assist in establishing a referral directory for our qualified members who would like to be referred to individuals and their families who suffer from eczema, we contacted the Australian Eczema Association and established a strategic alliance and a national register, inviting our members to register for potential referrals. This was approved mid last year as previously only dermatologist and healthcare professionals were included on their list. 6. DEVELOPING APJ WEBSITE FOR EDUCATIONAL ARTICLE We are currently working on an additional website, dedicated to APJ Journal that will include an extensive library of business and educational articles that members can access for the purpose of their newsletter, training staff and educating clients as well as for students who wish to access credible articles for their assignments. This program will be available later this year. It will be free for members, while nonmembers will be charged a small monthly fee.
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APAN refined and updated its CTARP and ARAP Registration program to include CPD points for cosmetic nurses, lecturers and other allied health professionals. This registration allows qualified practitioners to gain recognition of their qualifications by an independent industry body. 14. ONGOING REGULATORY AND GOVERNMENT REPORTS AND UPDATES APAN consistently liaises with the Federal Government and State Governments presenting industry updates and concerns for policies that do not serve the industry. This is a specialised area and one which requires persistence and determination as well as building a relationship with regulatory and government agencies, (the list for these activities is too long to include in this summary). APAN AND THE TEAM APAN is an industry Standard body/Association that is committed to developing initiatives that raise the standards of the industry and support professional development, business practices, ethics and integrity, as well as liaise with government agencies in the area of regulations. We represent individuals, educators and businesses within the aesthetics industry, especially for those whose professional focus is in skin and age-management. These also include cosmetic tattooists and cosmetic medicine. We attribute this to a small but committed team, as well as supporters who assist us. I would like to acknowledge and thank the following: Angus Thompson: Angus develops our various websites, both front and back end. He is the designer of our APJ Journal and is a real technical expert, who put together our online conference program that featured 40 speakers. We are thrilled to have such a talented guy. 7. AUSTRALIAN STANDARDS Participated on the standards committee for the review of HE-023 Processing of Medical and Surgical Instruments). 8. NSW REVIEW OF COSMETIC REGULATIONS At the invitation of the Health Minister, participated in the Proposed Review of Cosmetic Regulations 9. QUEENSLAND MEDICINES & POISONS ACT 2019 Invited by Queensland Medicines and Poisons to be part of the investigation of the composition and use of permanent makeup (PMU) inks in Australia. This review is at the request of the National Industrial Chemicals Notification and Assessment Scheme (NICNAS). This review is currently on-going and we wish to thank Robert McGowan from ThinkAesthetics, who with his extensive knowledge and qualifications in chemistry and pigments is representing APAN on this panel. 10. INVITED MEMBER OF THE COSMETIC MEDICINE ALLIANCE We were honoured to be invited to be part of the Cosmetic Medicine Alliance consisting of representatives from four cosmetic medicine societies who review the development of best practice documents and position statements. 11. BEAUTY TRAINING PACKAGE REVIEW Contributed to the review process with SkillsIQ for the update of various qualifications including the Advanced Diploma of Skin Therapies. 12. BEAUTYSTREAM GLOBAL SUMMIT Invited to provide an update on the Australian beauty industry, COVID-19 initiatives, current challenges and ways that we are supporting the industry through an interview. This information will be included in a major global report. 13. CTARP AND ARAP REGISTRATION In recognition of qualifications and ongoing professional development
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Lauren Thompson: Is our social media expert who takes care of all our social media platforms. She works very hard and her creative talent is very much appreciated. Margaret Whitaker: Margaret, is responsible for membership processing and taking care of registrations. Katherine MacCann: Katherine is truly passionate about standards, who recently stepped down as our editor to take on dual positions of Media Liaison and Standards and Regulations Advisor. Dr Giulia D'Anna: We are thrilled to welcome our new editor. Giulia - a qualified and skilled dentist who also holds qualifications and experience as a dermal therapist. She is an excellent educator and a woman of standards and integrity – a truly amazing professional. APAN also has an Advisory Committee with who we liaise for their wisdom and expert recommendations: I would like to thank the support of Gillian Fish, Terry Everitt, Carole Jackson, Chris Testa, John Fergusson and Vanessa Kirkham. Your membership with APAN will help us serve you and enable us to continue to fight for the safety and recognition of your profession. If you are not currently a member please consider joining us. We would love to extend a warm welcome to you. APJ Aesthetics Practitioners Advisory Network (APAN) 07 5593 0360 | info@apanetwork.com | www. apanetwork.com To register for the PANDEMIC INFECTION CONTROL PROGRAM please visit www.apanetwork.com.
Pandemic Infection Control Program We pledge safety for all
Join the International Movement Towards a Safer World This certified online study unit will equip you to gain: • The latest information on the pathophysiology of viruses and pandemics • Update your safety protocols in line with the latest evidence-based information • Join the global movement • Assure your clients or patients that they are in safe hands • Fight against the need for lockdowns
Enrol Today! 07 5593 0360 www.apanetwork.com
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Supported by
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BUSINESS PROFILE
dermal aesthetics
Step Into Great Skin and Health
An Interview with Kai Atkinson
KAI ATKINSON entered the aesthetics industry through his personal quest to resolve an aggressive acne condition. As he gained a deeper understanding and appreciation of what a differentce the right products and treatment can achieve, his passion grew and he realised that indeed, he would enjoy this field as his chosen profession. This resulted in enrolling for a Diploma in Beauty Therapy with the well-known lecturer Bev Greenwood in Victoria. Following his graduation in 2017, Kai was immediately employed and worked for different clinics - and so his love for his profession continued to grow. In a very short time Kai developed quite a reputation as a vocal and passionate therapist who contributed to articles, blogs and was active on social media. As successful skin treatments more and more became his passion, he recently landed his dream job as an Educator with Derma Aesthetics and Dermaviduals. We recently spoke with Kai about his new appointment. He was thrilled to share how Derma Aesthetics is helping businesses advance their education and achieve leading results and business success even during these turbulent times.
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APJ Q1: Recent research since the pandemic confirms that consumer behaviour is changing with a strong emphasis on safety, sustainability and a move towards a more personalised approach to skin therapy and wellness. How does Dermaviduals support this approach? The pandemic created a need for skincare to be personalised and supported with an efficacious, sustainable and results-driven product. While this is a growing phenomenon, Dermaviduals for the past 20 years has always focused on a personalised approach, and this concept has been their central philosophy in treating the skin with topical prescriptive formulations. This approach is not just for healthy skin, but also for barrier-disturbed skin that has been rendered defective and disrupted by genetics, disease, physical, mechanical, chemical and psychological insults. Every skin type and condition are unique and requires a personalised and corrective approach to achieve a sustainable solution — because anything that is good needs to be sustained. Dr Hans Lautenschlager and his team of formulating chemists who created Dermaviduals saw the need for a customised solution with a direct point of difference. This was way before personalised skincare was even on the radar; and so Dermaviduals was created to support the individual needs of its consumers at a time when customised skincare was not even recognised. At Derma Aesthetics, safety and sustainability have always been the number one priority. The company believes in looking after our planet, just as our planet looks after us. • The products have no outer plastic wrapping to avoiding excess packaging or waste and they are manufactured within an aseptic laboratory. •
The products have never contained plastic microbeads, nor do they contain anything that would compromise our environment.
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The ingredients come from a sustainable source and go through highly strict corneotherapeutic regulations to meet the principles of corneotherapy and of course, to also care for the environment.
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The products are not tested on animals.
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The packaging is eco-friendly and is recyclable.
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The boxes come from a sustainable source, where no trees have been illegally harvested.
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The packages are sent with corn starch nuggets, which are 100% biodegradable. They are also easy to handle due to being non-static, which reduces labour time.
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The boxes are stamped with eco-friendly ink to reduce the use of stickers where possible and we are currently trialling recycled cardboard bubble wrap as an alternative to the plastic bubble wrap that is readily available.
All Dermvidual products - cleansers, serums, moisturisers, facial masks, etc, can be customised with ingredients that are tailored for the client’s skin type and condition. No two people have the same fingerprint and no two people have the same skin; hence why it’s important to offer a customised and/or ‘bespoke’ solution to meet the requirements of the individual. By choosing a bespoke skincare line that is free from toxic chemicals, you’re not only helping the skin, but you’re also helping to reduce our carbon footprint and maintain the safety and sustainability of the environment and our industry. APJ Q2: What are the unique advantages that Derma Aesthetic offer a business that is considering to engage with your company? There are two highlights in particular that we focus on that are very important to Derma Aesthetics as a company. The first is education. Our team is so incredibly fortunate to have passionate industry leaders who deliver exceptional education to our team and clients. Within our company we are all about learning, updating, researching and developing educational content for not just our in-house team at Derma Aesthetics, but for the many industry professionals and clinical stockists who contribute to the success of our company. I feel very fortunate to have been given the opportunity to come onboard as an educator and to work in synergy with one of our co-managing directors who is the Head of Education - Simone Vescio. Education is at the forefront of what we do and without it, it is not possible to have a truly effective and successful business. Over the years I have invested a great deal
of time and money in my education, so speaking from personal experience, I know the value that education can bring to a clinical business. At Derma Aesthetics, it’s a priority for us as professionals and educators to nurture and look after the businesses that come onboard with us. It is essential that our clients feel confident in our ability to support them with exceptional education and to assure them that they can achieve leading results and client satisfaction. The second focus is to ensure consistent and exceptional customer support. Everything is bespoke; even the way we do business! Clinical partners can benefit from every single department; whether it be packing-up orders, a phone enquiry, speaking to Head Office about a particular concern, or attending our educational training events. We all complement each other and we support each other’s success. The success of our customers is the foundation of our business and our company values reflect this. We are pleased to say that Derma Aesthetics was awarded by the MyFaceMyBody in 2017 the ‘Customer Service of the Year’ award. It makes us proud that our customers and teammembers value our participation within their businesses and continue to serve us just as much as we serve them.
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APJ Q3: With the current restrictions many therapists are investing in online learning, do you offer any online study courses and what are they? Dermaviduals Day 1 and Day 2 training is an online educational training program available to therapists who currently stock our products, or are interested in becoming a clinical partner with us. During this two-day training program Derma Aesthetics goes into extensive detail about our product range, its core principles, how our product works with cells and systems of the skin, its chemistry as well as its delivery systems that can help treat many skin barrier disorders, all while staying within your scope of practice. We also offer AAC education (Australasian Academy of Applied Corneotherapy), which goes through advanced topics such as what is corneotherapy, embryonic development, perioral dermatitis, the role of histamine, microbiome and the differences between a physical and chemical sunscreen. Exceed Medical Microneedling is also another training program we provide and explain how the engineering of this German device works, why a corded device is best and why it’s important to look for FDA, TGA, CE and ISO Certifications when it comes to purchasing your Collagen Induction Therapy device. This device truly is leading the way within the medical aesthetics and the aesthetics industries and is 100% results-driven. Our education department is also in the middle of developing Skin 101 for beginners and getting them back to the fundamentals on skin anatomy and physiology, along with a comprehensive interactive online learning platform for Dermaviduals partners and a special login and education portal for nonDermaviduals businesses. Stay tuned for 2021.
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APJ Q4: Can you please explain the principles of corneotherapy? Corneotherapy is a progressive and remedial skin treatment methodology with its core principles being the repair and maintenance of the skin barrier defence system, while keeping the epidermis intact at ALL times. As the name suggests, corneotherapy is closely related to corneobiology, which is the physiological, biological and biochemical processes of the stratum corneum. The stratum corneum is more than just a conglomeration of ‘dead’ skin cells. It’s a highly active tissue consisting of enzymatic activity working to sustain tissue homeostasis that is often taken out of balance, due the to various chemicals and certain modalities that are not caring for the first three lines of skin barrier defence. This puts all other cells and systems under pressure to perform in a hostile environment. Corneotherapy also involves the care of the stratum corneum through topical therapies with products that mimic the skin’s structure and function to improve the functionality of the skin barrier and its defence systems. This is what makes a true corneotherapeutic product. One of the key principles in corneotherapy is the prescribing of topical solutions that are tailored to the specific skin condition and is as physiologically-compatible to the skin’s structure as close as possible. What do I mean by that? Specifically, the formula should be compatible with the phospholipid membrane of the skin’s own metabolism in a 1:1:1 ratio (ceramides, cholesterol, long-chain free fatty acids) to improve stratum corneum cohesion and reduce inflammation of the innate/ adaptive immune systems. You will never find fragrances, conventional emulsifiers, such as sodium lauryl sulphate, preservatives, parabens, silicones, amines and colours in a corneotherapeutic product. Corneotherapy is not a brand of ‘skincare’ per se, but rather is defined by the chemistry, science and the formulations that go into making a corneotherapeutic product – these are what truly define the principles of what is corneotherapy. APJ Q5: With the current pandemic we are seeing more and more skin rashes from masks, as well as an increase in skin inflammation, do you have any hero ingredients or approaches to address these concerns? We certainly do! Depending on the skin condition presenting, Dermaviduals offers a plethora of ingredients that can be utilised to treat many skin-barrier disorders. For example, if the client is presenting with acne because of an anaerobic environment, we have specific masks. The therapist can access the Liposome Concentrate Plus, which encapsulates azelaic acid in a phospholipid membrane composed of phosphatidylcholine. This also works on improving the condition of acne itself, delivering the actives past the lamellar lipids targeting the keratinocytes and sebaceous glands to influence cellular function. The therapist can also access the Vitamin B, Zinc and Green Tea concentrates as they are all 5-alpha Reductase inhibitors and work to improve skin-barrier defence. These are just a small example of how our treatments can be customised with the appropriate actives to respond to the presented condition. This is a winning approach and so useful, especially with the current common skin reactions we are experiencing with the pandemic. APJ Contact Kai Atkinson 1300 420 223 kai@skincorrection.com.au
UPGRADE YOUR SKILLS AND KNOWLEDGE IN
MICRONEEDLING Dr Lance Setterfield, M.D. Online study course now available in Australia WORLD-RENOWNED as one of the leading masters in Collagen Induction Therapy, Dr Lance Setterfield has updated his on-line study course in line with his manual The Concise Guide to DERMAL NEEDLING: Revised and Expand Manual - Third Medical Edition.
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Enable clinicians to achieve and maintain the best result using this modality
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Enable clinicians to grow their business substantially through the introduction of micro-needling services as the foundation for all other cosmetic treatments
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Determine the appropriate skincare products to use (which ingredients to use and which to avoid)
The course is non-product aligned and covers the application of both rollers and pens. However, the knowledge you will gain will go far beyond the use of Micro-needling. It includes valuable information on how you can combine this “treatment” with a variety of other modalities to optimise results, while avoiding complications.
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Determine which device to use and what needle depth for the desired outcome
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Determine if the inflammatory response should be provoked and sustained
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Gain the skills and knowledge on how to combine micro-needling with other modalities for optimising results
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Gain the knowledge on how to avoid complications
WHO SHOULD UNDERTAKE THIS COURSE? Medical professionals and non-medical professionals. (Clinicians who are performing or overseeing microneedling procedures.) COURSE GOALS AND EXPECTATIONS: •
Expand practitioner's scope of practice by ensuring enhanced foundational knowledge accepted as standard practice in the industry
COURSE OBJECTIVES AND COMPETENCIES:
COST: $699 – If you do not have The Concise Guide to Dermal Needling – Third Medical Edition you will need to also purchase that. The cost is $135 + freight. Completing this course will earn you 10 CPD points toward your professional development. WHAT DO I DO TO ENROL? Contact APAN to make your payment. You will then be given the access Code to download the study course. You will also need to read and agree to the terms and conditions of accessing the course. TO REGISTER CONTACT APAN 07 5593 0360 www.apanetwork.com info@apanetwork.com APJ 19
GUT HEALTH
THE GUT-BRAIN-SKIN AXIS
The Synergistic Play of Systems That Contribute to Skin Health
and Wellness
Debbie Dickson Regulat8 Founder and Formulator When the skin is functioning optimally, it works hard to protect us. When it is compromised, the skin’s ability to work as an affective barrier is impaired. To truly have healthy skin we must look beyond the surface. Healthy skin is in perfect balance - homeostasis. TO TRULY HAVE HEALTHY SKIN we need to not only focus on the skin, but also review other systems in the body that will impact on the health, healing and regeneration of the skin. In this article Debbie Dickson will explore the role that gut health plays in supporting and contributing to skin health. As interacting organs the gut and the skin have much in common. The gut and the skin have an intimate bidirectional connection and can communicate with each other. The absorption of nutrients has a direct effect on your skin health, as do hormonal changes that influence your skin on a physiological level. A healthy gut will even synthesize extra vitamins and minerals that benefit your skin, such as vitamin K, the B vitamins thiamine and riboflavin. THE GUT MICROBIOME The gut contains a collection of trillions of strains of bacteria and microbes called the gut microbiome. Essential to skin homeostasis, the gut microbiome impacts integumentary health. Different strands of intestinal microbiota exert their influence on skin homeostasis, through the signalling pathways that coordinate this process. Recent advances in metagenomics and the advent of highthroughput DNA-sequencing technology has enhanced our understanding of the microbiome and its dynamic influence on human health and pathology.
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Certain gut microbes, metabolites and bacteria promote the accumulation of regulatory T cells and lymphocytes which facilitate anti-inflammatory responses. A healthy skin has more T cells circulating. Segmented filamentous bacteria, alternatively, promote the accumulation of proinflammatory Th17 and Th1 cells. SCFAs, particularly butyrate, suppress immune responses by inhibiting inflammatory cells’ proliferation, migration, adhesion, and cytokine production. Psoriasis has an upregulation of Th17 cells. There is new evidence that the intestinal microbiome may impact cutaneous physiology, pathology and immune response more directly, through the metastasis of gut microbiota and their metabolites to the skin. If your skin is irritated, inflamed or congested, there is a chances that there may be an imbalance in your gut, meaning that there are too many bad bacterial cells, or not enough good bacterial cells. So, essentially, if you have a gut problem you will have a skin problem in some way, as your gut and your skin play similar roles. Both systems defend your body against pathogens, and both are covered in beneficial bacteria when in a healthy state. Western diets, medications, environmental toxins stress and emotional factors can all imbalance the gut microbiome, leading to bacterial overload, fungal overload in the gut and parasites, leading to leaky gut. GUT BACTERIA AND THE LINK TO SKIN CONDITIONS AND DEPRESSION Over 70 years have passed since dermatologists John H. Stokes and Donald M. Pillsbury first proposed a gastrointestinal mechanism for the overlap between
depression, anxiety and skin conditions such as acne. It is well documented that a period of insulin resistance occurs during puberty, one coinciding with the development of acne, depression and/or anxiety. Stokes and Pillsbury hypothesized that emotional states might alter the normal intestinal microflora, increase intestinal permeability, and contribute to systemic inflammation. When we have an overload of bad bacteria in the gut (gram negative bacteria), as they die, the outer lining produces these endotoxins or lipopolysaccharides, these enter the blood stream and are a big contributor to acne, eczema, psoriasis and rosacea. A study involving 40 acne patients showed both the presence of, and high reactivity to, lipopolysaccharide (LPS) endotoxins in the blood. Acne vulgaris is frequently associated with depression, anxiety and other psychological sequelae. Considering that 90% of your serotonin is produced in the gut, it makes perfect sense that acne and depression and anxiety would be associated with gastrointestinal disorders and skin problems. Psychological stress stagnates normal small intestinal transit time, encourages overgrowth of bacteria, and compromises the intestinal barrier. Acne patients are at a higher risk for gastrointestinal distress. For example, one study involving over 13,000 adolescents showed that those with acne were more likely to experience gastrointestinal symptoms such as constipation, halitosis, and gastric reflux. In particular, abdominal bloating was 37% more likely to be associated with acne and other seborrheic diseases. These authors connected emotional states depression, worry and anxiety - to altered gastrointestinal tract function, changes that cause alterations to the microbial flora, which they theorised, in turn, promotes local and systemic inflammation. They wrote ‘an important linkage of emotion with cutaneous outbreaks of erythema, urticaria and dermatitis by way of the physiology and bacteriology of the gastrointestinal tract’. Research shows that as many as 40% of those with acne have hypochlorhydria. Stokes and Pillsbury hypothesised that less than adequate stomach acid would set the stage for migration of bacteria from the colon towards the distal portions of the small intestine, as well as an alteration of normal intestinal microflora. Furthermore, Stokes and Pillsbury suggested that stress-induced alterations to microbial flora could increase the likelihood of intestinal permeability, which in turn sets the stage for systemic and local skin inflammation. The burden of inflammation and oxidative stress is increased, substance P is elevated and insulin sensitivity is decreased due to endotoxemia. In those genetically susceptible to acne vulgaris, this cascade increases the likelihood of excess sebum production, exacerbations in acne and additional psychological distress. Rosacea patients have an increased incidence of SIBO – (small intestinal bacterial overload). Researchers found that 46% of rosacea patients tested positive for SIBO, and that patients with rosacea were nine times more likely to have SIBO than patients without rosacea. Hypochlorhydria is a significant risk factor for small intestinal bacterial overgrowth (SIBO). SIBO damages gut lining, causing leaky gut which leads to the release of pro-inflammatory cytokines (regulators of host immune responses that promote inflammatory reactions) resulting in skin inflammation. SIBO presents itself in a wide variety between being asymptomatic and, at its extreme, a severe malabsorption syndrome. For many, there may be very mild gastrointestinal symptoms, including bloating, diarrhea, abdominal pain, and constipation. It is also reported to be prevalent in functional syndromes such as fibromyalgia and
chronic fatigue syndrome. SIBO can compromise proper absorption of proteins, fats, carbohydrates, B vitamins, and other micronutrients due to bacterial interference. Excess bacteria can successfully compete for nutrients, produce toxic metabolites, and cause direct injury to enterocytes in the small intestine. Several studies suggest that people with psoriasis are more likely to have Candida colonize in their bodies. Psoriasis is a chronic autoimmune disease that causes skin cells to turn over too quickly and has a strong connection with leaky gut where undigested proteins can pass from the digestive tract into other organs and tissues, triggering an immune response. Recent evidence has suggested that H. pylori infection plays a role in the pathogenesis of a variety of skin diseases including psoriasis and rosacea. H. pylori may be one of the organisms capable of triggering the inflammatory response in psoriasis. IBD and psoriasis also share a connection with obesity. Fat tissue seems to make chemicals that change how the body works, including the immune system. Having a lot of extra weight raises your odds of having psoriasis, Crohn’s, and UC. People with celiac disease also have a higher incidence of psoriasis. TAKING CARE OF GUT HEALTH I believe it’s clear to have a healthy skin we need to make sure our insides are healthy first and also reduce the destructive effects of stress. The brain affects the gut, the gut affects the brain and these then affect the skin. Just taking a probiotic in a dysfunctional digestive system isn’t going to work, as probiotics are very fussy about the environment, they live in. I always give the analogy of your digestive system as being like a garden. If you have a garden that is overgrown with weeds and snails and the soil isn’t good, when you try to plant flowers into this environment they won’t survive. It is the same with our gut, if we have an over load of bad bacteria, parasites and fungal overload, leaky gut and you take a probiotic they won’t survive in this environment, in fact, sometime they die off and can cause inflammatory cytokines that can then enter the blood stream and cause more problems. REGUL8 DIGESTIVE TUNE UP SYSTEM This is why we developed the Regul8 Digestive Tune up as a system. It provides a three-phase approach: •
Cleanse to clean out or weed the garden
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Restore to repair the gut or get the soil right and create the right environment for our pre and probiotics to flourish.
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Relax – our stress sleep formulation, as we don’t want stress to destroy all the good work we have done. Relax is also great for helping to balance the blood sugar levels and all the dysfunctions that stress causes in the body so we can successfully achieve balance for our clients. It goes without saying that your clients also have to make the appropriate dietary changes as well. Integrating these approaches into our skin revision delivers better treatment outcomes and customer satisfaction.
Nothing looks as good as healthy feels. When the skin is functioning optimally, it works hard to protect us. When it is compromised, the skin’s ability to work as an affective barrier is impaired. To truly have healthy skin, we must look beyond the surface. Healthy skin is in perfect balance - “homeostasis”.
APJ
For a list of references, please contact the editor. APJ 21
BUSINESS WISDOM
Survival of the Fittest Deb Farnworth-Wood
DEB FARNWORTH-WOOD is renowned for her ability to grow multi-milliondollar businesses specifically during times of economic recessions. She was the founder of the Australian Skin Clinics Franchise, which she grew to a multi-million-dollar enterprise right in the middle of the global economic crisis, which she sold in 2019. She is an MBA graduate, a Certified Franchise Executive and serial entrepreneur. She has incredible vision and passion for the aesthetics industry where she has immersed herself for 12 years, but she also has over 30 years’ experience in the management of large, complex and multi-disciplinary healthcare organisations, including pharmacy, GP Services, surgical facilities, dietetics, podiatry, nurse practitioners, counselling and secondary care services. Her new ventures - owner of Issada Cosmetics – the iconic Australian Mineral Make-up range and Shave With Valor – an organic men’s grooming range. She is also a Board Director for Timely Software. As of this issue of APJ we will be introducing BUSINESS WISDOM – a regular business column where Deb will share successful and proven business strategies. In 2007 when the GFC started to bite, I remember sitting down with my clinic team and outlining how we would face times that I knew would destroy many salons. Having steered businesses through several UK recessions I had no illusions about how hard it would be to survive. But survive we did. It’s 2020 and we are again in recession. Our industry has been struggling with heavy competition, excessive
APJ 22
discounting and transient staffing for a few years and now, unbelievably, we are in a pandemic, dealing with a deadly virus, while trying to run a business in a recession. It would be tempting to discount our services, but I believe the opposite should occur. Clients will be more discerning about where they shop, what they buy and risks that they expose themselves to. They will reward businesses who have a greater focus on standards of hygiene and quality of treatments. As business owners it’s critical to have a structured plan. Here are the five areas I believe you need to focus on now:
1. Staff Utilisation Staff without clients are costing you. Are you booking sensibly or leaving long gaps between treatments? Are you enforcing your cancellation policy? Do your staff have a script that helps them talk to clients about that policy? 2. Driving sales Do your position descriptions and pay structures drive sales? Do staff understand what is expected of them? Do you have systems in place to monitor sales daily? Do you have an incentive program to help drive sales? 3. Pricing If you haven’t reviewed your pricing for more than 12 months then do so immediately. The average salon is lucky to make 6-10% profit so you cannot take your eye off your costs and your fee structure. * Wages increase annually * Supplier costs increase We now have PPE and COVID-19 costs such as longer gaps between appointments (staff cost) and extra cleaning routines (cost of consumables). Have you diluted your purchasing power by using multiple suppliers for deals on individual items? Consider having one supplier and negotiating a decent discount. Every parcel checked, every invoice paid, every order placed has a transaction cost. One supplier consolidates these costs. 4. Technology that drives efficiency Does your salon technology help you recall clients, manage your email marketing, send SMS reminders? Does it help you avoid double bookings, does it let your clients book online? 5. Profit & Loss Account Keep a close eye on your P&L so you don’t unknowingly slide into bankruptcy. The P&L tells you if you are losing or making money. If you can’t read a P&L, learn how. It’s critical. APJ Please direct any questions you would like Deb to answer: info@apanetwork.com.
APJ 23
BOOK REVIEW
Resilience
BODY.MIND.SOUL. 21 World Wellbeing Experts Share their Insights Gillian Fish
UNDOUBTEDLY ONE OF THE MOST IMPORTANT ATTRIBUTES to focus on developing at this time would have to be resilience. When challenges arrive that are beyond our comprehension, they can overwhelm us. However, looking back in history, some of the most amazing discoveries and feats of courage have been achieved during times of immense pressure. It seems that the human spirit was made to overcome and rise stronger even when confronted with unsurmountable challenges. If we dig deep and seek spiritual wisdom, we can be surprised at the good that can surface, despite the evil around us. So, what is the key? In the words of Austrian Psychiatrist and Holocaust survivor, Viktor Frankl, who said in Man’s Search for Meaning: “When we are no longer able to change the situation – we are APJ 24
challenged to change ourselves. Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom”. Recently I was introduced to an amazing book, seasoned with a collection of heart-warming, wise and incredibly moving thoughts and ideas written by 21 world-leading experts, whom my friend and colleague, Gillian Fish, interviewed for her latest incredible book which she called RESILIENCE. Like all of us, challenged by the devastation of the global pandemic, Gillian reached out for answers for her own life and business. As the founder and CEO of 6amAgency one of the largest and most credible public relations and social media agencies in the health, wellness and
beauty space, Gillian has always been driven by a strong sense of purpose, community and giving back. And out of a desire to reach out to others with support and solutions, RESILIENCE was born. This book is making waves globally and its content has also been presented through interviews and Zoom presentation that have received rave reviews and helpS bring hope to many. For those of us who have had the privilege to possess a copy of this book, it has enriched our lives and given us hope. RESILIENCE is spiced with heartwarming stories, wisdom and amazing wellness advice on which to anchor your thoughts for survival and growth. APJ If you have not purchased it yet, it is a must-have book that is so timely at this present time. You can access your copy from Amazon.
“This global health emergency should move us into that which is really important in our lives. We need a redirection in many parts of our lives – and we got it. Sometimes it takes tragedy to transform us after getting our full attention. Do not miss the lessons learned. Change yourself for the better. Serve others and do not be selfish. Heed the words of the Greek philosopher Socrates to “Know Thyself.” - Dr Mark C. Houston
“…. Start focusing on things we can control, and what we know to be true right now, with a focus on the things we are grateful for.” - Dr Anna Cabeca
“Live not in fear, but be aware! Be aware that this virus, like the influenza virus, is just a virus. It is an organism that has its weaknesses – and science can, and will, find ways to exploit these in order to eradicate the disease … From every bad comes the potential of greater good. If we use the ‘bad’ in a positive manner we will become creative and lift ourselves out of the rubble and rebuild, by creating a better future.” - Dr Mark L. Gordon, MD “Our values tell us what is important to us, but our allocation of time tells us who is important to us. This social isolation has brought out loved ones closer into view.” - Dr Ali Walker
“One of the key pillars of immunity is community. We must embrace that.” - Dr David Haase
“Life is about a work in progress. We should encapsulate key learnings from this period and carry those into the future.” - Dr Ron Ehrlich
“We have experienced a definite reset that is creating an opening moment for something new, a different way of being.”
- Dr Andrew Monk
“The better we minimize and adapt to stress, the more our immune systems will be ready to respond.” - Dr James L. Wilson “Happiness, peace and contentment are the most powerful health strategies available to us all.” - Dr Ross Walker “With regard to the challenges posed by social distancing, look to the Bible – the New and Old Testament, the Koran, the Hindu ancient script, the book that guides your faith. The one common factor through all this is that ‘it is in giving that we receive’ – ‘do unto others as you would have them do unto you.” - Dr. Joseph C. Maroon
EDUCATION
GAY WARDLE EDUCATION
Providing New Levels of Educational Support During Challenging Times KNOWN THROUGHOUT the beauty and aesthetics industry for her kindness and generous heart, Gay Wardle has been instrumental in helping shape a more professional industry through her education and her infectious love for others. With extensive qualifications, experience and over 40 years in the aesthetics industry, Gay brings a wealth of knowledge to all her training and programs. Her training is noncommercially biased and delivers evidence-based education helping elevate the standards of practice for both practitioners and businesses. During the pandemic, Gay adapted to the limitations of the restrictions and developed many of her training modules for online learning, allowing the industry to access her knowledge at their own time and location. Here we interview Gay who shared with us some of these new developments and her experiences during these challenging times. APJ Q1: Gay this year you are making several changes to your training programs stepping up your delivery in several ways. What prompted you to put your training online? Share with us your developments and how does this work? This year I have extended my training options to include an online program. This transition from the face-to-face delivery was prompted by the need to have a greater virtual presence in order to reach a wider audience. I have been fortunate to attract a vast following both nationally and internationally however I have always been asked by my colleagues who haven't been able to attend the face-to-face workshops to provide an online program. Through my online delivery, I ensure that I maintain
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the relationship-based delivery so that each participant receives the personal touch through the digital platform. The units are available through a series of individual small videos that therapists can undertake in their own time. There are a variety of topics that will help enhance your knowledge on both the composition of the skin, skin manifestation and treatment options. These units will help you and your staff gain greater confidence in your communication with your clients as well as assist in achieving better treatment outcomes. APJ Q2. This year you are also introducing an exciting mentoring program. How does that work and how is this helping businesses? Through the mentoring program, industry colleagues who are seeking to review and refine their skills, step-up their programs and refine their operations are invited to attend my clinic in order to observe my practice. Prior to the commencement of the mentoring program, the participant identifies areas that they want to focus on. I use this information and integrate this with the skills required to develop and operate a high-performing clinic. The main objective of this program is to support, educate and encourage personal and professional growth. The mentoring program is simply an investment in one's personal growth which ultimately influences the operations of a successful clinic. These sessions are personalised and conducted on a one-on-one basis. APJ Q3. From your interaction with salon and clinic owners what changes are you observing this year in terms of their needs and how are your programs helping them? This has been a year like no other and one that has brought challenges as we have never seen before and hopefully likely to never see again in our lifetime - the year of COVID-19! Personally, I have been very concerned for everyone in our industry as we have been forced to navigate our way through unchartered waters. I opened my own clinic three weeks prior to the nation mandating that salons and clinics close. Along with everybody else, I felt very nervous for our future, however during this time I proudly observed a united front in our industry as we supported each other by listening, sharing and problem solving together. Through this, a strength was born and we started to operate in ways that we hadn't done before. Clinics turned to the digital world in order to provide their clients with home programs and online shops for product retail. We also used this time to upskill ourselves and online programs were the perfect platform to enable this. I was proud to be able to provide my colleagues with an online program that they could engage with during this time. I have seen many changes this year and we have all helped each other and we should all be very proud of what we have achieved. APJ To access Gay’s online study units or speak with her about her mentoring program please contact: Gay Wardle Education 0418 708 455 education@gaywardle.com www.gaywardle.com
“If you can’t explain it simply, you don’t understand it well enough” Albert Einstein
INTRODUCING TWO NEW PROGRAMS Online Study Units
Upskill your knowledge, grow your confidence, enhance your results.
Mentoring Program: Shadowing Gay
An exciting one-on-one mentoring program. Learn the winning protocols to grow your reputation and your business.
If you are a Nurse, Dermal Therapist or a Beauty Therapist wanting to expand your knowledge or returning to the industry, these training programs are for you!
+61 418 708 455 education@gaywardle.com www.gaywardle.com
MENTORING PROGRAM SCHEDULE DAY 1 •
Review questions completed by the work shadow.
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Discuss 7 Habits of Highly Successful Salon Owners
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Gay’s Signature Skin Analysis – the secret weapon
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Learn how this vital step can set you and your client up for successful treatment outcomes
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Skin treatment program
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Prescription of skin products
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Starting point and protocols for tracking progress.
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Work Shadow Gay while she performs treatments on clients
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Lunch provided
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Work Shadow Gay while she performs treatments on clients
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Reflections and check-out
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Question and answer time.
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Written assignment
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Personal development
DAY 2 •
Review learning from the previous day.
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Lunch Provided
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Discuss 7 Habits of Highly Successful Salon Owners – what did you see yesterday?
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Work Shadow Gay while she performs treatments on clients
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Work Shadow Gay while she performs treatments on clients
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Reflections and check-out
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Reflection writing and learning objectives.
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BUSINESS PROFILE
MEDER BEAUTY SCIENCE
Award Winning Formulations Setting a New Standard in Treatment Outcomes An interview with Leah Coughlan WHEN IT COMES TO COSMETIC FORMULATIONS many of the mega skincare companies who are formulating predominantly for the mass market experienced substantial growth during the pandemic, especially when salons and clinics were in lockdown. Meanwhile, professional brands were determined to maintain their competitive advantage. This contributed to leading brands stepping-up their formulas and proving that they were able to rival the mass-market brands in both potency and efficacy. One such brands is MEDER BEAUTY SCIENCE – a leading innovative clinical-strength skincare range from Switzerland that is making waves with its ability in breaking traditional limitations when it comes to results. In fact, this year Meder’s latest innovation - Vita-Long Oil won the prestigious Marie Claire Prix D'excellence De Beaute 2020 Award. This was the first time that a professional brand was awarded by this global award. We interviewed Leah Coughlan, the Australian Distributor for Meder Science and Beauty for Australia and New Zealand,who was able to share the latest updates on the brand and how it can help businesses continue to grow in this highly competitive market, even during times of business disruption. APJ Q1: LEAH, WHAT IS UNIQUE ABOUT THIS PRODUCT AND WHAT SPECIFIC SKIN CONDITIONS DOES IT ACHIEVE LEADING RESULTS? Meder Beauty Science (MBS) offers five Professional Targeted Facial treatments that address the most prolific aesthetic problems. The combination of organic plant extracts and the latest biotech ingredients and formulations makes Meder one of the leading highly-effective cosmeceutical brands on the market. The results of the treatments are instantly noticeable
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and lasting, while achieved without pain, risk, or skin trauma. The success of these treatment systems is attributed to their targeted approach to the specific skin concerns addressing them head-on, while allowing the client to continue to maintain these results at home between treatments, through unique ground-breaking formulations. The philosophy of Meder formulations is based on supporting the skin’s microbiome and supporting skin health and immunity as the primary objective. The success of these unique formulations is that they eliminate the need to strip the skin in order to correct the most common skin ailments and conditions such as acne, rosacea, ageing and dehydration. This is the new and future approach of exceptional skincare based on restoration and rejuvenation without trauma. APJ Q2: CAN YOU PLEASE TELL US A LITTLE ABOUT THE BRAINS BEHIND THE FORMULATION OF THIS BRAND? I am delighted to answer this question, as indeed, the success of this brand is attributed to a highly committed and innovative scientific mind. Dr Tiina Orasmäe-Meder is a renowned cosmetic dermatologist and aesthetic medicine expert with a 25-year reputation as a specialist in the development of topical solutions for aesthetic concerns, as well as theoretical research of their safety and efficacy. Up until 2009 she was the head of International Professional Training for Cellap Lab (Switzerland) and participated in the capacity of medical consultant in Research and Development projects of Thalgo Lab (France). Additionally, until 2014 she was a medical expert for cosmetovigilance participating in Sociris Lab's (France) research
“As a dermal therapist, working in skin therapy for over 17 years, I have worked with and personally used so many incredible ranges and Meder is certainly a leader and a favourite, as it ticks all the boxes when it comes to clinical results and client satisfaction. Meder Beauty Science is impressive. The range is simple, and the results are phenomenal. The six targeted professional products give therapists the incredible results that we strive for and which our clients demand in our busy clinics, while delivering all that has been missing from beauty therapy for so many years now available through new advances and biotechnology” Mimi Chambers Dermal Therapist – Sunshine Coast QLD Australia
projects. Building a reputation for evidence-based formulas for aesthetic concerns Dr Meder was keen to take results further, so in 2009 she founded her own company offering cutting-edge non-invasive clinical skin treatments to correct common disorders through programs using topical solutions and specific protocols. Today Dr Meder runs UK-based Meder Beauty International Ltd and contributes her medical expertise to R&D of Cosmotec Lab (Switzerland). She is the editor-in-chief of Cosmetic Products Magazine, a bestselling author of two books, Beauty Myths (2014) and The Science of Beauty (2015), which have been translated and published in five languages and is also a co-author of a medical textbook Age-related Cosmetic Care (2016). In 2014 Dr Meder was nominated for the Trofemina Award in France. Many of her article are published in leading aesthetic medicine magazines and she is a regular presenter at numerous national and international conferences. Dr Meder’s products far exceed any other brand I have ever used and I am honoured to represent the Meder Science and Beauty products in Australia and New Zealand, knowing the level of result will truly help businesses enhance their reputation and grow substantially. APJ Q3: SHARE WITH US A LITTLE ABOUT THE CURRENT SUCCESS OF THE BRAND IN EUROPE AND GLOBALLY AND TO WHAT DO YOU ATTRIBUTE THIS SUCCESS? Dr Tiina Meder was responsible for formulating some of the most successful skincare ranges in Europe prior to the release her own brand Meder Beauty Science (MBS). Since then, her own formulations far exceed previous results and bring a new level of professionalism and treatment outcomes to clinics
and salons who are keen to provide reliable and tangible solutions to modern day skin concerns. The Meder skincare ranges lead in innovation. Meder was the first product range to include pre and probiotics in their formulations and their innovation has never stopped. This year, the company’s latest product “Vita-Long Oil” resulted in winning the prestigious Marie Claire Prix D'excellence De Beaute 2020 Award. Vita-Long Oil consists of a blend of 10 natural oils that mimic and recreate the natural lipid mantle characteristic of a healthy 27-year-old skin. This delicate and very fine oil protects the skin against stress and pollution, while restoring and maintaining the skin’s defence and youthfulness. It contains five powerful antioxidants as well as three epigenetic ingredients with scientifically-proven effectiveness to prolong the life of the skin cells by 30% and to help restore mitochondrial DNA. Among this year's nominees for the Marie Claire Prix D'excellence De Beaute Award were some of the leading global brands such as: Chanel, Dior, Givenchy, Sisley, Shiseido, Guerlain along with many others. Most products awarded the Marie Claire Prix D'Excellence Award in the past years have become known as cult products and are considered simply impossible to live without! Just a little background - the Marie Claire Prix D'excellence De Beaute award was established 35 years ago by French journalists. Over the years it has become one of the most prestigious awards in the beauty industry. Held in France, a panel of national judges evaluate products based on five criteria: innovation, efficiency, usability, design,
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and brand communication. Each judge compiles a list of 30 fundamentals that attracted their attention. These fundamentals are then grouped by the majority to establish the finalists, and the winner is then determined by voting. We were delighted that this year Meder Beauty Science “VitaLong Oil” was awarded the Prix D'excellence De La Beaute 2020. This is the first time a professional product has ever won this award. APJ Q3: LEAH, WHY DID YOU ACCEPT AND TAKE ON THE DISTRIBUTION OF MEDER BEAUTY SKINCARE? When I was approached by Meder Beauty Science to work with them to represent the brand in Australia and New Zealand I felt extremely honoured. Having worked with Meder products before, I was well aware of the prestige and respect Meder had gained in the global beauty industry and Meder was already an indispensable part of my beauty routine, so I was already passionate about the brand. However, the task at hand was fraught with many challenges. Being in the middle of a global pandemic was an obvious dilemma to consider, but after much consideration the answer was clear, “when the wind changes one must adjust the sails” and so, I took on the challenge, knowing that the brand represented “excellence” and this would allow it to be successful regardless of the challenges. Although a product’s authenticity and superiority are always a major consideration, so is a company's ethos and integrity. Having known Dr Tiina Meder for some time I knew I was in good hands. Aside from her undeniable intellect in cosmetic dermatology and aesthetic medicine, Dr Meder has considered so much more than just formulating a brand that embodies a bold, no-nonsense strictly scientific vision. Her attention to other areas is also exceptional. Dr Meder has considered everything including a packaging system that locks-in the active ingredients to ensure they are never compromised. The product is released in specific measured quantities for each use, this not only ensures the exact amount of product is used, but also eliminates waste, therefore allowing the clinic to accurately determine their return on investment for each treatment. These are just a few unique features that go a long way in supporting the stockists and from my experience, the clinic owner identifies these features very quickly. Having worked in and on my own businesses throughout the years, both in and out of the beauty industry, I have come to understand what motivates people and also what support I need to ensure so that the end-user is happy. The support, advice, encouragement and structure that Meder is making available to Meder Australia has been exceptional and this in turn, will allow me to also deliver a business structure that will reward both businesses, their staff and clients. I am truly grateful to have the opportunity to introduce Australia and New Zealand to the Meder products and have absolutely no doubt that clinics and salons will fall madly in love with the brand just as the rest of the world has. APJ4: WHAT IS THE IDEAL CLINIC OR SALON THAT COULD BENEFIT FROM MEDER BEAUTY? There are so many business models in our industry these days and because Meder has a range of professional target treatments, it provides an excellent fit for many scenarios. We have worked very hard to make the product accessible to both home-based and shopfront clinics regardless of whether or not they are a full-service clinic, or specialising in focused treatments.
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Here is an example: MyoFix: This is the first-ever clinically-proven product to works on the neurotransmitters to help soften, relax and reduce wrinkles and is widely used by clients that seek to extend the life span of their injectable treatments, or perhaps unable to use injectables while pregnant. Myofix can also be something for specialist clinics, e.g. salons or clinics that also specialise in brows and lashes. The MyoFix “Brow Lift” would be an exceptional addition to their treatment menu as it provides incredible lifting results. 5. WHAT SUPPORT CAN BUSINESSES EXPECT FROM YOU AND WHAT RESOURCES DO YOU HAVE THAT A POTENTIAL SALON OR CLINIC CAN ACCESS? Clinic owners will be delighted with the opening order options we have created along with the training. We also provide an unlimited library of easy access resources, bonus rewards, image library access, online store locator and the product reward programme, designed specifically to thank the hardworking therapists for all that they contribute to the success of the business. Over the last decade times have changed so we need to provide innovative support. We truly want our clients to take advantage of all that we offer and feel engaged with the brand. Social media has its good and bad aspects, but all-in-all the analytics point to a changing story. Is this the best way to engage? Is this how we gain trust and build loyalty and how we are made to feel valued? Once upon-a-time I would have said yes, but these days I think we are slowly moving past all the “likes” and comments and are gravitating back to the good old face-to-face engagement, regardless if it is online or not. As destructive as COVID has been I truly believe it has been instrumental in reigniting face-to-face conversations and picking up the phone to talk to each other rather than send a text. Regardless of whether a face-to-face takes place online or inperson isn’t the issue, what's important is that with visual contact we can read each other’s expression and body language and build trust and relationships. At MBS we want to have relationships with our customers and let our customers know we value them and are here to talk to them whenever they need us. APJ
For further information contact: Leah Coughlan Meder Beauty Science Exceptional results delivered pain-free +61 0417 079 111 admin@mederbeautyscience.com.au mederbeautyscience.com.au
RESULTS TO HELP YOU BUILD A WINNING REPUTATION award-winning formulations with cutting-edge results. MEDER BEAUTY SCIENCE is a renowned Swiss biotech professional skincare line developed by Dr Tiina Orasmae-Meder, a dermatologist and renowned skincare formulator. We specialise in non-invasive transdermal professional treatments and highly effective premium skincare products pioneering the latest advances in biotechnological, evidence-based ingredients. We offer microbiome friendly, noninvasive, very effective solutions for the most common skin types and conditions delivered through specific protocols for safe, yet immediately visible results.
Leah Couglan 0466 338 844 admin@mederbeautyscience.com.au www.mederbeautyscience.com.au
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PRODUCT INNOVATIONS
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BANISH ACNE AND SKIN LESIONS WITH SCIENTIFICALLY-PROVEN PREBIOTIC THERAPY
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AGAVE DEW MULTIFUNCTIONAL SERUM
Eu-Seb is a unique skincare treatment system developed by Meder Beauty Science to successful target the key causes of acne - abnormal sebum production, inflammation and overgrowth of bacteria. This amazing product system utilises prebiotics topically that significantly influence skin health through a range of effects, including detoxification of xenobiotics, targeting the pathogenic microbes and modulating of the host’s immune response. This three-phased approach allows excellent results with acne and blemished skin conditions.
Agave Dew formulated by Roccoco Botanicals is an amazing newgeneration formula that restores hydration, acts as a protective barrier against pollution and particulate matter entering the epidermis. It reduces inflammation, and restores radiance and youthfulness. Suitable for ageing skin, rosacea and glycated menopausal skin. It lifts and instantly firms the skin, strengthens capillaries and is anti-glycation. Key actives include Bacillus Ferment (probiotic), Acetyl-Hexapeptide-1, Biosaccharide Gum-4 and Albizia Tulibrtissin Bark Extract.
MEDER BEAUTY SCIENCE 046633 8844 admin@mederbeautyscience.com.au mederbeautyscience.com.au
ROCCOCO BOTANICALS 07 3807 1429 jacine@roccoco.com roccoco.com
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VITA-LONG OIL – THE AWARD-WINNING LONGEVITY VEIL
A skin miracle in an ampule. Vita-Long Oil is a delicate, easily-absorbed oil consisting of 10 powerful skin-restorative natural oils with powerful skin rejuvenating properties. Additionally, three epigenetic ingredients were included that can influence the expression of genes responsible for the cells’ longevity, which prolong the skin’s appearance of youth and beauty. VitaLong Oils is a lab-synthesised longevity veil for the skin. Just a few drops reduce inflammation and boost the skin’s rejuvenation, no wonder it was the winner of the prestigious Marie Claire Prix D’excellence De Beaute 2020 Award. This was the first time that these global awards awarded a professional brand. An excellent treatment booster and homecare product for retail. MEDER BEAUTY SCIENCE 046633 8844 admin@mederbeautyscience.com.au mederbeautyscience.com.au
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WHY EYES LOVE JASMIN EYE CREAM
Why Eyes Love Jasmin Eye Cream Roccoco Botanical’s Jasmin Eye Cream is a treatment in a bottle – the ultimate eye firming formula. It contains natural, but powerful ingredients to nurture, hydrate and lift the look of fatigue around the eye area, giving it a more youthful appearance. The unique formula containing Jasmin Sambac Flower, which diminishes the appearance of dark circles, Colloidal Gold reduces appearance of wrinkles within two months of continued use, while Hydrolysed Rice Protein minimising puffiness and significantly reduces the depth of wrinkles. ROCCOCO BOTANICALS 07 3807 1429 jacine@roccoco.com roccoco.com
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ISSADA CC8 EIGHT SKINCHERISHING BENEFITS
Clinically engineered, Issada CC8 is a tinted moisturiser, anti-ageing serum, blemish treatment, pore minimiser, radiance booster, pigmentation fighter, mineral sunscreen, skin calming colour corrector makeup all-in-one. Packed with vitamins, minerals and powerful botanicals, it glides onto the skin to neutralise imperfections and even skin tone and texture. With prolonged wear CC8 will heal, strengthen, repair and protect the skin. Available in four skin tone-adapting shades. RRP $79. Please contact ISSADA if you are a Salons, Spas or Clinics and wish to become a stockist of this truly innovative Issada makeup range visit www.Issada.com/pages/skincarestockists
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PRODUCT INNOVATIONS
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SKIN NECTAR
One of the most impressive skincare formulations from Roccoco Botanicals is Skin Nectar. This product will treat acne-prone skin, pigmentation and ageing skin. It contains 16 actives including herbal and pre and probiotics. Skin Nectar is a delicious cream that improves and evens-out skin tone, stimulates collagen and is 100% natural with no synthetic ingredients. Contains Agave Tequilana Leaf Extract that fills out wrinkles, sooths and mattifies the skin, Polypodium Volgare Rhizome Extract increases hydration and accelerates wound healing. Muclura Cochinchinensis Leaf is a flavonoid that has a retinoid-like action regulating cell turnover, while Lactobacillus is a probiotic that balances the skin’s microbiome. ROCCOCO BOTANICALS 07 3807 1429 jacine@roccoco.com roccoco.com
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RAPID BARRIER SERUM
Rapid Barrier Serum is an amazing product that is super-hydrating, sooting, calming and reduces redness, when used after high-end treatments such as Microdermabrasion, IPL and Laser, or any treatment where the skin has been compromised in an attempt to rejuvenate it. This Australian-made organic formulation is available for professional use and also highly recommended post-treatment for 3-4 days for your client’s homecare. Rapid Barrier Serum will ensure the skin is protected and nurtured to calm and heal quickly for beautiful results. Dr. Anne-Marie’s Dermal Care info@dramdermalcare.com.au dramdermalcare.com.au +61 403 846 622
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NEW PICOSECOND TECHNOLOGY PICOHI 300
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ISSADA’S SILKY SMOOTH, BAKED MINERAL FOUNDATION
The latest in Picosecond technology, featuring a stable 300ps pulse duration for faster and more effective tattoo removal (all colours), skin rejuvenation and pigmentation treatments. Clinically proven to maximise results, the PICOHI 300’s pulse duration is perfect for pigmentation treatments, shattering the pigment without causing thermal injury to the cells.
The miracle of medical-grade minerals, a revolutionary light infraction technology and a unique baking technique have produced a silky-smooth soft matte mineral foundation.
ClinicalPRO 1800 628 999 metro@clinicalpro.com.au clinicalpro.com.au
Please contact ISSADA if you are a Salons, Spas or Clinics and wish to become a stockist of this truly innovative Issada makeup range visit www.Issada.com/pages/skincarestockists
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ACHIEVING BEAUTIFUL SKIN WITH CLINICAL SKIN CLEAR
Clear, blemish-free skin is beautiful skin. Grow your business with the unique ability to remove a wide range of skin lesions and superficial capillaries. The Clinical Skin Clear combines, Radio and High Frequency Technologies to target the fluids in lesions and dry them out before your eyes. This device is unique in that it uses a vapourisation technique (no burning) and causes no damage to the surrounding skin. As this technology offers treatments that are noninvasive, they can be delivered by nonmedical aestheticians. These amazing and instant results are possible through the Clinical Skin Clear and will allow you to expand your services and boost your profits. ClinicalPRO 1800 628 999 metro@clinicalpro.com.au clinicalpro.com.au
The five skin-adapting tones are created by blending three liquid colours into a mineral crème that is then blended with potent herbs and vitamins, hand swirled, then baked.
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Welcome TO OUR
NEW EDITOR
WE ARE THRILLED to announce the appointment of our new editor for APJ Journal – Dr. Giulia D’Anna. Katherine McCann, our previous editor, is transitioning to her dual positions within the organisation as Regulations and Standards Advisor and Press and Media Liaison. As APAN moves forward with a stronger focus on standards and regulations we believe that Giulia will provide our APJ Journal readers with valuable contributions of on-going rich educational content. Giulia D’Anna comes with unique and diverse professional background, she graduated from the University of Melbourne in 1996 as a Doctor of Dentistry, and later graduated from the AACDS as a Dermal Therapist. Within her practice, Giulia now runs two businesses; iDental and Dermal Distinction. Both these clinics are renowned, while Dermal Distinction has an incredible reputation as an
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institute of excellence. Her roles within the businesses include director, principal cosmetic dentist, advanced cosmetic injector and dermal skin therapist. She was the first dentist in Australia to pass through both Dental School and also achieve a qualification in Cosmetic Dermal Science. Giulia loves the uniqueness of her practice where she blends dental health, with the smile, aesthetically enhancing the facial zones. Giulia’s business life is busy, but she loves her ever-evolving role both as a practitioner, as well as an industry innovator. Additionally, Giulia is passionate about education and lectures in the area of injectables and dermal therapies. She is also acknowledged in the industry for her educational blogs and articles, which have featured in several professional and consumer publications. We are honoured that Giulia has accepted this position as editor of APJ and we look forward to working with her and her valuable contribution as our publication continues to evolve. While Giulia is based in Melbourne, our values unite us. We enjoy an amazing synergy through our shared passion and commitment for high standards of practice, purpose and a vision to enhance best practice principles that support the reputation of the profession, while enhancing collaboration between the aesthetic and medical sectors. APJ To reach Giulia with your suggestions and request please contact her editor@apanetwork.com
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COSMETIC FORMULATIONS
How Skincare is Leading the Way in the Pandemic Era A discussion with Dr Tiina Meder, Debbie Dickson, Jacine GreenwoodDrummond, Maria Enna-Cocciolone, Simone Vescio and Gay Wardle IN FACING THE CHALLENGES OF OUR TURBULENT WORLD in light of the global pandemic, there has been a fury of activity as skincare formulators and educators are more intently studying ingredients and methodologies that can offer optimal support to both the skin and body. This has resulted in amazing innovations allowing skincare to come into its own and provide excellent results even without the use of equipment technologies. To discuss these approaches we interview six thought-leaders to share what they are bringing to the table through both ingredients, product development and methodologies. DR TIINA ORSMAE-MEDER – MEDER SCIENCE AND BEAUTY: Dr Meder, we know that stress can rapidly age the skin especially during this current pandemic disruption, can you share with us some of the most effective evidencebased peptides that can impact neurotransmitters and create notable benefits in minimising the appearance of wrinkles? Professor Laurent Misery in speaking about skin’s sensitivity once said, “The skin and nervous systems are siblings, that are separated before the birth, but they still remain close and influence each other”. Embryologically, the skin and the nervous system used to be the same organ – ectodermic, which develops into the skin and the nervous system when the embryo is developing. The skin and nervous system use the same biochemical language, skin cells are very similar to nervous cells, even melanocytes are called sometimes “skin neurons”. So yes, if the nervous system is disturbed, this will also impact the skin. Stress stimulates and increases the activity of stress hormones, such as Cortisol. This aggravates all skin conditions including acne or rosacea and even contribute to premature ageing, That’s why all of us need to use specific sensitive skincare in current stressful situation! Speaking about peptides, there’s a whole class of neuromodulating peptides able to interact with different structures of nervous system, from sensitive nervous fibres, to mimic muscles cell receptors. My top three anti-stress and anti-ageing peptides are the following: 1. Skinasensyl (Acetyl Tetrapeptide-15) binds opioid receptors to inhibit CGRP release by sensory neurons, transforming stressed skin to “happy skin”. Also, this is a molecule which can effectively help to prevent the majority of contact allergic reactions, if used in recommended concentration. I use Skinasensyl as a “magic touch” in all Meder masks formulation to calm
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down the skin and obtain maximal anti-ageing and skinwellness response. 2. Calmosensine (acetyl dipeptide-1 cetyl ester) - that’s a small dipeptide Tyr-Arg (NATAH) stimulating a release of beta-endorhin in keratinocytes. Calmosensine reduces sensitivity of the skin to the stress and environmental damage with a confirmed calming and anti-irritating effect, but also stimulates elastin synthesis on fibroblasts, especially a tropoelastin. I am using this wonderful molecule in our face slimming Lipo-Oval Concentrate in a combination with a Caffeine, Niacinamide and Slim Excess complex, to fight stress-related puffiness and fat deposits. 3. Rigin (Palmitoyl tetrapeptide-7) - another small peptide with a great capacity to penetrate into the deeper layers of the skin. Rigin supresses excessive inflammatory messengers and interleukins production reducing the inflammation caused by nervous and environmental stress. Rigin is one of a few skin-identical peptides found in human skin that triggers a signalling cascade to release matricins, so it increases the production of collagen, elastin, proteoglycans and glycosaminoglycans such as hyaluronic and glucuronic acids. I use Rigin as a key player in Arma-Neck cream alongside with Vitamin E to restore the damaged neck and décolleté skin and diminish neck and décolleté wrinkles. DEBBIE DICKSON – REGUL8, DMK: Debbie, share with us your most effective treatment at this time in helping address stressed and inflamed skin and do Regul8 and DMK offer solutions that benefit the skin? With all the uncertainty during COVID, everyone is feeling stressed, and stress isn’t just being busy or worrying about what may happen, stress is anything that imbalances homeostasis in our body and the body only knows one way to respond - with more stress. I believe there has never been a more important time to take a holistic approach to our clients’ skin revision. Stress is very destructive to our health, it’s also one of the number one causes of premature ageing, as Cortisol breaks down protein, collagen is the most abundant protein in skin. The imbalances that stress creates in the body also can contribute to the passive hyper pigmentation, reactive inflamed skin conditions. The Regul8 Relax supplement is a great addition to reduce stress, rebalance all the negative impacts of stress and get clients sleeping better. We are also seeing more rashes and inflamed red skin conditions because of all the sanitising we have had to do during the pandemic. While the sanitising and wearing masks
has been necessary, it disrupts the skin’s important protective immediate and prolonged hydration. It reinforces the skin microbiome, so it is now more important than ever to be barrier function by stimulation loricrin and involucrin. using skincare that helps to restore the skin’s microbiome. The DMK Enbioment range is definitely a must! By including Ecoskin is a pre-biotic blend consisting of Alpha-glucan an Enbioment upgrade in your clients’ treatments and also oligosaccharide (and) Polymnia sonchifolia root juice (and) to their home routine it will help restore healthy, happy skin. Maltodextrin (and) Lactobacillus. It has been shown to During the pandemic, people are really missing that human stimulate the healthy bacteria to populate, whilst minimising connection so it is important that we get our clients back, the bacteria that are opportunistic and can become strengthen our professional treatments and really give them pathogenic. It stimulates the immunity of the skin increasing an incredible experience to deepen that connection with our beta defensins of the skin. clients. Never underestimate the value of human connection. MARIA ENNA-COCCIOLONE INSKIN COSMEDICS: Marie, JACINE GREENWOOD-DRUMMOND – ROCCOCO share with us how mindfulness protocols are providing BOTANICALS: Jacine, why is it important to restore the value and benefit to clients, as well as ingredients that skin’s biofilm especially at this time when many clients address stress skin and inflammation. are experiencing inflammation and irritation due to high One of the hero product ranges that we developed stress levels? What evidence-based ingredients are the that provides amazing support during the pandemic is most effective in rebalancing the skin? GINGER&ME. This range is about skin, mindfulness and the Both psychological stress and mechanical friction have sisterhood, which is so important and meaningful at this been shown to have a deleterious effect on the skin barrier time, especially as we are all subjected to the need of social function and health. Maskne (mask + acne) was first coined distancing and disconnect. back in 2013. Clinically it is called acne mechanica. It is the result of friction against the skin caused by a protective face What is timely about GINGER&ME is that it’s Australia’s mask. The occlusion of the face by a mask imposes a hot, first mindfulness brand. As you are aware we are also the moist environment from breathing and sweating, which alters creators of O COSMEDICS. Our second brand was launched the microbiome. to be everything that O is not and to fill a gap within the professional beauty industry. Where O is a serious skincare This prolonged occlusion, combined with heat and sweat line, active, multi-faceted and corrective in its approach, can result in pimples, acne cysts and rashes. It can lead to GINGER&ME has resurrected the return of luxury, relaxation, dry, itchy skin and aggravate conditions such as Rosacea, decadent massage, and a nurturing of three vital elements Seborrheic Dermatitis, and Folliculitis. Skin dryness occurs at SKIN, MIND & BODY. the level of the nasal bridge, cheeks and chin, predominantly in contact with masks and where friction is occurring. Released in three parts, the brand didn’t take its complete Mindfulness and Sisterhood concept until the third and final Stress downregulates the immune system in the skin by phase, coincidentally as the worldwide pandemic took life, decreasing antimicrobial peptides, predisposing the skin giving the brand an unprecedented platform, a captured to infection. Psychological stress triggers a fight or flight audience with an increased need for self-care and attention to response, prompting corticotropin-releasing hormone and mental health. catecholamine production, which disturbs the microbiota. Conditions such as acne, psoriasis and eczema are known to In 2016 GINGE&ME launched a decadent and sophisticated, worsen with stress. Australian-inspired body range with three memorable fragrances BE BRAVE, BE HAPPY AND BE GRATEFUL with each In the absence of stress, a healthy microbiotia produces bottle reflecting a relatable quote; messages promoting its short-chain fatty acids that exert anti-inflammatory effects. three ethics to live by giving the brand a gifting angle with a During stress, an altered gut microbial population affects the serious skin focus not seen before in the professional beauty regulation of neurotransmitters mediated by the microbiome industry. and gut barrier function. The gut and the skin are intertwined and linked, with the gut microbiome affecting the skin In 2018, GINGER&ME launched G&M NEUROCOSMEDICS face microbiome also. range, 13 products created to support modern living and its associated skin conditions known as the A.C.D approach, Some of the ingredients that can be used to counter the serious yet decadent, gentle and nurturing, with a focus on detrimental effects of both stress and mask-wearing are those daily self-care, embraced in a sensory journey and a daily that act as a barrier and also balance the microbiota of the ritual, encouraging guests to “BE HERE NOW”. The A.C.D skin. approach represents: Black BeeOme is an elixir that is obtained by fermenting the honey of a rare and old honey bee species. The honey of this bee is produced in isolated Swiss mountain valleys and it is fermented with the bacteria Zymomonas mobilis. In vitro and clinical studies have shown that after washing, Black BeeOme promotes faster regeneration of the skin flora and restoration of the skin barrier. It also reduced sebum and balanced oil flow. Skin friction from wearing masks can be minimised with Fucogel, a non-occlusive anionic polysaccharide that acts as a film forming matrix, hydrating and soothing the skin from friction-induced damage. It comprises galaturonic acid, L-fucose and D-galactose which is obtained through bacterial fermentation from vegetal sources. There is immediate reduction in stinging and irritation of the skin and it provides
A: The four A’s – Anti-Inflammatory, Antioxidant, Anti-Ageing, Anti-Pollutant C: Collagen and Elastin Synthesis and preservation D: Detoxification and Vitamin D synthesis In 2019 the final and most influential phase of the brand was launched, a series of Mindful Facial protocols which include a professional guided meditation with a number of very strong messages of ‘YOU ARE ENOUGH” and you have the “POWER TO CHOOSE YOUR TUDE”; •
Your attitude – the way you do life
•
Your altitude – what you get out of life
•
Your gratitude – the way you acknowledge life’s blessings
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Maria EnnaCocciolone •
Your beautitude – the way you show up to life
Already GINGER&ME partners can share stories of lives that have been transformed and even ones saved. The experience is unique, beyond special and one that could be described “Made for a pandemic”. SIMONE VESCIO – HEAD OF EDUCATION – DERMA AESTHETICS AND DERMAVIDUALS. Simone, how is the current pandemic influencing skin manifestations and what effective strategies and ingredients are you using to provide the best skin treatment results against stressed skin and inflammation? At derma aesthetics we recognise that no two skins are alike or will ever present with the same set of issues due to a multitude of factors including, but not limited to a person’s age, previous skincare history, medication, their health, genetics, physiological and psychological stressors from COVID-19 or from facial masks and coverings worn daily. However, what we are seeing and hearing from our educators and clinic owners does have a common thread. The most common skin concerns presenting to our clinics include an increase in perioral dermatitis, exacerbated rosacea, onset of acne within the perioral region (mainly presenting on the chin area), worsening of pre-existing acne and a new subgroup of clients suffering from congestion and/ or breakouts as a result of continual stress. The repeated use of personal protective facial equipment such as masks are also an aggravating factor in these skin conditions. These are certainly challenging times for not only clinics and their clinicians, but also for their clients’ skin and mental wellbeing. The current pandemic has resulted in an overabundance of hormonal activity and other chemicals such as histamine (the powerful chemical that leads to allergy symptoms) to be released into the bloodstream, which have a negative effect on numerous organs including, but not limited to, the digestive tract, vascular system, immune system, nervous system and skin. Histamine is an inflammatory mediator released by the degranulation of mast cells/basophils which enhances and prolongs inflammatory responses. This, in turn, leads to an increase in capillary fragility (exacerbated diffused redness) due to the activation of matrix metalloproteinases (MMP) enzymes, as well as the breakdown of the large polysaccharide, glycosaminoglycans, resulting in a decrease in cellular hydration. Oxidative stress, driven by psychological stress, contributes to major decreases in cell membrane integrity. This aggravates lipid-peroxidation causing significant tissue damage to the cells’ DNA respiratory chain, enzymes and proteins which compromise the formation of involucrin cross-linked cell envelopes and lamellar membrane structures (which are highly important for effective physical and water barrier APJ 40
Dr Tiina Meder
Debbie Dickson
functions within the skin). Oxidation of cell membrane lipid molecules can trigger, exacerbate and/or prolong barrier disorders such as acne, rosacea and perioral dermatitis due to an increase in reactive oxygen species (ROS) and the loss of built-in antioxidant defence systems. The effects of wearing masks and facial shields has led to friction causing the breakdown of the epidermal barrier and contact reactions - all of which may aggravate an existing skin disease such as those above. Personal protective equipment needs to be tightly attached to the skin’s surface, which compresses the skin at the fixed site for many hours and may result in pressure injuries. Large quantities of water vapour exhaled from the mouth and nose underneath facial masks keep areas of the skin moist for a long period of time, resulting in microbiome maladaptations due to changes in the skin’s pH. Overactive serine protease activity can occur due to an increase in stratum corneum moisture levels and prematurely cleave the bonds of corneocytes. Erythema, papules, pustules, macerations and premature desquamation are the most commonly reported skin changes caused by these adjustments in the microbial diversity. Derma Aesthetics offers solutions for challenged skins. Dermaviduals was first formulated over 20 years ago with skin barrier disorders being its main focus. The product is formulated free of ingredients such as common preservatives, colours, fragrances, silicones, mineral oils and common emulsifiers. We know that when the skin’s barrier is compromised, we must look for formulations and implement treatments that return the skin’s barrier back to balance. It is imperative to understand the importance of supplying the skin with the three lipids that form the permeability barrier and to provide them in the correct ratio. Utilising such a formulation to restore the acid mantle will decrease inflammatory processes within the epidermis and improve the skin’s antimicrobial defences. Dermaviduals and Corneotherapy offer clinicians this and is your pathway to improving your clients’ skin health. Dermaviduals base creams are customisable and contain patented DMS (Derma Membrane Structure) technology. This composition mimics the lamellar membrane structures that are naturally found within the stratum corneum and consist of many naturally occurring phospholipids such as ceramides, cholesterol and long-chain free fatty acids. DMS is the principle component behind Dermaviduals and is used as a preventative treatment that aims to maintain the skin barrier at all times to ensure skin conditions such as acne, rosacea and perioral dermatitis are maintained, supporting the clients’ journeys to skin balance and health. By using substances that mimic the skin membrane, the barrier defence systems become stronger and trans-epidermal water loss (TEWL) is reduced, enabling optimal skin health and function no matter what skin concern is being addressed.
Gay Wardle
The below liposomes and nanoparticles are very rich in essential fatty acids and thoroughly penetrate the skin barrier. They support the formation of ceramide 1 within the permeability barrier and are extremely anti-inflammatory. EGCG Liposomes (epigallocatechin gallate) An intensive renewal serum encapsulating a non-stimulating form of green tea. It works to support the keratinisation process by assisting with cell envelope formation, which addresses filaggrin abnormalities.  Liposome Concentrate Plus (azelaic acid) This serum works as a 5a-reductase inhibitor by modulating the conversion of testosterone into DHT to support those experiencing acneic lesions. It also decreases congestion and clears blemishes, lesions and inflammation caused by rosacea and/or perioral dermatitis. Vitamin B Liposome Concentrate (B3, B5, B6 and B7) Enhances barrier function by increasing ceramide and free fatty acid levels. This liposomal serum also helps to mitigate acne and congested skin, as well as supporting lipid and protein metabolism for a functioning skin barrier defence. Boswellia Nanoparticles (frankincense extract) Has anti-inflammatory properties which inhibit the enzyme 5-lipoxygenase. Boswellia has a high content of essential fatty acids and is prescribed in treating inflammatory disorders such as rosacea, perioral dermatitis, psoriasis and acne. Kiwi Seed Oil Nanoparticles Excellent source of polyunsaturated essential fatty acids and is known for its anti-inflammatory effects. Kiwi Seed Oil is commonly used for the care of reddened skin and frequently used in the therapeutic treatments of rosacea, perioral dermatitis and acne. GAY WARDLE EDUCATION: Gay, any effective treatment starts with an accurate assessment to determine skin type and identify areas that the skin is not functioning correctly and needs support. What are the key skin evaluation markers that help determine an effective treatment plan, particularly now during COVID impact on the skin? COVID has impacted our entire community and during this pandemic many of us have experienced very high levels of stress. When determining an effective treatment plan in these current times, I would investigate how and to what extent the client has been impacted by stress. During stressful situations the skin’s mast cells are activated. This activation produces stress hormones and inflammatory factors. Continued psychological stress – which many of us have experienced during COVID, increases the production of these stress hormones. As a result, the negative consequences to
Jacine GreenwoodDrummond
Simone Vescio
the skin are high. Some of the consequences include impaired stratum corneum cohesion, disturbance of permeability barrier, alteration of the antimicrobial properties of the epidermal barrier, delayed wound healing, compromised epidermal innate immunity, and cutaneous homeostasis. All of these conditions increase progression of infections and enhance the potential to affect chronic inflammatory skin diseases. There are studies that demonstrate the role of psychological stress factors in the aetiology or exacerbation of certain skin diseases such as atopic dermatitis, urticaria, psoriasis, rosacea, vitiligo, acne, ageing skin, pigmentation and alopecia areata. The constant rush of stress hormones can impact the whole body causing it to break down and become more prone to illness as the immune system becomes severely compromised. Apart from the obvious skin conditions, there are also physical signs which should be identified when treating a client who has endured long term stress. These signs can include fatigue, difficulty sleeping, constant headaches, irritability, poor digestion or diarrhea. The long-term health conditions can include depression, atherosclerosis, arrhythmia, heart disease, irritable bowel syndrome, ulcers, arthritis, lung disorders and fertility problems. It is for these reasons that we need to possess an understanding of how stress impacts the skin and overall health. During the COVID pandemic we have seen a spike in various skin rashes. These can be attributed to stress, however there is also a link to face masks, cleanliness and hygiene. It has been found that wearing a facemask is essential in preventing the spread of infection however prolonged use has seen people developing rashes, pimples and other skin problems. The reason that these rashes can occur is because the skin around the nose, mouth and chin area can become dry making them susceptible to these disorders. Perioral dermatitis is a disorder that is very common at the moment. Rosacea and eczema are also on the rise. To help prevent and control skin rashes associated with mask wearing, it is important that people practise cleanliness and hygiene. It is advisable that disposable masks be changed every two hours as studies have reported that masks become ineffective after a two-hour period. It is advisable that fabric masks are changed every two hours and washed in between uses. As we enter the warmer months, the risk of skin rashes and infections may increase with the wearing of facemasks. It is important to know that facemasks can increase our body temperature which changes the bacteria on our skin causing rashes to occur. We all must play our part in reducing the spread of COVID and adopt necessary safe practices such as wearing face masks however, it is essential that we maintain strict hygiene and cleaning practises in order to prevent the occurrence of skin rashes during COVID. APJ APJ 41
EDUCATION
AESTHETICS AND SKIN INSTITUTE
Empowering in Aesthetics
your success
An Interview with Dr Ben Chan
WHETHER YOU ARE STEPPING OUT INTO COSMETIC MEDICINE, OR AS A SKIN THERAPIST you are seeking to expand your scope of practice, accessing credible education is the key. In today’s ever-changing world on-going professional development is essential for survival, as well as to hold your professional position in the highly competitive world of aesthetic therapies and cosmetic medicine. The Aesthetics and Skin Institute (ASI) is a global training organisation based in Australia. It offers both e-learning and hands-on courses to help you succeed as a confident, allrounded aesthetics practitioner wherever you are. It offers a wide range of aesthetics and skin modules, which includes injectables, threads, lasers, microneedling and working with various technologies. Dr Ben Chan is the Clinical Director who heads the ASI. With over 30 years of experience, he brings a wealth of knowledge in clinical practice. Together with his competent team, training is delivered through sound science-based education to empower practitioners to achieve exceptional results and best-practice. Varying levels of training cover a wide scope of practice available to doctors, nurses, dentists and skin therapists. We were delighted to interview Dr Ben Chan who shared with us how the Aesthetics and Skin Institute is helping improve education and best practice. APJ Q1: DR CHAN, CAN YOU PLEASE LET US KNOW WHAT KIND OF TRAINING YOU OFFER - IS IT FACE-TO-FACE OR ONLINE STUDIES, OR BOTH? Originally all of our training was face-to-face, as we focus on ensuring it is tailored to the individual needs. This is because
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we train individuals across a diverse range of professional backgrounds. However, we also include online training and in recent times, we have added training through Zoom sessions. This allows the candidate to access personalised education regardless of their demographics. APJ Q2: WHAT AREAS OF TRAINING DO YOU COVER AND WHAT KNOWLEDGE AND SKILLS-OUTCOME CAN A GRADUATE EXPECT TO GAIN FROM YOUR TRAINING? Our educational and training program covers two streams – cosmetic medicine and skin therapies. For example, with doctors and nurses the focus is usually 80% on cosmetic medicine e.g. injectables theory and techniques and with 20% on skin therapies. On the other hand, a non-medical practitioner - beauty therapists or dermal therapists would undertake the 100% skin therapies program. As there are several levels of training available, all candidates also receive on-going mentoring support. This allows us to ensure their competence so that it does not stagnate, but continues to grow. Once someone takes the training into their clinical environment, questions will arise, so we believe it is important that we are available to guide the student during any challenges that they may encounter. Additionally, as they gain confidence, they may be ready to step their knowledge up to higher levels, rather than become stuck at a certain level. We therefore encourage them to open up to further learning once they master their current level of knowledge.
Dr Ben Chan
APJ Q3: DR CHAN, PLEASE SHARE WITH US A LITTLE ABOUT THE SCOPE OF TRAINING THAT YOU OFFER AND THE VARIOUS PROFESSIONAL LEVELS? Our scope is very wide and covers fundamentals, as well as advanced modalities. We cover skin science in depth, as well as anatomy and physiology, as these are very important. We then offer units in treatment options such as peels, skin needling, IPL Laser and several other equipment such as Radio-Frequency, as well as different techniques. We also cover specific protocols in addressing various skin conditions and disorders such as melasma. Additionally, we cover the correct clinical approach and sequence in intergrading various modalities. All our techniques are based on solid science and medical journal consensus of proven methodologies that work. APJ Q4: DO YOU ALSO OFFER POST-GRADUATE TRAINING FOR PROFESSIONALS WHO ARE AREADY WORKING ON THE SKIN? Our training is not just for beginners or those who wish to enter the industry. We have advanced modules that move into more clinical practice and in dealing with more challenging skin conditions. APJ Q5: WHEN IT COMES TO ETHNIC SKIN TYPES HOW IS YOUR TRAINING SPECIALISED IN THIS AREA? When training doctors and nurses in the area of injectables the issue of ethnicity is critical, as each ethnic group has different needs. For example, Asians have wide cheek bones, however, they may need a procedure that lifts their eyes. A Caucasian may wish to lift the cheeks and create more volume for their mouth, whereas a South Asian – Indian or Sri Lankan may have full lips and not need enhancement in that area.
It is important that an injector has an understanding and examines the different structural needs as they will require different approaches and different outcomes depending on the ethnicity of each patient. Similarly, for treating the skin, each ethnic category has different needs. For example, Middle Eastern skins often suffer from melasma, while Indian ethnic groups often have concerns with dark circles under their eyes and pigmentation around the mouth. Darker skins also have a tendency to scar more easily. Asian skins on the other hand, have less concerns with wrinkles, but they dislike the appearance of pores and they value a very clear complexion with even colour and no blemishes. With Asian skins, while they have less wrinkles, they do have high levels of complications and reactions that a practitioner needs to be aware of. All this information needs to be correctly assessed to identify the different causes of the various concerns. The practitioner needs to apply the appropriate approach for that skin, utilising different modalities and sequence of treatments to ensure successful clinical outcomes. All our training programs are based on evidence-based science and they are also accredited by various bodies such as ACRRM and also the APAN ARAP CPD program. APJ AESTHETICS AND SKIN INSTITUTE www.aestheticsandskininstitute.com info@learnwithasi.com +61 401 110065
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BUSINESS
How to Achieve Business in the New Decade
Success
Phillip Fernandez (ABNLP) Human Strategist, Mindset Winning Coach, Author CHRONOLOGICALLY AS A SOCIETY, GONE ARE THE TEENAGE years as we are now into our 20s (2020) and so is the way we do business, as the shift now centres towards nurturing and supporting human capital is the new era. We have seen the evolution of social media strategies and how this has made and is making individuals and businesses grow in a world of ‘likes’ or ‘unlikes’. How many people can be influenced and how many followers one has to perpetually aim for in order to build one’s brand, reputation and credibility. The aim is all about the what the followers are looking for to satisfy their needs and look at ways to add value to what they aspire to and can affect and benefit their lives, careers, and businesses. This is all done virtually online and the only interaction is with your mobile phone, tablet or laptop. It is the way the world now is communicating and doing it effectively at that. On the flipside of this - backed up by new generation studies and also seen in my day-to-day coaching of businesses and individuals, we are seeing more and more therapists struggling in the art of effective communication. The most common areas of deficiency are: •
The art of face-to-face conversations
•
The ability to show passion
•
The ability to read and connect with a client
They struggles with their own inadequacy, which they keep to themselves so as not to show vulnerability. This lack of self-confidence in effective connection also leads to anxiety in selling products and upselling, or cross-selling other services and treatments. This is happening because they have unconsciously created a world of stories that act as excuses, or justifications for all of the above. The innocent factor in all of this is that they don’t even know they are doing it, which leads to a very different way of approaching business success in the new decade. Yes, we do need to send them to product knowledge and retail training with the various products companies, upskill them in new skin techniques and the use of the various technologies they will be using. While this is a must to help equip both new and existing therapists, online training is slowly taking over due to the flexibility of when you choose to do your training or upskilling. They do an online assessment and on completion attain their certificate. This is leading to weakening the art of face-to-face professional interaction. All this training still does not provide solutions or answers, or even remotely change the way these therapists think, act and behave. You see, knowing all about a product range, what and how to consult, how to communicate, sell and even educate, is great, however, the effectiveness of the delivery of this APJ 44
knowledge can still be sabotaged by what they are still dealing with unconsciously, which is the stories they have been living on for years and which are limiting them from being the best they can be. To help businesses achieve ultimate success in staff performance I specialise in dealing with the underlying issues that inhibit a therapist from performing and being their best, which then leads them to taking ownership and really being productive and profitable for their business and in turn the salon business. To achieve ultimate productivity, this also involves mindset training - learning to believe in themselves, learning how to win the smaller goals, which then builds the winning confidence to taking on the bigger goals, like their profitable sales targets and beyond. REMOVING RESTRICTIONS – ENHANCING PRODUCTIVITY To achieve this, I have introduced specifically designed selfdevelopment training modules that allow each individual to take ownership of their thinking and win in life. Many of them don’t know how to win or have never been shown how to win. This type of training creates a more permanent change and it educates individuals to overcome any roadblocks that come up. This then allows them to identify and adopt behavioural changes to overcome these challenges and move forward towards productive solutions. Achieving this breakthrough is very powerful and so rewarding, both for the individual and of course the manager or business owner. CULTIVATING A WINNING LEADERSHIP MINDSET The other side of this type of mindset coaching is with the owner and or manager of the business. You see, we all come with our own roadblocks, limitations and vivid stories of how our staff should behave, or even what is the difference between a therapist with bad attitude and one that is resisting being spoken to or accepting constructive feedback. The biggest one is “how do I get my therapist to perform consistently without having to be on their back, or having to constantly remind them or drive them to perform?” It is very draining and in the long run, not good for our health and wellbeing. I therefore, equally work with the leaders in coaching and equipping them with the right mindset, the power of the conversation, the right tools and methods to achieve what I call the 80/20 rule. This is where 80% of the staff are productive and consistent and 20% float in and out but are still expected to perform. The leadership coaching and training in the power of the conversation with owners/or managers is a huge contribution towards staff ownership and performance. For staff to change and overcome their roadblocks, they must see change in their leaders too. My clients have told me that there isn’t a price that they can put on the value of investing in their staff. It is simply priceless. APJ If you wish to discuss your needs with Phillip Fernandez and identify ways that he can help please contact him on 0402 213 813 or phillip@busineswizards.com.au
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BUSINESS PROFILE
THE ROCCOCO
Difference
An interview with Jacine Greenwood-Drummond THOSE WHO KNOW JACINE GREENWOOD-DRUMMOND would agree that she is a woman on a mission. Her search to resolve her own acne condition drove her to study cosmetic chemistry and eventually formulate her own skincare line Roccoco Botanical Skincare – a brand that is fast developing a reputation as one of the leading professional lines, not just in Australia, but also gaining momentum in the US. Known also as a passionate educator, Janine is also well-known for her wealth of knowledge in ingredient science. In this interview she shares with us her journey, her philosophy and the principles on which she bases the Roccoco formulations. APJ Q1: Jacine please share with us your background and what drove you to have such passion for skincare ingredients and in developing your own skincare brand? My interest in skin began when I was unable to clear my own acne. It was what drove me into the beauty industry. I went to several clinics who were unsuccessful in treating my skin. I was given contradictory information from different clinicians and I became aware that none of the experts I had seeing for treatment were right, because here I was still with acne. I did numerous post graduate courses and I learnt more about comedogenicity and comedogenic ingredients. I started examining what I was using in my clinic and I realised APJ 46
that many of the products designed to treat acne, actually clog the skin back up. It explained why I could not always get everyone clear. It was from this that I was driven to create my own product. My passion for cosmetic ingredients came from my first clinical trials, where I had theories about herbs and their application for skin care. Clients who had seen dermatologists and had unsuccessfully managed their condition, yet within three months it was resolved with a handmade cream. I spent years researching skin conditions and cytokines, trying to find ingredients that targeted specific inflammatory pathways in the skin. The more I learnt about cosmetic actives, the more I became aware of just how much could be achieved topically. With advances in ingredient science, there is precious little that you cannot change in the skin. There are now actives that can re-pigment hair, grow hair, reduce capillaries, treat acne; literally just about anything that you want to achieve. APJQ2: You are well-known and respected in the industry as an educator of ingredient science, what do you hope to impact through your knowledge? I hope to raise awareness and the level of education for aestheticians and skin therapists, so they develop critical thinking. In my early years in the industry I would believe everything that was told to me, taking at face value any information shared. It is not uncommon for aestheticians to take at face value what is told to them by companies. It is my vision to develop in them the desire to think, analyse and to question how could an ingredient do this. The more that therapists can link ingredients to skin structure and science the better they will become with the results they can achieve in clinic. Part of understanding ingredients is also understanding the skin, so the more that a therapist becomes familiar with ingredients the more they will also understand skin as a consequence. The learning and awareness of new ingredients also leads to innovations in product development as well, which is exciting. The evolution and growth of the cosmetic industry over the past 20 years is truly inspiring. APJ Q3: Share with us the latest exciting new development at Roccoco? We have two new products that have launched within the last month. Our new Velvet Smooth cream and our Peptide Finisher. Velvet Smooth has been specifically designed to address the needs of Keratosis Pilaris by encouraging the production of ceramides and smoothing the skin’s surface. We have incorporated Caviar Lime, a native Australian botanical that modulates aquaporin expression in the skin and also encourages exfoliation. It
also contains a marine microorganism that is rich in natural carotenoids that regulate the keratin plugs found in hair follicles. The skin becomes less inflamed and smoother. Our Peptide Finisher is a unique product in that it uses less than 1% vitamin C but the efficacy is that of 15% vitamin C in a product. The perception has always been that the higher the active percentage, the better the result. However, it truly is about delivery systems and bioavailability of the ingredient. We have teamed our ascorbic acid with a glutathione molecule which enhances delivery into the skin. Glutathione also reactivates the Ascorbic Acid to its active form. Ascorbic acid is typically unstable and very sensitive to light and oxygen. It is also very pHdependent and has low skin penetration. Within six days ascorbic acid is normally only 80% active, so it loses efficacy very quickly. When teamed however with the glutathione it retains 100% activity and remains stable even at the 6-month mark. APJ Q4: How would you sum up Roccoco’s philosophy and approach to skin health and treatment results? Roccoco’s philosophy is do no harm. We believe that any of the ingredients we use should not have a negative impact on the skin. We have focused our formulations on being acne and allergy safe. Many of our clients have struggled with acne or sensitive skin. The majority of products on the market are not formulated with acne in mind, which presents a problem when you are still acne-prone at the age of 40. Even though we are a botanical line, we do not believe that everything natural is good for your skin. There are many natural ingredients that are barrier disruptive and hinder the healing phases of the integumentary system. We do not use oils high in oleic acid as it tends to disrupt the barrier and also makes it not safe for acne prone skins. We do not use artificial fragrances and avoid essential oils that have a history of phototoxicity. Because our products are 85-100% or more botanical ingredients our products are normally not white, which is something that many consumers and skin therapists are not used to. Our point of difference to other brands is that we don’t use ingredients whose primary focus is visual appearance. Our primary focus is on the efficacy and results. Our treatment philosophy is to keep the skin barrier intact at all costs. We believe that the keratinocyte is the king of communication and forcibly removing it prior to normal desquamation only inflames the skin further. We often see other brands
peeling the skin in order to rectify a skin concern; however, we don’t believe chemical peeling has any place in treatment of the skin. Often the reason why there is a dysfunction has to do with inflammation and our results validate this, so we focus on reducing inflammation within our clinical treatments and our professional home care recommendations. APJ Q5: Let’s talk about angry skin – what are the factors that contribute to skin inflammation and what is your position with treatments that contribute to an inflammatory response in order to achieve skin improvement? Angry skin can be from numerous factors, ranging from barrier disruption to sensitivity to skin ingredients. Barrier disruption is one of the biggest contributing factors. The COVID 19 restrictions with mask wearing, is also contributing to a decline in barrier function. The continual friction and rubbing of masks on the skin is contributing to inflammation being triggered in the skin, which not only makes the skin more sensitive, but also in many, an onset of acne breakouts as a consequence. There are also many cosmetic ingredients that cause issues with inflammation. Surfactants and emulsifiers can integrate into the skin's lipid bilayer and remain there, inciting ongoing inflammation in the skin. The challenge with many people who are APJ 47
struggling with barrier disruption is that the products they are using do not have the right actives to even address the issue. Our modern lifestyles also contribute to inflammation. Pollution particles have been shown to induce oxidative damage and lipid peroxidation of skin cells. Cell phones and computers expose the skin to 900 000 000 000 photos of light, hitting just 1 square centimeter of skin. Exposure to HEV or Blue Light increases the amount of lipid peroxidation and ROS (Reactive Oxygen Species) that are released. The radiation released from cell phones causes a depletion of the natural carotenoids in the skin and a break down in skin barrier function. 30 years ago, the use of mobile devices was nowhere near as prevalent, and exposure did not start until in your midtwenties. Now babies as young as six months are being exposed on a regular basis to blue light with mobile phones often being used as a babysitting device. Our philosophy at Roccoco is that we don’t believe in heat-based treatments. There are so many ways to stimulate collagen, however not all collagen production is created equal. Heat-based treatments such as radiofrequency delivers heat to the dermis at a controlled depth. This heating however can denature collagen which is irreversible. The heating creates scar tissue at the point of contact. Just like you cannot un-cook a steak, you can’t un-cook skin either that has been exposed to heat. Collagen that is produced by this methodology however leans more towards the production of scar-like tissue. Collagen normally should be healthy and the strands should be lined up properly. With fibrotic tissue the fibers are not orientated correctly. They get an immediate flash lift to the skin but over time the skin starts to look “plastic” and does not look normal. Heat based rejuvenation also destroys sweat glands on the skin, making the skin look artificial over time. There are so many other ways to rejuvenate the skin, such as LED therapy and microcurrent therapy which do not produce fibrotic collagen. They also increase the health of the mitochondria of the cells leading to a more refreshed look to the skin. APJ Q6: When it comes to pre and probiotics how do they benefit the skin and what is their role in skin cancer prevention and treatment? The role of prebiotics and probiotics is becoming more common in skincare. Studies have shown that the gut, skin
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and brain are all connected. Gut dysfunction has a direct effect on skin healthy and disease. They originally found that oral consumption of probiotics leads to not only better gut health but better skin health. More recently certain strains of probiotics have been shown to have a positive impact on skin health, affecting the tight junctions of the skin as well as being able to control the overproduction of opportunistic pathogens as well. What they have found is that with actinic keratosis and squamous cell carcinoma, there is an abundance of staphylococcus aureus. The bacteria also have the ability to alter the production of beta defensins in the skin, making the skin more prone to developing skin cancer. Probiotics have a modulating effect on the microbiome, killing off staphylococcus and reducing their population to normal levels. Probiotics have the ability to reduce inflammation in the skin and modulate the immune response of the skin. Prebiotics can modulate human beta defensins in the skin, which have alterations with squamous cell carcinomas. Prebiotics can regulate the development of cancer in the skin. Prebiotics also modulate the commensal population of bacteria on the skin, encouraging the normalizing of overgrowth of strains that have become opportunistic. APJ Q7: What are some new advances in our understanding on delivery systems, molecular size, bio-compatibility (bio-mimetic) and ways that we can contribute to enhanced penetration without traumatising the skin? One of the things that I was shocked at when I became a chemist was the fact that I learnt that creams as delivery systems will trump serums any day of the week. We have always been led to believe that for targeted results a serum is more potent and penetrates better, however unless it has a delivery system such as dimethyl isosorbide, then the same active in an emulsion cream will deliver better results. There was one study were they compared just putting evening primrose seed oil on the skin and the skin benefits where not achieved with using oil alone, but only in conjunction to the ingredient being formulated in a moisturiser. This is important because the number of oils being released on to the market in place of moisturiser use is increasing. Herbs are also able to penetrate the skin easily. Most plants are made up of thousands of chemicals. These components are all less than 500kDa which means they are able to penetrate the skin barrier and be absorbed by the skin. Plant compounds have the ability to interact with the stratum corneum lipids and increase diffusivity of the active across the skin. Aloe vera has also been shown to be a penetration enhancer, with further research being conducted on this. Liposomes were originally considered the ultimate in delivery of actives into the skin and also to stabilise the ingredient and to protect it when present in a formula. Liposomes however have recently been found that they can’t penetrate the skin to the degree we thought they did. This has been uncovered by histological studies, as much of the view that they can penetrate actives deeper into the skin were predominantly anecdotal. What they are discovering is that the moment the liposomal spheres touch the surface of the skin they unload the active ingredient. However, they are not totally useless, as liposomes have been found to help the process of penetration, as well as their phospholipid casing does protect the potency and degradation of the active ingredients within the formula for longer. Biomimetic ingredients are ingredients that mimic the natural functions in the skin. Peptides are a good example. One of the best peptide mimics is the “Botox alternative”, known as Agireline. This peptide mimics the botox-like action and is a chemical replica of a portion of SNAP-25, a protein involved in muscle contraction. The peptide replaces SNAP-25 and muscle contraction is greatly reduced. Plants that have survived extreme conditions, such as halophytes (salt loving) are also biomimetic. They can provide protective benefits for the skin. There are other actives that act on an epigenetic level, switching “on” or “off” genes. One example is a peptide called Chronogen that is a synthetic peptide that acts on the epigenetics for firmer skin. APJ Jacine Greenwood-Drummond ROCCOCO BOTANICLES 07 3807 1429 jacine@roccoco.com www.rococco.com
www.roccoco.com
roccocobotanicals APJ 49
EDUCATION
The Architecture of Facial Ageing Dr Giulia D’Anna Our clients need to understand that some of their concerns originate from multiple changes occurring over these different layers. If we limit our advice to our niche, we are also limiting the possibility of correct diagnosis and outcomes.
STEPPING UP OUR EDUCATION is so empowering – it allows us to gain appreciation and pride in what we do as well as gain confidence in our professional communication with our clients or patients. Expanding our knowledge is also so exhilarating as it opens new horizons of understanding and possibilities. We are so thrilled that Dr Giulia has joined us as our new editor. As an excellent educator, expect some great articles, as she shares her knowledge with us. Often in our daily working lives we come to focus entirely on our area of expertise. We do this in a bid to do the best for our clients as we develop our niche within our industry. We aim to provide our clients with a high standard of care, and we might even devise treatment plans that have multiple steps to get our clients the results that they deserve. For many of us, we focus mainly on the epidermis and dermis layers of the skin, and we do so with high diligence and detail. However, our clients are not just epidermis and dermis, their face is highly complex, with many intricate layers and anatomical structures of high importance. The art and science of client care should extend beyond our own limitations to include a collaborative effort in order to improve the function, integrity and the overall aesthetics of their wellbeing. The modern skincare approach needs to be innovative and inclusive of a broad scope of knowledge. This is where we recognise that as individual practitioners we cannot always provide all the solutions that our clients need. Skin maintenance and facial age-management is multi-layered and multi-tiered. To provide this level of care, it is important that we recognise not only our own strengths, but also our weaknesses. This is certainly true for me. My journey into the skin industry is different than the journey most of you have had. I started out as a dentist for the first 12 years of my career. I went into work every day, focused on my chosen field of teeth and gums. I didn’t see much else and worked away at it for years. And then two pivotal moments changed that for me. I remember both of those moments so clearly, that they could have happened only a year or two ago. The first moment was where a patient presented to me asking me to help resolve her excessive gum display when she smiled. Traditionally this would involve a few years of orthodontic treatment, with intervening oral surgery to reposition the bony components of her face. Not an enticing plan for a 20-something female who just landed her dream job. So, my pursuit for extensive education into non-surgical
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treatment options began. A year or two later, my second pivotal moment happened. Being passionate about everything I do I discussed a treatment plan with a patient that included both her dental and skin needs. However, at that stage I had limited my proposed skin plan to non-surgical treatments, like cosmetic injectables, because that was my scope of knowledge and skill. After listening to my proposed treatment plan, my patient asked me what I was going to do about her pigmentation that she was seeing on her cheeks. Well, what was I going to do? I had no idea because I did not have the education, nor had I collaborated with anyone else. This launched my educational pathway into dermal therapies. It became apparent to me from both of these pivotal moments, that knowing what I know, is not enough. We all need to broaden our scope of knowledge and embrace other practitioners in our treatment plans, to provide all the options and improve outcomes for our patients. So, let’s look at the different layers more specifically, and where other practitioners can assist us in our treatment offerings and broaden our scope of knowledge. STRATEGIES FOR SUCCESS To get real results for our clients, we need to consider their entire face – epidermis, dermis, fat layers, muscles and ligaments, skeleton and teeth. Each layer needs to be considered so that our diagnosis and treatment plan is geared towards stability, improvement of function and maintenance. Not only that, our clients need to understand that some of their concerns originate from multiple changes occurring over these different layers. If we limit our advice to our niche, we are also limiting the possibility of correct diagnosis and outcomes. For best results, they need to accept that a multitiered and collaborative effort needs to be undertaken. The Epidermis The epidermis (Figure a) is an ever-changing and evolving layer. The amazing thing is that the epidermis is only about 0.1mm thick. Without getting overly complicated, the basal layer of the epidermis contains two main cell types. These are the Keratinocyte stem cells and the melanocytes. The keratinocyte stem cells continually divide and push upwards to surface of the epidermis. As the cells move from the basal layer to the stratum corneum at the top, the cells differentiate and change shape, but also pick up melanin pigment from the melanocytes as they go. Finally, once the cells reach the
top surface, they will be shed as renewal continues. This process takes around 28 days when we are young, and is the reason why many of our treatments are timed to be at least one month apart. Another striking feature of the epidermis is that it is completely avascular, meaning that there are no blood vessels or lymphatic tissues within it. The epidermis is completely reliant upon the underlying dermis to receive nutrients, or the application of good quality skin care to receive the elements that it requires for health. As we get older this epidermal skin cycle is very sluggish.
looking lesions on the skin. The Dermis The dermis is comprised of a vast collagen network, which provides our skin with structure. These collagen fibres are a tri-helix of amino acids, interlaced with elastin to hold the collagen fibres together. Elastin provides our skin with the ability to stretch and recoil. In between all of this is a rich mesh of gylcos-amino-glycans (GAGs) or Hyaluronic acid. This is why our dermal tissues can be considered an extension of our lymphatic system. The GAGs readily attract water, providing an ability for fluid bound nutrients to leave the blood vessels and lymphatic tissues located in the dermis, diffusing through the tissues and reaching the epidermis as well. The junction between the epidermis and dermis has ridges or a papillary feature. These ridges serve to increase the surface area between the epidermis and dermis. The greater the surface area between the two layers, the greater the perfusion of nutrients from the dermis to the epidermis. A major change that occurs as we get older is that the interface between the epidermis and dermis flattens significantly (see figure c). As these ridges flatten, the surface area between the epidermis and dermis is significantly reduced, resulting in a reduced ability for any nutrients to reach the epidermis. Not only this, but the activity of the fibroblasts that produce the collagen, elastin and Hyaluronic acid is down-regulated. There is approximately 1% less collagen produced every year after the age of 25 years. This has effects on the structure, stretch and recoil of the dermis, but also the lymphatic ability of the dermis. So simply put, even with the best dietary intake, our skin has a reduced ability to receive the nutrients. It is important that our clients understand this to assume the responsibility of using good skincare, because without it, we cannot achieve the results we need. Figure C.
Figure a > Epidermis and associated desmosome attachments There is a down-regulation in the cycle for a number of reasons. The cellular connections between the keratinocytes are called Desmosomes (see figure B), and these tend to keep the cells plugged to one another for longer than normal. But why is that? Well, the dryer our skin is, the more desmosomes there are. This is an innate protective function of the epidermis to reduce mechanical trauma in the skin by holding it together, but more importantly desmosomes also assist in reducing the trans-epidermal water loss (TEWL) from further drying the skin. Aside from our role in epidermal management, with facials, skincare recommendations, dermaplaning, chemical peels and the like, we may need to consider referral to a dermatologist or skin cancer clinic to inspect suspicious
A. Young skin histological slide showing tightly packed dermal layers, but epidermal-dermal junction with papillary ridges. B. Mature skin histological slide showing flattened epidermaldermal junction, and loose dermal layers. Here we can look after our clients with dermal treatments like skin needling, radiofrequency or laser treatments, just to name a few. But perhaps our clients may also benefit from the advice of a nutritionist to assess their diet, or a cosmetic injector to replace some of the lost hyaluronic acid via mesotherapy, or the like.
Figure B. Electron microscope image of a Desmosome. Kowalczyk, A. P., & Green, K. J. (2013). Structure, function, and regulation of desmosomes. Progress in molecular biology and translational science, 116,
Fat and the hypodermis In youth, our face has a series of fat pads that are plump and connected seamlessly to one another. This creates a beautiful
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smooth skin surface, that is devoid of folds or sagging. The fat is arranged in compartments that are held in place by our ligaments, muscles and overlying skin. As we age, these fat pads start to reduce in size, leaving voids or gaps between them (figure d). This can also occur as a result of repeated muscle activity. These voids create “sink holes” where our skin begins to fold. For instance, the nasolabial folds and marionette lines are a result of the changes and shifting of the fat pads. This is truly important to consider, as there is no epidermal or dermal skin treatment that will alter the fat pad fullness or shape. So, for many skin practitioners, this will fall outside of your scope to treat. To be effective in treating this layer, we need treatments that are aimed at revolumising and restoring this reduced fat pad layer. This is solely in the hands of a plastic surgeon who may use fat grafts or facial implants, or a cosmetic injector that may place dermal filler to restore the lost volume. Figure d: Fat pads illustrated in a daughter and mother, showing
surgeon or the cosmetic injector to try and either reposition these layers or reduce the actions that are undesirable. Skeleton Our young facial skeleton is very robust and prominent. The orbital rims around our eyes are round and small and the forehead is vertical and short. The midface is full and wide, and the mandible or lower jaw sits forward and is wide. The teeth in the maxilla and mandible are fairly straight, and have good height. In a young adult, we would expect there to be at least 28 teeth, and an additional 4 if the wisdom teeth fit into position. The teeth help to provide the lower third of the face vertical height, but also lip support. The teeth provide great function, so that nutrition is optimal. Over time, the skeleton changes considerably. There has been some ground-breaking research undertaken by Mr Bryan Mendelson, a plastic surgeon in Melbourne, Australia, that documented the changes that occur with the facial skeleton as we age (see figure e). The main changes that occur are: 1. The orbits widen and become squarer in shape 2. The nose cavity widens 3. The midface and zygoma (cheekbones) flatten and retract backwards 4. The mandible becomes less prominent and narrows 5. The forehead slopes backwards and the brow bone above the eye sockets becomes more prominent. For our clients, this means that the fat pads and skin around the eyes loses support, creating noticeable tear troughs and under-eye bags. The malar apex (or prominence of the cheek) flattens with the loss of the zygomatic fullness. The nasolabial fold depth increases as the nose cavity widens and loses bone support. The lower face has mores sagging and increased jowls as the mandible narrows and the chin is less prominent. Figure E: Changes in facial skeleton with age. Produced by B.
the fat pad changes over time. Image produced by Allergan Ligament and muscles Our facial muscles and tissues are ‘tied’ to the skeleton at a number of points. These are called true ligaments, where there is a thick fibrous union between the soft tissues and the skeleton. There are three main true ligaments; Orbicularis (eye) retaining ligament, Zygomatic (cheekbone) retaining ligament and the Mandibular (lower jaw) retaining ligament. These points are fairly stationary. From these stationary true retaining ligaments, all other tissues are suspended. The muscles of our face act to provide us with function and expression. The muscles can be categorised in two main ways: elevators (where their action pulls upwards) and depressors (where the muscle pulls down). Both depressors and elevators work in balance of one another. Mendelson.
As we get older, the stretching of the ligaments creates the jowls, under-eye bags and other skin draping. The muscles tend to stretch too, elongating over time. As they do, the elevator muscles that normally pull up are hampered by their length and work less effectively. This means that instead of working in balance, the depressors tend to over-power their counterparts, further exaggerating the skin folds and draping. This is particularly noticeable with the lower half of the face and jaw line.
To alter the facial skeleton, we need to look at our plastic surgeon, or oral and maxillofacial surgeons for assistance. They may add bone grafts or implants to augment the lost bone structure. Hyaluronic acid filler with a high G-prime (thick filler) can be placed on the periosteum (bone surface) to augment the bone, or other substrates may also be used, such as calcium hydroxyapatite injections.
When we look for treatments, these layers are located deep in the skin. Treatments like HIFU may be an option for some of us, but these tissues can be truly targeted by deeper treatments. These largely fall into the hands of the plastic
DENTAL CHANGES With all of these skeletal changes, we see a number of dental changes too. As the lower jaw narrows, the teeth start to crowd and pull backwards. This leads to the upper teeth closing over the lower teeth more. This is a loss in vertical
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dimension (figure f). Compounding this, there may be a loss of teeth over time, and wear of the teeth, resulting in further bone loss and loss of further height of the lower third of the face. So how do we address the skeletal and dental changes? A great consideration is to seek the collaborative advice from a dentist. A dentist is able to rebuild the teeth or orthodontically move the teeth, which will provide support and width to our patients face. The overlying tissues will have decreased folds and sagging as a result.
devise a plan that changes their life. You might have done that already in your career, but there is more work to do. The skin team is expanding, and will continue to evolve and we need to embrace every practitioner’s role in the skin management team. I am beyond thrilled to be working with APAN. I look forward to delivering all skin practitioners more skin science and an expansion of knowledge, from both the dental/medical and dermal spheres. I am looking forward to collaborating with
Figure f: Loss of fullness and vertical dimension in the lower third of the face with dental and bone changes. Overlying skin will drape as these changes occur.
COLLABORATIVE RESULTS To truly take a global approach in facial rejuvenation, maintenance and treatments, we need to collaborate with all our health professional peers. Skin treatment is the responsibility and within the scope of many practitioners in these modern times. Skin is not all lines and wrinkles, nor is it just looking after pigmentation. In fact, these two issues are really only a tiny part of the equation.
you, on our journey together. For me, planning treatment for my clients involves considering all the different layers, and inviting different team members to be involved in producing effective outcomes. Our clients want results, and we are no longer are we singularly responsible. We must broaden our vision and evolve to a larger network, because if we don’t, we might miss an opportunity to embrace change, be innovative, but also to be truly effective.
Collaboration is key to expanding your scope of knowledge and providing excellent clinical outcomes. We cannot be singularly focused anymore if we want to survive. We must diversify and provide solutions for our patients that benefit our personal growth, but also to be wholly complete for our clients. Our clients expect results. They are smart and educated. No longer will our clients accept a partial or suboptimal result. They want more from us, and if they do not get the result, they will research and go somewhere else.
In my new role as editor of APJ, I do hope to meet and collaborate with as many of you as I can. I am passionate about education and delivering safe outcomes for our clients. I am excited to offer insight, qualifications and experience, and invite you to collaborate with me too. APJ
EMBRACE PROGRESS It is time that we all embrace that skin analysis and treatment is the responsibility of the whole team; the client, skin therapists, dermal therapists, nutritionists, dermatologists, cosmetic injectors, plastic surgeons and even dentists. For perhaps the first time, it is time to consider your role in providing dental education and providing referral options as part of your skin treatment plan. Imagine the pure satisfaction that you will bring to both your client and yourself when you
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RESEARCH COVID-19
Study Confirms COVID-19 is Mutating – What
does that mean to You? Tina Viney NUMEROUS STUDIES AROUND THE WORLD are investigating COVID-19 in an attempt to understand its behaviour. Reports in Europe are now confirming that the virus is already mutating. Researchers found evidence indicating that the virus has - under selection pressure - made itself more stable, giving it a “significant boost in infectivity”. This report presents an update on recent findings as conducted by The Scripps Research Institute in Jupiter, Florida.
In the Scripps news release, Farzan said, “more flexible spikes allow newly made viral particles to navigate the journey from producer cell to target cell fully intact, with less tendency to fall apart prematurely. “Over time, it has figured out how to hold on better and not fall apart until it needs to,” he added. “The virus has, under selection pressure, made itself more stable.”
While the COVID-19 pandemic continues to spread throughout the world, new research suggests that a coming genetic mutation within the SARS-CoV-2 coronavirus may make it much more dangerous than it already is. This finding has significant implications for clinical laboratories that perform COVID-19 testing and the in vitro diagnostics (IVD) companies that develop and manufacture tests for COVID-19. The mutation, called D614G, will provide the coronavirus with sturdier spikes that will increase its ability to latch onto and infect cells. That’s according to a study conducted at The Scripps Research Institute (Scripps) in Jupiter, Florida, which found that a mutated coronavirus may be up to 10 times more infectious than the original strain. “Viruses with this mutation were much more infectious than those without the mutation in the cell culture system we used,” said Hyeryun Choe, PhD, Professor, Department of Immunology and Microbiology, Scripps Research, and senior author of the study. Professors Choe and Michael Farzan co-chaired the study at the Department of Immunology at Scripps Research, as well as co-authored the study, titled, “The D614G Mutation in the SARS-Cov-2 Spike Protein Reduces S1 Shedding and Increases Infectivity.” Their work is currently under peer review. A MORE FLEXIBLE AND POTENT CORONAVIRUS MAY BE COMING The researchers found that coronavirus particles containing the mutation tend to have four to five times more functional spikes than particles without the mutation. The spikes enable the virus to bind to cells more easily. The research suggests that the greater the number of functional spikes on the viral surface the greater the flexibility and potency of the coronavirus.
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The image above, taken from the Scripps Research news release, shows “a cryogenic electron microscope image of a SARS-CoV-2 spike protein side view, the S1 section of the spike is shown in green and the S2 portion is shown in purple. This unique twopiece system has shown itself to be relatively unstable. A new mutation has appeared in the viral variant most common in New York and Italy that makes this spike both more stable and better able to infect cells.” (Graphic and caption copyright: Andrew Ward lab, Scripps Research.) MUTATION MAKES SARS-CoV-2 Coronavirus ‘Much More Stable’ The two Scripps scientists have studied coronaviruses for nearly 20 years and performed extensive research on the Severe Acute Respiratory Syndrome (SARS) outbreak that occurred in 2003. They noted that there is a difference between spike proteins of SARS, an earlier strain of coronavirus, and the new SARS-CoV-2 strain. The protein spikes of both strains were originally tripod shaped. However, the spikes of the SARS-CoV-2 coronavirus are divided into two different segments: S1 and S2. According to the published study: “The S1domain mediates receptor binding, and the S2 mediates downstream membrane fusion.”
This feature originally produced unstable spikes, but with the D614G mutation, the tripod breaks less frequently, which makes more of the spikes fully functional and the virus more infectious.
Further studies will be necessary to determine the impact of this change on the nature and severity of COVID-19,” the Scripps researchers concluded. However, not all Scripps researchers agreed with the conclusions of Choe and Farzan’s research.
“Our data is very clear, the virus becomes much more stable with the mutation,” Choe said in the news release.
The Time of Israel reported that Kristian Andersen, PhD, a professor in the Department of Immunology and Microbiology, Scripps California Campus, stated that “other analyses of virus variants in labs had not found significant differences in infection rates.”
IS COVID-19 SPREAD DUE TO ‘Founder Effect’? The scientists also examined whether the spread of COVID-19 could have been the result of the “Founder Effect”, which is seen when a small number of variants fan out into a wide population by chance. Could the founder effect explain why COVID-19 outbreaks in some areas of the world were more severe than others? The researchers believe their data definitively answered that question. “There have been at least a dozen scientific papers talking about the predominance of this mutation,” Farzan said. “Are we just seeing a founder effect? Our data nails it. It is not the founder effect.” The scientists at Scripps Research however, explained that their research was performed using engineered viruses and that their observations of the virus and its mutation may not translate to increased transmissibility when a virus attaches to a host outside the lab. COVID-19 and its mutation appear to be relatively stable and are mutating at a rate slower than that of the seasonal flu, which may be critical factors in the development of a vaccine. FINDINGS RAISE FURTHER QUESTIONS ABOUT COVID-19 CORONAVIRUS Nevertheless, the two scientists are curious about some of their findings. “Our data raise interesting questions about the natural history of SARS-CoV-2 as it moved presumably from horseshoe bats to humans. At some point in this process, the virus acquired a furin-cleavage site, allowing its S1/S2 boundary to be cleaved in virus-producing cells. In contrast, the S1/ S2 boundary of SARS-CoV-1, and indeed all SARS-like viruses isolated from bats, lack this polybasic site and are cleaved by TMPRSS2 or endosomal cathepsins in the target cells.
“That’s the main reason that I’m so hesitant at the moment,” Andersen said. “Because if one really was able to spread significantly better than the other, then we would expect to see a difference here, and we don’t.” Times of Israel also reported that in late May researchers at the University College, London said their studies of the genomes of more than 15,000 samples had not shown one strain being more infectious than others. So, the jury is out. Nonetheless, clinical laboratory leaders will want to remain vigilant. A sudden increase in COVID-19 infection rates will put severe strain on already strained laboratory supply chains. WHAT CAN WE DEDUCT FROM THIS? There is no doubt that COVID-19 is mutating, whether this will result in a higher rate of transmission or not, will need to be proven. What we do know is that we need to step-up our understanding of its behaviour and employ evidence-based protocols to protect ourselves, our families and our clients. What is important here is that we stay educated, informed and access accurate information as it comes to light. APAN is stepping up all efforts to ensure you are kept up-to-date and that you stay protected. APJ Related Information: Study: Dominant Form of Virus ‘10 times’ More Infectious than Original Strain Mutated Coronavirus Shows Significant Boost in Infectivity The D614G Mutation in the SARS-CoV-2 Spike Protein Reduces S1 Shedding and Increases Infectivity
“In summary, we show that an S protein mutation that results in more transmissible SARS-CoV-2 also limits shedding of the S1 domain and increases S-protein incorporation into the virion.
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REGULATIONS
UPDATE ON STANDARDS
NON-IONIZING RADIATION FOR COSMETIC PURPOSES Dr Michael K Molton
President – Cosmetic Physicians College of Australasia Information was presented on the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) website alerting to recently published Statement on Nonionizing Radiation for Cosmetic Purposes published by the International Commission on Non-ionizing Radiation for Cosmetic Purposes (ICNIRP). In this article Dr Molton will highlight key aspects of the Statement and draws some conclusions for consideration. COSMEITC DEVICES using non-ionizing radiation (NIR) are increasingly available both for professional and home use for the purpose of modifying appearance for aesthetic purposes. There are a wide range of NIR modalities used for cosmetic procedures, including devices that use optical radiation (Laser, IPL and LED), electromagnetic fields and ultrasound. As we know, common procedures involving the application of NIR include epilation, skin rejuvenation, body sculpting and contouring, treatment of vascular and skin lesions, tattoo removal and scar reduction. The majority of research on the use of NIR cosmetic devices however, has focused primarily on the efficacy of the treatment, rather than potential adverse effects or complications. Studies assessed safety considered mostly of individual case reports or small case series. The most common adverse effects that have been identified are erythema, swelling and changes in pigmentation. Less common, but more severe side effects however, include burns, blisters, scarring, persistent erythema, altered pigmentation and eye damage. Some of the latter may have resulted from treatment error. Particular group of people that may be at greater risk from optical radiation include people of dark skin with high sun exposure and taking photosensitising medications or supplements. There is a lack of sufficient studies review the evidence for the safety profile of cosmetic NIR procedures. These include
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risks during pregnancy. Reports of injuries to workers administering treatments with cosmetic NIR devices are rare, but inadvertent damage to the eyes from optical devices may occur. Further randomised controlled trials are still required to fully assess potential adverse effects from the use of NIR cosmetic devices, however this report alerts to areas for safety consideration, as well as the current regulation, (or lack of) and the present global status in this regard. Regulation varies world-wide and some regions apply the safe classification and guidance as for medical devices. In order to reduce harm associated with the use of cosmetic devices, ICNIRP considers it important that regulations that cover all types and frequencies of cosmetic NIR devices are adopted world-wide and that there is a greater oversight regarding their use. ICNIRP) has further identified a lack of knowledge regarding possible adverse health effects from cosmetic use of NIR. In this Statement cosmetic use is defined as the voluntary use of NIR to address perceived problems of appearance for purely aesthetic reasons. Accordingly, ICNIRP has based their Statement regarding adverse health effect of the spectrum of cosmetic devices that employ NIR, including electromagnetic fields (EMF) with frequencies up to 300 GHz (wavelengths down to 1nm to 1mm and ultrasound with sound frequencies of 1-40MHz. The aims of this Statement were focused on three specific areas: •
Review of the range of cosmetic devices employing NIR that are currently in use.
•
Description of potential risks to the health of persons undergoing cosmetic procedures with these devices, as well as the health of the person administering cosmetic NIR-based treatments.
•
Identifying situations of potential high NIR exposure during cosmetic procedures where protection may not be adequate.
LIST OF TECHNOLOGIES APPLYING NIR FOR COSMETIC PURPOSES AND THEIR REPORTED ADVERSE EFFECTS This Statement provided a comprehensive list of technologies that utilise NIR for cosmetic purposes. The technologies and modalities were: •
Lasers: Nd:YAG, Er:YAG, Q-switched Alexandrite, PSL, KRP, CO2 and Diode Laser
•
IPL
•
LED
•
Low-frequency and Radiofrequency EMF for skin rejuvenation and body shaping
•
Ultrasound
•
Combined technologies: Optical (laser), IPL, Infrared + RF current
•
Optical combinations
•
Home use: Laser, IPL and LED
Individual reports were also presented in this Statement on each of the above modalities presenting current studies and identified risks. The list also provided valuable information outlining the following: •
Identified each modality
•
Outlined the treatment that each modality provided
•
Outlined the appropriate wavelengths and frequencies
•
Allied energy power of each modality
•
Adverse effects reported.
GLOBAL REGULATION The global review on regulation of NIR from cosmetic devices was subdivided into two categories: a. Regulation governing device marketing and consumer safety (safe design, protection of clients and users), and b. Regulation governing the health and safety of the workers in clinics and beauty institutions that operate the devices. The countries and regions that were reviewed included: the European Union, United States, China, Japan, South Korea, Russian Federation and Australia. For the sake of this report I will only present their findings as they relate to Australia. Australian Regulation for Device Marketing and Consumer Safety In Australia it was noted, there is no uniform national regulation for the use of NIR-emitted devices for cosmetic purposes. Three out of eight Australian states and territories require license for use of laser for cosmetic application. These are Queensland, Western Australia and Tasmania. Tasmania also requires a license for the use of IPL devices. The remaining states have no mandatory regulation requirements. The TGA in Australia is also involved in reviewing and approving safety reports of imported lasers and IPLs for cosmetic purposes. There is no regulation for the use of radiofrequency or ultrasound cosmetic devices in any state. There is also no radiation protection standard for home-use devices. In 2019, ARPANSA, through collaboration with the states
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and territories of Australia, published advice for the use of light-based cosmetic treatments performed by lasers, IPLs, and LED phototherapy. The advice promoted safety in the delivery of cosmetic services by focusing on good practice for cosmetic treatments provided and risk awareness for consumers. International standardisation organisations, such as International Electrotechnical Commission (IEC) and International Organisation for Standardisation (ISO), and in Europe, the European Committee for Electrotechnical Standardisation (CENELEC), have developed technical standards with specifications for safe design and assessment of exposure of clients or workers to NIR from medical and cosmetic devices. These can be harmonised with government regulations to provide a means of assessing compliance with the regulatory requirements, for example, those of the EU regulation on medical devices. For TGA listing of these devices these standardised registration are of benefit and are taken into consideration when applying for registration. Regulation for Worker Health and Safety In Australia, ARPANSA’s national advice for cosmetic treatment also provides information for common standards of aid in managing risk to personnel performing treatments. States that require licensing include laser safety qualifications are Queensland, Western Australia and Tasmania. However, industry societies and standards bodies such as APAN, highly recommend that all practitioners in states where no regulations apply consider completing a Laser Safety Officer’s qualification as a safety and best practice measure. IN CONCLUSION Cosmetic devices that use NIR for the purpose of modifying appearance have become well established. These devices achieve their outcomes through the deposition of energy into specific target tissues. While there are individual modalities there are also devices that combine different modalities. In addition, to these devices being employed in a clinical setting or by treatment providers, there are also some available for purchase by individual consumers for home use. The homeuse devices are typically lower-powered however, they still carry a level of risk if used inappropriately. By its nature, the application of energy to biological tissue at levels high enough to cause an effect presents a potential adverse health effects to occur, so a level of risk does exist for all devices. These adverse effects of the treatment can differ based on the modality of use and can be transient
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or permanent. While permanent adverse effects are rare, they can occur. Less common, more severe side effects include burns, blisters, scarring, persisting erythema, altered pigmentation and eye damage. There are also reports what adverse effects can also be due to clinical error (incorrect diagnosis) or device misuse (incorrect energy settings or wrong device for indication), resulting in avoidable and serious health complications. This points to the need for adequate and comprehensive education and training for practitioners. The Statement also identified that certain groups are at particular risk from these cosmetic treatments. These groups include people with darker skin (Fitzpatrick skin type IV-to-VI), pregnant women, individuals with high sun exposure, people taking photosensitising medications or supplements and people with particular medical conditions. The increase risk proposed for certain groups was generally specific to the use of light-based treatments. Of higher concern for occupational exposure is injury to the eyes both from direct exposure and from reflected light. Another risk to consider is the indirect effect of air contamination when using lasers for cosmetic treatments. It was noted that within the scope of countries included in this Statement, there was extensive and significant regulation variation of NIR cosmetic devices across the world. This is an important consideration especially if purchasing devices from other countries. Currently in Australia there is a general lack of consistency in regulation as only three states out of eight jurisdictions regulate the use of these devices for cosmetic purposes, so protection of workers and clients applying NIR treatments also varies. This puts the onus on both the device supplier companies, as well as practitioners, as where mandatory regulation does not exist to enforce compliance, the issue ultimately comes down to best practice. Be guided by your society or standards body with regards to best practice as a duty-of-care. APJ If you are a practitioner of any of these modalities or a supplier, this Statement is considered recommended reading. If you wish to access the ARPANSA National Safety Advice, as well as the ICNIRP Statement that relates to this report here is the link https://apanetwork.com/resources/
COSMETIC MEDICINE
Reviewing Advances in the Non-surgical and Surgical Landscape An interview with Dr Naveen Somia
AS PART OF A REGULAR contribution to APJ Journal we caught up with Dr Naveen Somia, President of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) for an update on new advances in the surgical and non-surgical arena. APJ Q1: We have seen knowledge and new innovations increasing at a rapid rate in the past 10 years within our industry. How have these advances contributed to consumer expectation when it comes to cosmetic surgery versus non-surgical solution? During the past 10 years we have seen many changes in Medical Facial Aesthetics. While historically, surgical solutions were accessed as the standard procedure, the options through new innovative technologies have substantially broadened what we can offer. Consumers, particularly in the affluent community, are seeking on-going solutions and especially in non-invasive, or minimally-invasive solutions. These include pre-rejuvenation as well as more comprehensive rejuvenation treatment outcomes. The industry growth is now estimated at 7-9% and is largely consumer-driven. Non-surgical modalities including neurotoxins, fillers and cosmeceuticals, are in high demand. If you attend our conferences you will find that every company has each year something new to offer to cater for the significant growth of the industry. There are now so many options with various capabilities. Meanwhile, surgical solutions have not dropped, they are still in high demand with the most popular being breast augmentation, followed by liposuction and eyelid surgery coming in third. While the choice in non-surgical is extensive it does have its limitations. Non-surgical procedures are excellent for candidates who are too young for surgery, on the other hand there are other situations when fillers can only offer a limited result and a more invasive procedure will be needed. If you are skilled in both, you can ascertain what will provide the best solution and this may not necessarily be determined by age.
APJ Q2: What are some exciting new advances in Cosmetic Medicine that you believe will contribute to safer and more natural cosmetic enhancement procedures? There are so many exciting new developments in both the surgical and non-surgical space. We are seeing companies investing extensively in R & D to compete and contend for this growing market sector, resulting in credible solutions that are scientifically validated. We are seeing more sophisticated cosmeceutical products, new advances in lasers that can deliver more sophisticated treatment outcomes and new technology for fat grafting. Very impressive skin rejuvenation results can now be achieved through stem-cell therapies, while new advances in technology are allowing us to achieve better results with hair transplants. Not just in the non-surgical arena, but also in the area of surgery we are seeing new improved technology that allows for procedures to be anchored and heal more rapidly. Another area is skin tightening after liposuction, the advances are endless providing multiple levels that we can achieve more sophisticated solutions. APJ Q3: With the on-going advances in education and conference program do you believe that Australia can compete on the global stage, or do you believe that the US and Europe is still leading the way in Cosmetic Medicine? This is a great question. I honestly believe that since we established a collaboration of four not-for-profit medical societies, we are able to deliver world-class education that is second to none. We are able to access the very best from Europe and the USA as well as globally and deliver highquality education that is second to none. The quality of our content is world-class and our non-surgical education is also growing from strength-to-strength. This is all for the benefit of the patients as they can access skilled and educated practitioners that are up-to-date with leading techniques. APJ
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PRODUCT PROFILE
ALPHA SYSTEM
The First of its Kind Multifunctional, Premium Standard Light-based Technology with Optimum Safety and Efficacy
AS TECHNOLOGICAL INNOVATION evolves, new-generation equipment is providing not just safer devices, but also more efficient with multi-functional capabilities. This makes them also affordable as they can perform many tasks from the one platform. Another key advantage is that they are compact, less bulky and easier to move around. ClinicalPro recently released the amazing Alpha System. This device combines Diode Laser permanent hair reduction and IPL dermal treatments. It combines the two most in-demand technologies in a single device. The Alpha system provides over 20 clinical indications that will help you expand your treatment service and grow your business. This article further explains important information about this technology. Introduction FormaTK Systems Ltd, an Israeli manufacturer, is a global technology innovator and developer of medical aesthetic devices. Founded in 2008 by a group of industry veterans, FormaTK Systems’ goal is to empower practitioners through technological design by introducing a sophisticated product range that sets new standards in guaranteed results, quality, innovation and safety. Diode Lasers - 30x15mm(3Hz) and 12x10mm (10Hz) In the past few years, the introduction of Diode Laser technology has seen the industry move towards “platform technology” with various wavelengths including 807nm, 810 nm, 940nm, 1320nm and 1064nm that are now available for various treatments on the one platform.
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NEW DESIGN AND ENHANCE FUNCTIONALITY Diode Lasers possess all the characteristics seen in the various lasers mentioned above, but are engineered from semi-conductor plates stacked together with an optical grove to produce the lasing action. They only require a low voltage to energise them up to 10Hz and therefore do not need the larger power supplies required by traditional laser systems. Diode lasers are generally delivered to the tissue via a sapphire block, which is pre-cooled to protect the epidermis. They are small compact units that can be easily fitted into the delivery handpiece and these are taking the industry to new dimensions for its delivery speed and guaranteed results. One of the most recent, exciting and affordable innovations in Diode Laser technology is the Alpha system developed in Israel which combines 3-D IPL, with 808nm diode laser for up to 3 million shots. Interestingly, Dr. Shraga, one of the chief scientists behind this innovation, is part of the original team behind the development of the world’s first IPL systems. This innovation allows treatment plans to be tailored to the individual patient’s requirements. (see below)
Dr. Kevin Williams with over 30 years of experience within the medical laser industry was a member of the original team that was responsible for the invention of laser hair removal. He has studied electronics and laser engineering and is a researcher on numerous laser technologies and applications. He says he has used the Diode 808nm Laser with a pulse duration of 50ms and can confirm that he has seen incredible results of hair removal on a male’s back with active tan after only two treatments. INCREDIBLE SAFETY AND EFFICACY The Alpha 808nm Diode Laser is one of the first systems that is suitable to treat all skin types including skin type VI. This is due to its flexible pulse durations from 5ms to 400ms and chilled tip cooling system. Clinical trials in Israel showed an 86% clearance of hair removal after three treatments; many UK users are reporting
excellent results after only four treatments with lighter coloured hair. Platform lasers are already a reality, something which could have only been dreamt of 30 years ago. Who knows what the next 30 years will bring but one thing is for sure – the flexibility of Diode Lasers will be at the heart of the next generation, so the future is very exciting! LASER SOLUTION FOR DARKER SKIN TYPES The gap in the market for the treatment of darker skin types has now been effectively filled not only with Nd:YAG lasers (1064nm). but also with the 3-D IPLs in the Alpha system. With its wide spectrum of light from 400nm to 1200nm and its deep penetration power they were able to target and destroy the bulb of the hair inside the hair follicles, making Laser Hair Removal an easy treatment to sell. 3-D IPLs IN ALPHA SYSTEMS Another major milestone in the market was achieved when Dr. Eckhouse and Dr. Shraga from Israel introduced the Intense Pulsed Light (IPL) system. Unlike a laser system, this emitted a wide spectrum of light from 400nm to 1200nm. Optical filters were used to block out lower wavelengths enabling the IPL to be used for different applications. One of the great advantages of the technology was the fact that the energy could be delivered through a pre-cooled Sapphire block enabling the operator to press into the tissue, increasing the absorption of the light into the hair follicle. The early IPL systems were introduced to treat various vascular and pigmented lesions and were later developed for hair removal. The cheaper manufacturing costs and reduced development times opened the door for many companies to enter the market and moved the hair removal business into the high street. Unfortunately, large variations in specifications meant that hair removal results with IPL were not always as good as those seen with laser systems, with some clinics reporting upwards of 15 treatments with IPL. For most clinics today the 3-D IPL is a great tool as it is now the first choice for the treatment of fine or fair hair and also for general facial rejuvenation where the client’s concerns are mainly redness or reddish pigmentation known as Poikiloderma.
to be at the forefront of light-based aesthetics using a comprehensive solution – one device equipped with 3-D IPL and/or 808nm Diode Laser, two of the most in-demand technologies. The New Alpha offers astonishing treatment speeds e.g. full back hair removal in just 7 to 10 mins, with a very personalised treatment approach using a melanin meter for testing the density of the melanin in each area of treatment. The Milo (or melanin meter) is used prior to any treatment to diagnose and evaluate the patient’s skin, giving the operator an easy 3-step program to follow: 1. Measure the density of the melanin in the area being treated 2. Obtain the reading (from 1 to 100) from the melanin meter 3. Feed this number into the machine. The machine automatically selects the suitable parameters to be used for that area. This provides a scientific method for setting the treatment specifications in Hair Removal or Photo-Rejuvenation procedures, thereby making it a safe, easy and personalised procedure to suit your client’s skin type and treatment stage (see below).
In difficult times such as we are going through now, when most businesses are experiencing some kind of hardship, the choice of specialisation in one or more areas is becoming the new normal. Those operators who are experienced in IPL treatments only will now be able to move easily into 3-D IPLs allowing practitioners to
select from the 5 Treatment modes (see left. This is the most accurate treatment approach for optimal comfort and results. They can just concentrate on either the 3-D IPL handpieces which have the following modes (as seen in fig. 2) or the Diode Laser only (suitable for all skin types I to VI), or use both (3-D IPL and Diode Laser), depending on their investment budget at the time. UNSURPASSED RESULTS The NEW Alpha system is the ultimate choice for the modern clinic that wishes
This 3-step program makes training new staff very easy and less stressful for the business owner as all treatments are very reliable and parameters are scientifically chosen to produce the best results for the patient. Using the Milo eliminates any guesswork or doubts about the client’s skin type or sun exposure, removes the possibility of operator-fatigue errors and produces great results irrespective of the staff’s prior experience. APJ For more information visit www. clinicalpro.com.au free call 1800 628 999 or mail ask@clinicalpro.com.au.
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COSMETIC MEDICINE
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SkinMD Seattle
Laser and Aesthetic Medicine Tina Viney FOR THOSE THAT KNOW ME research is one of my passions, so whenever I visit another country, I am always keen to investigate a noteworthy salon, clinic or spa as part of my on-going global review and research of services, standards and operations, as well as their approach to client/patient care. So, as Seattle, Washington was on the cards at the end of last year, I researched my options. I finally settled for SkinMD Seattle Laser and Aesthetic Medical Clinic as it offered a broad spectrum of treatment options for skin, face and body, both for men and women, as well as being supported by excellent patient reviews. My appointment was with the clinic’s Director, Dr Balogun – a facial plastic surgeon, who completed her medical doctorate at Drexel University College of Medicine in Philadelphia, followed by Otolaryngology Head and Neck Surgery (ear, nose and throat, facial plastics and reconstructive surgery) specialty training, and further post-grad studies in New York City. Dr Balogun introduced her practice in Washington State in 2000 and over the past 20 years she had established a highly respected reputation. As part of my interview I was thrilled that I was given consent to sit in on a consultation with a patient to review the whole process, which was an added bonus. Starting with a master medical aesthetician, each patient is first required to complete a medical consultation form followed by a thorough skin consultation process, which in this case was conducted by master aesthetician Stephanie Wilson. This process included a VISIA Skin and Complexion Analysis – a thorough skin examination that covered eight areas including texture, wrinkles, pores, UV damage and other forms of skin
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discolouration, red areas (vascular and inflammation), as well as porphyrins to investigate the skin’s bacterial activity. The results were then discussed in detail with the patient and a full printout of the imaging was then presented to the patient and also to the physician. IDENTIFYING THE ROOT CAUSE The patient was then taken to another room and introduced to Dr Balogun who conducted a further examination and took additional photos. After a thorough and in-depth discussion with the patient to determine expectations and concerns, she presented potential options explaining how they would provide an appropriate solution. I was particularly impressed in how Dr Balogun specifically focussed on educating the patient, helping her understand the origin of the problem – in this case the weakening of collagen and elastin architecture of the underlying structure that was contributing to ptosis of the lower facial features. While the patient was hoping for fillers that could offer an immediate lift Dr Balogun took a more comprehensive approach, recommending a solution that would actually strengthen and built on the structural integrity of the underlying tissues providing greater support to the features and contribute to a more natural solution to the problem. I was also very impressed with the warmth and ease in which Dr Balogun connected with the patient, providing valuable strategic education through a gentle, well-articulated approach that contributed to the patient gaining immediate trust and confidence in her. Her recommendation was for PDO thread lifting, explaining that this would provide a more ideal solution to the ptosis through a treatment that would help restore collagen and elastin, as well as hyaluronic acid and in doing so, contribute towards a more natural and youthful lift. PDO threads procedure offers a complete minimally invasive, non-surgical facelift that uses absorbable surgical sutures made from polydioxanone (PDO). “Using these PDO threads, we will lift sagging skin on the face and neck, improve cheek shape and contour, improve jawline contour, as well as reduce facial wrinkles under the eyes and around lips”, Dr Balogun said. HOW DOES PDO THREAD-LIFTING WORK AND WHAT CAN YOU EXPECT FROM THE PROCEDURE? Thread lifting has come a long way since this procedure was first introduced over a decade ago. In the past, thread lifts used to involve surgery and became associated with undesirable side effects such as infections and thread breakage. However, today the thread lifting procedure has radically changed. PDO threads are new-generation threads that are actually finer than a hair strand. There are no incisions or cuts involved as the threads are injected into the treatment area using a fine needle. They are biocompatible, absorbable surgical sutures that are inserted into the subcutaneous layer of the skin, instantly toning and tightening the skin in the treated area. As PDO threads contribute to neovascularisation they improve skin texture. The procedure also stimulates new collagen and elastin production, supporting and restoring skin integrity. After their insertion, it is suggested that you may experience some temporary side
effects, including mild swelling, redness, and/or bruising in the treated area. These side effects typically subside on their own within a few days of your treatment session. Most patients see an immediate improvement in the treated area - a smoothing of wrinkles and fine lines, improvement in facial volume, lifting of loose and sagging skin, and an improvement in skin tone - within four to six weeks of their treatment session. PDO threads can also treat forehead wrinkles, marionette lines, vertical lip lines, as well as bags under the eyes.
SkinMD Seattle also provides their patients with a “membership” option that allows them to gain financial greater value for their dollar, as well as exceptional results. Their objective is to foster an on-going relationship with their patients based on trust.
Four to six months after the PDO threads have been implanted, they will totally disappear through simple hydrolysis as they are absorbed by the body, leaving behind the new collagen. Results can last two years or even longer so they are a great option for skin and facial rejuvenation and lifting. As this procedure is minimally invasive, patients can drive home straight after the procedure, which is also an advantage.
OTHER SERVICES SkinMD Seattle has a strong emphasis on skin health and provides a comprehensive array of skin treatments including their own Balanced Facial Rejuvenation procedure, exfoliating peels, laser and light-based therapies, microneedling and micro-infusion treatments. They also provide a wide selection of fillers and even PRP Hair Restoration for men and women, as well as scar reduction therapy, body contouring treatments, stretchmarks reduction and laser hair reduction and much more.
In order to achieve optimal results, SkinMD Seattle recommends the on-going use of medically recommended skincare formulations and skin-supporting treatments such as daily UV protection, following a PDO thread lifting procedure. Despite Seattle having long, cold and often snowy winters and short, mild summers, sunscreen is the priority recommended skincare, as it is reported that skin cancer is still prevalent in this state. What age group is best suited for threads? This treatment is recommended for men and women from 25 years of age and older who are interested in tightening and lifting loose or sagging skin on the face and neck and in improving overall facial contour. I asked Dr Balogun if there was an upper age limit for procedure, however she confirmed that the deciding factor is the quality and density of the skin and not the age of the patient. Once the threads had achieved their rejuvenation objectives, Dr Balogun would then consider if further improvement is warranted through the addition of a small amount of fillers for further lifting. In exploring trends, Dr Balogun confirmed that consumers today are well-informed of their options, however, the natural look that refreshes the appearance is by far the most popular with a common statement made, “I don’t want to look like a woman from the TV “Housewives” program, who look obviously enhanced.” “We always start by improving the quality of the skin,” she said. “On this foundation we can then build by providing further improvement, enhancing one’s appearance through the various techniques and technologies that are now available,” she said.
As a committed medical practitioner, Dr Balogun favours attending professional development conferences and training in Europe – they are her preferred option as in her opinion, Europe leads the way in aesthetic medicine. Her natural and confident manner impressed me and put me immediately at ease, making me feel as if I was speaking to a colleague, or friend – an endearing quality that I am sure contributes to her success with her patients. APJ SkinMD Seattle Laser and Aesthetic Medicine is located at 2611 NE 125th Street, Suite 228 Seattle, Washington Ph: (206) 202-8619 care@skinmdseattle.com APJ 65
PROFILE
Achieving
an Academic Milestone Tina Viney interviews Professor Terry Everitt I DON’T THINK THAT MANY in the aesthetics industry realise that a great deal of the high educational standards that we currently enjoy in Australia have come about because of Terry Everitt’s unwavering commitment to educational excellence. An avid lifelong scholar, Terry holds qualifications in aesthetics, a Bachelor of Health Science (Aesthetic Therapies) as well as a Masters in Education. Having known him for over 20 years I have sat with him on many occasions as educational units were promoted with at least two degrees, and numerous other qualifications. A regular speaker at aesthetic and cosmetic medical conference both in Australia and the US, Terry’s educational delivery is always of the highest standard. For over two decades he has been a regular contributor to educational articles that are based on comprehensive scientific studies and has had over 100 articles published in numerous journals and magazine. Within APJ alone, he does not only regularly submit articles, but he is also the author of the Scientific News section of this journal. Recently, Terry was awarded a professorship from the Scentia Academic Board of higher education (tertiary). The Board reviewed his extensive contribution to education over the years and unanimously agreed to award him the first ever professorship of Aesthetic Science. I am delighted to share this exciting news and to congratulate Terry for this welldeserved achievement. In this interview he shares some interesting information of his journey in the amazing world of aesthetics. APJ Q1: Share with us your professional background and experience in the US, and perhaps some highlights of your professional life there? I have had three primary career paths – nursing, hospitality, and aesthetics. I started in aesthetics in Los Angeles, but I was always drawn to the clinical side, as opposed to the salon or spa areas. I believe this was due to being at the right place, at the right time, as I worked in a clinic that was way ahead of its time, having a multi-discipline team of practitioners –
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chiropractors, acupuncturists, various massage modalities, Chinese medicine, general physicians, and dermatology residents. The clients went from Western medicine to ‘alternative’ medicine with treatments in the one visit, so I learnt a great deal from that situation. The dermatology residents who were just out of college were ready to do anything. This was the early 1990s and it was a time of much excitement in the cosmetic arena. I was there when Carbon Dioxide ablative laser and Botox ™ came into dermatology and the move to non-collagen dermal fillers. On the surgical side, the beginning of tumescent liposuction and SMAS face lifting techniques were starting to feature. These are all very commonplace now, but then, this was the new frontier that I was lucky to be interacting with. At that time, the ‘paramedical esthetician’ was becoming a speciality in the USA, and I started lecturing on such subject matter for esthetic and medical conferences (using the American spelling here), which became almost a fulltime job with the different groups, as I was involved with so many conferences across the USA. This work was not all clinical however, as I was also a CIDESCO International Examiner, so I was lucky to go to Europe several times in that capacity and travelled all over America. In about 1991, I decided I was doing esthetics in a clinical situation, so I called myself a Clinical Esthetician. This name has taken off and we now have it also in Australia, as it clearly describes what the position is. APJ Q2: Prior to the Pandemic lockdown and travel restrictions, you regularly travelled to the US and spoke at conferences there. How would you compare the Australian standard of education compared to the US regarding the aesthetics industry? I came to Australia in 1999 initially to set up an ‘Interfacing’ program between beauty therapists and doctors, which went well. Then another contract came up, and I stayed a lot longer than I thought. For a few years, I was commuting between
Sydney and Los Angeles every few months, due to my work in both countries, until I finally decided to base myself in Sydney. The educational structure between the US and Australia is vastly different. In the US, each state controls the education of estheticians (beauty therapist) and cosmeticians (hairdressers), with a great deal of variance from stateto-state. Some states have no standardised training requirements, which is of great concern. On the other hand, other states, such as California and New York require 600 hours to train as an esthetician, Alabama in comparison requires 1500 hours and Florida 260. So, there is significant variance in training hours. They then need to sit a practice examination to get their esthetic license. These licenses are only recognised in the state of licensure, so if you cross state borders, you must reapply for a license in that state, although a small number of states now allow licence transfers. Due to the variance of hours required by different state boards, as well as training hours, which are vastly different, I would have to say that generally speaking their training is nowhere near to the standard you will find from an Australian Diploma of Beauty Therapy. In California, for example, an esthetician is not permitted to: Tint or dye eyelashes or eyebrows, shave a client’s face (dermaplaning), use medium-grade or medical-grade skin exfoliants, or use any laser, regardless of its known health benefits. They are not allowed to remove superfluous hair by the use of light waves or remove skin tags or moles. Strangely enough, they can perform microdermabrasion and apply eyelashes (but cannot tint them). The use of equipment is very limited in American esthetics, unlike the situation in Australia. Due to this confusion within the states, so-called postgraduate training has a significant uptake with many cosmetic brands delivering their education and training within major conferences and conventions that are usually staged in multiple cities. In contrast, as Australia has the National Training Package, at least in theory, an employer can have some understanding what to expect from a graduate and what modalities they are capable of performing, based on the qualification level they hold, In Australia, we have a level of uniformity across all States due to the National Training Package which was introduced in 1998, I find however, that post-graduate training is not as big nor as developed here, as in America. Aesthetic education remains on a continuum in Australia. From the original self-accredited Beauty Colleges and Academies through to Registered Training Organisations delivering the National Beauty Training Package and the ongoing improvements in the Vocational and Training Education sector, moving through to the university sector Bachelor and Associate Bachelor degrees, education is very diverse and constantly changing. Overall, I do believe the general education of therapists is more outstanding in Australia than in America. Of course, Australia is well ahead of any country in terms of the number of university degrees available. Only two other countries I am aware of have aesthetic degree qualification, while America has none. APJ Q3: Why are current qualifications and knowledge so important to you? Truly, staying current in your knowledge and pursuing to enhance your qualifications is a mark of professionalism.
Ownership of one’s abilities and dedication to maintain their currency of knowledge, not only in techniques and products, but also enhancing your knowledge to be able to determine the best possible way to create a customised directive and care for each client, each and every time, is truly part of being a professional. Knowledge gives one the ability of independent thought. The more we know the more we will be able to expand our ability to assess and improve the tasks and results that we are performing in our practice. Ongoing knowledge acquisition will allow us to develop new treatment protocols through a greater understanding of how things work. We will gain the ability for greater adaptability to enhance what we do and improve our outcomes. This will ultimately lead us to enhance reputation, constantly improving clinical care and ongoing client satisfaction. APJ Q4: What do you enjoy teaching the most? I have been lucky to have learnt so much from so many and continue to do so. I love sharing that information with others who will be able to take it and use it to their benefit, not only for helping them create a successful career, but more importantly, for their clients who will receive care based on science and facts. It has frequently been said that I overshare, particularly in detail, but I believe you can never know too much if you want to be successful at what you do. My greatest hope is to instil critical and analytical thinking capabilities in my students. It is not enough to know how to do a series of actions to be successful. Following a standard procedure is simple, but to truly know how the outcome is achieved requires a comprehensive knowledge base, particularly when you need to determine if the system is not correct, or needs changing in some way to provide a better outcome. You must have depth of information behind the actions you perform, as to why and how to change aspects of what you do when the need to improve what you are doing arises. It is important to question what is presented to you and not just accept it as ‘fact’, as it may not be. It is important to critically examine and interrogate information that is presented to you. Check where it is coming from and be satisfied that the information is valid and reliable. While facilitating knowledge is more complicated than many may think and frequently not appreciated, I am always heartened by those who tell me how I made them a better practitioner and have helped them move ahead. Perhaps not that often, but it is rewarding. I think that the acknowledgement that you have been able to help others is the most important for an educator and not because you are doing it for money. APJ Q5: What has achieving a professorship means to you? On a personal level, it is a remarkable honour of recognition of the body of work I have achieved over a few decades in academic and aesthetic education on so many fronts. Having a Higher Education Academic Board comprising of professors, associate professors, doctors, academics, and administrators, many from outside the aesthetic arena debate and decide on conferring the first-ever Professor of Aesthetic Sciences title is impressive. It is a milestone recognition in the movement from an industry to a profession; having university degrees and academic leadership in such a discipline is vital. While I was the first to achieve this, I am hopeful that I will not be the only one to hold such a title, as I am sure others will move through to take my place in the ever-expanding clinical aesthetic. APJ APJ 67
AESTHETICS INDUSTRY BULLETIN
CREATING OPEN STREAMS OF GLOBAL BORDERLESS EXCHANGE THE OPENSREAMS GLOBAL BEAUTY INDUSTRY SUMMIT is an open-forum think tank comprised of key international beauty associations from over a dozen countries. Today’s crisis underlines just how interconnected we are throughout the world. We are entering a new era where borderless collaboration and a holistic industry approach are more vital than ever. The conference was originally scheduled to be held at the United Nations Headquarters, New York on October 23, 2020. The United Nations location was chosen as it symbolises diplomacy among nations, and therefore, an ideal location to host this pivotal summit of the world’s key associations. However, due to the recent pandemic, the event took place online. The Openstreams Foundation was established by BEAUTYSTREAMS, the global beauty industry reference source. The foundation is a nonprofit organisation whose mission is
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to foster global collaboration, further awareness of key issues related to the beauty sector, and support education. APAN’s Tina Viney was invited to be interviewed and share information about what is happening in Australia. The interview was conducted by Creative Director of Openstreams Michael Nolte, based in Paris on the 20th September this year. “It was a privilege to share industry updates and to be part of an international collaboration of information exchange,” Tina Viney said. Beautystream provides incredible resources specifically for product developers through a membership structure where stakeholders can access global industry intelligence and resources to help them grow and expand their product reach. These interviews will be included as part of a global industry update report. We are delighted that Michael Nolte has accepted to present an article for APJ Journal about Beautystreams’ methodology and upcoming beauty industry trends. We trust it will be available for publishing in the next issue of APJ. For further information on Open Streams foundation visit www.openstreamsfoundation.org APJ
Image from NBC News
COSMETIC BRANDS FIND NEW NICHE WITH MENTAL HEALTH FOCUS NEW STUDIES PREDICT THAT mental health and loneliness will reach epidemic proportions over the next decade leading to a new niche focus in makeup and skincare formulations. Recognising this need, Selena Gomez created Rare Beauty two years ago, launching a line of cosmetics that truly bridged the gap between the worlds of beauty and mental health, something she felt was lacking from the makeup aisle. Now, that vision is a reality — and it's so much more than just foundation and highlighter, there is foundation and highlighter, too. Gomez, sitting in a pale-pink powder room — to match her new packaging — with a voluminous blowout and wearing her signature red lipstick in the shade Inspire, recently gave the rundown on Rare Beauty over a Zoom session which went viral with her fans. The brand was launched at Sephora and the official brand website. "I wanted this line to feel like everything fits together, and that you could trust it," Gomez says. APJ
This section presents the latest news, training dates and other Aesthetic Industry information
ALPHA-H FOUNDER PASSED AWAY AT AGE 57 IT WAS WITH GREAT SADNESS that we reporte the passing of Alpha-H’s founder Michelle Doherty on July 23, 2020, having lost her battle to cancer. Michelle was a true industry icon and a real achiever. While we have released news of her passing APAN would like to honour her memory in this issue of APJ as we have had a long-standing relationship with her over the many years. Michelle actually acquired the ownership of Alpha-H in the late 1999s, which at the time consisted of just three products. As an acne sufferer Michelle had experience the benefits of this glycolic acid-based formula in helping clear her acne, so she decided to purchase the brand. Since then, Michelle continued her tireless research into ingredients and constantly added products to the range that were not just glycolicbased, but also helped build and nurture the skin enhancing vibrancy and skin health. Under Michelle’s leadership, Alpha-H became one of the world’s leading skincare ranges
with her best-selling product ‘Liquid Gold’ selling thousands of bottles every single day and included a strong celebrity following. The award-winning resurfacing treatment uses a state of the art, low pH delivery system to help to diminish wrinkles, pigmentation and sun damage and of course help clear problematic skin and acne conditions. As an individual, Michelle was a caring human being who loved to give back. In the early 2000s Michelle served on the APAA Association Board and contributed to the industry’s credibility and professional development. However, above all, Michelle loved to produce cuttingedge formulations that were effective, affordable and resultsdriven. Indeed, she excelled at everything she did, both in product development, as well as an astute business genius. Above all her trademark was her beautiful smile and her caring nature. Our condolences to her family. Michelle will be truly missed and remembered as an industry iconic figure. APJ
PATHWAY TO SKIN PENETRATION – NEW HOPE FOR SKINCARE RESULTS A RECENTLY peer reviewed article published in Cosmetic and Toiletries Magazine examined pathways to skin penetration with some interesting findings. The paper revealed recent findings about three skin penetration pathways (including a “polar pathway”) and four types of penetration enhancers (enzymes, vesicular systems, ceramides and chemical enhancers). The researchers stated that at the very early stages of understanding the roles of the body’s organs, it was understood that the skin functions as a barrier between our body and our surroundings. Therefore, it was clear that the skin would challenge penetration of compounds and repel outside insults. Having such a nature it was not surprising to discover that the skin’s upper layer, the stratum corneum (SC), is a sub-tissue that very efficiently limits penetration of compounds.
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AESTHETICS INDUSTRY BULLETIN MICROBIOME TAKES THE LEAD IN SKINCARE FORMULATIONS CONSUMERS ARE MORE AWARE of the term “The Skin Microbiome” than ever before, yet a complete understanding of the skin microbiome is still emerging. How can skincare brands communicate and launch products that specifically consider the skin microbiome today? A brief history of the skin microbiome, evolving market trends for microbiomefocused skincare and key takeaways for ingredient selection provide guidance to answer this question.
Over the years scientists have attempted to find compounds or systems that will allow overcoming this barrier and interaction with deeper sub-tissues or tolerating permeation to the circulation system. After years of research, it is now clear that there are ways to allow permeation of compounds to and through the skin. The focus has shifted toward understanding the microstructure of the skin, as well as the mechanism of action of these enhancers. Because skin penetration enhancers provoke structural changes in the stratum corneum, they often trigger undesired immune system reactions such as irritation, allergy, or inflammation. Most of the enhancers are not specific and will allow penetration of any compound that is small and lipophilic enough to penetrate (such as in liposomes, various enzymes and chemical enhances). When dealing with cosmetic formulations this means that compounds such as fragrance components and preservatives will penetrate in conjunction with the active compound. Moreover, the skin is a very viable tissue. It includes many metabolic
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systems that were originally aimed to drive biochemical processes such as desquamation, creation of extracellular lamellar sheets, programmed cell death (apoptosis) and sebum or sweat secretion. These enzymes may attack active or inactive compounds as they penetrate, and convert them into an inactive, active or toxic form. Although, this paper confirmed that one can distinguish between different routes for penetration with different properties, most compounds applied to the skin will permeate through more than one pathway and that is key to ingredient penetration. A certain compound, however, depending on its characteristics and its vehicle may exhibit a preferred route of penetration. Understanding this will allow skincare formulators to identify the correct pathway that will allow their specific actives to reach the targeted layers of the skin in order to achieve the desired result. This information is an interesting discovery that gives rise to hope that will allow skincare of the future to achieve more advanced and longer-lasting results. The complete paper can be accessed through this link: www. media.cosmeticsandtoiletries.com/ documents/CT_120_06_067_07.pdf APJ
Microbiome 101 and The Consumer Education Journey Our understanding of the Skin Microbiome has trickled down from the breakthrough results of the Human Genome Project conducted in the late 2000s. The project sparked new ideas and approaches to understanding the non-human DNA that forms our superorganism: the bacteria, bacteriophage, fungi, protozoa and viruses collectively forming our “microbiome.” In 2008, the Human Microbiome Project was launched by the National Institute of Health and concluded in 2013 having generated over 14 terabytes of data from 300 individuals. By 2014, journals were publishing about the novel deal that millions of bacteria lived on our skin and that brands were leveraging this fact to deliver benefits. By 2020, Byrdie officially declared the Skin Microbiome ‘the next big thing’ flanked by articles in various consumer publication such as Vogue, Elle and a host of other publications in late 2018 and 2019. Consumers, who had become aware of the importance of maintaining a healthy gut and how the “3 P’s” can help (Prebiotics, Probiotics, Postbiotics) were now becoming aware of the “Skin Microbiome.” Today, most skin therapists and many consumers know these basics: the s kin is home to micro-organismsand that an imbalanced or unstable microbiome is bad. The Emerging Positioning of the Microbiome Formulators are now
This section presents the latest news, training dates and other Aesthetic Industry information
confirming that they are on the verge of a major wave of new products designed to support a healthy microbiome. Between 2016 and 2020, the number of products referencing prebiotics and probiotics dramatically increased with orders as references to the “microbiome” began to grow. In fact, the first half of 2020 saw more launches referencing “microbiome” than all of 2018, according to Mintel GNPD. Professional and consumer brands alike are leveraging the term. Just in the consumer categories, Dove, Johnson and Johnson, Aveeno, Ren, Tula, and Indie Lee are just a few brands using microbiome claims and providing consumer education. New product directors interested in joining this trend can take stock of these two, key ingredient characteristics, as pre
such as S. aureus, from secreting toxins that have been linked to Atopic Dermatitis. Other brands, such as Aveeno, have now dedicated websites showcasing clinical studies promoting pre-biotic ingredients and outcomes that promote the diversity and balance of the microbiome in relation to moisturisation. On the other hand, some standards and research are helping brand leaders develop products with the microbiome in mind, even if they don’t use specialty prebiotics or probiotics. This is useful because everyone’s microbiome is impacted by their unique environment, food intake and genetic identity making sweeping conclusions and clinical trials very difficult. For this group, a simpler approach could be to choose
emollient used by top brands in skincare, on the microbiome. The study concluded that Neossance™ Squalane maintained a stable microbiome while increasing the diversity of the microbiome by 17.9%. As Squalane can be used in creams, lotions, serums and more, it is an ideal go-to ingredient for launches considering the microbiome. Squalane, is naturally present in the skin’s lipid barrier of plants, animals and humans. Due to the complete saturation of squalene it is not subject to auto-oxidation. For cosmetic purposes most of the squalane used is mainly derived from olive oil or rice bran. New studies and standards now offer clarity, choosing microbiome friendly ingredients that will support the growth for new skincare launches for years to come. APJ
FAREWELL TO ANOTHER INDUSTRY ICON Monday September 21 friends and family gathered at the Tobin Brothers Tree of Life Chapel in Malvern Victoria to celebrate the life of Kathleen Crabtree who lost her battle to cancer on September 2020. She was 64 years of age. Kathleen was an APAN member and an incredibly passionate industry professional and owner of Skin Brilliance – a clinic based in Brighton, Victoria.
and probiotics are now becoming mainstream in skincare formulations. Approaches for Launching Microbiome Products Some brands focus on using specific prebiotics or probiotics based on early clinical trial results, while a growing number are referring to the microbiome more generally. The first approach is driven by promising new research. For example, recent studies have suggested that promoting proper ratios of species in the microbiome can inhibit bad species,
ingredients with known skin therapy benefits that do no harm to the microbiome. One criterion for doing no harm is maintaining microbiome stability, which is a characteristic of healthy skin. Another criterion is to ensure a diverse number of species are in proportion to each other. These two characteristics – diversity and stability – are keys to success. One brand Aprinnova for example, has evaluated the impact of Neossance™ Squalane, a natural and sustainable
Kathleen was renowned for her energy and commitment to high standards who loved her clients and her staff. We regularly saw her at our conference and her lovely smile always lit up the room. Kathleen was such an inspiration to many and she will be sadly missed. The business is now owned by close friend and colleague Nicolle Knox who is taking over the clinic “I feel very privileged to continue this work for her,” Nicolle said. Our condolences to her family. Indeed, she will be missed. APJ
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BUSINESS
SOLUTIONS FOR COVID DOWNTIME
Rising Stronger During the Disruption Giulia D’Anna I LOVE LOOKING AFTER MY CLIENTS. I love my business and I love the creativity that comes from the work I do. I always have. Every day that I spend in the skin and beauty business is fun, rewarding, and exhausting all at the same time. If there was just one thing I could change, it would be to have more time. I would love to have a better grip on the daily juggle of running a successful business, having a family and looking after my own wellbeing. I just never seem to get the balance right, and inevitably I always put something off to another day. There just never seems to be enough hours to fit everything in. That was up until late March. Without much warning, the normal daily juggle just stopped. All of the certainties I thought we all had, were gone. No appointments or clients. No stock turnover. Nothing. Gone, just like that. It has been a big shock to the system for all of us. Never in our lifetime have we seen anything like this, nor could we have predicted it. Our doors were shut for an undefined period of time, and it all happened so quickly, there was little time to prepare. COVID-19 has proven to be a big turning point in our industry, and also in our lives. I think that it has made us all reflect on what we feel is important to us on an emotional level, and also given many of us a clearer direction about where we are headed. Coming out at the other side of the restrictions, there are so many areas of clarity that we have had to evaluate. REASSESS FOR SUCCESS Outlining your business processes and protocols is super important, so that we can consistently achieve a defined level of service and business success. During any regular trading day, business decisions are made by each member of the team as well as the business manager and owner and we need to ensure that those decisions are in keeping with the business branding and standards. What is critical APJ 72
to our success is to ensure that our clients receive the best treatment and the level of attention is consistent each and every time, regardless as to which team member is looking after them. The COVID closure allowed many businesses, including my own, to really reassess our procedures and protocols. During the first few weeks of this time, my whole team sat down and we were able to create a very detailed “clinic manual” that included the ‘how-to’ on every single procedure we undertake at Dermal Distinction. It includes everything from how we answer the phone, how to set up for and complete a treatment, how to process payments or even how to apply for leave within the business. Every single thing is mapped out. I learned during this process that some of my team had a limited idea about how I wanted things done, and in other areas, there were better and less complicated ways of handling things that what we were currently doing. Our clinic manual has been a game-changer and we are now focused and prepared to step up what we do as we are all on the same path. DISRUPTION PLANNING Planning for disruption is essential. Although I was not expecting a pandemic in 2020, I have always been prepared for disruption in my business. Disruption is when there is a competing or new interest that drives the clients’ attention away from a business or industry. COVID-19 certainly has been disruptive. I believe that disruption is an opportunity to grow and change. It is important for any business to accept change and growth, for only those that adapt will survive the challenges of disruption. I have seen many wonderful examples of this in our industry. Some businesses adapted by providing virtual consultations, others helped clients give themselves semi-professional
treatments at home, and some businesses even created ‘beauty subscriptions’ that were delivered every fortnight to their clients. This adaptation is a beautiful example of businesses stepping up to the disruption challenge. As we go forward, I think that this will become even more important. I strongly believe that every business must be prepared for a “what if” moment. TRIMMING THE FAT The most profitable and successful businesses look at business expenditure compared to the business profit every day. For smaller businesses, this can be difficult as we are often trying to work in the business, as well as manage it. During the COVID closure, I know that my team and I worked together to ‘trim the fat’. Why did we look at this together? Because I believe that it is important that as a business owner, my whole team helps to create profitability. While this can be really uncomfortable for some people, I believe that if your team understands what it takes to create success, they will have an interest in helping you reach your united potential. Success means job security, job stability, job satisfaction and a culture of working to a common goal. During the COVID closure, we have been able to look at reassessing our staffing levels, reducing product waste and improving profitability. Our unity in this has created excitement in the whole team to work to hitting targets and creating rewards for us all. CREATING A NICHE Just because you have always had a menu, doesn’t mean you need to stick to it. This is probably the biggest change I have seen across our industry during this time. Spending time away from the daily grind means that we have all been able to shift our focus to things we love the most in our lives. Some therapists have loved spending time with their family so much, that the post-COVID era will not include working in the industry again. However, for most others, I have consistently
seen therapists wanting to focus on just those treatments that they truly enjoy and are most passionate about. This is where I believe skin businesses will truly shine. I believe that going forward, skin businesses will become more niche-based and specialized. No longer is there the need to do every possible treatment in your salon or clinic, but rather I can see that business success post-COVID, will hinge more heavily on excelling in an area of expertise. In essence, this is a more focused business structure that will ensure excellence in your specialised field and success long term. KEEP-UP WITH PROGRESS TO SURVIVE During the closure time, the big winner has been education. I know that I have sat in on many Zoom conferences or webinars at all hours of the day or night. It has been amazing, with experts in skin, medicine, infection control and business all coming together to improve our industry and our standards through education. Never before have we had so many educational offerings available to us from the comfort of our own homes. I have loved the unity that this has given our skin industry, as we are all striving to be the best at what we do. Education for the whole team brings success. My team has attended webinars that have focused on our niche area, so that we stay up-to-date and leaders in our chosen area. FINAL NOTES The COVID closure has been challenging, but it has also been a time that has enabled reflection, reassessment and change. The skin and age-manage industry will come out of this with strength, focus and unity. I would encourage you to put together a clinic manual so that your team understands the challenges, but also the direction that the business needs to work towards. Look at your treatment menu; reassess where your passion lies. Most importantly, take this time of reopening as an opportunity to find your niche and become a true expert and talent at what you do. APJ APJ 73
COSMETIC TATTOOING
Understanding the Capabilities and Characteristics of Various Cosmetic Tattoo Needles Maja Ercejovac BUILDING A REPUTATION AS A SKILLED COSMETIC TATTOO artist and practitioner is key to making your mark in a highly competitive market. To achieve this, you need to start with a foundation of quality education coupled with on-going skills development, as refining your technique will need to be a lifelong endeavor. However, your ability to establish your own brand of artistry will rely on two components – constantly refining your technique and choosing the right tools to deliver the outcomes. MAJA ERCEJOVAC is a highly qualified and experienced Cosmetic Tattooist renowned for her high standards of practice that have gained her the respect of her peers, as well as an international reputation for her commitment to education. In this article she explores needle designs, their applications and suitability to different procedural outcomes. There are many variations of cosmetic tattooing needles, each one with its own characteristic and suitability for different end results. Understanding needle variations will allow the cosmetic tattoo artist to identify the capability of each tool and select the right needle for the outcome they wish to achieve. It is important to understand that every cosmetic tattoo brand manufacturer crafts their needles differently. Some are more flexible than others and each design is better suited to specific skin conditions and procedures you wish to perform. As a cosmetic tattoo artist, it is up to you to decide which design suits you best for the task you wish to undertake. Additionally, different application techniques performed by
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the artist will give a different finish, even if the same needle is used. Therefore, two artists can perform the same procedure, but due to technical variations of the tattooing process, they can produce distinctively different end results. As a cosmetic tattooist, these variations are your competitive advantage and contribute to your reputation or work, which ultimately is your brand. This is why it is important to explore both tools and their capabilities that will allow you to refine your technique making it truly your own. NEEDLE COMPOSITION Cosmetic tattoo needles have equivalent properties to needles that are used for medical applications or acupuncture. Today, stainless steel is almost exclusively used for both cosmetic tattooing and decorative tattooing, although there are also some needles made of rustproof carbon steel. Cosmetic tattooing is executed with needles designed for both cosmetic and decorative applications, although some artists may utilise acupuncture needles. Decorative tattooing needles and acupuncture needles are often preferred as they are more affordable. While cosmetic tattoo needles are made of surgical stainless steel, they often contain alloys such as Nickel (6-8%) and chrome (15-20%), which are mechanically released from the needle to the skin. The most commonly used needles for biological application are comprised of austenitic SAE 316, martensitic SAE 440, SAE 420 and 17-4 stainless steels. These are preferred due to their strength and their resistance to
corrosion. Likewise, there are alternate options such as stainless 304, containing more chromium than nickel aiding to the tool’s durability and strength. Adherence to appropriate biocompatibility standards are a must in tattoo needle manufacturing. According to an international study conducted at the German Federal Institute for Risk Assessment, metal particles can be abraded from the needle during its use and these particles can penetrate into the skin if the tattoo ink contains the white pigment titanium dioxide (TiO2). Therefore, micro and nanoparticles of such metals can reach the skin, which can potentially migrate to the lymph nodes. Further studies are required to determine if such risks can also contribute to allergic triggers and perhaps possible corrosion in the case of body implants. https://particleandfibretoxicology.biomedcentral.com/ articles/10.1186/s12989-019-0317-1 In terms of quality, the 1.4310 steel needling is considered the most suitable for decorative tattooing as it has the greatest hardness, making it more resistant against wearing of the needle tip, thus deterioration is at a significantly lower rate. Another advantage is that the nickel content in the 1.4310 is lower compared to the steel. Technically it is not possible to produce nickel-free needles. Due to its strength, the 1.4310 stainless steel needle is very difficult to grind and requires special machines to do so. For this reason, such needles made by European manufacturers are also considerably more expensive than others. Asianmade needles are therefore produced with softer steel and at reduced cost.
THE FOUR DEFINING PROPERTIES OF COSMETIC TATTOOING NEEDLES Grouping format of different needles can be overwhelming as needling systems are not a standardised procedure. Grouping or assortment of tattooing needles is often referred to as soldering. The four defining properties of cosmetic tattooing needles are: •
the diameter
•
the taper
•
the count
•
the configuration
There are numerous criteria that determine the quality of a needle and its capabilities. Let’s examine a few: THE NEEDLE GRINDING The issue of the cut length is currently overrated as promoted and marketed by various suppliers. Studies confirm that the geometry of the needle and the material of which it is made play a more significant role in the potential end result of the tattoo. Cosmetic tattoo needles are grained in two different ways: Triangular, or sharp needles Round, or bullet needles Triangular grained needles are designated to cut through the skin. When using these needles almost no skin resistance is present. This option is preferred for treating scarred or rough tissue, for lips and fine lined eyebrow hair-strokes. Also, triangular grained needles are usually less painful than round needles. The puncture, or the hole created in the skin, tapers downwards and indention in the skin appears similar to the needle tip itself. These needles are more suitable for use with pigments that are more liquid in viscosity, for example when using black ink, such as when performing a winged eyeliner outlining.
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Round needles when penetrating the skin have a higher piercing resistance as the tip is not as sharp. Upon contact with the skin, a round needle slightly depresses the skin and only then does the needle enter the skin. This is usually a more sensitive experience for the client, as the piercing created within the skin is relatively larger and hardly tapers downwards. Inks that are thicker or with a pastier viscosity are best applied with round cut needles. On the other hand, liquid pigments and carbon black, as used for designing an eyeliner, are optimally applied with triangular needles. Both needle types are suitable for tattooing and both have limitations. Each has its optimal area of application, depending on the viscosity of the ink used and the outcome you are looking for. THE GRINDING LENGTH OR THE NEEDLE TAPER The length of the needle is only one consideration when determining the outcome. A long cut creates a narrower puncture, while a short cut creates a wider hole. The choice of the grinding length or taper will depend on skin type and choice of ink viscosity used. The geometric shape of the needle and the material in use are the most important considerations when determining the outcome that you are trying to achieve with your cosmetic tattooing. COSMETIC TATTOOING NEEDLE CODES Some manufacturers use Codes to grade the various needle designs, while others use names such as, Nano needle, HD Needle, Micro needle, Power needle, Shader needle, Liner needle. This is another aspect that the cosmetic tattoo artist takes in consideration when tattooing. Commonly used codes to identify and differentiate tattoo needles are - 5RL 5-Round Liner Needles and 3RM 3-Round Magnum needles. Regardless as to how a tattoo needle is described, either by code or name, the key consideration you should look for in a tattooing needle is the diameter, needle count and grouping format as these are more indicative of the result they can produce. Cosmetic tattoo artistry is divided into two applications: * Filling: achieved either by shading or colouring * Lining: that is used to shape and contour
as to what taper they use. Randomly used terminology to define grinding lengths as follows: Short taper (short point length less than 1mm), Standard taper (usually 1.5mm long point length), Long taper is usually (2.0mm long point length) and an Extremely long taper (as much as 7mm long point). Short taper needles are usually not the best needles to be used for lining, but they are good for shading and are more suitable for younger, oily skin types. The best ink viscosity for short taper needs are the more pasty, coarse pigments. Long taper needles are suitable for all skin types including fine and older skin types. They are used for both lining and shading. Ink flow with these needles is better controlled than when using a short taper needle. Not many artists are skilled enough and often don’t like to work with these needles as they have a slower ink flow speed when shading, but the end result they offer are precise, fine line finishes that are outstanding. Nano-needle and HD needles are long taper needles. These needles work with liquid and pasty pigments. Standard taper needles are suitable for normal skin type. This needle type is ideally used for line and shading. The skin can be very gently exfoliated before commencing cosmetic tattooing with a standard taper as this will help ease the release of the pigment into the skin. This can be challenging to work with at first. Super-long taper needles are best for lining and precision work, that you would want to take time to perform and perfect. Acupuncture needles are often used for this as they have similar capabilities. Shading can be time-consuming with super long taper needles however, they offer a flexible and painless solution suitable for very fine, thin skin when used by skilled artist. Friction and pressure created over the skin when shading, is feather-like and lining pressure is minimal upon contact, as only the very top end of the tip is used. NEEDLE SURFACE OR TEXTURED NEEDLES Needle surface is the determining factor on how effective ink adhesion is on the needle. There are two types of needle surface textures: •
Polished
•
Textured
The needle that is used for lining can also be used for shading, but most multi-shading needles cannot be used to create crisp lines, only thicker outlines or strokes. The best needles for cosmetic tattoo lining techniques are usually performed by single needles. Multiple needle groupings are used to speed up the shading process and to create different effects. TAPER CONSIDERATIONS AND THEIR USE The taper of the needle has to do with the shape of the point and the point-length. The taper, or point-length, will determine the shape of the point and its capabilities. A short taper will have a short point. A long taper will have a long point. Different manufacturers have their own specifications
Originally, cosmetic tattooing needles were manufactured and sold as a polished wire with a smooth surface. At times, the needles underwent an electropolishing process to achieve an extremely smooth polished surface. This process usually follows the grinding process. Textured needles however, are a specialty that have been roughened to create micro fine groves towards the end of the tapers or ends, resulting in holding the ink better. For example, textured magnums hold the ink especially well, as the ink can sit between the two rows of pins and also stick to the textured needle better, instead of just dripping out
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of the tube. It is believed that you can receive a higher level of pigmentation into the skin, especially during solid colour tattooing when using a textured needle. The needle texturing technique is a complex one and only mastered by a limited number of companies. The artist is required to treat the surface in such a way that the ink adheres optimally to the needle, but still flows well when tattooing. Extra polished needles are no longer as popular, as they are not as efficient in retaining the ink and therefore difficult to get into the skin. Textured needles are best suited for tattooing, because the ink gets into the skin with much greater ease. THE ISSUE OF PRECISION AND DEFECTS Regardless of the shape and length of the cut, the tip of the needle must be ground evenly from all sides and be absolutely centred. Only with really good needles can an optimal needle group be soldered, which brings the colour evenly into the skin. The tip of the needle is very sensitive and can easily be damaged during soldering, especially needles made of soft stainless steel. The tip of the needle can become blunt or even hooks can form. A poorly designed tip can contribute to skin damage - the tattoo heals poorly, the colour can often be rejected and scar tissue may form. Despite extensive manufacturing control measures, it is not uncommon that a finished soldered needle with defects is not identified and removed. For this reason, each needle should be carefully checked with a magnifying glass for defects also by the practitioner before tattooing.
thickness of 0.30mm and 0.33mm are the most frequently used. Often 0.30mm needles are used for lines and 0.35mm needles for shading and filling. For filling areola some cosmetic tattoo artists use 0.40mm needles. In contrast, for fine lines, needle thickness in the vicinity of 0.20mm and 0.25mm are usually used for tattooing purposes. In instances where acupuncture needles are used, the finest needle diameter is used is 0.16mm. Ultimately, every tattoo artist must determine his or her own optimal needle size by constant trial and reviewing what is providing the best possible outcomes. A tattoo needle's diameter affects ink flow. The narrower the diameter of the needle the finer and more controlled the stream of ink that flows out of it. That's why finer needles are so popular for line work; the ink flows in a finer and more controlled manner. Besides the needle itself, the way a group of needles is soldered also plays an important role. IN CONCLUSION Manufacturing excellence is always on the rise, providing us with greater evidence and options of both tools and techniques. Cosmetic tattooing is an ever-growing profession and an extending scope of practice with incredible possibilities. However, whether we stay within the scope of beautification, or move into medical cosmetic tattooing, the key to our success is by consistently growing our education, refining our techniques and gaining a better understanding of the tools available to us and their capabilities. APJ
THE DIAMETER Tattoo needles are mainly offered in 4-5 different diameters: 0.20mm, 0.25mm, 0.30mm, 0.33mm and 0.40mm. The needle
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TIPS FOR BETTER BUSINESS
THE RISE OF THE HOME ENTERPRISE THE SCALE AND IMMEDIACY of change created by COVID-19 is disrupting the very idea of how work is done in Australia. Due to the lockdown, larger corporations have had to work remotely with their staff via regular Zoom meetings and this has opened up a whole new way of relating. Several of these businesses are questioning whether they really need large premises to operate, as they identify more costeffective ways to conduct business and to do it efficiently. In our industry, the lockdown has forced many to finetune their online presence and conduct video and Zoom consultation sessions with their clients in order to maintain contact and continue to enable a level of business flow. Our research confirms that most businesses have reviewed their social media presence, upgraded their technology and improved their skills on how to work remotely.
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A considerable number of smaller salons with one or two staff, have also re-evaluated their business model, downsized and decided to move their business to their home. Some surveys confirm that approximately 27% of businesses have decided not to renew leases and return to their premises once their rental contracts have expired – this is nearly one-third of the businesses in our industry. For some, the change has been refreshing. They believe that in going back to work, they will go back better, as they lower their stress levels and retain the clients who are the most important and valuable to them. While this has resulted in some job-losses, it has also given the opportunity for both staff and business owners to evaluate their direction, dedicate more time to study, improve their skills and even expand their scope-of-practice. Research suggest that these changes could well become sustainable, as it also reflected the new trend for smaller spaces. The drivers towards this trend are commercial, residential, social and economic. Consumers are also gravitating to smaller, more intimate spaces
to conduct their shopping, seeking purchasing experiences that allow them to interact more closely with others in the process. Several global studies confirm that boutique businesses such as clothing, personal care products etc, are growing in popularity, while the large department stores that are void of personal service are not as popular. The consumer focus is shifting to environments that are more nurturing and interactive. Confirming this trend in Australia, large department stores such as Myer and David Jones have not performed as well as smaller boutiques both for clothing and cosmetics e.g. Priceline achieved growth since COVID-19. The lockdown has created a greater need for human interaction. This is an important trend also for our industry, as it is impacting consumer expectations on their return for their services to salons and clinics. Businesses now need to review their protocols and programs allowing for a greater emphasis on mindfulness strategies and opportunities for clients to also experience the benefit of meaningful human interaction. APJ
Business & Legislation, New Tools and Research Outcome
NEW ENTITLEMENTS FOR RUNNING YOUR BUSINESS FROM HOME ON THE 15TH SEPTEMBER the Tax Office released some new guidelines of entitlements for businesses that are running from home. As this number is escalating this report may be relevant to you. If your home is your main place of business, you may be able to claim the business portion of some expenses. You may be able to calculate your home-based business running expenses using:
JOBKEEPER PAYMENT EXTENDED UNTIL 28TH MARCH 2021 THE JOBKEEPER PAYMENT has been extended and is available for eligible businesses from 28 September 2020 until 28 March 2021. The key changes include: Changes to JobKeeper payment rates for employees based on the total hours each employee worked during their reference period there will be a tier 1 and a tier 2 JobKeeper payment rate for eligible employees A requirement for the business to demonstrate a decline in actual GST turnover with a comparable period. If you are already receiving JobKeeper payments for your eligible employees and/or business participant, you don't need to re-enrol. You will need to pay your eligible employees and/or business participant at least the new JobKeeper amount that applies to them each JobKeeper fortnight.
From 28 September2020 until 3 January 2021, this will be either: Tier 1: $1,200 per fortnight (before tax) Tier 2: $750 per fortnight (before tax). From 4 January 2021 until 28 March 2021, this will be either: Tier 1: $1,000 per fortnight (before tax) Tier 2: $650 per fortnight (before tax). To qualify, you will need to continue to complete your JobKeeper monthly business declaration on time to be reimbursed for payments you made in the previous month. You will need to specify which payment tier you are claiming for each eligible employee and/or business participant in your November monthly business declaration. You will also need to determine and submit your decline in turnover for each quarter through the ATO’s online systems. Eligible businesses and not-forprofits can enrol at any time until the program closes. APJ
A fixed rate of 52 cents an hour for each hour you operate your business from home. This covers heating, cooling, lighting, cleaning and the depreciation of furniture and furnishings. You will need to separately calculate phone and internet expenses, consumables and certain depreciation expenses. The temporary working from home shortcut method of 80 cents an hour. This can be used by individuals running home-based businesses from 1 March 2020 until 30 September 2020. This covers all the expenses normally included under the 52 cents rate and all additional deductible running expenses. Any other reasonable method. You may also be able to claim occupancy expenses, like rent, in certain circumstances. Exclude your private living costs and keep records to show how you calculated your expenses. You can’t claim the same expenses two different ways. The temporary working from home shortcut method is all-inclusive. For example, you can't claim the full cost of purchasing a photocopier using instant asset write-off and also claim with the home shortcut method. Remember, registered tax agents can help you with your tax. APJ
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TIPS FOR BETTER BUSINESS qualify. Prefer that option rather than terminating them too soon.
KEEPING YOUR BUSINESS AFLOAT DURING A PANDEMIC
THE DESTRUCTIVE EFFECT OF COVID-19 has forced many businesses to face some hard truths. Many businesses have realised that they might not be able to weather the storm, whereas others have accepted that the only way to make it through is cutting costs and terminate staff. The businesses that have managed to survive so far have learned to do less with more. They have had to get by on the limited resources available to them and consider new, more effective directions than those they were accustomed to before the pandemic. They have scaled back some of their services, while focusing on those that most likely will bring the best return. Time and staffing are now a critical commodity that must be costed in carefully when delivering a service. So, is the return on investment sustainable for the business? If not, should it be replaced or eliminated? Given the uncertain times that lie ahead, businesses need to do everything in their power to stay
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afloat. Here are a few tips that can help with that endeavour: BEGIN WITH THE FINANCES Since most businesses’ finances have taken a thrashing from this pandemic, business owners need to take the time to re-assess the situation and figure out how to manage their cash flow in the upcoming months: Analyse the situation Any business has to keep a close eye on two things: where its revenue is coming from and where it is spending money. However, this obligation is all the more necessary during this pandemic. On the one hand, the sources of revenue are bound to shrink drastically. After all, several clients might fail to meet their financial obligations, and the return on your services may also shrink, especially with having to allocate extra time between clients for infection control measures. Have you costed these into your overheads? It is important to review all your expenses and assess if there a more cost-effective way to reduce expenses, such as purchasing bulk quantities. It is also important to discuss this with your supplier and identify special deals or progressive payment options. When it comes to staff make sure you ensure to apply for jobKeeper if they
TALK WITH CREDITORS AND LANDLORD The government is encouraging mediation between businesses and landlords. It is important that some level of flexibility and compromise is reached. If you are struggling to achieve a level of negotiation that will work for you please contact APAN, our lawyers have had great success in helping business owners and their landlords reach a compromise. It is important to stay calm when discussing these matters with your landlord, and show a willingness to meet with your rental obligations, but you will need to point out to them what is now considered ‘reasonable’ under the current circumstances. Everyone is stressed out at this time, this is why objective mediation can help bring great support to this process. If you cannot meet with your loan repayments, whether for equipment or other purchases, please don’t go into ‘freeze mode’ and denial. Talk to your lenders and see if you can secure a restructuring that will best suit you. Consider deferring and paying later. After all any debtor would prefer to be paid later than not at all. TAKE ADVANTAGE OF GOVERNMENTAL SUPPORT We are fortunate in Australian that we do have government support. Discuss this with your accountant and seek all potential options, as well as potential grants that the various states are making available. It is worthwhile to see if you qualify. ADAPT TO THE NEW CONDITIONS It’s not enough for a business to cut a few discretionary expenses here and there; businesses also need to adapt to this new reality, for example: Adapt to new market trends The current pandemic hasn’t only had a profound impact on the economy; it has also altered the market trends, making them much harder to predict or even understand. However, this tectonic shift represents an opportunity for most businesses. They can reposition themselves and capture a previously
Business & Legislation, New Tools and Research Outcome
unavailable market segment. For one thing, businesses that operated through brick and mortar stores can now explore selling online. If anything, this has been a necessity for most businesses to survive, and the majority of businesses that have thrived during this pandemic are those that operate online. While professional lines prefer to only sell product following a consultation, there are several other products that can be sold online, such as body care products and even wellness products. For facial skincare, include a consultation form online that can be completed and returned to you followed by a phone or Zoom consultation to discuss needs further. Even with states that have opened up to salon visits, some clients are still happy to purchase online. It has now become imperative to foster this connection with your clients. Retain employees There is nothing like increasing your knowledge to stimulate confidence and a positive focus on the possibilities of change. The coronavirus has presented the world with plenty of downtime, something businesses should make the most of. One way to do so is to train employees. For instance, a business might be able to provide remoteworking teams with online courses, enabling each member to upgrade their respective skills. If a business is worried that training might be a cumbersome expense and feel they are not capable of handling right now, it is worth remembering that training is one of those things that pays generously in dividends. Learn how to market differently Many businesses have had to shrink their marketing budget due to the pandemic. For some, this has been a death knell, but for others, this has been an opportunity to find new and innovative ways of reaching their customers. Focus on new ways for client outreach Businesses have had to get creative over the past few months, which will probably continue into the future. For instance, customer referral programs
and social media contests have recently been very prevalent. Businesses should narrow their focus on the most profitable customer segments. To that end, they may rely on business intelligence solutions or other similar data-driven approaches that help save money. However, the most important thing a business can do is build and strengthen its relationships with its clients. This means keeping a constant connection with them and serving them in any way possible. It also means listening to customers and trying to discern whether they are changing their thinking. Are their needs shifting? Will they still prefer making their purchases remotely even after the pandemic is over? Assess your clients’ preferences. Gaining answers to these questions will better enable businesses to tweak their business model enough to weather the crisis. Research new marketing trends If a business feels that it has no idea what to do during these difficult times, check out what other businesses are doing, speak to your supplier and partner with them for creative ideas and shared resources. APAN also offers members business mentoring, book a session and explore options with an industry expert who can help you, don’t struggle alone. Partner up Another way that businesses can stay afloat is by joining forces with other businesses that complement their services. Build a relationship with your hairdresser, naturopath, psychologist, cosmetic tattooist, etc. Offer them a free treatment to trial your services and provide and exchange services, or offer a free service for every five bookings you can secure through their referral. This strategy has worked really well for many businesses. Consider to expand your scope of practice Review trends and expand your scope of practice, either by expanding your education or employing a skilled expert who can provide this service to your clients. For example, introduce
injectable services, cosmetic tattooing, naturopathic consultation to your services. One service that is gaining demand is stress management through relaxation massage. There is a real return to tactile services for their benefits in human connection and stress management. Plan for the worst-case scenario To avoid being taken by surprise in the future, businesses need to carefully determine their feasibility for survival and prepare for multiple possible scenarios, particularly the worst-case one. This concerns more than just the pandemic. Instead, it should be a habit that carries through for the rest of a business’s life. To prepare for different scenarios, businesses should ask themselves simple questions such as: what other factors could go wrong? What would happen if all the business’s data was lost? Does the business have a data recovery plan in place, or will this spell bankruptcy? It’s important to realise that the struggle is still not over As mentioned earlier, there is still plenty of uncertainty in the days to come. Nevertheless, even during these times, business owners can do plenty to keep their business afloat. But, what is more important than the actions of business owners, is their outlook. If a business owner remains positive and works hard to survive, their probability of making it through is much higher than if they give over to pessimism and become convinced that their survival is not in their hands. Although luck does play a part in who gets to make it and who doesn’t, it is paltry compared to dedication, commitment, and perseverance. Working on strategies for personal development, resilience, immune support and staying on track with your wellbeing should also be your key consideration. APJ
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AROMATHERAPY
Clary Sage
Essential Oil for Hormonal Balancing Eva Boyd SPEAKING TO SEVERAL DOCTORS about women’s health in recent times a common question I have been asking them is “how is the current pandemic effecting women’s health the most?” By far the most common answer is that they are seeing hormonal changes due to the escalating stress that many are experiencing. One doctor also told me that many menopausal women who were symptom-free for several years are now experiencing hot flushes once again, like in earlier days when they first entered menopause. While it is recommended to seek medical advice for such conditions there are simple and safe ways that we can also offer relief from many hormonal symptoms through the effective use of high-quality essential oils. One that would be especially useful at this time is Clary Sage. Whether we’re talking about PMS, hot flashes or stress, every woman can benefit from the use of clary sage essential oil. Clary sage is an incredibly versatile oil with amazing therapeutic constituents that can support hormonal balancing and can be used on its own, or blended with other synergistic essential oils. A BRIEF OVERVIEW Clary sage originated in Europe in the northern Mediterranean region. Its botanical name is Salvia Sclarea and the essential oil is extracted from the flowers and leaves of this herb. It has a mellow, herbal, nutty tea-like earthy fragrance and blends well with other essential oils that can further enhance the hormonal benefits including lavender, rose, frankincense, cedarwood, sandalwood, bergamot, lemon, orange, geranium and ylang ylang. For those who are interested in its chemistry, the therapeutic
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constituents of clary sage include: Sclareol, Geraniol, Alpha Terpineol, Linalyl Acetate, Caryophyllene, Linalool, Neryl Acetate, and Germacrene-D. If you research clary sage you will see that its beneficial effects on hormonal concerns are well support by several studies. As an oil it has been anecdotally praised for its many health benefits, however, as further research comes to light, it is encouraging to see that the health benefits of this oil are now scientifically validated. This article will review some of these benefits: SEVEN BENEFITS OF CLARY SAGE ESSENTIAL OIL FOR HORMONAL IMBALANCE 1. Relieves Menstrual Cramps There are two main reasons why clary sage is a great choice for relieving period pain. First, it’s a natural antiinflammatory and we know that inflammation lies at the heart of cramps because it’s linked to excessively high levels of pro-inflammatory prostaglandins. As you may know, prostaglandins are hormones that cause uterine contractions. High amounts pf prostaglandins have a pro-inflammatory effect that causes repeated and painful contractions. The second reason why clary sage helps with cramps is that it improves circulation, meaning that it is able to open and relax blood vessels. As a result, you get more blood flow to the uterus which eases pain. In addition to all this, research confirms that clary sage (combined with lavender and marjoram oil) is effective at reducing the duration of cramps. 2. Regulates Oestrogen Clary sage is well known for harmonising estrogen levels
and as a result, supporting overall female health. This can be beneficial whether one is struggling with PMS, irregular cycles or menopause-related symptoms. It is well-know that stress can fluctuate oestrogen levels and contribute to hormonal symptoms such as bloating, swelling and breast tenderness, mood swings, headaches, anxiety and panic attacks, weight gain, trouble sleeping sleepiness of fatigue and even memory loss. So, an estrogen-regulating oil like clary sage can make it easier for your body to self-adjust and find its natural balance once again. 3. Lowers Stress and Cortisol Levels This one is an important one. High stress contributes to high cortisol levels, which can throw off insulin levels, cause irregular periods, disrupt fertility, speed up weight gain, contribute to adrenal fatigue and so much more. Thankfully, clary sage is one oil that you can rely on to help you get a handle on stress and cortisol. So, just how effective is clary sage for lowering cortisol and stress? One study shows that simply inhaling clary sage all by itself results in a 36% reduction of cortisol levels. Other reports indicate that clary sage helps to boost confidence, create a sense of ease and ultimately, can help alleviate anxiety and depression. In fact, recent studies confirm that clary sage affects dopamine (the feel-good hormone) pathways. 4. Supports Healthy Thyroid Function Because of its ability to lower stress and cortisol, clary sage also supports the thyroid, here is how: The adrenal glands (which produce cortisol) and the thyroid balance each other out all the time. This means that when adrenal function goes up cortisol production increases, as a
result, thyroid function goes down. On the other hand, when thyroid function goes up, adrenal function goes down. So, by using clary sage you lower the production of excess cortisol, which means your adrenals aren’t working quite as hard. And healthier adrenals automatically help to boost thyroid function. 5. Relieves Insomnia Insomnia and poor-quality sleep are the most common symptoms of hormonal imbalance. Clary sage happens to have a naturally calming and sedative effect that makes it ideal for improving insomnia. In addition, as we’ve already seen, clary sage is known to reduce cortisol. High cortisol is one of the main causes of insomnia in the first place. So, by lowering cortisol and inducing a sense of relaxation, clary sage helps improve sleep quality. 6. Supports Healthy Digestion A healthy digestive system means you are able to absorb more hormone-balancing nutrients from food. It also means that your body is able to eliminate toxic hormone disruptors quickly, before they have a chance to accumulate in your system. It turns out that clary sage can increase the release of bile and gastric juices. This results in less bloating and cramping. Bile is also essential for breaking down fats. This matters a lot for hormone balance because various hormones (including sex hormones and all the adrenal hormones) are made from the fat we eat. By having sufficient levels of bile means you can break down the fat into its various components and use it at the cellular level. 7. Supports Healthy Skin, Hair and Nails Dry and thinning hair, skin or nails tend to occur with
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Menopausal and hot flush relief Inhalation: A very simple tip to help with hot flushes is by simple inhalation: Place 2 to 3 drops of undiluted clary sage oil on a cotton ball or tissue and inhale it slowly and deeply. When essential oils are inhaled, their aroma is first processed in the olfactory bulb in the nose. The olfactory bulb is connected to the limbic system of the brain which influences memory and emotions. The aroma will also activate the amygdala which also alters mood and emotions. The antiinflammatory effect of clary sage can help calm the nervous system and support the body’s homeostasis. Massage oil: Mix 29 drops with 30 mls of a carrier oil such as almond oil. Shake it well and allow it to blend. Please use a glass bottle, not a plastic bottle. If you wish to add other essential oils use 12 drops of clary sage and add 9 drops lavender, 3 drops orange, 3 drops geranium and 2 drops ylang ylang. Perform a gentle relaxing full body massage. Studies now confirm that gentle massage can lower cortisol levels within one hour – it does not need to be a remedial massage to benefit your client in this way. If you do not have the facilities to conduct a full-body massage, conduct a facial, neck and shoulder massage. You could also include a hand and foot massage, while the client is under a mask. The possibilities are endless. Facial spray: You can also do a wonderful facial spray to help with hot flushes with this simple recipe: hormonal imbalances. Clary sage can help with all three of these because it:
•
3 drops clary sage oil
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2 drops sandalwood oil
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Regulates production of your natural scalp oil (sebum) and supports a healthy scalp.
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2 drops lavender oil
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1 Tbsp witch hazel
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Balances the production of sebum on your skin depending on your particular needs. This means you can use clary sage on both dry and oily skin. The oil works with your skin type.
•
Distilled water
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A 30-mls spray bottle
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Nourishes the cuticles and nails.
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In addition, clary sage contains linalyl acetate, which is an anti-inflammatory that helps with acne and other inflammatory skin conditions.
A NEW INTERPRETATION OF WELLNESS Recent global research companies examining consumer behaviour across several jurisdictions have confirmed the strong shift in consumers expectations requiring a more comprehensive approach to treatments that address wellbeing. The research identified the need for a stronger focus on tactile modalities, such as facial and body massage, as well as lymphatic drainage that can work on the nervous system, calm, restore and enhance wellbeing. It is highly recommended that our industry considers this information and when recommending treatment programs, reviews ways to include these modalities in a way that steps up their approach to supporting wellbeing. We are now recommending that in your client consultation you dedicate a division to Mental and Emotional wellbeing. Ask questions that identify stress levels, sleep patterns, anxiety and depression, as well as hormonal activity. Even if you do not offer a full body massage, it is advisable that you consult with an aromatherapist and include a few protocols using essential oils to support hormonal, mental and emotional health. So, here are a few formulas you can utilse using a blend of clary sage and other oils for hormonal balancing:
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Just all the ingredients to a spray bottle, seal and shake. Spray onto the face, neck and other areas as needed to cool down. Keep in the fridge and use as a refreshing spritzer. If possible, please use a glass bottle when using essential oils. Stress Relief Diffuser Recipe Your first option is to simply diffuse 3 drops of clary sage oil by itself. Otherwise you can also diffuse this blend: 5 drops clary sage 2 drops frankincense Relaxing Calming Sleep Blend 3 drops mandarin oil 3 drops bergamot oil 2 drops clary sage oil Add to 15 mls of carrier oil. For topical application: For menstrual pain apply lower abdominal area as well as lower back. For stress apply to the neck and shoulders as well as inhale. For menopausal symptoms over kidney area and adrenals as well as over the chest. CONCLUSION No matter your age or symptoms, clary sage is one essential oil that you can use to address multiple needs. However, when it comes to hormonal balancing, this is where clary sage can truly shine. APJ
APAN’s standards recognition program continuing
As of July 2018, the CTARP and ARAP programs are now linked to a more comprehensive Continuing Professional Development (CPD) Program.
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For further information visit www.apanetwork.com/arap and complete an online Application Form.
There are five ARAP registration classifications:
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APA N
COSMETIC INGREDIENTS
Australian Natives Rich in Vitamin C Dr Donna Lee Marçal, PhD
IN OUR CURRENT CONSUMER CLIMATE there is a rise in demand for products that are Australian-Made. Consumers are gaining a greater understanding on ingredients with an appreciation for those that are locally-sourced. What is fantastic is there are some powerful and unique ingredients that are primarily from Australia, or only grow natively in Australia. Dr Donna Marcal presents the latest science on the efficacy of some amazing Australian natives used in cosmetic skincare. We have some of the harshest conditions here in Australia, and don’t we know this from our summer season? Many plants have had to evolve over thousands of years to survive and thrive in these unforgiving conditions. One category of plants that have been around for centuries, and now becoming increasingly popular for skincare is Australian native plants and fruits rich in vitamin C. ASCORBIC ACID We are all familiar with vitamin C in skincare in the form of ascorbic acid. Ascorbic acid is a fractionated purified molecule of the vitamin C complex, and can also be synthesized in the lab. Quite often, vitamins and their isolates or components get confused for each other. A vitamin is a complex of molecules and cofactors working together in a process. We know very well that ascorbic acid can be quite unstable. However, vitamin C or its purified ascorbic acid as ingredients are highly sought after in skincare as a result of its wonderful properties. Vitamin C is a powerful water-soluble antioxidant that is active in hydrophilic (water-loving) environments. It is a vitamin that cannot be produced in our bodies and therefore must be supplemented in our diet. It is a very effective antioxidant even at low levels. As an antioxidant, it helps protect critical molecules including proteins, lipids, carbohydrates (sugars), and DNA from free radical damage. Vitamin C is also essential in the process of collagen synthesis.
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With the advances in technology, the ability to test and analyse natural extracts relatively easily and accurately for the complement of molecules they contain, we now know so much more about natural extracts and their molecular composition. We can then link these compositions to the amazing properties that have been experienced for centuries by our ancestors. As a result, we have discovered just how amazing some of our native Australian plants are in their composition, including their levels of vitamin C. KAKADU PLUM Currently, our native Kakadu Plum (Terminalia ferdinandiana) is the natural source with the highest known concentration of vitamin C. Also known as Gubinge, Billygoat Plum or Murunga, this tree is native to the Kimberleys and Northern Territory. The Kakadu Plum fruit has been used for centuries by Indigenous Australians for its wonderful healing properties. What is brilliant about the vitamin C in Kakadu Plum is that it is also highly stable, something very sought after for skincare formulations. The amount of vitamin C in Kakadu Plum fruit is 7g / 100g of dry weight content. That’s a whopping 7%! This is 100 times more than the levels of vitamin C contained in oranges. And we all know we’ve been taught to eat or drink our oranges to get our vitamin C intake. It is also much higher than blueberries which have shown to have a relatively ‘high’ level of vitamin C at 0.646 g / 100 g), which is only 0.6%. What makes the Kakadu Plum so amazing is it also contains the phytochemicals gallic and ellagic acids which are well known for their antibacterial and antifungal activities. These are other important properties for skincare formulations. DESERT LIME Our next Australian native is Desert Lime (Citrus glauca). This is a small tree that gives a light green fruit that looks somewhat like a typical lime and is closely related to other citrus fruits. It is native to the semi-arid regions of Queensland, New South Wales and South Australia.
The extract contains 0.962 g / 100 g of vitamin C by dry weight (nearly 1%) and also has high ferulic acid which is an antioxidant that works to boost the effects of other antioxidants. It is also a really great source of calcium.
C but it is an amazing ingredient for helping intensify the actions of vitamin C from its counterparts. It contains the active molecules epigallocatechin, rutin, as well as both tri and tetrahydroxyflavone.
FINGER LIME Not to be confused with Desert Lime is the Finger Lime (Citrus australasica), also known as Citrus caviar. Finger lime grows naturally in the sub-tropical rainforest along the border of south-east Queensland and New South Wales. However, due to land clearing for settlement, much of the wild growing trees have been destroyed. Wild harvesting is now rare and it is mainly sourced from cultivated trees. The fruit it gives with its interior caviar look has quite a variation of red and green tones, and with cultivated growth, the colour of the fruit can be controlled a bit more. It has been reported that Finger Lime has about 3 times the level of vitamin C as oranges, however hard evidence for this is still lacking.
DAVIDSON PLUM The Davidson Plum (Davidsonia jerseyana) is an Australian native tree bearing a blue/purple plum that is native to the rainforests of New South Wales. Some sources report that Davidson Plum contains high levels of vitamin C, yet this has not been proven or detected in recent studies. What it does contain, and where the confusion may come from, is that it contains high levels of flavones that help enhance the activity of vitamin C. Therefore, combining Davidson Plum with other ingredients rich in vitamin C is highly beneficial.
DESERT QUANDONG Also native to Australia is Desert Quandong (Santalum acuminatum) which is from the Sandalwood family. It is often referred to as the ‘native peach’ and is native to the deserts of Australia. It has a red fruit and almost looks a bit like a driedup pomegranate on the outside. Several sources indicate that the Desert Quandong contains about twice the amount of vitamin C as oranges do, and thus a good source of vitamin C. It also contains complex beneficial oils and is antibacterial, historically used by indigenous communities to heal skin. ILLAWARRA FLAME TREE A unique ingredient that helps support vitamin C and boost its potency is the Brachychiton acerifolius or Illawarra flame tree. This is a large tree native to subtropical regions of the Eastern coast of Australia. It is commonly referred to as the ‘Kurrajong’ and is well known for its bright red bell-shaped flower it bears when it loses its leaves (after the dry season). This particular extract does not have the high levels of vitamin
AUSTRALIAN JACARANDA Our last ingredient for discussion is the Australian Jacaranda. The Jacaranda is originally from South America (Brazil) and now grows widely throughout Australia. The extract from the Jacaranda is another fantastic extract that helps stabilize and support vitamin C. The extract also behaves like an alpha hydroxy acid, so how good is that! IN SUMMARY From what we can see, Australia has some pretty potent sources of vitamin C and natives that contain extracts that help support vitamin C and its potency. So why is that? We don’t know specifically why this is, however, one can suggest that it is likely to help protect these natives from the harsh and intense conditions that exist in our climate that promote free radical damage. This is great for our Australian skincare industry as we have local access to these potent and effective antioxidant extracts and give the Australian formulartions a great point of difference. APJ
For a list of references, please contact the editor.
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NUTRITION
Update on the Benefits of Spirulina for Skin and Health Tina Viney IT IS AN ESTABLISHED FACT that a glowing healthy skin is a reflection of inner health. Working on skin corrective procedures externally can therefore be well supported if internal nutrition is optimised. This is why the future of aesthetic care and dermal therapies lies in the profession being classified under the category of allied health. Even if you are not a qualified natural therapist you should consider working collaboratively with one, as well as undertake study units that educate you in simple and safe procedures and lifestyle support information that can benefit your clients as well as yourself. In every issue of APJ we always include both skincare ingredient profiling, as well nutritional ingredient profiling to help create awareness of scientific updates. In this issue let’s look at some interesting facts about spirulina. WHAT IS SPIRULINA? If you’re looking for a plant that can nourish your body by providing most of its protein requirements, can prevent allergies and reinforce your immune system, then spirulina is what you need. Spirulina is a natural algae (cyanobacteria) that is incredibly high in protein and nutrients. It is obtained primarily from two species of cyanobacteria: Arthrospira platensis and Arthrospira maxima. Unlike other plants that grow in the soil, Spirulina grows in the form of blue-green algae in both fresh water and salt water in the wild. It is also commercially cultivated in Spirulina farms. The name originates from the Latin word for ‘helix’, or ‘spiral’, because of its spring like physical characteristics. This plant is consumed as food as well as a dietary supplement. It’s available in tablet as well as powder and flake form to include in smoothies. Besides being consumed by humans, it is also used as a feed supplement in aquaculture, aquarium and poultry industries. Spirulina is largely composed of proteins and amino acids, hence it is beneficial for vegetarians as well as for strengthening collagen and skin integrity. The high content of protein and iron makes it beneficial during pregnancy, after surgery and for boosting the immune system. Since it is a concentrated whole food, it is easily incorporated in various dishes, particularly for children who do not like vegetables.
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THE HEALTH BENEFITS Spirulina is a “superfood” which possesses tremendous nutritional value. Being rich in vital nutrients, this plant offers excellent health benefits. Here is a brief outline of how it can benefit health: ALLERGIES: According to research, Spirulina can help in the treatment of allergic rhinitis. Consumption of Spirulina helps in reducing symptoms like nasal discharge, sneezing, congestion and itching. LOWER BLOOD CHOLESTEROL LEVELS: Spirulina reduces the blood cholesterol levels naturally and boosts the absorption of vital minerals. Consumption of several grams of Spirulina daily can reduce LDL or bad cholesterol and improve the cholesterol ratio. This normalisation of cholesterol plays a great role in weight reduction. BENEFICIAL IN DIABETES: Several studies observed that taking spirulina as a dietary supplement for 12 weeks results in a significant reduction in blood-fat levels. It is particularly beneficial for diabetics as it decreases inflammation and helps reduce blood pressure and cholesterol. AIDS IN WEIGHT LOSS: Spirulina is rich in beta-carotene, chlorophyll, fatty-acid GLA and other nutrients which are particularly beneficial for overweight people. Taking this supplement is beneficial while fasting, as it supplies the nutrients that are needed to cleanse and heal the body, while curbing appetite. CANCER PREVENTION: Several studies have proven that Spirulina can arrest the development of cancer progression, reduce the risk of cancer initiation and boost your immune system. It is a great substitute for animal products as it contains a special form of protein that assimilates well. Unlike animal proteins, it does not burden your body with waste products. It is also rich in phycocyanin, a pigment with anti-cancer properties. It strengthens immunity and inhibits excess cell division. Spirulina also offers some protection against oral cancers. IMPROVES BRAIN/COGNITIVE FUNCTION: Folate and vitamin B-12 play an important role in the healthy functioning of the brain and nervous system. Being rich in these nutrients, Spirulina helps in protecting cognitive function as one starts to age. This nutritional supplement helps maintain brain function.
BENEFICIAL FOR DEPRESSION: Spirulina is a good source of folic acid which provides nourishment for the brain and supports the production of energy and blood cells. This makes it beneficial in the treatment of depression. EYE HEALTH: Research has shown that Spirulina is beneficial for the eyes. It is proven to be effective in treating eye diseases such as geriatric cataracts, diabetic retinal damage (retinitis), nephritic retinal damage and hardening of retinal blood vessels (angiosclerosis). PROMOTES SEXUAL VITALITY: The high content of protein in Spirulina, as well as the presence of other vitamins, minerals and enzymes, makes it beneficial for improving sexual vitality. DENTAL HEALTH: Spirulina has a high content of phosphorus and helps improve your teeth. ANTIBACTERIAL PROPERTIES: Chronic candida yeast is responsible for worsening symptoms of various autoimmune diseases. Spirulina keeps candida overgrowth under control by encouraging and supporting the growth of healthy bacteria in your stomach. HIV, AIDS AND OTHER VIRUSES: Spirulina can cure the symptoms that are a side-effect of HIV and AIDS treatment. It also helps inactivate the human immunodeficiency virus associated with HIV and AIDS. Spirulina possesses antimicrobial properties that can destroy bacteria and viruses such as HIV-1, enterovirus, cytomegalovirus, measles, mumps, influenza A and herpes simplex. It also boosts the immune system by making it produce more monocytes, natural killer cells and macrophages, all of which destroy invading pathogens in the body. ELIMINATES CANDIDA: According to researchers, “Candida species belong to the normal microbiota of an individual’s mucosal oral cavity, gastrointestinal tract and vagina.” What does that mean? Well, without a healthy microflora balance in our body, we are simply much more susceptible to sickness and disease. In fact, leaky gut syndrome and improper digestion are directly connected to micro-floral imbalance. Not only is invasive candidiasis the leading cause of mycosisrelated death in the U.S., candida overgrowth has become the hallmark sign for most autoimmune diseases today.
vitamin B-12, vitamin E, calcium, iron and phosphorus, all of which are vital for your skin’s health. Free radicals make your skin look tired, limp and flabby. Taking Spirulina supplements on a regular basis works wonders for your skin, making it look toned, youthful and vital. It also treats flabby skin by eliminating the body’s metabolic waste products and strengthening the body as a whole. TREATMENT OF DARK CIRCLES: Spirulina is effective in treating dark circles and dry eye symptoms. Its detoxifying effects give your eyes new energy and power, removing dark shadows and dryness. ANTI-AGEING BENEFITS: Spirulina contains tyrosine, vitamin E or tocopherol, and selenium, all of which are known for their anti-ageing effects. Tyrosine slows down the ageing of skin cells as well as prevents against pigmentation. The antioxidants present in it eliminate free radicals which are responsible for skin ageing. Try this facial mask to prevent premature ageing of skin and fight acne. Make a paste by mixing some Spirulina with water and apply it on your face. Keep on for 20 minutes and wash off. This will make your skin amazingly soft and smooth as well as prevent signs of ageing like wrinkles. SKIN DETOXIFYING: Spirulina facilitates faster cell turnover that helps skin heal faster. It wards off free radicals and eliminates toxins from the skin to increase skin metabolism. It also prevents candida overgrowth that can cause acne breakouts. HEALTHY NAILS: Not just for the skin, regular use of Spirulina treats fingernail ridges and other nail problems. Spirulina contains 70% high-value protein which is required by the body. Consuming it for about four weeks can help alleviate nail problems and warts. HAIR BENEFITS: Spirulina is being widely used for promoting hair growth and to combat hair problems like thinning hair and baldness. Spirulina contains amino acids, essential fatty acids, vitamin A and beta-carotene, all of which are great for hair. It can also be used topically for external use to help speed hair growth. It is also used as an ingredient in
Because of our shift toward a diet rich in sugar and unnatural ingredients, antimicrobial resistance and ineffective antifungal drugs, we have seen a significant rise in yeast infections since the 1980s. Thankfully, spirulina appears to be able to help. Several studies have shown that it’s an effective antimicrobial agent, particularly for candida. Specifically, spirulina benefits have been shown to promote the growth of healthy bacterial flora in the intestines, which in turn inhibits candida from thriving. Additionally, the immunestrengthening properties of spirulina can help the body eliminate candida cells. BENEFICIAL DURING PREGNANCY: Spirulina has a high content of iron which is required during pregnancy, particularly for those with anaemia. It also prevents constipation. THE SKIN BENEFITS OF SPIRULINA Being loaded with proteins, vitamins, minerals and fatty acids, Spirulina has a lot to offer in terms of skincare. It is beneficial for your skin in the following ways: SKIN TONING: Spirulina has a high content of vitamin A,
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shampoos and conditioning treatments as well as hair masks to help with hair re-growth. Alopecia is an autoimmune disease characterised by hair loss at an alarming rate. It is not just confined to the scalp alone, but also leads to hair loss across the body and face. This can result in bald spots, even in women, and even complete baldness. Spirulina acts as an alternative medicine to deter further loss of hair and facilitate hair renewal. NUTRITIONAL PROFILE VITAMINS: B-vitamins refer to a group of water-soluble vitamins that are required for energy production as well as formation of red blood cells. Spirulina is a good source of B-vitamins and it contains an exceptionally high amount of vitamin B-12. It also contains vitamin B1 (thiamine), B2 (riboflavin), B3 (nicotinamide), B6 (pyridoxine) and B9 (folic acid). Other vitamins found in these algae include Vitamin, K, Vitamin C, Vitamin D, Vitamin E and Vitamin A. The level of Vitamin E in Spirulina is comparable to that of wheat germ and it possesses four times as much vitamin B12 as raw lever. PROTEIN: Spirulina comprises at least 60% protein. A 112gram serving provides approximately 64 grams of protein. 83% to 90% of this is digestible because, unlike yeast and chlorella, these algae do not have cellulose walls. It has a high net protein utilization ratio (NPU) of 53% to 61%. The high protein efficiency ratio (PER) of Spirulina indicates that your body is efficiently able to use the amino acids. Protein makes up 15% of the body’s weight and is a vital nutrient for healthy growth and of course, very important for skin health.
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Dietary fibre: 1 gram
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Sugars: 0.9 gram
Fats: • Total fat: 3 percent DV •
Saturated fat: 4 percent DV
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Omega-3 fatty acids: 230 milligrams
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Omega-6 fatty acids: 351 milligrams
Minerals: • Copper: 85 percent DV •
Iron: 44 percent DV
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Manganese: 27 percent DV
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Magnesium: 14 percent DV
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Sodium: 12 percent DV
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Potassium: 11 percent DV
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Zinc: 4 percent DV
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Phosphorus: 3 percent DV
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Calcium: 3 percent DV
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Selenium: 3 percent DV
Vitamins: • Riboflavin: 60 percent DV •
Thiamine: 44 percent DV
BETA-CAROTENE: Beta-carotene is a pigment belonging to the carotenoid family and is widely known for its antioxidant properties. It is mostly found in fruits and vegetables, imparting red, orange or yellow colour to them. A half cup of dried Spirulina provides about 342 mg of beta carotene.
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Niacin: 18 percent DV
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Pantothenic acid: 10 percent DV
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Vitamin K: 9 percent DV
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Vitamin E: 7 percent DV
ESSENTIAL FATTY ACIDS: Essential fatty acids are also known as good fats. Since these fats are not produced within the body, they have to be provided from the food sources that contain them. Their main function is to produce prostaglandins that control the body functions like heart rate, blood pressure, fertility and immune system function. Spirulina contains 4% to 7% essential fatty acids such as gamma-linolenic acid (GLA), alpha-linolenic acid (ALA), linolenic acid (LA), stearidonic acid (SDA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and arachidonic acid (AA).
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Folate: 7 percent DV
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Vitamin B6: 5 percent DV
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Vitamin C: 5 percent DV
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Vitamin A: 3 percent DV
MINERALS: Spirulina is also rich in minerals required for the body’s daily activities. These minerals are calcium, potassium, zinc, magnesium, manganese, selenium, iron and phosphorus. They aid in metabolism, maintain water balance and improve bone health. Its calcium, phosphorus and magnesium content are similar to that of milk. CARBOHYDRATES: Spirulina has only 15% to 20% of carbohydrate content. It also contains 18 different amino acids. The major reason why many nutrition experts prefer spirulina to chlorella? Dietary spirulina is arguably the most nutrientdense food on the planet. It’s why taking dietary spirulina supplements is essential to good health. Taken as an average of different spirulina species, just one ounce delivers the following nutrients: •
Calories: 81
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Protein: 39 grams
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DOSAGE RECOMMENDATIONS A common question when first trying out this incredible ingredient is: “how much spirulina should I take daily?” Although there’s no standard spirulina dosage, most studies have found a beneficial effect when consuming 1–8 grams per day. For reference, one tablespoon of blue spirulina is about 7 grams. Can you overdose on spirulina? According to experts, taking even large amounts of spirulina is unlikely to cause serious harm, but may result in digestive issues like nausea, diarrhea, bloating and cramps. Therefore, it’s best to start with a lower dosage and slowly work your way up to assess your tolerance. When it comes to how to take spirulina, the options are endless. Spirulina capsules and spirulina tablets can be found at many health stores and pharmacies for a quick and convenient way to get in your daily dose. Organic spirulina powder is also available and can be easily combined with other superfoods to create a nutritious and delicious spirulina smoothie. APJ
THE POWER OF KNOWLEDGE In a time of turbulence and change, it is truer than ever that KNOWLEDGE IS POWER. - John F. Kennedy APAN is pleased to announce that in collaborations with several accredited institutions we have expanded our professional development courses available through online study. Additionally, each course has been reviewed and has been allocated CPD Points acknowledging ongoing professional development. There is no better way in boosting your confidence and improving your business position than through structured and credible education.
Courses Include • Pandemic Infection Control • Pandemic Clinical Infection Control • Safe Use of Topical Anaesthetic • Dr Setterfield’s Skin Needling Course • And much more …
How You Can Benefit • Increase client retention • Build and strengthen confidence • Expand your recognition and credibility • Re-energise your staff • Improve efficiency • Enhance your competitive advantage
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info@apanetwork.com
www.apanetwork.com/courses
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COSMETIC CHEMISTRY
The Targetted Approach to Skin Rejuvenation Proven actives for optimum result with anti-ageing Jacine Greenwood-Drummond THE MOVE TOWARDS a targetted and prescriptive approach to skin rejuvenation is based on understanding your actives and how they impact the skin. In this article ingredient educator and skincare formulator, Jacine GreenwoodDrummond discusses proven cosmetic actives for successfully treating ageing skin. Ageing of the skin is not one symptom, but a multiple of symptoms that give clues of the age of the skin and even the chronological age of the client. There are many ingredients on the market, no ingredient however, targets every facet of ageing, which is why a combination of actives is required to treat the various symptoms of ageing skin. Fine lines and wrinkles are a result of a decline in collagen product, as well as an increase in MMP enzymes (Matrix Metalloproteinases). Matrix metalloproteinases are enzymes that digest collagen weakening collagen fibres. Deeper wrinkles are when the dermal epidermal junction is breached and there are gaps. So how can we be target-specific when addressing a particular ageing concern? To achieve this, we need to know the action of specific cosmetic actives and how they can work on reversing or minimising the causes of a condition in the skin. •
Here are the results that we should be looking for when selecting actives:
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Ingredients that stimulate collagen or increase fibroblast health
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Ingredients that inhibit MMP’s aka prevent collagen breakdown
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Ingredients that stimulate elastin
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Ingredients that inhibit Advanced Glycation End Products (AGEs)
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Ingredients that increase adipocyte proliferation and size
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INGREDIENT THAT STIMULATE COLLAGEN AND PROTECT COLLAGEN Here are the most important evidence-based ingredients with the most studies form proven efficacy: Renewing Extracellular Matrix Matrixyl 3000 (Palmitoyl Tripeptide-1 and Palmitoyl Tetrapeptide-7) both these ingredients contain matrikines that are messengers of cutaneious restructuring. They are capable of regulating cellular activities and interact with specific receptors to activate genes involved in the process of renewing the extracellular matrix. Matrixyl 3000 stimulates collagen 1 by 50%. Wrinkle filler Matrixyl Synthe-6 (Hydroxypropyl Cyclodextrin, Palmitoyl Tripeptide-38) functions as a wrinkle filler, filling in wrinkles from the crows-feet as well as the forehead lines. It has been shown to increase collagen 1,3,4, fibronectin, laminin and hyaluronic acid. Matrixyl Synthe-6 has also been shown to increase production of collagen 1 by 105% and collage 3 by 104%. Collagen Production and Prevention of Collagen Degeneration SYN®-COLL (Palmitoyl tripeptide-5) is a small tripeptide with a unique sequence to mimic the human body’s own mechanism to produce collagen via TGF-b. It has been shown to stimulate collagen 1 by 76%. It is a synthetic tripeptide that helps slow down the skin’s ageing process. It mimics the body’s own mechanism, simultaneously boosting collagen production and protecting against collage n degradation. Both activities work synergistically to achieve a maximum anti-ageing effect. Muscle attenuation Argireline is a peptide that mimics the N-terminal end of SNAP-25 and it competes with the natural protein for a position in the SNARE complex. If the SNARE complex is slightly destabilised, the vesicle cannot release neurotransmitters efficiently and therefore muscle contraction is attenuated, preventing the formation of lines
and wrinkles. It also stimulates collagen 1 production in the skin. Magnesium Ascorbyl Phosphate (MAP) is one of the most stable and preferred ascorbyl esters. This lipophilic molecule is easily absorbed into the skin and the rate limiting step for absorption is its release from the vehicle and not the rate of diffusion across the stratum corneum as one might suppose. MAP has a hydrating effect on the skin and decreases transepidermal water loss. It is also a free radical scavenger that is photo-protective and increases collagen production under laboratory test conditions. Magnesium Ascorbyl Phosphate has been shown to increase collagen 1 production by 25%. Progeline (Trifluoracetyl Tripeptide-2) is a biomimetic peptide derived from elafin. It inhibits the production of progerin, a cell-ageing accelerator protein. Progeline reduces progerin to a young cell level to delay cell senescence. It has been shown to stimulate sirtuin production and activity to extend cell lifespan. It boosts collagen production and inhibits degradation enzymes’ activity (collagenase, elastase, MMP-1, MMP-3 MMP-9). SYNŽCOLL has also been shown to inhibit the destruction of collagen by inhibiting matrix metalloproteinases by 98%. Retinol has been shown to increase the production of collagen and prevent matrix metalloproteinase release. Clinical studies examining a topical application of 1% Retinol for 7 days increased fibroblast growth and collagen synthesis. Resveratrol is a polyphenol produced by plants under microbial attack. It has significant antioxidant and antiinflammatory properties. Topical application of a cosmetic formulation containing resveratrol and retinoid proved to have multiple beneficial effects on skin such as reduction of wrinkles and improvement in skin radiance. Resveratrol has been shown to stimulate Collagen 1 by 225%. Collagen 3 by 230% and Collagen 4 by 160%. It has also been shown to inhibit matrix metalloproteinases by 480%. INGREDIENTS THAT PROMOTE ELASTIN SYNTHESIS AND INHIBIT ITS DESTRUCTION Plant extracts have been shown to have a significant impact on the protection of collagen and elastin in the skin. Plants that show the highest anti-elastase activity are in the following order:
White tea (89%, cleavers (58%), burdock root (51%), bladderwrack (50%), anise and angelica (32%). Dill Seed Extract increases LOXL (lysyl oxidase homolog1) specifically and plays a very important role in the formation of elastic fibres in human skin, increasing formulation by 71%. Pisum Sativum Extract increases elastin by 50%, as well as stimulating collagen 1 production by 140%. INGREDIENTS THAT INHIBIT ADVANCED GLYCATION END PRODUCTS Albizzia Juibrassin Bark Extract protects from glycation by supporting the detoxification systems (glyoxalase and proteasome). Glyoxalae plays a critical role in the prevention of glycation. Albizzia Julibrissin Bark Extract has been shown to decrease advanced glycation end products by 43%. Blueberry Extract has been shown to have a potent effect on advanced glycation end products. Both the leaf and stem have anti-glycation properties but the stem extract was found to be far more potent, inhibition glycation by over 90%. INGREDIENTS THAT INCREASE ADIPOCYTE PROLIFERATION As we age our fat cells that cushion the features giving them a youthful look start to disintegrate. Blackberry leaf Extract has been shown to increase adipocyte proliferation and size, leading to a volumizing effect on the skin. Sea Fern (Dictyopteran membranacea) is a brown alga that has been shown to have a volumizing effect on the skin. It increases the number of adipocytes, as well as their size. IN CONCLUSION There are various actives on the market that target the many facets of ageing. Choosing the right active will change the results your clients are achieving. For example, menopausal skins require actives that add volume and shape to the skin, to address the structural changes that occur during this time. On the other hand, younger skins should be using actives that target specific elastin fibres as these are the first structural proteins of the skin to decline during the ageing process. All skins should be using ingredients that aid in the production of collagen from 25 years of age to address the decline of collagen. APJ
APJ 93
HEALTH SCIENCE
Treatment Options for
Systemic and Localised Sweating Disorders Gay Wardle
MOST PEOPLE SWEAT WHEN THEY EXERCISE, or exert themselves. Others may sweat due to a hot or humid environment, or even due to anxiety or stress. Sweating is part of your body's mechanism to cool itself. Your nervous system automatically triggers your sweat glands when your body temperature is overheated, so it is a normal bodily response and part of the negative feedback loop of homeostasis. However, excessive sweating is known as hyperhidrosis and far exceeds normal sweating. In these instances, medical treatment may be required. In this article Gay Wardle will look at potential treatment options for this disorder. WHAT IS HYPERHIDROSIS? When someone has persistent sweating, the disorder is known as hyperhidrosis. Hyperhidrosis can be subdivided into generalised hyperhidrosis, or focal hyperhidrosis. If the sweating is excessive and over the entire body it is generalised hyperhidrosis. It can be anywhere from the persons feet, hands, axillary, facial area, limbs (arms and legs). On the other hand, focal hyperhidrosis is restricted to just one area, such as axillary and this is the most common form of hyperhidrosis. Psychologically, the condition can be very stressful, especially when there is very visual evidence of its existence, such as when sweat is soaking through clothing, or when it contributes to strong odour. This type of heavy sweating is not only embarrassing, it causes social anxiety. Focal hyperhidrosis is the most common form of the disorder and affects the nerves that are responsible for signalling the sweat glands. The sweat glands become overactive, even though they haven't been triggered by physical activity or APJ 94
have been affected by an increase in temperature. With stress or nervousness, the problem becomes even worse. Focal hyperhidrosis usually affects the palms of the hands and soles of the feet and sometimes can affect the face as well. Individuals who sweat profusely are more prone to skin infections. With constant perspiration on the surface of the skin, the skin’s own bacteria will be disrupted. The barrier function starts to break down, allowing bacteria to enter the skin which may cause infection. There is no known medical cause for both generalised, or focal hyperhidrosis, although there may be a hereditary component as it sometimes seems to run in families. There are several treatment options to address this disorder, however, it is important that the patient explores each one to ensure they are comfortable with their treatment choice as there are often side effects. Here are some common medical treatments. TREATMENT OPTIONS The first one is a prescription antiperspirant. The product contains aluminium chloride. The downside is that it can cause eye and skin irritation. This product is usually applied to the affected skin prior to bedtime and then washed off in the morning, making sure to avoid any contact with the eyes. If the skin becomes irritated, hydrocortisone cream is usually recommended to help relieve the symptoms. If hyperhidrosis is affecting the face and head, the recommended treatment is a prescription cream containing glycopyrrolate. Several oral medications are also available to treat hyperhidrosis. Each has different side effects and dose recommendations. These include Oral Robinul (glycopyrrolate), Clonidine as well as Dipropan. These are
medically prescribed medications that work by blocking the chemicals that permit certain nerves to communicate with each other. However, they do not reduce the sweating in everyone that has hyperhidrosis and they sometimes have side effects, such as blurred vision, bladder problems and dry mouth. Some medications used for depression can also decrease sweating. In addition, they may help decrease the anxiety that worsens the hyperhidrosis. Did you know that Botox is not just for treating wrinkles? Botulinum toxin can also be used to temporarily block the nerves that cause sweating. Each affected area of the body will need several injections. The effects last three to six months and they will need to be repeated. However, this treatment can be painful, it is expensive and some people can also experience temporary muscle weakness in the treated area. Fractional microneedle radiofrequency treatment appears to be a new safe and effective treatment alternative for moderate to severe primary axillary hyperhidrosis. Repeated sessions of fractional microneedle radiofrequency treatments can be considered to achieve a complete response. Another technology used for hyperhidrosis is microwave therapy. This treatment delivers microwave energy that is used to destroy sweat glands. Treatment involves two 20 to 30-minute sessions, three months apart. Possible side effects can include a change in skin sensation and some discomfort. This therapy may be expensive and not widely available. Sweat gland removal is also an option and is performed through minor surgery. It is a minimally-invasive technique known as suction curettage. This is an effective treatment if there is no response to other treatments. Another option is nerve surgery (sympathectomy). This is a procedure where the spinal nerves that control sweating
of the hands are cut, burnt or clamped. In some cases, this procedure can trigger compensatory excessive sweating in other areas of your body. Surgery is generally not an option for isolated head and neck sweating. A variation on this procedure interrupts the nerve signals without removing the sympathetic nerve. SECONDARY HYPERHIDROSIS Secondary hyperhidrosis is often the result of another underlying condition or a side effect to a medication, or as a result of a surgical procedure. It can also be caused by taking recreational drugs. It is less common than primary hyperhidrosis and is more likely to be asymmetrical or generalised. IN CONCLUSION Anyone suffering from hyperhidrosis must maintain good hygiene standards. They should bathe daily and pay special attention to affected areas that experience dryness of the skin, particularly the feet. This will help to reduce bacterial concentration in these areas. Individuals with axillary hyperhidrosis may benefit from using absorbent pads to prevent sweat from soaking through clothing. People who suffer axillary hyperhidrosis may need to carry extra clothing to allow them to change as needed. They should be advised to avoid garments using synthetic fibres and prefer to wear clothing of breathable fabrics, such as cotton or silk. In some cases, hyperhidrosis occurs in response to emotional stimuli, so, practising relaxation techniques may assist individuals to cope with emotional stimuli that trigger sweating. Excessive sweating may lead to dehydration if fluids are not replaced. Ensuring proper hydration is maintained is therefore an important component of managing the condition. APJ
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TECHNOLOGY
LED THERAPY AND EYE SAFETY CONSIDERATIONS Tina Viney
THERE IS NO DOUBT THAT LED LIGHT THERAPY offers many benefits, not just for the skin, but also for overall health. Known for its photo-rejuvenating benefits, in particular red LED is proven for its numerous benefits, healing and antiinflammatory effect making this technology a must-have for every salon and clinic. Additionally, hand-held devices are often promoted for home use to complement the in-clinic treatment. However, there appears to be some misconception about LED light and eye safety, with varying opinions circulating, not just within the industry, but also with some suppliers. In this article, I would like to briefly touch on the benefits of LED light for skin therapy. but also point out some safety issues for consideration and in particular, with regards to LED and eye safety. THE SCIENCE OF LIGHT THERAPY Despite the fact that light therapy sounds like magic, it is actually just creatively applied science. Photo-rejuvenation is a skin care treatment that uses infrared light in varying wavelengths — most commonly red and blue — for skin treatments. This is not the same as UV light — the kind that causes suntans and skin cancer. As we know, essentially the different wavelengths and colours send a message into the layers of skin to trigger a different reaction. Used alone, or combined with other salon treatments, light therapy can effectively target a variety of skin conditions from acne to ageing to texture issues in the skin. Light therapy is beneficial because it stimulates skin tissue to regeneration. With increased blood circulation, collagen production is enhanced, which is the foundation of plump and firmness and characteristic of youthful skin. LED therapy also helps support the skin against sagging. Research confirms that red light therapy also helps speed wound healing. It can help repair sun damage, reduce signs of ageing and treat other skin conditions such as rosacea.
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Blue light therapy is most commonly used to treat acne. It can be used to reduce sebaceous hyperplasia, also known as enlarged oil glands, which contribute to ongoing acne breakouts, whiteheads and blackheads. It can also be helpful in treating acne and acne scarring. However, the verdict on blue light is that it also carries certain risks. In the spring issue of APJ (Vol. 42), Terry Everitt presented a comprehensive scientific article and the potential risks of blue light. In his article he stated: While several studies indicated that blue LED is beneficial against various acne bacteria, it is now proven that it can also cause pigmentation. Not only do the melanocytes take a hit from blue light, so do the fibroblasts. In another study, Opländer et al., (2011) the effects of blue light at distinct wavelengths (410, 420, 453, 480 nm) emitted by light-emitting diodes on viability, proliferation and antioxidative capacity of human dermal fibroblasts were investigated. The study found that irradiation with 410, 420 nm led to intracellular oxidative stress and toxic effects in a dose and wavelength dependent manner, which did not occur with 453 nm and 480 nm. Additionally, irradiations at 410, 420 and 453 nm reduced fibroblast proliferation. The study surmised that blue light at different wavelengths induce varying degrees of intracellular oxidative stress with different physiological outcomes, which could contribute to premature skin photo-ageing. As skin care professionals, you know already how you can counterbalance this to prevent the ongoing damaging effects from blue light. The study further discovered that blue light interacts with porphyrin containing enzymes and flavoproteins causing generation of reactive oxygen species like singlnet oxygen and hydrogen peroxide within the fibroblasts, thus causing antiproliferative effects on the fibroblasts.
Singlet oxygen is prevalent in higher numbers with 410 nm and 453 nm inducing higher hydrogen peroxide proliferation. These findings confirm that previous that postulated blue light increased free radical production. On the positive side, knowing the effects of blue light on fibroblast proliferation, this could be useful in treatment of hypertrophic scarring where fibroblastic hyperproliferation is the problem, so isolating the blue light emission to the scar tissue only could provide a new approach to scar treatment”. WHAT ABOUT EYE RISK? Speaking to professor Laurence Walsh, (who is also an expert in light-based therapies), regarding LED and eye health risk, he alerted me to two studies: * The ASNZS 4173 Australian Standards, which were established in 2018 – The Safety of Lasers and IPL in Healthcare. * The International Commission on Non-Ionising Radiation Protection ICNIRP latest report released this year on LightEmitting Diodes (LEDs): Implications for Safety. In reviewing both documents the key considerations I found that related to LED for cosmetic use were as follows: The first report stated that the use of intense light sources, including IPLs and by extension LED arrays, was included as this was considered a rapidly growing technology in medical care, and, while they are incoherent (i.e. not laser) sources, the patient and operator safety issues are very similar. Some laser users may also use intense light sources, and some clinical applications can use either technology. It is also interesting to note that ARPANSA also had added LED in their guidelines for IPL and Laser, as new information is suggesting there are safety considerations that also extend to LEDs. Check out the guidelines on the APAN website https:// apanetwork.com/resources/ While these reports went beyond LED for skin therapy there were certain parallels in their observations. Studies that looked at different colours definitely identified that the use of LED light for long periods of time can contribute to ‘photo-toxicity’ that can lead to irreversible loss of retinal cells, diminished sharpness of vision. The report also sighted the potential for photochemical retinal injury with excessive exposure. Both reports distinguished between acute exposure of highintensity LED light, and "chronic exposure" to lower intensity sources. While less dangerous, chronic exposure has been shown to "accelerate the ageing of retinal tissue, contributing to a decline in visual acuity and certain degenerative diseases, such as agerelated macular degeneration," the report concluded. The key concerns raised were for the increase risk of age-related macular degeneration (AMD) from chronic exposure to bright lights, not just LED. Despite conflicting epidemiological data on the relationship between sunlight exposure and AMD, it is believed that high levels of umulative light exposure may lead to oxidative stress in the retina. This can then lead to the abnormal accumulation of reactive oxygen species in the macular of the eye, which can induce mutagenic mechanisms, leading to degenerative eye-diseases such as AMD (SCHEER 2018).
Both reports indicated that red LED was safer than blue-rich LED. If the LED therapy duration of the treatment is short (20 minutes) with appropriate protection, it is not expected to pose retinal hazards for healthy individuals. However, some segments of the population e.g. newborns, young children and the elderly (SCHEER 2018), may be more susceptible to some biological effect particularly form blue LED, UV, IR. THE NEUTROGENA RECALL Recently, Neutrogena recalled its home LED mask for treating acne. The following message was included on their website: “You may have noticed that the NEUTROGENA Light Therapy Acne Mask and Activator are not available where you shop in the United States. That’s because these products have been recalled from wholesalers and retail stores. Our decision to recall this product is being made out of an abundance of caution. The NEUTROGENA Light Therapy Acne Mask is safe for use by the general population when used once per day as directed. Reports of visual effects associated with the use of the NEUTROGENA Light Therapy Acne Mask are rare, generally mild and transient. For a small subset of the population with certain underlying eye conditions, as well as for users taking medications which could enhance ocular photosensitivity, there is a theoretical risk of eye injury. If you experience any visual discomfort when using the mask, you should stop use and contact your healthcare professional”. ®
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Concerning the Neutrogena recall, the Australian Department of Health stated that certain people may be susceptible to “varying degrees of retinal damage that could be irreversible and could accelerate peripheral vision impairment or loss.” THE USE OF GOGGLES Both the salon and the home photo-rejuvenation masks emit incredibly bright light. Even with your eyes closed you can experience the transmission of the light going right through you. The truth is, light therapy can cause eye damage. Therefore, eyes should always be protected. Please make sure that the goggles you use are of high quality and shield all the light during an LED treatment. Goggles are not always created equal as they can come in varying blackout versions. When it comes to goggles, “the best possible type of eye protection is a blackout goggle which basically does not allow any light through. These glasses or goggles can be more of an oversized shield fit to cover the orbital region and block any and all potentially harmful or degenerative rays from the eyes. These can provide more than enough dimming so that the intensity for any LED light could not cause interference, discomfort or any sort of damage. As a professional, you need to ensure that when introducing any type of light therapy LED, IPL or LASER to always use high quality eye shields and always advise your client to keep their eyes closed during the treatment, while wearing the goggles. While home masks will probably be less intense than clinic equipment, you still need to ensure that your client’s eyes are protected. Also please ensure that your clients follow the recommended time of 20 minutes. Extending the treatment time or repeating the treatment again on the same day could be dangerous. Generally speaking, LED offers great benefits, however, the appropriate safety precautions must be adhered to. If used at home make sure that babies or young children are not in the room, as well as the elderly, who may be experiencing diminishing eyesight. APJ
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NUTRITION
The Health Benefits of
Chia Seeds
Tina Viney SPEAKING REGULARLY WITH WOMEN I can confirm that we all want to look good and feel fantastic but if at all possible, we don’t want to give up our simple pleasures – one of these is our desserts. Moving forward with skin and age-management treatments, we are seeing the need to address diet when helping to both improve skin, energy levels and wellbeing. While delivering advice in this area may be considered outside of the scope of practice for some, there are ways that we can still guide our clients to make wiser choices when it comes to their food. One such recommendation is to provide your clients with a list of nutritious and healthy options that have good scientific support and allow them to make the choice as to what would best suit their health and other considerations. With information about the importance of the microbiome in skin and wellbeing, we now understand the connection between skin, brain and overall health and the importance of preferring foods that provide us with valuable nutrition, support the skin, weight management and healthy digestion. In this article I would like to profile a small and humble seed with an amazing health profile. I am talking about the chia seed. Much of the information I will be presenting has been backed by scientific studies, so if you wish to access the reference please contact me. WHAT ARE CHIA SEEDS? Scientifically known as Salvia Hispanica, chia seeds are considered to be one of the few superfoods that nature has bestowed upon us. Originating in Mexico, and dating back to the Mayan and Aztec cultures, these seeds are known for their richness in omega-3 fatty acids, fibre, protein, antioxidants, and minerals such as calcium and manganese. They also act as a natural laxative. It is believed that Aztec warriors consumed chia seeds for endurance. According to popular legend, one spoonful of chia seeds could sustain them for 24 hours. In the Mayan language, ‘chia’ means strength. The seeds are an unprocessed, whole-grain food that are absorbed by the APJ 98
body as seeds. Though originally used as equine feed, the benefits are found to extend to humans as well. In the recent times, research has found the benefits of chia seeds to be far greater than what anyone knew – which is precisely why I want to bring this information to your attention in this article. And by the way, chia seeds can be good for your pets too. It is also easy to store. It doesn’t have any specific taste or smell for your pet to turn its nose up at. The dosage would be ¼ of chia seeds for every 4.5 kilos of your pet’s body weight. Let’s take a closer look at some of the amazing benefits of chia seeds. HEALTH BENEFITS First, chia seeds are rich in omega-3 fatty acids. Research suggests that many of us consume high levels of omega-6 through vegetable oils, yet the body requires a correct balance of omega-3 fatty acids which are usually found in fish, however chia seeds are rich in omega-3, which many of us are low in. Consuming chia seeds is probably the easiest way to intake these healthy fatty acids. Yes, we have flaxseeds or salmon that are good sources of omega-3s, but it’s all about the ease of intaking. You don’t have to grind or cook the chia seeds. One serving of chia seeds contains 5 grams of omega-3 fatty acids. Second, they contain soluble fibre. Simply get the chia seeds a little wet, and you will see them turning into a gel – which is the soluble fibre. The benefits of soluble fibre are many – it helps manage blood sugar, feeds the gut-friendly bacteria, and even bulks up the stool. A single serving of chia seeds meets almost a third of your daily fibre requirement. If you have bone issues, you can swear by chia seeds. A high content of calcium, phosphorous, and manganese make them good for the bones. CHIA SEEDS NUTRITION FACTS 100 grams of these seeds contain about 485 calories, 31 grams of fat and 42 grams of carbohydrates. The seeds also contain 18 of the 22 amino acids – and all of the 9 essential amino acids namely lysine, leucine, isoleucine, methionine,
threonine, tryptophan, phenylalanine, valine, and histidine. One serving of chia seeds equals 28 g. The nutritional values below are based on one single serving of chia seeds.
Nutrient
Adequate Intake
Dietary fibre
10.6 g (42% of daily value)
Protein
4.4 g (9% of daily value)
Calcium
17 mg (18% of daily value)
Manganese
0.6 g (30% of daily value)
Phosphorous
265 mg (27% of daily value)
Potassium
44.8 mg (1% of daily value)
Sodium
5.3 mg
Zinc
1 mg (7% of daily value)
Copper
0.1 mg (3% of daily value)
Total omega-3 fatty acids
4915 mg
Total omega-6 fatty acids
1620 mg
LEADING CHIA SEEDS BENEFITS 1. Stimulate Weight Loss Weight loss is probably the number one reason most people do what they do. In fact, it is a multi-billion-dollar industry. And if you are looking to lose weight, chia seeds could be one of the first options you can consider. Of course, no single food can aid weight loss or cause weight gain. It all depends on our food habits and lifestyle. However, what makes chia seeds a good weight loss food is its excellent fibre content. A normal intake of chia seeds a day, which amounts to 25 to 38 grams a day, can go a long way in helping with losing some extra weight. The seeds are also found to reduce belly fat. To assist with weight loss just add two tablespoons of raw or whole chia seeds into a glass of water. Stir well. After allowing the mixture to settle (for a few minutes), drink them quick before they get swollen due to water absorption. The fibre in chia seeds also helps you feel full for longer periods of time. It promotes satiety. The seeds absorb water in the stomach and then expand, thereby suppressing your appetite. This can eventually lead to weight loss. Please ensure when consuming chia seeds that you also drink plenty of water to avoid constipation. 2. Prevent Constipation Since they are packed with fibre, especially insoluble fibre, chia seeds turn into a gel when they come in contact with water. This adds to your stool and aids bowel movements, thereby relieving constipation. Fibre also has been found to improve digestion.
3. Regulate Blood Sugar Levels and assists in preventing Diabetes Chia’s ability to slow down digestion can be linked to diabetes prevention. The gelatinous coating chia seeds develop can also prevents spikes in blood sugar levels. According to the United States Department of Agriculture, chia is one of those foods considered to be useful in diabetes treatment. Studies also confirmed that the seeds were also found to improve the blood pressure levels in diabetics. Another reason chia can be good for diabetics is the presence of omega-3 fatty acids that are known to be nutritionally important for the treatment of the disease. 4. Fight Breast and other forms of Cancer As per a report published by the UCSF Medical Centre, chia seeds are a good source of alpha-linoleic acid, which can help prevent breast cancer. The same goes for omega-3 fatty acids. 5. Supports Healthy Blood Lipid Levels The omega-3 fatty acids get the credit, again. These fatty acids help lower blood cholesterol and prevent coronary heart disease in the process. The monosaturated fats in chia seeds help lower the cholesterol levels. The Academy of Nutrition and Dietetics also states that adding chia seeds to the diet can keep a check on the cholesterol levels. According to a report published by the West Virginia University, chia seeds, as part of a heart-healthy diet and lifestyle, can enhance heart health and prevent heart-related ailments. The omega-3s also reduce triglycerides, a type of fat in the blood. In addition, they reduce the risk of irregular heartbeat, lower blood pressure, and slow down the accumulation of arterial plaque. Chia seeds were also found to treat dyslipidaemia, a metabolic disorder where there is an abnormal amount of cholesterol in the blood. In another Argentine study, the alpha-linoleic acid in chia seeds had improved the condition of rats suffering from dyslipidaemia. Additionally, chia seeds were also found to increase the levels of HDL or good cholesterol. 6. Boost Energy and Metabolism Chia seeds are packed with B vitamins, zinc, iron, and magnesium – all of which help boost energy. You can add the seeds to your favourite smoothie and enjoy a refreshing burst of energy. As per a report published by the University of New Hampshire, chia seeds can also boost metabolism. 7. Packed with Protein We all know that protein is so important not just to a healthy skin, but to overall health. Chia seeds are a great source of protein. As confirmed by a Brazilian study, chia seeds had shown great protein quality. They also had improved the lipid profiles (cholesterol levels). Chia seeds contain 19% protein. And according to the American Journal of Clinical Nutrition, a high-protein diet can reduce hunger and encourage satiety. The seeds contain high-quality protein with all the necessary amino acids. 8. Enhance Mood Chia, considered a superfood, is believed to enhance your mood when eaten regularly. A Pittsburgh study confirmed that omega-3 fatty acids are associated with improved mood and behaviour. Consuming chia seeds might also help you combat depression. 9. Rich in Antioxidants and Minerals We all know how important antioxidants are. and chia seeds have them in abundance. The antioxidants are not only good
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for the cells, but for the skin as well – as they help slow down the signs of ageing. The antioxidants in chia seeds have also been found to reduce the risk of cancer and heart disease. A high antioxidant content is what makes chia seeds more shelf-stable than other seeds. One study has shown that increased consumption of calciumrich foods, like chia seeds, can improve skeletal health. Consumption of chia seeds is also considered an effective way to improve calcium intake. Did you know that one serving of chia seeds contains 30% of the RDA of magnesium? The mineral has several benefits – a few them include treatment of hypertension and heart disease, osteoporosis, and type 2 diabetes. Magnesium also helps in the production of energy in the body, and a lack of it can cause fatigue, insomnia, irritability, and poor memory. 10. What about Skin Health? The omega-3 fatty acids in chia seeds have been found to increase circulation and reduce dryness and skin inflammation. And as per a Manchester study, omega-3s help protect the skin from UV radiation. Chia seeds contain antiinflammatory properties that could help prevent wrinkles as well as reduce skin sagging. Used topically, chia seeds are also used as a beneficial facial scrub. 11. Help Treat Diverticulosis Diverticulosis is the presence of tube-like structures in the intestine with no signs of inflammation. Chia seeds, simply because they are vegetarian and rich in omega-3s, are found to help prevent diverticular disease. Lack of fibre has also been linked to diverticulosis – and chia seeds, being an excellent source of fibre, can help treat this condition. They absorb the water in the colon and smooth the bowel movements. 12. Can be used as a substitute for Eggs If you think you want protein but don’t take eggs, you have some good news! You can use chia seeds as a substitute for eggs. The process is simple. All you need is a tablespoon of chia seeds and three tablespoons of water. Grind the chia seeds, and then mix them with water in a small bowl. Keep it aside for 5 minutes until the mixture takes on a gooey consistency – similar to raw egg yolk. You can add this to your dishes and enjoy the goodness of high-quality protein. 13. Have Anti-Inflammatory Properties The presence of omega-3s, fibre, and protein make chia seeds one of the best anti-inflammatory foods out there. The antiinflammatory properties of chia seeds can also aid in the treatment of arthritis.
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14. Gluten-Free Gluten is the protein present in cereal grains, especially wheat, and is responsible for the elastic texture of dough. In certain individuals, gluten is known to cause allergies and gluten intolerance. However, with chia seeds, it’s a different scenario. It is 100% gluten-free. It is particularly helpful in gluten-free baking. Chia seeds are especially beneficial for individuals suffering from celiac disease. As per studies, people with celiac disease tend to consume less calcium and fibre than recommended and chia seeds, being rich in these two nutrients, can bridge the gap. 15. Improves Sleep There are two hormones that are essential for sleep – serotonin and melatonin. These two hormones are produced by tryptophan, an amino acid in the body. Chia seeds, being high in tryptophan, aid good sleep and relaxation. According to an American study, tryptophan is also used for treating numerous sleep disorders. How Much Chia Seeds Per Day? 20 grams of chia seeds is recommended (1 ½ tablespoons) twice a day. You can add the seeds to your food or snack and enjoy. STRAWBERRY JAM Earlier on I talked about women loving sweets and I am no exception. One of my guilty pleasures is high quality fruity jams with chunks of fruit in them. However, the sugar is always a concern, but I have found a solution which I will take the liberty to share with you. As we are currently in strawberry season, I discovered a wonderful way to create a guilt-free jam or dessert. Take two large punnets of strawberries combined with three tablespoons of chia seed, just half a cup of water (as strawberries are full of liquid) and 2-3 teaspoons of organic stevia or xylitol to up the sweetness. Then gently cook until the strawberries tenderise but do not disintegrate. Allow to cool and refrigerate. The chia seeds will gelatinise and hold the fruit together either as a jam or a pudding. Either way, it is a delicious way to enjoy a sweet treat. Feel free to enjoy this and share it with your clients if you wish. We all deserve a little treat now and then. There are many ways that we can support our health, as well as guide our clients with creative ways of improving their skin and staying healthy. APJ
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APJ 101
SCIENTIFIC NEWS
SCAR FORMATION BEGINS IN THE FASCIA WE KNOW SIMPLISTICALLY that scars form when fibroblasts, reach wounded skin and deposit plugs of extracellular matrix. Exactly where these fibroblasts come from has not been answered, until now as researchers found that scars are made from a tissue beneath the skin: fascia. Without all the details, researchers concluded that fascia contains a specialized prefabricated kit of sentry fibroblasts, embedded within a movable sealant, that preassemble together all the cell types and matrix components needed to heal wounds. They are assuming that guided homing of fascia initiates the hallmark response to external and internal injuries. When fascia was removed the skin simply did not heal, resulting in long term open wounds. While you might not like scars, they are essential for the skin and thus body survival. Correa-Gallegos, D., Jiang, D., Christ, S., Ramesh, P., Ye, H., Wannemacher, J., Gopal, S., Yu, Q., Aichler, M., Walch, A.,
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Mirastschijski, U., Volz, T., & Rinkevich. Y. (2019). Patch repair of deep wounds by mobilized fascia. Nature, 576, 287–292. DOI: 10.1038/s41586-019-1794-y
PLATELET-RICH-PLASMA IS SUPERIOR TO PLATELETS OR PLASMA FOR WOUND HEALING IN VITRO WOUND HEALING IS A MULTI-STEP process involving many different types of cells, growth factors, platelets, fibroblasts and cytokines. This study looked at platelets which release chemical signals to activate fibrin-platelet clots and draw white blood cells to the wound site to clear out damaged, dead, or pathogenic cells. Growth factors and cytokines released by platelets also promote tissue repair, influence angiogenesis, and inflammation at the wound site.
The hitherto tenet in wound repair was that scars form de novo by fibroblasts depositing extracellular matrix at sites of injury with these novel findings adding to current paradigms of how wounds repair. This new knowledge led to further discoveries about scarring mechanisms and the fascia matrix which are crucial for the research on scar less skin regeneration and the prevention of fibrosis. APJ
Researchers from the Netherlands generated platelet pools approximately 3-to 4-fold more concentrated (compared to physiological levels)
Research and Scientific New Developments In every issue of the journal, 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.
and these platelet concentrates were resuspended in plasma (PC-plasma), which significantly increased fibroblast proliferation and migration and was superior in stimulating chemotaxis of white blood cells. Van der Bijl, I, Vlig, M., Middelkoop, E., & de Korte, D. (2019). Allogeneic platelet-rich plasma (PRP) is superior to platelets or plasma alone in stimulating fibroblast proliferation and migration, angiogenesis, .and chemotaxis as relevant processes for wound healing. Transfusion, 59(11), 3492-3500. doi.10.1111/trf.15535 This technology is not completely new, but the amount of concentration is definitive and needed in topical application which is upcoming soon. While injection has always been the technique, including needling, this information brings new developments, but still will need at least needling to penetrate although with higher concentrations, RF would be able to be used. APJ
half of the videos were considered high-quality. Gray, M., Gemmiti, A., Ata, A., Jun, B., Johnson, P., Ricci, J., & Patel, A. (2020). Can You Trust What You Watch? An Assessment of the Quality of Information in Aesthetic Surgery Videos on YouTube. Plastic and Reconstructive Surgery, 145(2), 329-336.
presented with is of high quality, which is not the case as is known and this study reiterates that most information is non-scientific, inadequate and inaccurate. Most videos did not contain any discussion of the risks or complications associated with various procedures, only marketing to get people to have the surgery. APJ
Social media is a tremendous influence on patients interested in cosmetic surgery. With more than two billion users – representing almost one-third of the internet – YouTube has emerged as an essential platform for reaching people interested in plastic surgery. Unfortunately, many patients use YouTube as a resource on aesthetic surgery, leading to misinformation. Currently, there are no objective assessments of the quality of information on YouTube about aesthetic surgery. APJ
AN ASSESSMENT OF THE QUALITY OF INFORMATION IN AESTHETIC SURGERY VIDEOS ON YOUTUBE MICRONEEDLING OF SCARS: A LARGE PROSPECTIVE STUDY WITH LONG-TERM FOLLOW-UP
THIS INTERESTING STUDY looked at 523 videos on the 13 most common aesthetic surgery procedures. Of the 523 videos, 310 (59.3 per cent) were developed by physicians, 108 (20.6 per cent) were developed by patients, and 105 (20.1 per cent) were developed by other sources. Using a modified Ensuring Quality Information for Patients (EQIP) (used by physicians to determine if medical information is understandable, nonbiased and properly describes the risks, benefits and alternatives of medical treatment). Possible score using EQIP is 27 and the authors found the mean average score across all the videos studied was 13.1. Quality was higher for videos developed by physicians or surgeons: average EQIP score of about 14, compared to 12 for videos developed by patients and 10 for videos from other sources. But even for physician-produced videos, only about
Worst scoring videos were “nose reshaping” 10.24, while “breast augmentation” had the highest score of 15.96. Since so many use the internet for their medical and surgical information, it is vital that the information they are
I KNOW YOU ARE PROBABLY AWARE that micro-needling has been increasingly used to treat several dermatologic conditions, including scars. Although initial studies demonstrated improvement of (mostly) atrophic scars with microneedling, the studies have been on a small number of respondents and devises and treatment parameters have differed wildly, making any substantive analysis difficult. This study is the first large-scale, long-term evaluation that looked at 120 patients (skin phototypes I through VI) with facial and non-facial scars from a variety of etiologic
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SCIENTIFIC NEWS sources (acne, trauma, surgery). These candidates were treated using a mechanical microneedling device, needle depths ranging from 2.5 to 3 mm with no other treatments undertaken. Blinded to treatment protocol, assessors rated clinical improvement of scars 1, 3, 6, and 12 months after treatment on a fivepoint scale.
simple treatment, great care is needed in working with scarring, as it is not as easy as it appears. However, if the practitioner is well trained then amazing results are possible. APJ
HA is generally synthesised as a highmolecular weight polymer (HMW HA) that ranges from 1000 to 6000 kDa, however this can be degraded by hyaluronidases and ROS, thus
HYALURONAN: MOLECULAR SIZEDEPENDENT SIGNALLING AND BIOLOGICAL FUNCTIONS IN INFLAMMATION AND CANCER
unbalancing the equilibrium toward a higher concentration of low-molecular weight HA (LMW) species at less than 250 kDa.
All scars improved at least 50 percent after an average of 2.5 treatments. Over 80 per cent of patients had 50 to 75 per cent improvement, and 65 per cent of patients demonstrated over 75 per cent improvement.
Atrophic acne scars on the cheeks before (left) and 6 months after (right) two microneedling treatments.
Traumatic scar on the arm before (left) and 6 months after (right) two microneedling treatments.
Alster, T., & Li, M. (2020). Microneedling of Scars: A Large Prospective Study with LongTerm Follow-Up. Plastic and Reconstructive Surgery, 145(2), 358-364. All treatments were performed by Tina Alster, a well-known dermatologist. Even with such an experienced practitioner, side effects were reported, however they consisted mainly of transient erythema and oedema with an average duration of 3-to-7 days in all patients. More concerning was purpura formation (4.2 per cent) and herpes simplex virus reactivation (2.1 per cent) were experienced. While micro-needling may seem a
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HYALURONAN (HA) is a linear nonsulphated glycosaminoglycan of the extracellular matrix that plays a pivotal role in a variety of biological processes. High-molecular weight HA exhibits different biological properties than oligomers and low-molecular weight HA. Most will know only about HA in terms of the dermis, but did you know it is involved in inflammation and cancer (and not in a good way).
It has been known that abnormal accumulation of HA in cancer stroma is considered as a marker of malignancy for several types of solid tumours, however this study shows LMW HA is predominant during tissue injury and stimulates the production of proinflammatory cytokines, with HA fragments < 500 kDa induce the expression of inflammatory genes in renal tubular epithelial cells and bladder cancer cells.
This study found that depending on their molecular size, HA fragments can influence cellular behaviour in a different mode of action.
Tavianatou, A., Caon, I., Franchi, M., Piperigkou, Z., Galesso, D., & Karamanos, K. (2019). Hyaluronan: molecular size-dependent signaling and biological functions in inflammation and cancer. Federation of European Biochemical Societies Journal, 286, 2883â&#x20AC;&#x201C;2908.
This phenomenon is attributed to the different manner of interaction with the HA receptors.
Many of HA functions depend on specific HA-binding proteins and proteoglycans that bind HA through noncovalent
Research and Scientific New Developments In every issue of the journal, 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.
interactions and contribute to create a highly hydrated and charged domain on the cell surface as well as in the extracellular space. In this way HA can perform various functions dependant on its ‘fluidity’ from a more solid dermal structure to the articular joint’s synovial fluids.
explain how they cause an allergic skin rash.
The studies evidence suggests that the increased synthesis and the further fragmentation of HA by tumour cells stimulate inflammation, which in turn sustains tumour malignancy and progression. The study is heavy reading, yet amazing in the detail of how HA is denatured and in small molecular weight causes so much irritation and subsequent inflammation and cytokine induced damage thus mutation. As the authors point out, identification of the signalling pathways and molecules that are involved in each response could be useful in the development of the future pharmacological targeting strategies. APJ
An allergic reaction begins when the immune system's T cells recognise a chemical as foreign. T cells do not directly recognize small chemicals and research suggests that these compounds need to undergo a chemical reaction with larger proteins in order to make themselves visible to T cells.
known to trigger allergic contact dermatitis were able to bind to CD1a molecules on the surface of Langerhans cells and activate T cells. CD1a molecules normally bind the skin's own naturallyoccurring lipids in its tunnel-like interior. These lipids protrude from the tunnel, creating a physical barrier that prevents CD1a from interacting with T cells. Researchers identified more than a dozen small chemicals that activated T cells through CD1a, the most prominent were benzyl benzoate and benzyl cinnamate Work with farnesol, one of the allergens identified in this study, can hide inside the tunnel of CD1a, displacing the natural lipids that normally protrude from the CD1a molecule. This displacement makes the CD1a surface visible to the T cells, causing an immune reaction. Nicolai, S., Wegrecki, M., Cheng, T., Bourgeois, E., Cotton, R., Mayfield, J., Monnot, G., Le Nours, J., Van Rhijn, I., Rossjohn, J., Moody, D., & de Jong. A. (2020). Human T cell response to CD1a and contact dermatitis allergens in botanical extracts and commercial skin care products. Science Immunology, 5(43)
STUDY EXPLAINS WHY SOME CREAMS AND COSMETICS MAY CAUSE SKIN RASHES THIS STUDY FOUND that some compounds in many personal care products displace natural lipid molecules in skin cells, which may
Small compounds in skincare products that trigger allergic contact dermatitis lack the chemical groups needed for this reaction to occur – they should be invisible to T cells, but they're not. In this study, conducted with human cells in tissue culture, the researchers found that several common chemicals
Allergic reactions in the skin can be caused by many different chemical compounds found in creams, cosmetics, and other topical consumer products, but how they trigger the reaction has remained somewhat mysterious. This discovery raises the possibility that allergic contact dermatitis could be stopped by applying competing lipids to the skin to displace those triggering the immune reaction. It is of interest that benzyl benzoate and benzyl cinnamate are major constituents of Balsam of Peru and farnesol, which are found in many personal care products, such as skin creams, toothpaste, and fragrances. APJ
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SCIENTIFIC NEWS
LIVING SKIN CAN NOW BE 3D-PRINTED WITH BLOOD VESSELS RESEARCHERS HAVE developed a way to 3D print living skin, complete with blood vessels. The researchers show that if they add key elements - including human endothelial cells that line the inside of blood vessels and human pericyte cells that wrap around the endothelial cells with animal collagen and other structural cells typically found in a skin graft, then the cells start communicating and forming a biologically-relevant vascular structure within the span of a few weeks. The print was grafted onto immunodeficient mice. The vessels from the printed graft began to communicate and connect with the mouse's own vessels, showing a transfer of blood and nutrients to the graft which is keeping the graft alive.
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Baltazar, T., Merola, J., Catarino, C., Xie, C., Kirkiles-Smith, N., Lee, V., Hotta, S., Dai, G., Xu, X., Ferreira, F., Saltzman, W., Pober, J., & Karande, P. (2019). Three Dimensional Bioprinting of a Vascularized and Perfusable Skin Graft Using Human Keratinocytes, Fibroblasts, Pericytes, and Endothelial Cells. Tissue Engineering Part A, doi: 10.1089/ten.TEA.2019.0201. [Epub ahead of print]
A significant barrier to that integration has been the absence of a functioning vascular system in the skin grafts. This is a step toward creating grafts that are more like the skin that our bodies produce naturally. Initially this technology would be useful for wound healing. More work will need to be done to address the challenges associated with burn patients, which need to include the loss of nerve and vascular endings. However, this is an amazing beginning to have printable live grafts. APJ
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