LNE & Spa—the magazine for skin care and spa professionals
February 2013
$7.50
Industry Leaders in Keeping the Planet Green. Éminence offers products with the highest organic standards worldwide including USDA Certified Organic, ingredients certified by Demeter International – the only global certifier of Biodynamic® products – and Biokontroll Hungaria. Éminence cares about the planet from harvest to production, packaging to delivery. We are committed to being the “Greenest Company in Town” with the following initiatives: Wind and Solar Powered Manufacturing, Sustainable Farming Practices, Handmade Products, Recyclable Packaging, Vegetable Inks in Printing, Recycled Paper in Outer Packaging, Biodegradable Corn-Based Packing Materials, Green Warehouse Practices, Hybrid and Biodiesel Car Deliveries, Green Transportation Support for our Staff, Green Community
NENC MI
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Supporter, Tree Planting Initiatives, Green Spa Program, ISO 90001/2001 Certified Manufacturing.
G AN IC
Boldijarre Koronczay President and Master Trainer
AR E
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GREENSPA SKI N
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The good news is, we will plant it for you. We have taken our commitment to the environment to a whole new level with our new tree planting initiative, Forests for the Future. For every product purchased, we will plant a tree by joining forces with Trees for the Future. Visit www.eminenceorganics.com for more information.
THE ORIGINAL SINCE 1958
Toll-Free 1-888-747-6342 info@eminenceorganics.com | www.eminenceorganics.com ENVI RON M ENTALLY R ESPON SI B LE P ROVI DER OF P R EM I U M SKI N C AR E
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CONTENTS FEBRUARY 2 0 1 3
skin
PRP Facial Treatments 22 Face Up to New Choices 24 A Four to Six Week Journey 32 Breast Augmentation & The Esthetician 36 Flushing & Blushing 40 Peel and Heal 44 Keratolytic Therapy 48 Effectively Treating Hyperpigmentation 52 Types 1 & 2 57 Skin News 59
Flushing & Blushing page 40
N U M BE R 2
Beauty From Head to Toe page 73
spa
In a Medical Setting 62 Vein-ity 72 Beauty From Head to Toe 73 How’s Your Pain Management Menu? 78 Oh My! 81 Spa News 83
organic & wellness
Hospitality in the Medical Spa
Top 10 Trends Alternatives to Acne Prescriptions 100 Integrating Wellness 103 Organic & Wellness News 105
page 94
business
Waiting Room Marketing 85 6 Steps to a Profitable Acne Program 86 Technology 90 Hospitality in the Medical Spa Biz News
94 97
CleanSpa: A New Kind of Spa page 114
image The Ugly Truth CleanSpa: A New Kind of Spa Liability in the Nail Department Image News
VOLUME 28
Sunken Eyes 107 Treatments for Youthful Hands 108 111 114 119 121
99
Alternatives to Acne Prescriptions page 100
extras
From the Editor 6 Dr. Patty’s Dental Boutique, Fort Lauderdale, FL 10 LNE & Spa’s Best Product Awards 64 Calendar of Events 124 Advertisers’ Index 130
Cover
courtesy of Jean Marc Maniatis
Les Nouvelles Esthétiques & Spa, American Edition, (USPS 003-687) (ISSN 1043-9641) is published monthly, 12 times per year and is sold exclusively by subscription. Publisher’s Name: Jean Jacques Legrand, M.D., 3929 Ponce De Leon Blvd., Coral Gables, FL, 33134. Periodical postage paid at Miami, Florida, with additional mailing offices. Postmaster: Send address changes to: Les Nouvelles Esthétiques & Spa, American Edition, 3929 Ponce De Leon Blvd., Coral Gables, Florida 33134, United States Subscription: Annual Rate $45.00 Canada Subscription: $55.00 (American) 1st Class Postage Overseas Subscription: Two years for $140.00 (U.S.) Air Mail Postage
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Les Nouvelles Esthétiques & Spa • February 2013
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Medical Aesthetic Insurance Services
from the
EDITOR
D
We can cover the entire facility or individuals operating in single or multiple locations. Our program includes:
Medispas Day Spas Injectables Weight Loss Laser Centers Laser Assisted Lipolysis Dietitians / Nutritionists Wellness Analysis Hormone Treatments Beauty Industry Aestheticians Medical Directors Permanent Cosmetics Tattoo Removal Products Liability
medispa-ins.com or 415.475.4300
I D Y O U K N O W T H AT A M E R I C A N S spent $10.4 billion on cosmetic surgery in 2011? As estheticians, therapists and spa professionals, we all need to be well aware of the latest techniques, medical breakthroughs and best practices. The completely medical February issue of LNE & Spa provides all this and more! As partners in providing health and wellness, we want to stay within our scope of practice, but we can also collaborate with board specialists to expand our clientele. According to the American Society for Aesthetic Plastic Surgery, middle America is seeking out cosmetic procedures. Professionals such as nurses, police officers, school teachers and real estate agents all want nips and tucks. One survey found that almost 30 percent of cosmetic surgery patients earned less than $30,000 a year, and an additional 41 percent earned between $31,000 and $60,000. Are these figures indicative of the demographics in your spa? Reach out and educate your community on what you have to offer in the latest anti-aging treatments and therapies. Have you considered partnering with a cosmetic surgeon, dentist or vein specialist? Edward P. Miranda, M.D., offers the latest information on breast augmentation, and urges all physicians to partner with a licensed esthetician to assist with a patient’s rapid recovery, comfort and educational guidance on page 38. We also celebrate the winners of the coveted LNE & Spa BEST awards for 2013 on page 64. Readers were invited to vote and determine the BEST of our industry’s products and equipment in 34 categories. Les Nouvelles Esthétiques & Spa began in 1952, and continues to be the number one publication for skin care and spa professionals. We are thrilled to be able to deliver cutting-edge information to you monthly, and to be a partner in your success! n —Denise R. Fuller, denise@lneonline.com
PROFESSIONAL PROGRAM INSURANCE BROKERAGE / PP INSURANCE BROKERAGE CA license #OB17238 / #OH27235 Say you saw it in LNE & Spa and circle #208
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Les Nouvelles Esthétiques & Spa • February 2013
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3929 PONCE DE LEON BLVD. CORAL GABLES, FLORIDA 33134 800.471.0229 (USA)
Skin Care on Your Terms
no contract no minimum buy in
305.443.2322 Worldwide fax 305.443.1664 www.lneonline.com e-mail: tradeshows@lneonline.com subscriptions@lneonline.com Publisher Dr. Jean Jacques Legrand Chief Executive Officer Rodolphe Legrand rodolphe@lneonline.com Editor in Chief Denise R. Fuller denise@lneonline.com Art Director Sacha Smith sacha@lneonline.com Assistant Editor Amanda Clinton Winter amanda@lneonline.com Director of Sales Aché Fougere ache@lneonline.com Marketing Director Christèle de La Haye christele@lneonline.com Conference Coordinator Laura G. Bazo laura@lneonline.com Exhibitor Operations Assistant Mayli Bueno mayli@lneonline.com International Editor Michele de Lattre-Pierantoni 7 Avenue Stephane-Mallarme, 75017 Paris, France - 43 80 06 47 ADVISORY BOARD Lydia Sarfati • Ben Johnson, M.D. • Lake Louise • Nina Curtis Diane Buccola • Camille Hoheb • Joseph Mandato
Contributors Alyssa Adams Jennifer M. Anderson Patti Biro Kris Campbell Laura Cooksey Susan Etter Jenny Flanagan James E. Fulton, M.D., Ph.D. Adam Gropper, M.D. Ruthie Piper Hardee
Camille Hoheb Alison Howland Patty Kovacevich Jennifer Linder, M.D. Danae Markland Janet McCormick Edward P. Miranda, M.D. Zein Obagi, M.D. Tommy Parsons
Dana Rhoden Robert Sachs Louis Silberman Dori Soukup Jeni Spring David Suzuki Dave Waggoner Anne C. Willis Gül Zone
Printed with 100% soy-based ink. This magazine is recyclable. Please recycle where facilities exist. Say you saw it in LNE & Spa and circle #139 on reader service card
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Les Nouvelles Esthétiques & Spa • February 2013
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SPA
OF THE MONTH
A SPA ... IN THE DENTIST’S OFFICE? DR. PATTY’S DENTAL BOUTIQUE FORT LAUDERDALE, FL
Dr. April Patterson
IMAGINE IF THE SIGHTS, SOUNDS AND smells of your dental office resembled those of a world class spa. That was the idea behind Dr. Patty’s Dental Boutique, South Florida’s first dental spa. Think paraffin wax treatments, champagne and a personal concierge at one’s service during a routine dental cleaning. April Patterson, D.D.S., more affectionately known as “Dr. Patty,” wanted to change the negative stereotype associated with the dental chair. Armed with extensive research, planning, technology and design, she set out to create the ultimate pampering experience based on the
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principles of relaxation dentistry. The result is a client focused, comfort conscious, upscale dental boutique nestled in eastern Fort Lauderdale, FL. One of the main reasons people avoid visiting the dentist is anxiety. About 30 to 40 million people avoid essential dental care out of fear. “This is not your father’s dentist office,” explains Dr. Patty. “Dr. Patty’s dental spa is a sanctuary that successfully blends my expertise in cosmetic, laser and general dentistry with pampering spa treatments from licensed estheticians and therapists. I have successfully carved a niche in continues Les Nouvelles Esthétiques & Spa • February 2013
photos courtesy of Dr. Patty’s Dental Boutique
by Dana Rhoden
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spa of the month|dr. patty’s dental boutique
the dental industry with an all encompassing approach to esthetics which couples veneers, cosmetic braces and smile makeovers with rejuvenating facial fillers such as Botox®, Dysport®, Juvederm® and Restalyne®, a full-service lash and brow bar, massage and facials.”
Outstanding employees Dr. Patty is a highly experienced cosmetic and restorative dentist. The backbone of her practice is a professional, well-trained staff, which includes a “client happiness director” and a “client concierge.” The client happiness director is devoted to pampering and taking care of clients to ensure that their every need is met from the minute they schedule an appointment. They are committed to improving the comfort and safety of the client experience at all costs.
Clients can choose from a broad palette of colors, textures and lengths of weightless lash extensions for customized looks, which run the gamut from subtle and natural to trendy and glamorous.
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The client concierge helps arrange cab or limo transportation to and from appointments for clients who may need sedation. The concierge is also responsible for educating clients on the various insurance and payment plan options available to them. Dr. Patty actively scouts local beauty schools, including the Aveda Institute, to source talented estheticians and therapists to oversee the boutique’s spa services. For the launch of her high definition brow and lash bar, Dr. Patty tapped a local master brow sculptress to open a 300 square foot space within the dental boutique to complement the existing spa services menu. The technician is skilled in the traditional Indian art of eyebrow threading and lash artistry. Clients can choose from a broad palette of colors, textures and lengths of weightless lash extensions for customized looks, which run the gamut from subtle and natural to trendy and glamorous.
Unique patient perks Dr. Patty’s Dental Boutique promises to pamper clients with state-of-the-art, high-end dental care coupled with the multisensory amenities and treatments of a spa. Each client is personally greeted upon arrival and treated to the complimentary champagne, wine and coffee bar. A locker room stocked with robes, slippers and a private shower area is available before and after treatments. Client perks in the exam room include a refreshing lemon scented warm towel service; silky paraffin wax treatment for the hands; temple massage therapy, a cucumber eye press and personalized movie and music selections. The jarring sounds of buzzing drills have been replaced with nearly noiseless electronic tools. They are further silenced by relaxing music available in surround sound via earbuds. The malodorous scent of chemicals has been replaced by aromatherapy, diffused through the office ventilation system and the use of odorfree, eco-friendly products. Dr. Patty’s extensive menu of dental services includes “six month smiles,” cosmetic braces that straighten teeth in a fraction of the time of ordinary orthodontics; innovative implants and continues Les Nouvelles Esthétiques & Spa • February 2013
An Exciting New Range of Botanical Stem Cells for Stronger, more Resilient Skin Since being first in the industry to introduce the Apple & Edelweiss combination in 2009, we’ve seen amazing results with stem cells in their support of skin health and their energizing, anti-aging effects. Along with the steady growth of stem cell technology in recent years, we’ve added multiple new and unique plant based stem cells as we strive to give our clients the most effective and diverse ingredients to improve skin health and appearance. Our (LPAR) stem cell line delivers the most effective and widest range in plant stem cell technology, combined with state-of-the-art peptides, and formulated with high level cosmeceutical concentrations for professional skin care and result-driven retail.
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THE INTERNATIONAL CONGRESS OF ESTHETICS AND SPA
PRESENTED BY
Endorsed by:
CONTACT US TODAY FOR YOUR FREE SHOW PROGRAM:
1.800.471.0229 • LNEONLINE.COM 3929 Ponce de Leon Blvd., Coral Gables, FL 33134 USA: 305.443.2322 • FAX: 305.443.1664
THE TRENDSETTER OF BEAUTY
MIAMI BEACH FL MIAMI BEACH CONVENTION CENTER
APRIL 7 & 8, 2013 The International Congress of Esthetics and Spa in Miami Beach is The event of the year in Florida for spa professionals. The two-day conference offers dynamic education, cutting-edge companies and opportunities to build relationships with leaders in the spa industry from around the globe. Estheticians, therapists, spa owners and resort directors sharpen their knowledge, advance their skills and collaborate with leading companies and manufacturers to create a dynamic, successful and thriving industry!
2-DAY ALL-INCLUSIVE ADMISSION
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$75 when you register after 03/15/13
ALL-INCLUSIVE ADMISSION INCLUDES: • All General Session Lectures and Demos • Medical facilities, Aesthetic and Wellness Center Track • Salon/Spa Seminar Management • NASN-National Aesthetics Spa Network • Medical Esthetics Seminar • Medical Spa Business Seminar
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$50 when you register after 03/15/13
• Image Seminars
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• Cutting Edge Salon/Spa Business Seminar • AIA-Aesthetics International Association • Spa Business Lounge NEW • The Green Spa Network Village • All Manufacturers’ Workshops • Exhibit Hall flooded with hundreds of exhibitors
NEW
spa of the month|dr. patty’s dental boutique
extraction techniques; porcelain veneers; and sedation dentistry (“sleep dentistry”), which encompasses multiple types of sedation procedures and smile revitalization with revolutionary teeth whitening, a restorative approach to teeth whitening that no longer damages enamel or leaves teeth sensitive and strained. Dr. Patty administers the facial rejuvenation treatments (fillers), and licensed estheticians are available for the facials, body treatments, brow waxing and eyelash extensions. In addition to providing unparalleled client perks, the combination of dental treatments with spa services enables new client referrals for both professions. By offering a “one-stop-shop” to accommodate the busy schedules of clients, Dr. Patty, the estheticians and the therapists benefit from the unique crossover and integration of a spa and a doctor’s office. A client can come in for a cleaning and stay for a brow threading, or get a relaxing massage followed by a facial and finish their visit with a facial filler service. A client coming in to get their dental veneers placed has the option to arrive early and treat themselves to a facial or massage. While they are enjoying their spa treatment, their Valium is setting in, so they feel completely relaxed by the time they are seated in the dental chair. Another benefit is the way each service enhances the other services. A client who comes in for a facial may want to consider teeth whitening and/or facial fillers to further ensure a more youthful appearance. Dr. Patty, her staff, the massage therapists and estheticians are all trained to cross sell each other’s complementary services.
A client can come in for a cleaning and stay for a brow threading, or get a relaxing massage followed by a facial and finish their visit with a facial filler service.
left to right: before and after smile makeover
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Technology “I actually coined the term ‘iDental’ office because I only use Mac computers, Apple products and accessories,” admits Dr. Patty. “Not only are they fashionable, providing a more streamlined, white and clean esthetic throughout the office, they are functional and integrated to work together.” In the reception area, clipboards and cumbersome client forms have been replaced with Apple iPads, which allows Dr. Patty to electronically capture important client information. It is also more environmentally friendly, as it saves paper. continues Les Nouvelles Esthétiques & Spa • February 2013
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spa of the month|dr. patty’s dental boutique
“I use my iPad every day in my dental boutique,” explains Dr. Patty. “For example, I use special dental applications to illustrate dental diagnoses and procedures, along with all the pros and cons of each treatment. These 3-D visuals don’t have a voiceover, which enables me to explain the animation based on my professional recommendation for each individual client. I love the DDS GP, an app created by Kick Your Apps, because it has quality animations and it’s made by dentists for dentists.” Dr. Patty also uses her iPad in the treatment and conference rooms to help clients apply for Care Credit financing, which is making financing approvals easier and more personal. It also prevents Dr. Patty from having to physically move clients around the boutique multiple times. In addition, Dr. Patty uses The Monthly Pre scribing Reference app to check for details and interactions of drugs that physicians have prescribed for her clients. Page 18 • www.LNEONLINE.com
Say “I do” to creative bridal services Brides typically pose for a few hundred pictures during their big day, so they want their smile to look bright, white and beautiful. Before walking down the aisle, some brides are even treating their bridesmaids to teeth whitening, Botox and other beauty treatments to ensure their wedding photo album looks perfect. At the advice of the boutique’s publicist, Dr. Patty decided to capitalize on the bi-annual wedding seasons with the launch of “Wedding Smile Makeover” packages for the bride-to-be (and even grooms) and their respective wedding parties. Promotionally priced packages were designed for groups of four or more, and include a champagne-fueled bleaching party with laser teeth whitening treatments administered by Dr. Patty, using advanced technology and custom-fitted trays to take home for maintenance. continues Les Nouvelles Esthétiques & Spa • February 2013
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Half Moon Bay, CA Global Beauty Exchange
2.24.13 - 2.27.13
Bologna, Italy Cosmoprof 3.08.13 - 3.11.13
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Chicago, IL
Face & Body 3.09.13 - 3.11.13
spa of the month|dr. patty’s dental boutique
The bridal party can also take advantage of the pampering menu of esthetic treatments, including massages, facials and eyebrow threading/ shaping. For those craving a wrinkle-free wedding day, Dr. Patty will administer fillers such as Botox, Restalyne, Dysport, Perlane and Juvederm to fill frown lines, eyebrow furrows, nasolabial folds and crow’s feet. Since opening her doors in March 2002, Dr. Patty has appeared on numerous TV shows, including ABC’s Good Morning America, and she has been interviewed for numerous newspapers and magazines. Gold Coast magazine recently named her to their annual “40 Under 40” list, which celebrates ingenuity, innovation, leadership and excellence among Broward County’s young professionals. In celebration of the one year anniversary of Dr. Patty’s Dental Boutique this coming March, a huge party will be held at the boutique to thank everyone, including staff, clients and vendors for their continued support. Considering how much Dr. Patty has accomplished within her first year of business, the future is surely giving her something to smile about. Page 20 • www.LNEONLINE.com
Dr. Patty’s Dental Boutique is a client-focused, comfort-conscious upscale dental boutique offering cosmetic dental services, eyelash extensions and spa treatments in an ultra-chic, modern and relaxing environment. The boutique is located at 646 N. Federal Highway in Fort Lauderdale, FL. For more information, visit www.drpattydental.com. n
Dana Rhoden is founder of The Dana Agency. With more than 12 years of experience in the public relations industry, she has managed the reputations of more than 150 luxury lifestyle brands. Rhoden was the recipient of a 2001 PRSA PRism Award. She currently serves on the board of the Leading Ladies League as the communications director and is an avid supporter of the Melanie Finley Ovarian Cancer Foundation. Les Nouvelles Esthétiques & Spa • February 2013
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skin
PRP facial treatments by James E. Fulton, M.D., Ph.D.
Page 22 • www.LNEONLINE.com
before
youthful facial appearance. The results of this program speak for themselves.
The case of BC This client pictured here used her vitamin A conditioning lotion daily, combined with the dermal roller. Over a period of after
photos courtesy of James E. Fulton, M.D., Ph.D.
Adherence to this regimen results in amazing skin rejuvenation. In cases of mild to moderate facial sagging, the results may be better than a surgical facelift. the Vampire FaceLift program, there are no scars, and the new skin stays lifted. For severe facial sagging, the best solution may be both—a conventional facelift combined with the Vampire FaceLift. In this case, the surgeon removes portions of the severely sagging skin. Then fat marinated in PRP can be injected into the face to create a more youthful appearance. The PRP helps to nourish the injected fat and provide a better result. Following a good daily skin care regimen after this procedure will maintain the rejuvenated skin and
two months, she had either the PRP injections or the radiofrequency treatments every two weeks. She continues to use her vitamin A lotion with the dermal roller to maintain the results. n James E. Fulton, M.D., Ph.D. is the medical director for Vivant Pharmaceuticals, LLC. His other accomplishments include the development of the patented Benzoyl Peroxide gel delivery system and the co-development of Retin A®. Dr. Fulton was the first to use and patent vitamin A propionate in skin care products. Les Nouvelles Esthétiques & Spa • February 2013
photo: Studio 37/Shutterstock.com
THE VAMPIRE FACELIFT ® IS A procedure for facial rejuvenation in which Platelet Rich Plasma (PRP) is injected into the face. This procedure has become very popular with both the public and medical professionals. The patient’s blood is drawn and centrifuged to remove the red blood cells, and the platelets are collected. Small aliquots are injected into the skin at the dermal level multiple times, either with a small syringe or a mesotherapy injection gun. Once in the dermis, the platelets release growth factors, which stimulate the resting fibroblasts to jump into action and generate new collagen, elastic fibers and more hyaluronic acid. The hyaluronic acid holds the water that plumps up the skin, and the new collagen and elastic fibers lift the sagging skin. For best results, the Vampire FaceLift should be combined with a complete step-by-step skin care program recommended by an esthetician. Daily use of a vitamin A conditioning lotion applied with a dermal roller keeps the fibroblasts moving. Every two weeks, a radiofrequency (RF) treatment is added to contract the new collagen. By heating the dermis, the collagen contracts by one third, which helps to lift the skin. The PRP sessions are repeated monthly, and the RF treatments are repeated in between the PRP sessions. It is important that the topical skin care program is a daily routine. Adherence to this regimen
results in amazing skin rejuvenation. In cases of mild to moderate facial sagging, the results may be better than a surgical facelift. With the conventional facelift, the old skin is pulled up, and the results may look good temporarily. However, the old skin tends to sag again eventually. With
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skin
FACE UP TO NEW CHOICES DISCOVER A NEW WORLD OF SURGICAL PROCEDURES
photo: Piotr Marcinski/Shutterstock.com
AS MANY OF US CAN ATTEST, THE STRESSES OF the recent holiday season have left their mark on both our own faces and those of our clients. Each one of us might now consider taking a closer look at ourselves so we can face the upcoming new year and its challenges head-on. If the mirror reflects a bit more loose, sagging skin, a few more tiny wrinkles and fine lines, facial spider veins around the nose, a lackluster skin tone or dull texture, it may be time to click the “Refresh” button. The 2013 world of facial esthetic medicine is ready and waiting for us to discover it, with an abundance of advanced surgical and non-surgical esthetic facial procedures that can transform us, often with little to no downtime at all. New face-saving breakthroughs are designed to shave years off the face, possibly in less time than it takes to post a message on Facebook. These quick new fixes can get you in and out of the office faster now, with less pain to the body and sometimes even the checkbook, and with fabulous looking results! Increasing client affluence and esthetic sophistication has boosted demand for esthetic medical options on a global scale. Minimally invasive and non-invasive facial contouring, the use of autologous fat to achieve facial contouring, effective pigment removal, advances in acne treatment and numerous other progressive procedures have advanced with the expansion of the sophisticated customer base. New dermal filler treatments, skin tightening and neurotoxins join the latest weaponry of energy-based treatments in the war on aging. 4
BY PATTY KOVACEVICH
Page 24 • www.LNEONLINE.com
Les Nouvelles Esthétiques & Spa • February 2013
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skin|face up to new choices
Laser experts report that fine lines and wrinkles will continue to be smoothed using Intense Pulsed Light (IPL) photorejuvenation and CO3 Laser, while loose, sagging skin will be firmed up with Ulthera and Thermage. Sun damage and brown spots will be zapped by IPL, Photodynamic Therapy (PDT), CO3 Laser, Fraxel Repair and Active FX or Deep FX treatments. Red spots and broken blood vessels will be erased with IPL, Cool Touch Varia, Cynergy, V-Star Pulse Dye Laser, Ruby and Alexandrive Lasers. The CO3 Laser, CoolTouch2, Active FX/Deep FXX or ALA/ Blu-U laser will fight acne scars and deep wrinkles. New hybrid procedures that creatively combine a number of technologies to create highly customized results are also growing in popularity. After all, no two faces are alike. William Groff, D.O., a board certified dermatologist in La Jolla, CA, anticipates that one of the most successful resurfacing techniques in his practice this year will be a customized treatment called Ultra Repair. By combining the use of
multiple laser treatments with fillers and Botox, Dr. Groff is able to treat the signs of aging. The procedure reduces the appearance of age spots, wrinkles, skin imperfections and sun damage on a patient’s face, neck and chest, providing them with excellent results. “Instead of undergoing a surgical facelift, Ultra Repair utilizes a combination of three different lasers and resurfacing technologies to restore a youthful appearance,” Dr. Groff explains. “Treatments can be performed on the full face, neck and chest. The unique treatment plan is based on each individual’s specific cosmetic procedure needs. By targeting exact skin conditions and attacking several areas simultaneously, the Ultra Repair is able to remove imperfections and significantly rejuvenate the skin, refreshing a patient’s entire facial appearance.” Patients will start seeing results soon after their initial Ultra Repair treatments. The amount of downtime required following this procedure Page 26 • www.LNEONLINE.com
is significantly less than what is needed after a surgical facelift. Most patients need between seven and 10 days to fully recover. The less aggressive the treatment is, the quicker a patient can recover. Age is also a factor. Younger patients may only need five or six days to recover. While effects are visible within the first week, full results are not visible for three to six months. Patients may experience mild side effects such as swelling or redness after the procedure, but this clears up within a week. Dr. Groff also notes the virtues of procedures to enhance the neck area. “I think treating wrinkling that occurs in the décolleté area with Sculptra, three treatments, one month apart, will continue to be an effective injectable procedure of choice, as well as Ultherapy, which was recently approved for use in the upper portion of the neck to lift lax tissue in the neck and under the chin,” he explains. continues Les Nouvelles Esthétiques & Spa • February 2013
photo: Lev Dolgachov/Shutterstock.com
William Groff, D.O., a board certified dermatologist in La Jolla, CA, anticipates that one of the most successful resurfacing techniques in his practice this year will be a customized treatment called Ultra Repair. By combining the use of multiple laser treatments with fillers and Botox, Dr. Groff is able to treat the signs of aging.
For results you can see Nothing emphasizes an esthetician’s professional expertise more than the quiet snap of an ampoule neck and the subsequent application and working-in of the precious liquid.
The PROFESSIONAL COLLECTION The DR. GRANDEL PROFESSIONAL COLLECTION offers twelve results driven concentrates in ampoules which provide solutions to the full variety of skin-beauty concerns and allow for a highly flexible & customized approach to skin care. They are divided into six easy-to-navigate-through categories: ● ●
moisturizing anti-age
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refining
60 years of expertise For over 60 years, DR. GRANDEL has been very successful in developing and manufacturing active concentrate ampoules for the professional beauty market. This background has provided us with a unique expertise in this category of skin care products. All active concentrate ampoules are made in Germany under the same strict standards that apply to the manufacture of medicinal preparations.
What makes active concentrate ampoules unique? They give skin the tools for visible
Concentrated formula Safe to use and dermatologically tested Highly effective
improvement from the first application. The fresh and smooth formulations are
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skin|face up to new choices Allergan, Inc., the California based maker of the anti-wrinkle treatment Botox, is competing with German-based Merz Pharmaceuticals, which has recently launched the botulinum drug Xeomin to the U.S. medical esthetic market, giving patients a new injectable choice for removing facial wrinkles. Surgical facelift procedures are expected to continue to surge, according to the American Society of Plastic Surgeons (ASPS). More than five years after facelift surgery, three fourths of patients still look younger than they did before surgery, according to a longterm follow-up study published in the December 2012 edition of Plastic and Reconstructive Surgery. Although some facial areas show signs of aging, a range of objective and subjective assessments demonstrated long lasting facelift
More than five years after facelift surgery, three fourths of patients still look younger than they did before surgery, according to a long-term follow-up study published in the December 2012 edition of Plastic and Reconstructive Surgery.
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small that role may be—that we need to carry out. While we all evolve as we age and mature, we need to remind ourselves that radiant beauty and genuine attractiveness also incorporate purposeful, joyful living. Each of us has a unique gift, and it is our responsibility to find that gift, make use of it and share it with others. For those who touch and heal others, remember these words from Maya Angelou: “People will forget what you said; people will forget what you did; but people will never forget how you made them feel.” n Patty Kovacevich has been the executive producer and host of her own Internet radio show, The Health and Beauty Revolution Show … On Living a Beautiful Life for over six years. She has interviewed over 800 renowned physicians, surgeons, lifestyle experts and authors. Kovacevich is also CEO of Steel Magnolia Marketing & PR, providing professional consulting to clients in the health, beauty and private aviation industries. She can be reached at Patty pattykov@san.rr.com. Les Nouvelles Esthétiques & Spa • February 2013
photo: AISPIX by Image Source/Shutterstock.com
surgery results, providing strong evidence that it can deliver significant, long-term esthetic improvements. The journal sums up these findings in this conclusive statement: “This study also supports facelift surgery as the only rejuvenation technique to have objective and subjective evidence for long term efficacy, emphasizing the current lack of evidence of other interventions.” Most facial esthetic health care professionals offer a variety of specialty skin treatments to complement their esthetic medical procedures. Treatment administration of non-surgical procedures by facial esthetic health care professionals is mandated state by state, particularly regarding laser and other energy-based treatments. Some states require that an administering professional must be a physician’s assistant or nurse to perform laser or injectable treatments, while other states are less restrictive regarding the credentials of administering health care professionals. Regardless of whether clients are looking for an extreme makeover or simply to refresh their appearance, it is essential in our modern world that we look our best in order to remain competitive. In some cases, this is essential in order to stay relevant. As professionals, each of us is a player with an important role—however large or
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skin
journey BY JENNIFER M. ANDERSON
AGING IS A PART OF LIFE. If someone had a magic potion that could stop the process, they would be a millionaire. The cell renewal rate slows down when we age. This is because there is less blood circulation, so less oxygen is delivered to skin cells, and they are not replaced as quickly. Cell turnover rate slows down, so new cells take longer to reach the surface. This leads to a buildup of dull, devitalized, dead surface cells and rough skin texture. When this build up occurs, skin conditions such as hyperpigmentation, uneven skin tone and texture, fine lines, wrinkles and growth of pores are more prevalent. As a skin therapist, it is crucial to explain to your clients how the cell cycle works so they can understand why certain exfoliation treatments are chosen, and why they will need more than just one to do the trick. I like to think of weekly treatments as if they are chiseling away at the skin, little by little, by way of a controlled trauma (exfoliation treatments such as peels, microdermabrasion and enzymes), until you get your client’s skin through a full cell cycle. It is as if your client’s face is a block of marble ... and bit by bit you are carving out their beautiful skin. Metaphorically, you are using a small pickaxe instead of a one shot treatment via a chainsaw. I explain to my clients that if they want faster results, then they will need to endure more downtime. By treating their skin on a weekly basis and getting them through a full cell cycle, the need for
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downtime and possible adverse effects is minimized. Working with a client’s skin on a weekly basis is a very involved process, however it is the best way to treat them.
The epidermal cell cycle The epidermis is composed of the outermost layers of cells in the skin. In Greek, “epi” means “over” or “upon.” When put together with the dermis, it forms the cutis. The epidermis is the skin’s outer structure, serving a protective function. However, the part we can see—the “horny” layer—is only a minute part of this stratified, squamous layer. The term horny refers to the look of the skin under a microscope. The microscopic “tags” the skin cells have allow for natural daily exfoliation. It is the ultimate result of the keratinization process and marks the final stage of a four to six week journey made by the keratinocytes. Human skin is continually being renewed. The desquamation of cells on the skin’s surface should naturally be compensated for by renewal of the epidermis, a process that is responsible by the keratinocytes (which make up 85 percent of the cells in the epidermis). These possess two properties that successively come into action—the ability to actively divide and the ability to differentiate. The epidermis contains five layers. The upper or outer layer of the two main layers of cells make up the skin. The epidermis is mostly made up of flat, scale-like cells called squamous cells. Under the squamous cells, there are round cells called basal cells. The deepest part of the epidermis also contains melanocytes. These cells produce melanin, which gives the skin its color. From bottom to top, the layers are named stratum basal, stratum spinosum, stratum granulosum, stratum lucidum and stratum corneum. The bottom layer, the stratum basal, has cells that are shaped like columns. In this layer, the cells divide and push already formed cells into higher layers. As the cells move into the higher layers, they flatten and eventually die. The top layer of the epidermis, the stratum corneum, is made of dead, flat skin cells that shed around every two weeks. This layer, the most superficial of the epidermis, is in direct contact with the external environment, and therefore plays a vital role as a barrier against all sorts of aggression. It also regulates the amount of water released from the body into the atmosphere through transepidermal water loss (TEWL). 4
Les Nouvelles Esthétiques & Spa • February 2013
photo: Alila Sao Mai/Shutterstock.com
A FOUR TO SIX WEEK
photo:Bart78/Shutterstock.com
February 2013 • Les Nouvelles Esthétiques & Spa
www.LNEONLINE.com • Page 33
skin|a four to six week journey
The thickness of the epidermis varies in different types of skin. It is thinnest on the eyelids at .05 millimeters, and thickest on the palms and soles at 1.5 millimeters. The epidermal layer is the one that we estheticians exfoliate and treat on a weekly basis.
STIMULATING THE CELLULAR TURNOVER OF YOUR CLIENT’S SKIN TO THE POINT THAT THE BASAL LAYER GETS FATIGUED IS CRITICAL. Cell cycle treatment
CELL CYCLE GRAPH Treatment 1/week 1- day 1 of a cell cycle Treatment 2/ week 2- day 7 of a cell cycle Treatment 3/week 3- day 14 of a cell cycle Treatment 4 /week 4- day 21 of a cell cycle Treatment 5/week 5- day 28 of a cell cycle Treatment 6/week 6- day 35 of a cell cycle Three days after abrasion, the cell cycle time for basal keratinocytes is drastically reduced to about 11 hours, compared to five to seven days in the normal epidermis. At five days, the cell cycle time gradually increases to 14 hours. At seven days, it speeds up to one or two days, and at 14 days after abrasion, it is four to five days. This dramatically changes the skin, minimizes skin conditions and skin is renewed! Some exfoliation treatments can be extremely strong and may require more recovery time. Jessners, TCAs and other stronger peels that shed the skin necessitate more time for the skin to heal. These peels can be used on a rest period of 10 to 14 days. In other words, with these stronger peels, you will have to double your time and get your client’s skin through two full cell cycles. This takes longer and creates more opportunities for adverse effects. Just take precautions and work within your comfort level. Perform a Jessner treatment on the sixth scheduled session with a client that is having a Page 34 • www.LNEONLINE.com
series of consecutive peels. That is the “crescendo” of their treatment. After they have had their five consecutive weekly treatments, the skin is prepped and ready for such a peel. Only offer these treatments and services when you have been educated, had hands on practice and feel comfortable.
The baseline After you work with your clients on a weekly basis and get them through a full cell cycle, other treatments can be utilized. I call this stage in their course of treatment (and you know you will always want to see them for maintenance and further treatments) “the baseline.” This term refers to the fact that you have gotten their skin through a full cell cycle, and their skin is functioning at its optimal level of cellular turnover. Take advantage of the enhanced function of the skin in this stage. Oxygen treatments, LED, ultrasound, microcurrent and other skin care treatments can be more effective due to the speed of their skin cells’ cycle being increased. n Jennifer M. Anderson is a public speaker, master makeup artist and beauty industry educator with over 21 years of experience. She is a licensed paramedical esthetician who has been a member of developmental teams for skin care and makeup lines. Anderson formerly hosted the weekly Internet radio show About FACE on Rhino on Air, and is the owner of Skin Chic Inc. She has written curriculums for two Florida beauty institutes. Visit www.skinchicinc.com for more information. Les Nouvelles Esthétiques & Spa • February 2013
photo: Pressmaster/Shutterstock.com
The first exfoliation treatment takes place on day 1. The basal cell layer (the “nursery” as I like to call it) starts kicking out new cells. These new cells replace the old cells. It takes between 28 and 40 days for the new cells to reach the surface of the skin. I want to give my client an exfoliation treatment once a week for six weeks. By their fourth treatment, the basal layer gets very stimulated and becomes fatigued. The basal layer then calls for backup, and thus collagen and elastin are synthesized. Stimulating the cellular turnover of your client’s skin to the point that the basal layer gets fatigued is critical. As a therapist, I like to explain to my clients that I want to get their skin through a full cell cycle in order to achieve optimal results. This speeds up the cellular turnover, and results are achieved.
Say you saw it in LNE & Spa and circle #304 on reader service card
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Les Nouvelles Esthétiques & Spa • February 2013
skin
BREAST
BY EDWARD P. MIRANDA, M.D.
AUGMENTATION & THE ESTHETICIAN
THE TECHNICAL TERM FOR BREAST AUGMENtation is “augmentation mammoplasty.” This surgical procedure is performed using breast implants to enhance one’s size and shape. Women choose breast augmentation for a variety of reasons. The most common reasons include size enhancement, which women seek when they feel that their breasts are too small or disproportionate to their overall body contour; restoring breast volume and firmness after weight loss, pregnancy or breast feeding; and improving the shape of breasts that are sagging or have lost skin elasticity (another common reason for breast lift surgery). It is also often done to restore breast(s) lost to mastectomy and injury, which is considered breast reconstruction. Of course, every woman that chooses to surgically enhance their breasts does so for reasons that are entirely personal. Once they decide breast augmentation is right for them, it is important that they choose a surgeon who is certified by The American Board of Plastic Surgery. This certification designates surgeons who are specifically trained in plastic surgery of the face and body. An initial consultation helps them choose the right implant shape and size to achieve their ideal profile.
photo: BananaStock
Silicone vs. saline Silicone or saline? This tends to be one of the first and most common questions regarding breast implants. Most women feel that silicone breast implants look and feel more like natural breast tissue when compared to saline implants. Saline and silicone breast implants both have an elastic outer silicone shell but differ in material and consistency. Saline implants are filled with sterile salt water. They’re inserted empty, and then filled once they’re in place. Silicone implants are pre-filled with cohesive silicone gel—a thick, sticky fluid that closely mimics the feel of human fat.
February 2013 • Les Nouvelles Esthétiques & Spa
Is silicone safe? Silicone implants were previously thought to be unsafe because of reported potential adverse effects from unnoticeable leakage. Like many other medical devices on the market today, silicone gel-filled breast implants have evolved substantially over the last two decades. Today’s silicone gel-filled breast implants incorporate advanced technology and an enhanced safety profile, thanks to several refinements in product design and manufacturing. The most significant improvements available today include a more cohesive silicone gel and a thicker, yet supple shell with an additional barrier layer that is distinctive from earlier breast implant devices. The silicone gel implants on the market today undergo rigorous safety testing, and data shows they have low long-term rupture rates. Additionally, most breast implant manufacturers offer comprehensive warranty programs to cover the cost of new implants, and surgical fees if any of their implants do rupture.
TOP CHOICES OF CLIENTS TODAY
Why choose a board-certified surgeon? Breast implant manufacturers offer hundreds of implant options, varying in size, shape (profile) and texture. Consulting with a Board of Plastic Surgery certified surgeon gives patients the chance to explain exactly what type of look they are trying to achieve. Implants are by no means “one-size-fits-all.” Having such a wide array of implant options ensures that surgeons should be able to find the perfect fit and size to achieve each patient’s desired look.
Implant alternative? One of the newest and most innovative plastic surgery trends is known as “fat grafting.” Fat grafting can be considered as an alternative to breast implants, or it can be used in addition to them. The two main things the fat grafting recontinues
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desired results. The biggest advantage of fat grafting instead of implants is the ability to correct abnormally shaped or asymmetric breasts. Fat grafting is a much more detailed procedure, whereas implants can change the size of the breasts. However, the shape typically remains the same. Plus, fat grafting acts as two procedures in one, since the fat has to be harvested from the patient, and liposuction is part of the whole process.
Skin care and breast augmentation
sults depend on are the patient’s desired look and how much fat is available to safely harvest from the patient. The amount of fat that can be safely harvested is directly correlated to how much augmentation can actually take place. Breast implants tend to provide patients with projection (think of pushing the breast outward, away from the chest wall), whereas fat grafting provides the breast with width and fullness (not nearly as much projection). Typically, the ideal candidates for fat grafting to the breast are women with large hips and small breasts; this body type tends to have the necessary fat elsewhere on the body to augment the breasts. Fat grafting to the breasts usually consists of two to four small outpatient procedures over an approximately three-month period to achieve
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Edward P. Miranda, M.D. is a board certified plastic surgeon. He specializes in high-risk surgeries, and offers a full range of modern cosmetic and reconstructive procedures. Dr. Miranda’s philosophy on esthetic surgery is that natural, subtle changes reveal true beauty. Les Nouvelles Esthétiques & Spa • February 2013
photo: CandyBox Images/Shutterstock.com
RECOMMEND A LYMPHATIC MASSAGE FOR POST-PROCEDURE SWELLING, DIFFERENT TYPES OF SCAR GELS AND CREAMS FOR POST TREATMENT (TO MAKE SURE INCISIONS HEAL WITH MINIMAL SCARRING) AND THE PROPER SUNSCREEN.
Estheticians are ideal for assisting with pre- and post-procedure treatments and making proper recommendations in a medical spa or medical center setting. They can recommend a lymphatic massage for post-procedure swelling, different types of scar gels and creams for post treatment (to make sure incisions heal with minimal scarring) and the proper sunscreen based on the patient’s skin type, allergies and area of the body. Additionally, most estheticians are trained in camouflage makeup techniques (if the incision from implants needs to be visible shortly after surgery). Most importantly, estheticians can educate patients on what to apply pre/ post operation to help the skin adjust to breast enhancement. Solutions for this include stretch mark treatments, cocoa butter and the like. Today’s medical spa that offers breast enhancement should partner with licensed estheticians to assist with each procedure. This helps the physician, and more importantly the patient with rapid recovery, comfort and educational guidance. n
Say you saw it in LNE & Spa and circle #294 on reader service card
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Les Nouvelles Esthétiques & Spa • February 2013
skin
&
FLUSHING BLUSHING MANAGING FACIAL REDNESS BY ZEIN OBAGI, M.D.
February 2013 • Les Nouvelles Esthétiques & Spa
A COY BLUSH CAN BE PROVOCATIVE AND CHARMING, but persistent facial redness may be a sign of an underlying condition called rosacea. Striking more than 16 million Americans—most of whom are undiagnosed—rosacea is an often debilitating inflammatory skin disorder that is characterized by unexplained redness that can come and go. Visible symptoms include tiny red blood vessels, acne-like bumps and even red-rimmed, watery eyes. Rosacea tends to first appear between the ages of 30 and 50, and it occurs more frequently in women than men. However male cases of rosacea are often worse because of delayed treatment. The disorder typically afflicts people with fair skin, and has greater frequency in Scottish and Irish skin types. It is not fully understood why some people develop symptoms and others don’t, but there are some triggers that seem to be clearly related to the condition. Hormones have a strong role in the development of the condition, and many women notice rosacea flare-ups around the time of their menstrual period and the onset of menopause. Other triggers include stress, sun exposure, extreme cold, heat or windy conditions, spicy foods, alcohol, hot beverages and the use of irritating makeup or skin care products. Rosacea sufferers are advised to keep a food diary to determine which foods will trigger a flare-up. Redness is also a symptom that occurs with aging. As the skin thins, tiny red veins or capillaries start to peek through and create blushing. It is normal to get a little red in the face after exposure to rosacea triggers like sun or spicy foods, which cause blood vessels to dilate. Usually, the redness dissipates after awhile. However, with rosacea, repeated exposure to these triggers causes the capillaries to lose their ability to return to their former inconspicuous state, resulting in persistent redness. While there is no known cure for rosacea, the use of mild or specially formulated skin care and beauty products or medical treatments for aggressive cases can ease the symptoms. When choosing skin care products, look for those without alcohol, fragrance or witch hazel. continues
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skin|flushing and blushing
for rosacea consist of ingredients intended to calm, soothe and counteract redness—some even contain a green color neutralizer to correct the appearance of redness. The moisturizer should feature hyaluronic acid to create a moisture barrier, and photosomes to reduce the appearance of discoloration and inflammation. Canadian Willowherb has been clinically proven to significantly reduce chemical and UV-induced redness, inflammation and irritation. After cleansing and moisturizing, daily UV protection is a must for all skin types, particularly those suffering from rosacea. Choose a non-chemical sunscreen with zinc or titanium dioxide for broad spectrum protection, and make sure it has an SPF of 15 or higher. Many guests prefer a tinted formulation that can also serve as a makeup primer. Early diagnosis and treatment are key to controlling rosacea. If left untreated, more extreme symptoms can develop, such as papules (bumps) and pustules (pimples), and the nose can even become bumpy and swollen. Clinical treatments include laser and light therapies. For example, the Candela V Beam system is widely used to treat vascular lesions and diffuse redness. Luckily, the small spider veins or capillaries that appear on the surface of the skin can easily be removed by laser or intense pulse light therapy, but unfortunately others can still develop. The more you understand the triggers for rosacea, the more you will be able to help your clients avoid flare-ups and enjoy clear skin that is free of redness. n
Zein Obagi, M.D., is a researcher, innovator, scientist, published author, lecturer and boardcertified dermatologist. He is the founder and medical director of ZO Skin Health, Inc., and is responsible for the development of new skin care treatments, protocols and products to achieve healthy skin. Dr. Obagi pioneered the concept of skin health more than 25 years ago, and brought a line of medical skin care products to market. Page 42 • www.LNEONLINE.com
Les Nouvelles Esthétiques & Spa • February 2013
photo: Blend Images/Shutterstock.com
Clinical treatments include laser and light therapies. For example, the Candela V Beam system is widely used to treat vascular lesions and diffuse redness.
Gentle cleansing is extremely important for skin with rosacea to remove excess oil, debris, bacteria and makeup residue. Unless one’s skin is oily, non-soap cleansers are the best option. If the skin is very dry, a creamy, low foaming cleanser with panthenol will help it retain moisture. For a home care recommendation, clients can use it twice a day, and it won’t disturb the skin’s natural moisture barrier. Daily moisturizer use can also help ease rosacea symptoms by preventing the burning, itching and irritation often associated with the condition. Regular use will support and strengthen the skin’s moisture barrier to repel impurities and irritants. Moisturizers developed specially
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www.MEG 21.com a portion of the proceeds from each MEG 21 product supports cancer research Say you saw it in LNE & Spa and circle #344 on reader service card
A CHEMICAL PEEL IS A SKIN RESURFACING technique, typically characterized as the application of a variety of chemical solutions to peel away the top layers of the skin. The benefits of the peels are multi-fold. First, they remove the dead, rough and uneven top layers of the skin to reveal a smoother, even textured surface. Second, they instigate the skin’s inherent repair and rejuvenating mechanisms to produce new skin cells. Third, they reduce excess oils and corneocyte adhesion to minimize the occurrence of acne while controlling oil production and hydration. Fourth, they increase cellular turnover, thereby reducing the appearance of hyperpigmentation. These changes are manifested in more healthy, youthful looking skin. Chemical peels have been shown to greatly benefit the signs of aging, including the fine lines, wrinkles and other ravages to the skin brought on by the sun, hormones and environmental stress. Many skin conditions such as acne, rosacea, scarring and hyperpigmentation have also profited from the results derived from this skin resurfacing technique. While chemical peels can be a very effective cosmetic tool—especially when utilizing more powerful medical strength formulary or combining multiple resurfacing procedures—it should be emphasized that training, experience and quality of products—including pre and post care—are critical elements to the procedure’s success. Chemical peels may be performed alone or combined with other skin resurfacing modalities, including the layering of multiple peeling agents, the addition of a physical abrasive such as microdermabrasion, or energy producing treatments like lasers. Chemical peels may be applied intermittently as an individual treatment or recommended as a series of progressive treatments over a period of time. Given that there are so many types of chemical peels, it is imperative that each peel be categorized in terms of active peeling ingredients, concentration, pH (if applicable) and the cosmetic delivery method. These four factors, along with the unique composition of a patient’s skin, will determine how many layers of the skin will peel off, and correspondingly the depth of the peel. continues
BY GÜL ZONE
Page 44 • www.LNEONLINE.com
Les Nouvelles Esthétiques & Spa • February 2013
photo: Vann Photography/Shutterstock.com
PEEL AND HEAL THE SCIENCE BEHIND CHEMICAL PEELS
skin Physiology: Peel science The skin is composed of two layers, the epidermis and the dermis, which are integrally connected and share a symbiotic relationship. The epidermis, the external layer that would superficially be considered one’s skin, sits atop the dermis. The epidermis, with its tough outer layer of keratin-packed cells, provides protection for the vital structures of the dermis. In turn, the highly vascularized and fibrous dermis provides the nutrients and hydration for the epidermal tissue and its structural backbone. The epidermis is a very dynamic skin layer with a relatively high rate of production of new cells, called keratinocyces or corneocytes. Newborn cells evolve from the base of the epidermis, the so-called basal layer. These basal cells, referred to as stem cells, distinctly change in size, shape, chemical composition and function as they mature. Within a 14-day period, the cells transform from vital, cubic-shaped cells with a pronounced nucleus, into flattened cells with no nuclei that are packed with keratin protein. These elongated flattened cells, referred to as stratum corneum, are dead cells in layers of 10 to 30, depending on their location of the body, with oily substances called lipids filling the spaces between cells. The stratum corneum, with its “plates” of keratin cells, provides mechanical and chemical protection to the skin’s substructures. These organized plates of cells can give skin a uniform texture and appearance. The appearance is maintained through our youth by a constant replenishment cycle, where old cells slough off and are replaced by newer cells. However, as the body ages, the time it takes to replace older cells with new cells slows. In other words, the skin rejuvenates or heals at a slower rate. As a result, the older surface cells begin to accumulate and become disorganized. This has the effect of diminishing both the quality and barrier properties of the skin, leaving it with a rough, dehydrated and dull appearance.
Formulary: Peels at work In order to be effective, chemical peels must first breach the chemical resistant cellular barrier of the stratum corneum to penetrate the deeper layers of the epidermis. Cosmetic formulary plays an important role here. The stronger the active peel ingredients are, the higher the peel concentration and the lower the peel pH, the more aggressively the chemical peel will behave—and the deeper it will penetrate. February 2013 • Les Nouvelles Esthétiques & Spa
While pH is often considered a key parameter of a peel’s strength, the protein kinase A (pKa) is what characterizes the acidity of the active peel ingredient. The interesting fact is that most peeling agents on the market, including wine acids, pyruvic acid, lactic acid, glycolic acid and salicylic acid are very close in pKa, ranging between two and four, approximately. Even weaker fruit acids such as ascorbic and citric acids fall within this range. Not surprisingly, trichloroacetic acid (TCA)—which is used in medical offices—has a pKa as low as 0.66. Besides TCA peels, many medical peels contain a mixture of the peeling agents mentioned here within the pKa range of two to four. However, they contain a higher concentration of free acids than their spa strength counterparts. As many formulations are buffered or pre-neutralized, the final active concentration of free acids is lower than the actual concentration that was placed into the product during manufacturing. This is critical, yet it is often misquoted by vendors, and should be addressed by testing the final pH of the product itself. Besides peel concentration and pH, another pertinent factor that has a major impact on peel performance is the delivery system. When comparing two lactic acid formulations side by side with the same final concentration of lactic acid and pH, the delivery system with the smaller particle size penetrates better and produces more exfoliation. This would hold true for any other chemical resurfacing agent. Particle size of the delivery system and other ingredients within the formulary determine how well the peel penetrates the skin.
CHEMICAL PEELS ARE OFTEN CLASSIFIED BY HOW DEEPLY THEY CAN PENETRATE THE SKIN, AND ULTIMATELY HOW MUCH THEY WOUND THE SKIN.
Classification: Peels Chemical peels are often classified by how deeply they can penetrate the skin, and ultimately how much they wound the skin. The deeper the peel penetrates, the more the skin is wounded, and the greater the downtime and risk involved. While light chemical peels are performed by estheticians, medium and deep chemical peels should only be performed by physicians. Light chemical peels are defined as superficial peels. These peels reach into the epidermis and only impact the top layers. They are used to treat fine lines, wrinkles, acne, uneven skin color and dry or oily skin conditions. Light chemical peels usually have a concentration of less than 40%, depending on the peeling active ingrecontinues www.LNEONLINE.com • Page 45
skin|peel and heal dients utilized. Potential ingredients may include wine acids, pyruvic acid, mandelic acid, citric acid, azelaic acid and lower concentrations of glycolic, lactic and salicylic acids. Medium chemical peels can be prone to more complications. They have been shown to remove more skin cells by penetrating both the epidermis and the top layer of the dermis, which is called the papillary dermis. They are used to treat deep wrinkles, acne scars
and dermal pigmentation issues. They should be performed intermittently. The benchmark for this depth peel used to be 50% TCA. However, due to the complications that may arise from this ingredient, it is now performed at a maximum of 35% TCA, along with other resurfacing agents. It may be combined with Jessner peels, 70% glycolic or lactic peels and solid carbon dioxide. Deep peels may remove skin cells from the epidermis all the way down
to the mid to lower layer of the dermis. The most common peel in this category is the phenol peel. These are mostly recommended and performed by physicians for the removal of precancerous growths, deep wrinkles and acne scars. While a significant amount of time is spent with the education of peel procedures, little time is spent understanding the chemical peel formulary and ingredients or the complexity of the skin peel physiology. It is imperative that skin care professionals deepen their understanding of the chemistry of the peel formulary, specifically the ingredients and the delivery system, as well as their interaction with the multiple unique layers of the epidermis and underlying dermis. It is equally imperative that the skin care professional appreciate that all chemical peels wound the skin in varying degrees, whether they are light, medium or deep peels. In order for the skin to heal properly, four elements must be in place for every chemical peel. First, the skin must be prepped and properly assessed prior to the peel. Second, the correct peel must be matched to this skin’s tolerance level and needs. Third, the peel must be performed in conjunction with other treatments to reduce inflammation and increase healing speed. And lastly, as healing continues to take place over the next couple of weeks or months, proper home care must be recommended. n
Gül Zone is CEO and founder of Ecozone, Inc. and Dermaware®. She is a biochemist who has contributed to the development of several international skin care lines. Zone leads educational seminars that focus on the importance of honesty and scientific facts to empower the esthetic community while raising the bar of knowledge in our industry to a higher level. Say you saw it in LNE & Spa and circle #209 on reader service card
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Les Nouvelles Esthétiques & Spa • February 2013
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skin
KERATOLYTIC THERAPY
AT ANY GIVEN MOMENT, ENZYMES ARE working inside our cells. An enzyme’s purpose within a cell is to allow the cell to carry out chemical reactions very quickly. Enzymes are substances that act as catalysts in living organisms. Catalysts increase the rate at which chemical reactions take place within the cell environment without being affected in the process themselves. Without enzymes, reaction time in our cells could not happen at a rate fast enough to sustain life. Enzymes have remarkable properties that resemble chemical reaction machines. These reactions allow the cell to build things or take them apart as needed. This is how a cell grows
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and reproduces. Enzymes do everything, from breaking glucose down for energy release to building cell walls. Enzymes even construct new enzymes, which allows our cells to reproduce. In each of our cells, there are hundreds or millions of copies of each different type of enzyme, depending on how important a reaction is to a cell and how often that reaction is needed. Enzymes are made from amino acids, which are proteins. When an enzyme is formed, it is made by stringing together amino acids in a very specific order. The chain of amino acids then folds into a unique shape. That shape allows the enzyme to carry out specific chemical reactions. Les Nouvelles Esthétiques & Spa • February 2013
photo: Poznyakov/Shutterstock.com
BY DAVE WAGGONER
ENZYME ACTION
photo: Levent Konuk/Shutterstock.com
Can you imagine a world where there was no cheese, bread, wine, beer or yogurt? Thanks to chemistry, the catalytic activities of enzymes are used in a variety of ways. The wine, beer, baking and pharmaceutical industries, makers of detergents and soaps and of course the skin care industry rely on the use of enzymes. Enzymes are also used heavily in medicine. The uses of important enzymes in medicine include killing disease-causing micro-organisms, prompting wound healing and diagnosing certain diseases. These applications include using enzymes as pharmaceutical products. In contrast to industrial uses (where production is on a much larger scale), uses of medical and pharmaceutical enzyme applications generally require small quantities of highly purified enzymes. Enzymes and enzyme-generated products are administered to patients in very small doses; this is done in order to avoid possible side effects. Enzymes can also be used in drug manufacturing, where the synthesis of drugs is difficult. Therefore enzymes are used to perform the chemical procedure. Enzymes can also be used to aid digestion where they are used to supplement amylase, lipase and protease, produced mainly by the pancreas. Lactose intolerant people provide an example of this, as they require lactose that their bodies do not produce. In the late 1800s, papain, an enzyme found in papaya fruit, was first investigated and recognized simply as a proteolytic enzyme. Proteolytic enzymes break peptide bonds, which hold proteins together. Papain is the most common enzyme used in skin care today. The skin care industry has certainly embraced enzymes over the years. Enzyme treatments are typically used to further the exfoliation processes. Think of the enzymes in your stomach that digest food; enzymes such as papain are used in skin care to digest dead skin to reveal fresh, healthy skin cells. If you review your skin physiology, you remember that we have natural enzymes within our epidermis that dissolve desmosomes to allow for natural exfoliation. As we age, the natural exfoliation slows down, which leads to a buildup of dead skin cells. We see this built up dead layer as fine lines, uneven skin tone and even acne in some cases. Natural fruit enzymes enhance the natural desquamation process, revealing fresh and healthy skin cells. Monthly enzymatic facials will keep the skin fresh and glowing. February 2013 • Les Nouvelles Esthétiques & Spa
How to use enzymes Water regulates almost every enzymatic action, and enzymes must be liquid to be active. The product’s pH levels and temperature will also affect the activity of an enzyme. Adding steam to an enzyme for seven to ten minutes will intensify the activity if needed. On another note, the pH levels of the enzymes need to be low enough (acidic enough) to permeate the stratum corneum. Steam softens the skin and opens pores to allow for easier, gentler extractions. Open pores and softer skin leads to better penetration of serums that nourish and hydrate the skin. Our natural epidermal enzymes also require water to be activated. If there is not enough water among our skin cells, our natural desquamation process is greatly reduced. This exfoliation process can be enhanced with fruit enzymes, which brings up an interesting question. How many of your clients drink enough water to properly hydrate their skin? Do they live in an environment where transepidermal water loss (TEWL) is great? One goal of a professional treatment is to add more water to the skin during your facial treatment to enhance the natural enzyme activity of the client.
ADDING STEAM TO AN ENZYME FOR SEVEN TO TEN MINUTES WILL INTENSIFY THE ACTIVITY IF NEEDED.
How to choose an enzyme By nature’s design, enzymes and their individual properties deliver a myriad of skin benefits. For example, papain or kiwi enzymes are gentle, while a pumpkin enzyme can be much more active and aggressive. Depending on the skin condition and concerns of your client, choose an appropriate activity level. Today’s market offers the esthetician a wide variety of enzyme choices. continues www.LNEONLINE.com • Page 49
skin
Lemon: Brightening and anti-aging. Good for normal to dry skin. Pomegranate: Hydrating. Good for combination skin. Papaya: Mild enzymatic action. Good for all skin types. Raspberry: Soothing and calming. Good for all skin types. Pumpkin: Excellent exfoliation properties. Good for acneic skin types. Blueberry: Brightening. Good for acneic skin. Passionfruit: Firming and anti-aging. Good for mature skin.
Why fruit enzymes?
How to enhance enzymes
Fruit contains natural enzymes, and is safe to use on most skin types. Fruit enzymes also deliver antioxidants to skin. Enzymatic fruits, such as papaya and pumpkin, provide both antioxidant nutrition and exfoliation to the skin when mixed with other fruits such as lemon, pomegranate, blueberry and kiwi. Enzymes are also very safe to use. When the enzymes “digest” or dissolve the topmost layer of the epidermis (unlike all other methods such as glycolic acid peels, dermabrasion or laser resurfacing), there is no induced heat. Hence, the skin is not traumatized. Trends indicate that consumers are seeking treatments that do not require long healing periods. Enzymes offer today’s savvy consumers the best of both clinical and relaxation services. n
Proper treatment and product choices are dependent on the trained esthetician performing a thorough skin analysis. Is the skin dry, oily, acneic, pigmented with melasma, sun damaged or suffering from hyperpigmentation? Take the age of the skin into consideration. Depending on the enzyme you choose, perhaps a papaya/papain for sensitive skin or pumpkin for thicker, more resilient skin, you may elect to add a chemical peel to your enzyme. By combining enzymatic activity and a slightly more aggressive alpha hydroxy acid (AHA) or beta hydroxy acid (BHA), you can boost the activity and results from your facial enzyme/peel treatment. Of course, you should be properly trained to combine peeling methods. Combining enzymes and acids results in
Dave Waggoner is a licensed massage therapist, esthetician and certified laser technician. He is currently the director of education and public relations at Skin Script Skin Care in Tempe, AZ. Waggoner has a passion for all things educational, and he develops advanced classes for the skin care industry. For more information, visit Skin Script Skin Care at www.skinscriptrx.com.
Most product lines produce an enzyme that is used for exfoliation purposes. To ensure efficacy and safety, read the manufacturer’s directions for intended use.
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Les Nouvelles Esthétiques & Spa • February 2013
photo: Yeko Photo Studio/Shutterstock.com
FRUITS AND THEIR SKIN BENEFITS
a more clinical or corrective treatment. An enzyme with an added benefit of kojic or arbutin (natural brighteners derived from mushroom and bearberries) or other added ingredients is an added bonus. Enzymes with a pH of 2.5 have a higher potential delivery of active ingredients. Penetration of antioxidants, as well as kojic and arbutin, is very effective at this point, and can reach the tyrosinase enzyme to start inhibiting the production of excess melanin. When you boost your enzyme with an AHA or BHA, choose the appropriate exfoliant to match your client’s skin concern. Lactic acid is a good choice to promote hydration and brightening effects. Glycolic acid is a natural choice for acne or pore refinement. Retinols work well for clogged pores. Salicylics are great for acneic or oilier skin. The esthetician controls how strong the enzyme peel is via the combination of enzymes, chemical peels and mechanical exfoliation. The resulting peeling or flaking of the skin will depend on the synergy of the various ingredients and modalities. How long is an enzyme active? As long as an enzyme is liquid, it is active. Steam is generally used to sustain the activity level during the exfoliation process. As mentioned earlier, a timing rule of thumb for steaming an enzyme exfoliation mask is between seven and ten minutes. After the enzymes have processed, be sure to remove them thoroughly with water and esthetic wipes or barber wrap.
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HYPERPIGMENTATION IS ONE OF THE MOST difficult challenges skin health professionals face. The broad and varied base of patients that seek treatment for this frustrating condition make it necessary for the clinician to have a deep understanding of its etiology. Outstanding and consistent results can be achieved by approaching treatment from two angles: topical treatment and patient education. Ensure that the professional treatments you perform and the daily care products you recommend address the melanogenesis process at multiple points. Be certain you take the time to properly educate each patient about their role in the success or failure of their treatment outcome. Doing these things will lead to the fast, dramatic results both you and your client desire. 4
EFFECTIVELY TREATING
HYPERPIGMENTATION BY DANAE MARKLAND
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Les Nouvelles Esthétiques & Spa • February 2013
skin What happens in the skin Hyperpigmentation is the deposit of melanin (pigment) due to a process called melanogenesis. This process encompasses the production of pigment and its duplication in the skin. It is the end result of inflammatory insults. Regardless of the source of the inflammation—UV exposure, hormonal triggers or cutaneous inflammation, such as heat or trauma— this activity of the melanocytes is designed to protect the skin cells’ DNA from damage and mutation. After the initial inflammatory response or hormonal fluctuation, the melanocyte’s stimulating hormone is released. Within the melanocyte, a chain of events is then triggered: • The enzyme tyrosinase is released from the rough endoplasmic reticulum (RER). • Tyrosinase acts on the amino acid tyrosine to convert it to L-DOPA. • Tyrosinase then binds with copper and acts on the L-DOPA, converting it to DOPAquinone. • DOPAquinone stimulates the release of melanin, which is packaged into melanosomes. • These melanosomes are transported along the dendrites (arms) of the melanocyte and transferred into the keratinocyte, creating an umbrella-like pattern to protect the DNA within the cell, resulting in hyperpigmentation.
Types of hyperpigmentation UV-induced hyperpigmentation is a result of UV exposure and can be caused by the sun, tanning beds and fluorescent and ambient lighting. It is identifiable by its appearance as diffused spots that are evenly distributed around the face. This type of hyperpigmentation can also be referred to as actinic hyperpigmentation. Hormonally induced hyperpigmentation is typically referred to as melasma, and it is caused by hormone fluctuations. The term melasma comes from the Greek word “melas,” which means black. It is commonly associated with a fluctuation of hormones (pregnancy, oral contraceptives, thyroid dysfunction, menopause or hormone replacement therapy), and will worsen with UV exposure. It typically appears as large sym-
metrical patches with jagged borders that form around the jawline, upper lip, cheeks and forehead. The exact cause of melasma is unknown, but it is widely believed to be a result of an increase in the formation and distribution of melanosomes (packets of melanin pigment) among the keratinocytes, along with increased branching of melanocytic dendrites. Research also indicates that the elevated estrogen levels that result from pregnancy and birth control pills increase both the number of melanocytes and the activity of tyrosinase. Conversely, studies indicate that the androgen dominance that occurs during menopause is responsible for an increase in tyrosinase activity. Post-inflammatory hyperpigmentation (PIH) is a result of skin irritation, inflammation or abrasion. It is identified as a darkened area left behind at the sites of trauma. It is common in patients fighting acne, dermatitis, psoriasis and eczema, and can also be caused by bug bites. Regardless of the cause or type of hyperpigmentation you are working to treat, there are four common strategies that must be followed: gently exfoliate the skin, increase cell turnover, inhibit melanogenesis and protect the skin from UV exposure and other inflammatory insults. There are multiple ways to achieve each of these goals, but when creating treatment plans you must employ multiple products in the professional setting, as well as in the patient’s daily care regimen. There simply is not one single “miracle product” that will clear and prevent this common condition.
Benefits of superficial chemical peels The melanin deposited in the skin due to hyperpigmentation will appear darker to the naked eye as it rises toward the stratum corneum on its way to being shed. Part of a successful treatment plan is to remove these darker impacted cells to keep the appearance of the pigmented area to a minimum—even as you are working to increase cell turnover and lift deeper pigment to the surface. It is wise to perform a superficial peel every three weeks to keep the unwanted pigment from redepositing onto the surface. Although this is a normal way of lifting pigment, a better way is to gently remove the stratum corneum before it has a chance to become visibly darker to continues
At right: A client’s skin before and after a three month home care regimen of products targeted to hyperpigmentation. No professional treatments were applied. photos courtesy of PCA SKIN before
February 2013 • Les Nouvelles Esthétiques & Spa
after
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skin RETINOIDS, SUCH AS RETINOIC ACID, RETINOL AND RETINALDEHYDE INHIBIT TYROSINASE TO SUPPRESS HYPERPIGMENTATION, ENHANCING CELL TURNOVER.
containing a variety of topical melanogenesisinterrupting ingredients with different mechanisms of action typically leads to accelerated results, in comparison to using a single tyrosinase inhibitor.
Proven melanogenesis inhibition Because melanogenesis is a process with many interconnected reactions, effective treatment is achieved by using topicals that contain ingredients that are proven to interrupt melanin production at multiple points, using a variety of proven over-the-counter (OTC) products and cosmeceuticals. The use of multiple products
At right: Results were achieved following a five month home care peel regimen using a blended 10% TCA and 20% lactic acid peel with a 10% retinol and 20% lactic acid booster treatment. photos courtesy of PCA SKIN before
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after
Les Nouvelles Esthétiques & Spa • February 2013
photo: AISPIX by Image Source/Shutterstock.com
the patient. They will likely be happier and remain more compliant with your predetermined plan if you follow this method. Because inflammation is the direct trigger of hyperpigmentation, gentle exfoliation is crucial. If aggressive methods are employed, the condition will worsen rather than improve. Avoid high percentage straight acid peels and any mechanical methods, like harsh scrubs or loofahs. It is important to make your hyperpigmentation patients aware of this so that they are not inadvertently undoing the positive progress you help them achieve by irritating their skin at home.
• Hydroquinone (HQ) is the most prescribed skin-lightening agent worldwide. HQ suppresses the binding of copper and tyrosinase, thereby inhibiting tyrosinase activity. Studies have also demonstrated that HQ decreases the formation and promotes the degradation of melanosomes, and induces melanocyte-specific cytotoxicity. Cosmeceutical products can contain up to two percent of HQ. Using these lower concentrations as opposed to higher prescription strengths is a good choice to avoid potential inflammation and post-inflammatory hyperpigmentation (PIH) that can be experienced when using this potent ingredient. Due to the potential for irritation, patch testing patients with HQ prior to use is highly recommended. • Kojic acid disrupts melanogenesis by chelating the copper bound to the tyrosinase. Kojic acid also decreases the number of melanosomes and melanocytic dendrites. There is a potential for contact dermatitis continues
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skin|effectively treating hyperpigmentation
At right: Results were achieved after three months of home care and three peel treatments consisting of 14% lactic acid, 14% salicylic acid, 2% Hydroquinone and 3% kojic acid. photos courtesy of PCA SKIN *Clients in these images were advised to wear daily sunscreen for protection.
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following kojic acid application. Therefore, highly sensitive patients should be patch tested to avoid unwanted inflammation from treatments or product use. Lactic acid is a water soluble alpha hydroxy acid (AHA) that increases exfoliation. The melanin-filled keratinocytes are lifted and removed, and dyschromias ultimately fade. Lactic acid also suppresses the formation of tyrosinase, without which melanogenesis cannot occur. L-ascorbic acid is able to convert DOPAquinone back to L-DOPA during melanogenesis, preventing melanin formation. L-ascorbic acid’s antioxidant, anti-inflammatory and UV-protective capabilities are also important in the suppression of melanogenesis. Retinoids, such as retinoic acid, retinol and retinaldehyde inhibit tyrosinase to suppress hyperpigmentation, enhancing cell turnover. Retinol is typically used in cosmeceutical preparations, as it is successfully converted to retinoic acid within the skin. This is especially important for patients with sensitive skin, as prescription retinoic acid can be highly stimulating on some skin types. This overstimulation could instigate melanogenesis. Azelaic acid inhibits tyrosinase activity and suppresses the proliferation of melanocytes. Arbutin is a natural derivative of HQ that allows the controlled release of HQ into the skin. Arbutin also suppresses the activity of tyrosinase, inhibits melanosome maturation and provides antioxidant protection. Resorcinol derivatives, such as phenylethyl resorcinol, inhibit the conversion of tyrosinase to L-DOPA during melanogenesis. Resorcinol derivatives are also antioxidants. Undecylenoyl phenylalanine prevents the synthesis of the melanocyte stimulating hormone. As a result, it prevents the formation of tyrosinase and melanin, as well as melanosome transfer.
Avoiding UV-induced damage Daily use of broad spectrum sun protection with an SPF of at least 30 is critical for all patients throughout the year. It is especially important for those fighting hyperpigmentation, as the inflammation resulting from UV exposure is a direct Page 56 • www.LNEONLINE.com
before
after
cause of melanogenesis. As a result of new sunscreen labeling regulations by the Food and Drug Administration, products can only be labeled “broad spectrum” after passing a rigorous critical wavelength test, so it is now easier to identify effective sunscreens.
Patient education is key Regardless of a clinician’s expertise, history of treatment success or business growth, positive treatment outcomes are unlikely if a patient is not compliant. If a patient does not understand why they have developed a skin condition, they will have a difficult time buying into your plan of action. Compliance is critical to success, especially with such a multifaceted condition like hyperpigmentation. If you take the time to make patients aware of the many actions you are suppressing and stimulating with your treatments and the daily regimen you dispense, they are much more likely to use the products you recommend correctly and schedule regular appointments. It will also be more palatable for them to buy the multiple products you recommend to overcome hyperpigmentation if they understand the process you are working to correct. By taking a holistic approach to the treatment of hyperpigmentation, positive outcomes are achievable. Ensure that your treatments and patient regimens are gentle, increase desquamation and inhibit melanogenesis. Educate patients well and impress upon them the integral nature of daily SPF use to their success. If you and your hyperpigmentation patients work together, you can help them overcome this frustrating condition. n Danae Markland is a licensed esthetician and certified massage therapist. She has specialized in various therapeutic devices, corrective esthetics and laser treatment. Markland is the editorial manager for PCA SKIN® and an advanced educator. She shares her passion for skin health with fellow estheticians and medical professionals at presentations all over the world. Les Nouvelles Esthétiques & Spa • February 2013
by Kris Campbell
skin|types 1 & 2 diabetic options and treatments DIABETES AFFECTS OVER 20 million Americans, and more than 40 million Americans have prediabetes. It is very likely that a portion of our own clients represent some of these prediabetic individuals. The first thing we need to understand is the difference between the two types of diabetes, and the related conditions that may affect the skin. We can then determine
Diabetes affects the skin as well as the rest of the body. Common areas include hands, feet and elbows. Dry skin occurs in these areas due to loss of fluid with high glucose levels. Dry skin needs to stay hydrated and protected, because if left untreated, fissures or cuts may present on the area. Moisturizing and using anti-itch products will also be beneficial, as many develop severe itching.
photo: Bochkarev Photography/Shutterstock.com
Conditions most likely to affect a spa or facial treatment may include the following: poor wound healing, infections and neuropathy issues. a course of treatment that will be most beneficial, and at the same time calming to irritating skin conditions. Diabetes mellitus is a group of metabolic diseases that causes a person to have high blood sugar. This is commonly known as diabetes, a condition in which the body cannot produce the required amount of insulin to properly break down the glucose (sugar) in the blood. This can be caused when the cells don’t respond to the insulin that is normally produced, or when the pancreas does not produce enough insulin. The two main kinds of diabetes are Types I and II. In cases of Type I diabetes, the body makes little or no insulin. Type II is the most common form of diabetes. It arises when the cells cannot use insulin properly. February 2013 • Les Nouvelles Esthétiques & Spa
Anti-bacterial, anti-fungal and antimicrobial types of products will also be beneficial, as the hands and feet are prone to infection. Bacterial and fungal infections can also occur around the nails, hair follicles, armpits, groin and corners of the mouth on a diabetic client. Anti-glycation ingredients are becoming more popular for anti-aging, but they are also needed by the diabetic client, since there is a predominant thickening of the skin that occurs due to the glucose level problems. These ingredients include carnosine, benfotiamine, plant extracts of the ericaceae family (cranberry, blueberry, huckleberry), tocopherols, antioxidants, Matrix Metalloproteinase Inhibitor (MMPI), amino acids and other collagen supporting ingredients.
The body is affected in many ways by insulin issues. This opens the door to a new way of thinking for the therapist, since we definitely do not want to do any harm to the client during a treatment. Conditions most likely to affect a spa or facial treatment may include the following: poor wound healing, infections and neuropathy issues. Poor wound healing and infections are both issues that need to be looked at in regards to sanitation. Gloves should always be worn in order to prevent further issues for them to battle. How a client is massaged and draped can affect areas of the body due to neuropathy. These areas can be sensitive to warm or cold temperatures, and the client may experience pain when touched. Several contraindications for clients with diabetes must be considered and explained to the client. Microdermabrasion, chemical peels and dermal needling are all contraindicated for the diabetic client. If a case of diabetes is advanced or poorly treated (tissues are unhealthy or circulation is poor), several other “normal” treatments should also be avoided. These may include micropigmentation, laser resurfacing, waxing, laser hair removal and electrolysis. Body services, including hand and foot treatments, must also be carefully considered by therapists. Massage can decrease the blood glucose levels by increasing the action of serum insucontinues www.LNEONLINE.com • Page 57
skin|types 1 & 2 lin. Some diabetics can tell when their sugar levels are dropping, but some do not have that knowledge. Lighter, more simple massage should be offered. If the client feels clammy to the touch or makes any mention of being dizzy or faint, have some juice available. This will quickly raise the blood glucose level. The hands and feet are key areas where a client may experience neuropathy symptoms. These areas are also more
prone to infections when nail treatments are performed. Hot stones and paraffin wax should be avoided due to the possible increase or decrease of sensation in those areas. When you are giving a foot treatment, look for nails that are thickened, infected, swelling, red, calloused or have cracked skin. When you touch the client, you will be able to tell by their pulse whether they are getting enough blood
flow. You will also notice if the feet are hot, which means they could be inflamed. These criteria are important for helping you determine the right course of treatment and products for the client. Several treatments have been shown to offer relief for the diabetic client. Reflexology, meridian therapy, aromatherapy and auricular therapy are just a few. The wellness movement has pushed these types of therapies to the forefront. More research and studies are being done to see the types of each that work best to relieve the skin conditions caused by diabetes. Realize that each client with diabetes has their own unique set of conditions, and should always be looked at as an individual. They may also be suffering from other health issues that could create a contraindication. Most people with diabetes will suffer from skin disorders caused by the condition at some point in their lives, depending on the severity of the diabetes. Skin problems can be a key sign to the professional that a client has diabetes. With the incidence of diabetes on the rise, the skin care professional needs to be able to identify dry skin, bacterial infections, fungal infections and itching in order to treat clients with diabetes. The next diabetic person who walks into your treatment room could become a loyal client because of your specialized knowledge on how to relieve the unique issues they face. n
Kris Campbell is CEO and a formulator for Tecniche, a skin care line dedicated to sensitive skin. She is a certified oncology esthetician, and works with Morag Currin (author of Oncology Esthetics: A Practitioner's Guide and HealthChallenged Skin: The Estheticians' Desk Reference) to address the skin concerns of clients who are undergoing cancer treatments. Campbell runs trainings, writes for trade publications and speaks at industry events about conditions faced by people with health challenged skin. Say you saw it in LNE & Spa and circle #104 on reader service card
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Les Nouvelles Esthétiques & Spa • February 2013
VIBRANT GLOW Help your clients maintain healthy balance with HydroPeptide® Tone, a results-oriented, hydrating toner that treats wrinkles, prevents collagen loss, reduces pore size and fades age spots. Licorice, mulberry and bearberry inhibit melanin, fade age spots, reduce discoloration and improve overall skin radiance within weeks, says the company. www.hydropeptide.com
COMPLETE CARE Skin Script is dedicated to beautiful, healthy skin, using fresh thinking to deliver the latest for a vitalized, youthful complexion. Skin Script is a clinical, professional skin care line containing retinols, glycolics, lactics, salicylics and natural lighteners/brighteners, allowing you to customize a treatment regimen for your clients’ skin. www.skinscriptrx.com
February 2013 • Les Nouvelles Esthétiques & Spa
The skin regularly needs intensive regenerating care, a booster to rebalance and revive cell functions. Plasma 27 is a regenerating and restructuring “treatment care” that stimulates and highlights the complexion and lifts and firms facial features. Plasma 27 is a unique pre-impregnated mask with a serum type formula, intended for use on a weekly basis. Key ingredients include centella asiatica, calendula and bisabolol extracts. The results are visible immediately after application, says the company. www.cosmetics27-us.com
CLEAN AND CLEAR The new Clearskin from PCA SKIN® is a light, nighttime hydrator for oily and blemish-prone skin. With 4% niacinamide, as well as a fresh aroma and a lighter texture, Clearskin provides exceptional calming, blemishfighting and antioxidant action. Additionally, vitamin A, marigold, butcher’s broom and cucumber work together to help minimize skin discoloration. www.pcaskin.com
SKINNEWS
RAPID RENEWAL
SKIN CARE PRODUCTS AND TREATMENTS MORE NEWS
www.LNEONLINE.com • Page 59
HELLO BRIGHT EYES!
SKINNEWS
DermaMed Solutions’ eye-radiance K’reme removes dark circles and puffiness beneath the eyes with its anti-inflammatory compounds. With 2% Haloxyl™, eyeradiance K’reme increases blood flow to reduce dark pigment deposits under the eyes. No harmful chemicals, preservatives, artificial fragrances or dyes are included in the formula. www.DermamedSolutions.com
SKIN CARE PRODUCTS AND TREATMENTS
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QUALITY COLLECTION Elavo Skin Care, a new skin care line that was created by dermatologist Dr. Ahmet Altiner, encompasses the three major aspects of dermatology: prevention, treatment and maintenance. “Elavo” is Latin for clean, and all the products in the line are reflective of Dr. Altiner’s professional philosophy. “Cleanliness is vital when it comes to skin care, as we strive to return the skin to its most basic state and optimal function,” he explains. “Furthermore, I wanted the products themselves to be clean in order to allow the powerhouse ingredients to truly shine.” The Elavo Skin Care line includes the Beta Cleaner, Keratin Scrub, Radiant Eyes and Solar Defense SPF 30. www.elavoskincare.com
TECHNOLOGY TRIO The Tanda Luxe Rejuvenating Photofacial Device uses a three-pronged approach to target signs of aging using red light technology, heat and vibration to combat fine lines, wrinkles and dull skin. A super luminous LED delivers concentrated beams of red light for a fractional phototherapy effect. It is coupled with sonic vibration and gentle warming in a unique massaging treatment head. These technologies complement one another to deliver a professional photofacial experience that creates luxurious, soft, smooth and glowing skin. Tanda Luxe leaves clients feeling more youthful, rested and refreshed. www.tanda.com
COMPLEXION PERFECTION The PERFECTION AP from Dr. Grandel is an anti-pigment concentrate specifically designed to reduce hyperpigmentation and age spots and prevent the development of new pigmentation. The formula contains a plant-based complex composed of watercress and lupin extracts that work in a very gentle manner. With regular use of this concentrated product, skin appears flawless, even toned, luminous and younger looking. www.grandel-skincare.com
Les Nouvelles Esthétiques & Spa • February 2013
Rebuild your skin from the
inside out Introducing Control Corrective’s EGF Serum 30
Our proprietary concentration of multiple epidermal growth factors derived from fibroblast media stimulate the skin’s natural tissue repair and rejuvenation process. Liposome encapsulated DNA enzymes work to shorten the repair time from sun damage and natural aging.
Epidermal Growth Factors – Developed to encourage faster, healthier wound healing by boosting the skin’s production of collagen and elastin fibers, restoring resiliency, texture, tone and consistency to the skin Superior Functionality – Diminishes signs of aging around the eyes, the full face, the body and hands Total Compatibility – Safe and efficacious for all skin types and compatible with retinol, antioxidant and sunscreen regimens
Client: 68 years old. Results after 1 month of EGF Serum 30 use. Before and after images are not retouched.
Enhanced Healing – Accelerates skin repair after chemical peels, IPL, laser or microdermabrasion treatments
Discover what EGF Serum 30’s advanced cosmeceutical skin rejuvenation can do for your business Client: 54 years old. Results after 1 month of EGF Serum 30 use. Before and after images are not retouched.
Professional Skincare Since 1997
Contact controlcorrective.com | 866.290.4290 | info@controlcorrective.com Say you saw it in LNE & Spa and circle #272 on reader service card
in a medical setting
by Robert Sachs
CAN ALTERNATIVE TREATMENTS and spa therapies be offered in a modern Western medical setting? Alternative medicine is nowadays often called “complementary” medicine, which suggests that it is an adjunct to modern allopathic medicine. It actually comes from traditions that are thousands of years old, including Chinese medicine, Ayurveda, shamanic healing practices from all over the world and the varying modernization and subsects of these traditions, including homeopathy, naturopathy and so on. These forms of medicine have always been holistic, recognizing the inseparability of body, mind and spirit. Thus, healers employing such methods have always talked about, understood the value of and/or made recommendations on diet, exercise, relaxation, prayer life, massage, supplementation and possibly surgery. Modern allopathy really emerged during the time of the Industrial Revo lution in the United States (in the mid1800s). It primarily employs a refinement of old herbal supplementation through the wonders of modern chemistry, surgical procedures and some of the emerging methodologies that utilize forms of energy, such as electricity and radiation. This form of medicine is especially useful in addressing industrial accidents, catastrophes (both individual and collective) and the horrors of war. Advancements in saving limbs, patching up badly damaged bodies and brilliant innovations in prosthetics are testaments to the invaluable contribution allopathy has made in ending a great deal of human misery. However, the greatest contribution allopathy has made even beyond these methods comes in the discovery and implementation of the importance of hygiene and sanitation. This alone has Page 62 • www.LNEONLINE.com
probably saved more lives worldwide than any other form of healing, be it allopathy or alternative. While industry, commerce and warfare so dominate our western psyche, modern allopathy has only recently established a prominent position in the collective mind, politics and econom-
Satisfaction and relaxation are important components in the healing process.
Kansa foot treatment at Integrative Medicine & Spa Center in Clifton Springs, NY
ics of society. Virtually nothing that is alternative or complementary has been recognized as legitimate or insurable on a widespread level. In most forms of media, things like massage therapy, herbal remedies and alternative diet practices continue to be maligned and mocked. But the simple truth is that people are holistic by nature. As a result, the methods that have been around for millennia are re-emerging to address the stresses of modern living that accumulate and lead to chronic, degenerative diseases that the wonders of allopathy are—by design—not qualified or capable of addressing. Millions of consumer
Robert Sachs is a counselor, licensed massage therapist and educator. He is the author of Tibetan Ayurveda: Health Secrets From the Roof of the World and coauthor with Melanie Sachs of Ayurvedic Spa. Visit Sachs’ website at www.DiamondWayAyurveda.com, email him at ayurveda8@earthlink.net, call him at 866.303.3321 or phone/fax him at 805.543.9291. Les Nouvelles Esthétiques & Spa • February 2013
photo courtesy of Integrative Medicine & Spa Center in Clifton Springs, NY
spa
dollars are now being spent on better quality food, herbs and the occasional massages and trips to a spa. A younger echelon of doctors who have been observing this and demanding more integrative medical training can attest to the value of a healthier lifestyle for themselves and their clients. The Clifton Springs Hospital in upstate New York and its spa, The Springs, demonstrates that there is an old history of this marriage in American health culture. When Melanie and I offered training in Ayurveda to the spa staff there, we did not fully appreciate how far therapists and their medical director, Les Moore, were going to take our teachings in their hospital community. Therapeutic hot tubs and massages are now included in the package at hospital admission, as is Abhyanga, Shirodhara and our own Ayurvedic foot treatment. Beyond Clifton Springs, there are any number of skin care facilities offering laser and therapeutic plastic surgery who prepare their clients with facials beforehand and recommend quality oils and products post-op. What we hear from these facilities is that the preparatory facials and skin care that is offered before more radical procedures makes them go more smoothly. And the follow up esthetic work that comes after these procedures shortens healing time. The message behind these examples? People feel nourished and nurtured when many alternative or complementary therapies are included in their treatment and healing regimens. And patients in a hospital are more satisfied with their stay. As we all know, satisfaction and relaxation are important components in the healing process. n
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Bio-Therapeutic World Wide USA | 800.971.6259 | bio-therapeutic.com Para informaci贸n en Espa帽ol llame al 800.971.6474
Body Exfoliant Sugar Dust Exfoliating Scrub, Prana Spaceuticals™ A sweet mixture of turbinado sugar and nourishing botanicals that exfoliates even the driest skin! 866.589.2949
Antioxidant Body Lotion Whoopie! Shea Butter Cream, Farmhouse Fresh® The lightly scented shea butter for the body is like white velvet buttercream from a whoopie pie dessert! 888.773.9626
Antiox-6™, HydraFacial MD® This unique formula naturally detoxifies and protects skin from environmental free radicals, lavishly hydrates, replenishes elasticity, and improves the texture and clarity of skin. 800.603.4996 See advertisement on page 21
Acne Acne Spot Treatment, SAIAN This all-natural spot treatment kills breakouts overnight. It destroys germs and bacteria, disinfects and dries blemishes to treat even the most severe and cystic acne without leaving red spots and discoloration. 800.291.1130 See advertisement on page 82
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Les Nouvelles Esthétiques & Spa • February 2013
lne & spa’s best product 2013 It’s that time of year again, when LNE & Spa recognizes the outstanding products that you, our valued readers and professionals of our great industry, have selected from our lineup of exceptional nominees. For our 2013 LNE & Spa BEST awards, we nominated standouts in a record breaking 34 categories! The products and equipment on the following pages represent the best of the best, based on your votes. We are pleased to present LNE & Spa’s BEST for 2013!
Cellulite Professional Firming and Shaping Gel, Circadia by Dr. Pugliese A light, cool and fast absorbing gel formulated with effective ingredients to dramatically smooth the uneven appearance of cellulite. 800.630.4710 See advertisement on page 55
Body Wrap Thermo Reducing Clay, Phytomer This unique self-heating system promotes the elimination of fat. Suaeda maritima helps to break down cellulite, and pure clays soak up toxins from engorged tissue. 800.227.8051 See advertisement on page 7
Cleanser Daily Cleanser, Skin Authority This lightweight, fragrance free wash gently removes dirt and oil from the face and body and loosens dead skin cells, leaving the skin soft, refreshed and primed for a daily regimen. 866.325.SKIN
Bronzer Mineral Illuminator, Éminence Organic Skin Care The long-wearing, oil-controlling and illuminating bronzing powder is infused with acai berry, green tea and vitamins A and E. Offering sheer highlight and contour, the all natural mineral illuminator provides a subtle glow for all skin types and tones. 888.747.6342 See advertisement on pages 2-3
February 2013 • Les Nouvelles Esthétiques & Spa
www.LNEONLINE.com • Page 65
lne & spa’s best product 2013
Detox/Wellness Lavender Herbal Bath, Kneipp® Known for its balancing effects, this aroma intensive bath treatment helps combat mental and physical fatigue. The relaxing effect of the lavender herb is most helpful when one feels nervous or itchy, and it can also be very energizing. 800.937.4372 See advertisement on page 75
Equipment for the Face Bio-Ultimate Platinum™, Bio-Therapeutic This cutting-edge device features nine pre-programmed facial modes that deliver unparalleled anti-aging results! Independent studies found significant increases in collagen, elastin and ATP using the patented Suzuki Sequencing Microcurrent Technology platform. 800.976.2544 See advertisements on page 8 and 63
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Face Mist Cucumber Hydration Toner, Skin Script™ This mist is much more than a toner! It re-hydrates the skin to improve cellular and epidermal enzymatic functions, and it contains hyaluronic acid and essential fatty acids. 480.543.1121
Equipment for the Body Silhouet-Tone®, P.R. Cell 2G The deep-tissue massage unit combines a skin fold and vacuum massage to reach deep into subdermal tissue. It reduces the appearance of the dimpling and “orange peel” effects of cellulite. Treatments are easily adaptable to different body shapes. 800.552.0418 See advertisement on page 47
Eye Cream Eye Zone Treatment, Christina The telltale signs of aging eyes are reversed and protected by this treatment, which reduces fine lines, dark circles and puffiness while minimizing the appearance of fatigue. Formulated with vitamin B complex, algae extract and additional antioxidant-rich ingredients, the serum stimulates cellular regeneration, strengthens collagen and elastin and provides hydration to prevent wrinkle formation. 888.608.6268 See advertisement on page 77
Les Nouvelles Esthétiques & Spa • February 2013
Green Product Herbal Recovery Oil, Éminence Organic Skin Care The toning and hydrating oil is formulated with precious herbs and nourishing oils to soothe and renew sensitive and aging skin. It is clinically proven to reduce fine lines and wrinkles and increase hydration! Age defying clary sage and balancing ylang ylang combine with olive and sesame oils for a radiant complexion! 888.747.6342 See advertisement on page 2-3
Hyperpigmentation Treatment Catalyst With SRGF-7™, Osmosis Skincare Zinc Finger Technology™ is used to repair DNA damage and assist in the production of proteins and antioxidants within the cell. The combination of amino acids and key cofactors improves wound healing, lightens pigmentation, reduces visible capillaries, and stimulates collagen and elastin production. 877.777.2305
Hand Treatment Floridian Body Butter, Terra Dolce This pure body butter is made with concentrated natural ingredients and nothing more. It melts in heat and upon contact with skin. 877.MY.DOLCE
February 2013 • Les Nouvelles Esthétiques & Spa
Innovative ProScope HR™, Scalar Your very own personal assistant! The high-tech camera solution keeps track of your clients’ skin photos. It makes an excellent tool for both consultation and clinical use. Use it on your existing clientele and gain new clients with ease while increasing your retail sales! 916.201.5618 See advertisement on page 29
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Male Product Sake Toner, RAW This peel for men is a powerful blend of sake and skinregenerating acids, which works to reduce fine lines, tighten skin and help fight free-radical damage. The gentle and effective peel improves skin texture and tone while diminishing fine lines. 888.743.8729 See advertisement on page 9
Mask Rosaderm Masque, A Natural Difference™ The hydrating gel masque provides anti-inflammatory and moisturizing benefits. It assists the skin’s regenerative and repair process, balances moisture levels and soothes irritation. 888.568.3150 See advertisement on page 5
Lash Product Eyelash & Eyebrow Enhancing Serum, RapidLash™ This clinically proven serum improves the appearance and condition of lashes and brows in as little as 30 days. The formula features a proprietary mix of six highly effective ingredients that nourish lashes and brows. 877.760.6677
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Makeup Fountain of Youthful Color Eyebrow Mousse, blinc This eyebrow product provides the water-resistant color of a tint, fills in sparse areas like an enhancer/filler and tames brows like a gel! 877.454.7763
Les Nouvelles Esthétiques & Spa • February 2013
lne & spa’s best product 2013
Nail Product
Massage Oil Coconut Mint Massage Oil, PINO Regenerating soybean oil, calming coconut oil and skin protecting jojoba oil in this formula improve the elasticity of the skin and leave behind a silky smooth feeling. This excellent blend replenishes and moisturizes the skin, making it suitable for all skin types. 866.446.5930
Peptide HydroStem+6, HydroPeptide® This powerful peptide formula includes a collagen-stimulating dual peptide that restores skin’s smoothness and structure while six botanical stem cells trigger epidermal stem cell activity for skin that looks and acts younger. 800.932.9873 See advertisement on page 19
February 2013 • Les Nouvelles Esthétiques & Spa
Nail Lacquer, SpaRitual® Each vegan nail lacquer is topped with a sleek, patented Plum Cap® that opens easily with a non-slip grip. A shorter brush length also offers more application control and accuracy. 877-SPA RITUAL
Moisturizer Ageless Total Repair Crème, Image Skincare The glycolic and retinol based antiaging night repair crème delivers vitamins and nutrients in a time-release formula for visibly firmer skin. It works overnight to repair and resurface skin. 800.796.SKIN
Peel Ultra Peel I, PCA Skin® This peel is formulated to treat maturing skin, and can improve many skin types and conditions including hyperpigmentation, sun damage and breakouts. The result is hydrated, luminous skin. 877.PCA.PEEL See advertisement on page 11
www.LNEONLINE.com • Page 69
lne & spa’s best product 2013
Sunscreen
Spa Table Spa-Comfort, Équipro The versatility of this table allows the operator to put it in a flat position for back exfoliations, seaweed wraps and body services, as well as any positions desired for facials, waxing and many other treatments. 877.324.2226 See advertisement on page 131
Face SPF 20 Rose Essence Tint, Coola Suncare® This sheer sunblock keeps delicate facial skin even, hydrated and protected. It delivers antioxidant and antiaging powers and provides broad-spectrum UVA/UVB protection. 760.940.2125
Serum
Spa Wear Verité by Barco, Barco Uniforms Ultra-soft fabrics, clean lines and elegant details characterize this quality line of spa wear that awakens the senses, soothes the spirit and stands the test of time. 888.770.7856
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Rx Complex Serum, Le Mieux This technologically advanced serum provides a high concentration of peptides and liposomes to naturally improve skin rejuvenation. It is most effective at reducing expression lines and oxidative DNA damage, and works well with dry and dehydrated skin. 888.327.8188 See advertisement on page 39
Les Nouvelles Esthétiques & Spa • February 2013
Supplement Omega 3, Ocean+ These capsules are formulated with omega-3 oils of superior purity. They contain 350 mg EPA, 250 mg DHA and 80 mg DPA. 855.623.2688
Tanning Premier Silent System, South Seas® This top-of-the-line system is designed for premier spas and salons that require a virtually silent machine that delivers a flawless tan every time. This system includes all the products you will need, as well as a training DVD and brochure. 866.961.9903
Therapeutic Oil
Wax Citrus Mojito Thin Film Hard Wax, Satin Smooth® This no strip disposable wax provides sensuously soft results, soothing and moisturizing skin with vitamin C and natural spearmint oil. It is perfect for Brazilian bikini waxing! 800.7CONAIR See advertisement on page 35
February 2013 • Les Nouvelles Esthétiques & Spa
Muscle Therapy Massage Oil, Bon Vital’® This lightweight oil with a clean absorption is perfect for sports massage, deep tissue, neuromuscular and trigger point modalities that allow you more control, less slip and more grip. The pleasing aromas leave your clients feeling calm and relaxed, and are known to help combat sore, achy muscles. 800.253.6466
www.LNEONLINE.com • Page 71
by Adam Gropper, M.D.
spa|vein-ity
Spider veins Spider veins, or telangectasias, are abnormal blood vessels that appear as tiny red, purple and blue linear and branching veins close to the surface of the skin. They can form anywhere on the body. Increased vein pressure is often the cause of development of telangectasias. They are most commonly hereditary. When spider veins occur without any of the symptoms described above, they are often easily treated with sclerotherapy, which involves the injection of a chemical through fine needles that destroy the vein(s). In some cases, new devices that employ thermocoagulation, similar to electrolysis devices, can be used. The use of IPL or Yag lasers to treat spider veins is generally not as effective, particularly on larger veins, and lasers can cause significant pigment changes in the skin. The other option is thermocoagulation, which is FDA approved specifically for treatment of spider veins. This Page 72 • www.LNEONLINE.com
revolutionary device eliminates spider veins anywhere on the body by delivering an electrical pulse to the spider veins through a tiny needle. In patients who also have symptoms such as itching, burning, fatigue, leg aching, cramping or restlessness, a more thorough evaluation of the legs should be performed before undergoing cosmetic sclerotherapy.
Varicose veins Varicose veins are twisted, enlarged vein branches caused by weakened valves in the underlying veins. When these valves do not work properly, blood collects in the legs, vein pressure increases and the veins dilate, appearing large and twisted. Risk factors that increase the risk of developing varicose veins include: • Age: Varicose veins usually appear between ages 30 and 70, and get progressively worse over time. • Sex: Women are more likely to develop varicose veins than men. • Genetics. • Obesity. • Jobs that require prolonged sitting or standing. For patients with varicose veins and symptomatic spider veins, meticulous physical and ultrasound examination is needed to identify the proper veins for treatment, and the best treatment modality. Conservative treatments like weight loss, physical activity and compression stockings can help reduce their appearance without invasive procedures. If conservative treatments aren’t enough, ultrasound guided foam sclero-
therapy, endovenous laser ablation (also called EVLA or EVLT) or radiofrequency ablation (RFA) can be used to close and shrink larger veins using ultrasound guidance. Laser and RFA treatments destroy the veins by heating them, leading to closure, whereas foam sclerotherapy works by chemically injuring the vein lining. The old surgical technique of vein stripping is now considered obsolete by most experts. Clarivein, or vein embolization, is a relatively new procedure that destroys large varicose veins without heat or local anesthetic. This is quick and more comfortable than laser and RFA. Veins that cannot be removed by the methods discussed can be treated with an ambulatory phlebectomy, or removal of the veins through tiny skin punctures. n
Adam Gropper, M.D. is board-certified in vascular and interventional radiology and diagnostic radiology by the American Board of Radiology. Dr. Gropper is an expert in the treatment of conditions through the use of minimally invasive techniques. He developed North Beach Vascular & Aesthetics in order to create an atmosphere where both the medical issues of venous insufficiency and the esthetic complications can be treated in a serene and relaxed environment. Les Nouvelles Esthétiques & Spa • February 2013
photo: Rob3000/Shutterstock.com
S PA C L I E N T S S O M E T I M E S complain of aching, cramping, itching and burning sensations in the legs, or perhaps restlessness of the legs at night. They may have a road map of spider veins or swollen, twisted and protruding varicose veins. Untreated vein disease can lead to serious medical problems such as ulcers, blood clots and even amputations if not properly diagnosed and treated. The first step in treating vein disease is recognizing the difference between spider veins, which are often strictly a cosmetic problem, and varicose veins, which can lead to serious health issues.
spa
BEAUTY FROM
photo: Tereshchenko Dmitry/Shutterstock.com
HEAD TO TOE ESTHETIC PROFESSIONALS, ONCE KNOWN PRIMARILY for facial treatments, can now perform procedures that rejuvenate the neck and chest area, tighten jiggling skin and even remove toenail fungus. Clients no longer have to seek out a plastic or cosmetic surgeon to achieve their desired results. Non-invasive medical esthetic procedures that utilize everything from laser light to radio frequency and ultrasound waves can help you become a one-stop resource for your clients. Also, did you know that in most states you do not have to be a medical professional to perform cosmetic laser treatments and many other medical esthetic beauty procedures?
It is important for us to educate ourselves and our clients about the latest advances in body treatments because it can improve the overall customer experience and boost our earning potential at the same time. For example, your client may be aware of what a body wrap is, but does she know that a photofacial can treat the sunspots on her arms and shoulders? Does she know that there are body contouring treatments that can smooth the appearance of cellulite without liposuction or any other surgical procedure?
Beyond facial treatments Let’s start by looking at the intense pulsed light (IPL) photofacial. It has become one of the most sought-after facial treatments in the marketplace because of its ability to reduce fine lines and irregular pigmentation while causing only minimal redness and requiring no downtime following the procedure. The photofacial works by using a series of intense pulsed light beams that penetrate the skin at the deepest level, where they target unwanted skin pigmentation and stimulate collagen production. 4
BY LOUIS SILBERMAN February 2013 • Les Nouvelles Esthétiques & Spa
www.LNEONLINE.com • Page 73
spa|beauty from head to toe
treating the toenail with laser light, the heat sterilizes the area, zapping the fungus and preventing the spores from multiplying. Millions of Americans suffer with this condition every year, but not many spas offer this treatment. That means there is a lot of opportunity to capture a share of the marketplace.
The bacteria that causes acne cannot survive when temperatures reach a certain level, and the intense pulsed light is able to heat the treatment area to the point where it kills the bacteria and allows the skin to rejuvenate naturally. While the face remains the most popular treatment area and the chest is often requested, photofacials can also address problems on the arms, legs, back and buttocks. In addition to addressing spots and wrinkles, this technology can be used to treat acne by targeting its source. The bacteria that causes acne cannot survive when temperatures reach a certain level, and the intense pulsed light is able to heat the treatment area to the point where it kills the bacteria and allows the skin to rejuvenate naturally. For people suffering with the pain, irritation and embarrassment of acne, this treatment can offer life-changing results. Another popular facial procedure that is typically done to treat wrinkles can also be used to treat a common skin condition that causes people to feel self-conscious and hide their skin: stretch marks. A fractional laser is an intensive light-based treatment that projects thousands of microscopic beams into the skin’s dermal layer. This pixilated light generates heat to stimulate the body’s natural healing process and accelerates collagen regeneration, creating healthy new tissue. This treatment can be a great up-sell for many clients, and especially new moms who may have gained stretch marks as a result of pregnancy. Certain lasers can also be used to treat toenail fungus (scientifically known as onychomycosis), an infection that can cause nails to become yellowed, cracked and brittle. In severe cases, it can cause the nail to fall off completely. By Page 74 • www.LNEONLINE.com
Don’t we all wish that someone could wave a magic wand and make the problem areas on our bodies disappear? Well, while we don’t have that magic wand just yet, we do have technology that seems magical—although it is really quite scientific! In addition to laser technology, there are treatments that use other high-tech methods to smooth, tighten and contour skin to help people create their ideal bodies. Cellulite reduction treatments have become increasingly popular in recent years (they have even made appearances on some of the most popular reality TV shows, which has helped make the public aware of many amazing devices). The treatments incorporate a number of modalities ranging from infrared light, radio frequency energy, ultrasound technology, suction and massage. Each treatment works differently to achieve smoothing and slimming results. Ultrasound treatments work by delivering a localized heat that creates a micro-massage effect on fat cells. This procedure warms the connective tissue— stimulating blood circulation and redistribution of fat, which reduces the appearance of cellulite. Infrared and radio frequency modalities use light and radio frequencies to produce heat while a mechanical vacuum massage works to decrease the appearance of fat and cellulite, resulting in a smoother, more contoured shape. In addition to body contouring, many clients are interested in solutions that can treat loose and sagging skin without getting it surgically removed. Fortunately, medical esthetic technology has provided a number of options. Common skin tightening treatments use radio frequency technology to get results all over the body. These desired results are achieved by using radio frequency energy that sends heat into skin’s dermal layer (while the superficial layer remains protected). This treatment is effective because the controlled heat causes the skin’s tiscontinues Les Nouvelles Esthétiques & Spa • February 2013
photo: Shutterstock.com
Body beautiful
Say you saw it in LNE & Spa and circle #324
spa|beauty from head to toe
The industryaccepted standard in cosmetic laser education is two weeks of combined classroom instruction and clinical handson training at an accredited facility.
Expand your services by learning new skills When you are treating clients on a regular basis, it is all too common to fall into a familiar routine or set of habits. But sometimes it’s important to step outside of the box and think of ways that you may be able to upsell your clients and provide them with more inclusive services. There are exciting developments in our industry all the time! By informing your clients about the latest advancements in skin care and body
contouring, you are helping them get excited about the amazing possibilities. If you haven’t received training to perform medical esthetic procedures yet, you may want to consider taking a course that trains you to perform the most popular modalities, and educates you so that you can successfully incorporate these services into your esthetic practice. The industry-accepted standard in cosmetic laser education is two weeks of combined classroom instruction and clinical hands-on training at an accredited facility. Depending on the state you live in, there may be certain rules in place that require mandatory training hours as a prerequisite for offering cosmetic laser services or other medical esthetic procedures. However, even if laser education is not required in your state, comprehensive education and training are crucial. Becoming a skilled practitioner is essential to achieving success in this industry. Without proper training and education, practitioners run a high risk of burning, scarring or otherwise injuring a client. Plus, there is valuable information that needs to be learned about skin type, skin conditions, safety protocols, pre- and post-treatment care instructions and procedures that protect the person administering the treatment. By expanding your services to include the entire body, you are able to introduce your clients to services that can solve the skin problems that they didn’t know could be solved! This helps boost their confidence in both themselves and you. You are now the go-to person for all of their skin questions and concerns, and you have cemented their opinion that you are a true skin care expert. n Louis Silberman is president and founder of National Laser Institute, the largest cosmetic laser and medical esthetic training center in North America. An expert in medical esthetics, Silberman is a medical spa owner and nationally recognized author, marketing speaker and business consultant. Contact Silberman at (800) 982-6817 or louis@nlionline.com.
Page 76 • www.LNEONLINE.com
Les Nouvelles Esthétiques & Spa • February 2013
photo courtesy of the National Laser Institute
sue to retract, stimulating collagen production, which tightens and renews the skin. This procedure offers noticeable skin tightening without the downtime and risks associated with surgery.
Create Great Skin Eye Zone Treatment Named Best in 2013
Find out why for yourself and your clients.
Celebration special! Buy 10 get 2 Free!
| Tel: 1-888-604-6268 (se habla espanol) | Fax: 1-941-296-7320 | Web: www.christina-usa.com | E-mail: customerservice@christina-usa.com Say you saw it in LNE & Spa and circle #107 on reader service card
BY RUTHIE PIPER HARDEE AND JENI SPRING
RELAX, ASHIATSU HAS GOT YOUR BACK! WE HAVE BEEN HAVING AN ONgoing love affair with resorts and spas since the late 1980s. As consumers back in those days, we would lay on those hot marble slabs in the perfectly balanced eucalyptus steam rooms under the drenched cucumber eye cover towels. During these times, we would often wonder to ourselves, “How can I get paid to do this on a regular basis?” Was there some spa junkie payroll somewhere out Page 78 • www.LNEONLINE.com
there that we weren’t aware of? And if so, how could we get in on the action? Fast forward two decades. Now, as licensed spa professionals, our question is, “How can I get this staff up and operational in a short amount of time, be safe and teach them the tools they need to be taken seriously in today’s spa market with regards to pain management? And in addition to all this ... can I still deliver tangible results?” It is the duty of continuing education providers to educate spa directors and lead therapists on how to offer several approaches to treating and managing
Les Nouvelles Esthétiques & Spa • February 2013
photos courtesy of Ruthie Piper Hardee
HOW’S YOUR PAIN MANAGEMENT MENU?
pain for their guests. They must be committed to ensuring that the training they receive will have an impact on the guest experience, as well as the employee’s longevity for a greater spa community. How can this be accomplished when you barely have time to change linens and adjust the table in between clients, let alone focus on a personal intake form? The answer doesn’t come without challenges, but it is the responsibility of the licensed professional to take this training seriously. That is by far the biggest reward. In other words, don’t offer a service on the menu if you are not able to deliver and be responsible with your guests’ safety. We’ve come a long way since spas were viewed as “fat farms.” Just as important as creating the environment that helps a guest make a direct emotional connection to a healthier lifestyle, one should address pain management options with thought and care. Medical spas, intake forms, products and treatments have also come a long way. While it’s important to know some personal medical details about your client so you don’t accidentally mix up ingredients that will give them an allergic reaction, you also need to know about their pain and the treatment you are providing to treat it. Spas offer all kinds of alternative pain healing treatments, from bathing in a particular spring for the powers of the mineral water to offering a bonanza of massage techniques and deep tissue tools. Pain management services are alive and well in spas around the world, and they generate big bucks. The more knowledge and training spa professionals have on the treatment options they’re delivering within the relationship to pain management, the more ownership they have in helping that guest break through the pain cycle. Chronic pain affects millions of Amer icans. The most requested service in today’s spa market is deep tissue massage, which can either be tailored for relaxation or pain management. So it makes practical sense for spas to offer a comprehensive massage treatment for a wide
spa range of chronic pain conditions, including the following:
• Spinal pain, including lower back, neck and thoracic pain • Failed surgery for back pain • Sciatica • Myofascial pain • Neuropathic pain • Chronic pelvic pain • Joint pain
This barefoot bar therapy is recognized as a specific deep tissue technique, and has shown remarkable results for persons suffering from:
• Chronic pain • Limited mobility • Recovery from injuries (whiplash, falls, sports, etc.) • Repetitive strain injury, such as carpal tunnel syndrome • Postural problems • Ostearthritis pain • Fibromyalgia • Muscle tension or spasm
Ashiatsu Deepfeet Bar Therapy is a perfect service for spa guests who suffer from long term chronic pain and want to avoid surgery, or are taking medications that are not helping. Having staff who understand how to explain Ashiatsu barefoot compression to guests is imperative as well. Eric Dzwonkowski, D.C. of Journey Health Center in Denver, CO endorses Ashiatsu Bar Therapy as a natural alternative treatment for many of the conditions mentioned above. “The Ashiatsu style and technique focuses on realigning deeper layers of muscles and connective tissue,” he says. “It is especially helpful for chronically tense and contracted areas such as stiff necks, low back tightFebruary 2013 • Les Nouvelles Esthétiques & Spa
ness and sore shoulders. While pain is a subjective and highly individualized experience, I feel that Ashiatsu is a great source that treats the whole mind, body connection and we use it on a daily basis here in the office.” Two common areas where massageseeking spa-goers experience pain or discomfort are the middle and lower regions of the back. Many times these clients experience nagging, chronic pain in the general location or specific “knots” felt within the tissue. Often they schedule a deep tissue massage, and the pressure requested or required may be more than a massage therapist can easily provide. DeepFeet offers techniques helping massage therapists achieve consistent, broad pressure at the level of depth needed to address the underlying issue, while still providing a transformative mind-body experience for clients visiting a spa or resort.
barefoot bar therapy, the pain can easily start to diminish just minutes into the first session, with holistic benefits lasting throughout the week—beyond what a traditional deep tissue massage typically provides. Ashiatsu is known as the “deepest, most luxurious massage on the planet,” yet it also works at a profound, therapeutic level that helps clients reduce and eliminate pain. Our “Make Nice” series of strokes at Ashiatsu addresses thick connective tissues of the lumbodorsal fascia. Working this area of the low back and hips starts a chain reaction of relaxation throughout the entire body. Gliding barefoot compressions to the sacrum and surrounding areas gently mobilize the web of deep and superficial membranes— increasing range of motion and tissue rejuvenation, naturally assisting a passive realignment of the sacroIliac joints and pubic symphasis. Prolonged com-
Ashiatsu Deepfeet Bar Therapy is a perfect service for spa guests who suffer from long term chronic pain and want to avoid surgery, or are taking medications that are not helping.
Once the early waves of relaxation wash over the client, a deeper level of therapeutic bodywork will naturally begin. The superficial fascia moves under the therapist’s arch. Layers of dehydrated and chronic scar tissue begin to melt under the ball of the therapist’s foot, allowing for the client’s deeper hypertonic and spasmodic muscles to stretch and lengthen under their soft heel. All this takes place within the first five to ten minutes of the massage! Lower back pain can stem from many issues—postural, past injury, travel, etc. Without a doctor’s referral or recurring sessions with this client, it may be hard for a resort or spa therapist to fully grasp the entire situation. Creating a comprehensive plan on the spot that will provide effective pain relief within one single massage can be difficult. However, with the series of strokes in
pressions will heat, stretch and energize connective tissues while also activating the parasympathetic nervous system as the body gently attunes itself. The parasympathetic part of the nervous system slows heart rate and normalizes blood pressure—it is responsible for telling the muscles to relax, improving one’s digestion and absorption, boosting immunity and promoting good sleep. As we travel up past the sacrum and into the lumbar region, our famous “Morticia’s Rack” stroke elongates the spine and opens the intervertebral space, increasing the disc’s height and centrally aligning its position. Irritation on the spinal nerves may be relieved with a variety of broad, gentle directional forces applied by a well-trained foot. Traction builds toward the head with a rolling decompression of joint capsules. Pressure continues www.LNEONLINE.com • Page 79
spa|how’s your pain management menu?
It saves the body of the hard working massage therapist, so that they can continue to provide effective bodywork year after year!
• According to Cherkin, Eisenberg, et. al. in the April 2001 issue of the Archives of Internal Medicine, massage is effective for providing long-lasting relief for patients suffering from chronic low back pain. • The October 2002 issue of the American Journal of Public Health reported research showing that muscle-specific massage therapy is effective for reducing the incidence of chronic tension headaches. • A pilot study conducted by Gregory P. Fontana, M.D. at Cedars-Sinai Medical Center in Los Angeles, CA in 2000 found that massage reduces pain and muscle spasms in patients who have multiple incisions. When surveyed, 95 percent of patients felt that massage therapy was a crucial part of their hospital experience, and that their need for medications dropped on the days they received a massage.
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saturates the client’s body, creating slight articulations of flexion and extension. With each carefully applied stroke, subtle gravity flows through the therapist’s foot down into the client’s tissue with a safe and steady comfortable weight. This helps release chronic postural holding patterns, increases your client’s awareness of space, reduces nagging pain and feels like a fabulous massage steamroller has lengthened them out! In the case of mid back pain, the forward rounding of the Thoracic spine and shoulders can create an aching, sometimes sharp or radiating sensation between the shoulder blades, near a pivoting point in the upper back. Then, 15 to 20 minutes into the session, we begin to apply the single-sided “Warrior” strokes, which, with the help of the lateral plantar edge of the massage therapist’s foot, address the intrinsic muscles of the spine that live within the lamina groove to help alleviate chronic mid or upper back soreness. Muscles such as rotatores, multifidi and spinalis each act similar to shoelaces, weaving through all aspects of every vertebrae, affecting range of motion while maintaining alignment on the spinal column. Offering Ashiatsu recipients access to wellness education, onsite amenities such as steam, sauna or even physical fitness activities like yoga can inspire a new beginning to their own healing process and better pain management. For clients who love deep pressure massage and are looking for fast relief from pain, an Ashiatsu specialist can easily create a single session that effectively assists in managing chronic or acute pain. Ashiatsu provides the depth many massage consumers crave, and focuses on injury treatment. Plus, it saves the body of the hard working massage therapist, so that they can continue to provide effective bodywork year after year! n
Ruthie Piper Hardee is the founder of Ashiatsu Oriental Bar Therapy. She created the first nationally approved course study for a western barefoot effleurage technique using bars on the ceiling. Hardee pioneered the gravity assisted barefoot-bar massage treatments used in the spa and massage industry today. For more information, visit www.deepfeet.com, email e-info@deepfeet.com or call 303.300.2511. Jeni Spring is an authorized educator in the state of Texas and a certified instructor for Ashiatsu Oriental Bar Therapy. Her training center is located in San Antonio, TX. For more information, visit www.HeelingSole.com or contact Spring at Jeni@HeelingSole.com or 210.623.0026. Les Nouvelles Esthétiques & Spa • February 2013
by Susan Etter
spa|oh my! cellulite, stretch marks and flab!
photo: gosphotodesign/Shutterstock.com
WHILE PREGNANT WITH MY FIRST son 12 years ago, I was ecstatic! In my ninth month, my stomach was as smooth as ever. A regimen of regular walking and slathering myself with cocoa butter lotion had me convinced that I was my own skin guru. Unfortunately, my bubble burst one morning when I awoke to find a map of streets had spread across my abdomen during the night! I cried for two days, in mourning that my bikini wearing days were now gone. Even with all the joy I felt when my son arrived with 10 toes and a healthy appetite, I was dismayed by the stretch marks. They looked so bad—especially as they conspired with saggy skin and cellulite. At that time, it seemed that my only two options were to use a mystical crème, claiming to smooth that cellulite into oblivion or a tummy tuck. I was more than skeptical about the first option, and the second one just wasn’t practical, as my childbearing days were not yet over. Wow, have times changed! Now it isn’t so much a concern about being able to reduce cellulite, tighten skin and reduce the appearance of lines and wrinkles, but an all encompassing question of how.
Choices, choices Medical spas and day spas across the country are advertising that they can resculpt our bodies. While cellulite reduction and body contouring are not new concepts, quite a few non-invasive products have recently appeared on the market, challenging historical methods. Each of February 2013 • Les Nouvelles Esthétiques & Spa
these methods targets the problem in their own way, although the basic concept is relatively similar. A source of light, heat, cold or motion causes the fat cells to release the fat molecules they are holding onto, sending them off to the lymphatic drainage system. Then they are flushed out of your system. The fat cells deflate, causing the reduction of the cellulite because the fat cells are no longer pushing up against the collagen. A variation of the same energy source that was used also stimulates collagen production in the body, which tightens the skin and improves oxygenation or circulation. Let’s take a look at the technologies available today.
Cold lasers These devices use low level laser therapy to energize the fat cells and release their contents. This liquefies the fat to prepare it for excretion.
Vacuum and massage This pulls the tissue, stimulating oxygen flow and increasing circulation, which in turn improves the reabsorption of fat.
Radio frequency This uses a low frequency wave to heat the fat cells to induce “death” in them, causing the body to break them down into fatty acids.
Ultrasound These ultrasonic waves rupture the fat cells, causing them to dissolve into the body.
Cold therapy The fat cells are frozen to a temperature so low that they are permanently destroyed. The cells are slowly released over the following weeks.
Combination machines A number of devices are coming onto the market that combine technologies to work together. One combines radio frequency with magnetic pulses. Others include electrical current with radio frequency and infrared energies. Some seem to throw everything together.
Decision time! All of the treatment options discussed in this article are non-invasive. All of them also claim to be virtually pain free or manageable with minimal topical anesthetics. So, how should your clients decide which intriguing method to pursue? They should consider the length and frequency of the treatments, the time before results are visible, the long term potential and the risks. Each session time varies from as little as 20 minutes to as long as an hour. Some of these treatments show results after one week, and others can take up to two months. Those that do permanent damage to the fat cells tend to be more long term than others, but that is of course dependent on a person’s commitment to maintaining their continues www.LNEONLINE.com • Page 81
spa|oh my!
weight and a healthy lifestyle. Swelling, bruising and redness are all common risks associated with these procedures. However, review the individual side effects and contraindications provided by the manufacturer, and make sure your client is aware of these.
Aftercare Many of the manufacturers recommend some form of exercise or whole body vibration after the procedure in order to immediately speed up blood flow and stimulate lymphatic activity. Maybe Betty Boop was actually onto something when she strapped herself into the belt weight loss machine.
Convenience The best thing about these methods is that you don’t have to be a doctor or nurse to use one in many states. The use of these machines is allowed by a
medical esthetician, laser technician or medical assistant, and some require a supervising physician. Of course, you want to check with your own state before purchasing one.
The small print
covered within your medical spa, then you may only need minor changes to include this. If you have a day spa or salon and have upgraded your menu to include body sculpting, chances are good that your insurance may need an upgrade as well. n
Before settling on a device to add to your repertoire of services, do your homework. As with any new service, be sure that you receive the proper training. Each of these devices is unique, and requires new proficiency prior to setting yourself loose to remodel the world, one body at a time. Confirm whether your medical director needs to sign off on any paperwork after each service with the client. Also, check with the insurance provider to be sure they are going to cover these procedures. Not all companies cover new technology when it is first introduced to market. If you already have laser services
Susan Etter joined the underwriting team at Professional Program Insurance in 2010. With 16 years of experience in insurance, she has a strong knowledge of the issues that face medi-spa, beauty and body art businesses. Etter is becoming a well-known speaker and writer, providing advice on how to develop a successful business and implement procedures for loss prevention. Previously, Etter managed a number of independent retail insurance agencies, focusing on personal and commercial lines.
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Les Nouvelles Esthétiques & Spa • February 2013
REDUCE WRINKLES
The i-Lipo™ from Chromogenex™ is a cutting-edge development in laser lipolysis, offering a way to achieve inch loss and body contouring with no anesthesia, pain, needles or downtime! It triggers the body’s natural processes to release the contents stored in fat cells, says the company. The treatment, suitable for both men and women, is relaxing and painfree, and can be performed on the calves, knees, thighs, buttocks, stomach, arms and chin. www.chromogenex.com
BROADEN YOUR AWARENESS Anne C. Willis, a leading holistic skin care educator and entrepreneur, is proud to announce the national launch of the Oncology Skin Therapeutics™ professional training DVD. Highlights of the in-depth training DVD include an oncology patient interview, skin assessment technique, hydrotherapy and pressure point demonstration. Willis firmly believes that advanced training is necessary when performing skin therapies on clients undergoing cancer treatments. This DVD demonstrates each step of performing skin therapies, and how the client responds to the treatment. www.delaterreskincare.com
MICROCURRENT TRAINING Upgrade your service offerings with the 106-page manual on Unlocking the Secrets of Microcurrent Therapy from Dr. Joseph Ventura. Get lessons on facial rejuvenation, smoking cessation, fibromyalgia control and more. The second part of the manual contains expanded training guidelines, with an additional 60 pages of educational, marketing, training and research information on various forms of revenue streams for your business, such as methods of smoking cessation, weight loss and facial rejuvenation. www.posturepro.com
SPANEWS
LASER POWER
Fractora by Invasix, Ltd. is a new fractional skin treatment using radio frequency (RF) for rejuvenation and remodeling, offering physicians a new level of precision and control in fractional skin resurfacing, says the company. Benefits include an increase in collagen production, a youthful looking complexion, the smoothing of fines lines and wrinkles and the evening of tone and pigmentation. Physicians utilize the device to send concentrated beams of RF at problematic or aged skin, adjusting it according to the client’s specific needs. The beams treat the skin, while simultaneously heating below the dermis to stimulate the growth of new collagen fibers. As the treated area heals, firmer, smoother new skin forms. Treatments are relatively non-invasive, and require little recovery time. www.invasix.com
BODY, EQUIPMENT AND SUPPLY PRODUCTS MORE NEWS
February 2013 • Les Nouvelles Esthétiques & Spa
www.LNEONLINE.com • Page 83
INCREDIBLE IONS
SPANEWS
The Quantum from Allied Health is a patented treatment modality that generates a plasma field to treat the skin. This plasma field (Electo Ionization) creates a highly charged stream of negative ions. Electro Ionization is excellent for skin that is sensitive, thinning or lacking elasticity. Besides promoting rapid collagen formation, the Quantum sterilizes, hydrates, tightens, heals and firms the tissue, says the company. Clients suffering from acne or rosacea should notice an immediate calmness and reduction of inflammation in the irritated areas. www.alliedhealth.net
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STEAMY SENSATION The facial steamer Wankelform AluVap by Gharieni is an ideal partner for the modern beauty therapist. Made of quality aluminium, it serves all functions for any modern beauty treatment while consuming a minimum of space, says the company. The modular construction of this attractive unit allows the individual combination of tools. Various modules such as peeling, high frequency and others can be integrated. www.gharieni.de
DIAMOND TREATMENT Add some high end luxury to your retail lineup with a microdermabrasion device created by a master esthetician and endorsed by boardcertified dermatologists and plastic surgeons. Riiviva Microderm works by removing the outer layer of the skin with a high quality, gently polishing, genuine diamond tip while vacuuming the loosened skin cells away into its filter canister. This resurfacing effect stimulates the skin, causing collagen production for smoother, softer and healthier looking skin texture, says the company. www.riiviva.com
SUN DAMAGE REPAIR SESHA Skin Therapy’s Active Recovery Hand Cream is enriched with antioxidants that are absorbed to recover moisture and nutrients back into the hands. Sunscreens and MDI Complex help protect skin from UV damage and diminish the occurrence of age spots, while vitamin C and alphaarbutin aid in correcting existing hyperpigmentation. www.seshaskin.com
Les Nouvelles Esthétiques & Spa • February 2013
business
waiting room marketing
by Alison Howland
Time is precious Successful businesses understand that everyone’s time is valuable. Therefore, it is helpful to realize how best to use that usually unremarkable and sometimes dreaded space known as “the waiting room.” Leveraging technology to respect people’s time and better market your business in this space is all about ensuring that every minute is used wisely by staff and guests alike.
The waiting room, a marketing void The waiting room is a space that service businesses must provide. It should be comfortable, well-lit and professional. It may also be equipped with special amenities such as a fireplace, flat-screen TV, refreshments and the latest supply of industry related magazines. Your waiting room should reflect your branding. The typical experience for a client is to make an appointment at a business, arrive at the appointed time, and possibly spend as much as 30 minutes waiting there before their treatment begins. How much has the client been actively engaged in your business during this time? Did they read a brochure or notice the cups and napkins displaying your logo? Do you have any way of measuring the effects of your current marketing techniques? The answer may very well be no, you don’t.
Set up for success What if the waiting room experience was changed to utilize innovative technologies to create a customized, more meaningful experience for the guest? What if it engaged them in the specifics of your business, and became a place of action or living instead of waiting? February 2013 • Les Nouvelles Esthétiques & Spa
The “living” room: customized marketing Make no mistake—technology is growing at an unprecedented rate. Experts say it is doubling every 12 to 14 months! It is a fact of marketing that the way to successfully capture the interest of your clients is to actively engage them. Imagine if your guests were to fill out a form directly on a computer (tablet) kiosk in a private area of the waiting room? An interactive “app” or program on a computer kiosk enables your business to obtain better data, ask relevant questions and make appropriate suggestions. Your clients are all unique individuals who want their personal responses to be recognized. One form no longer fits all, and a form or app that is developed to lead to a more individualized intake of information makes for a more relevant consultation. An interactive program like this can quickly analyze data and recommend additional services and products customized to meet the needs of your guest. They can then immediately see the information right on the computer or have it emailed directly to them.
Customized marketing through technology The goal of marketing by utilizing technology during the waiting room experience is the future of our industry. Leveraging the time in the waiting room to market specifically to the client deepens their connection to your business, and the benefits are enormous. These benefits include: • Guests have more treatment options, and their experience is improved. • Dialogue among medical and spa professionals during precious
consultation and treatment time is facilitated. • The client can have direct communication with a professional while their questions and concerns are fresh in their minds. • Data is better and more accurate, with staff spending less time on data entry. • An expedited follow-up plan is customized to the client, rather than sent via a general, mass produced email.
A form or app that is developed to lead to a much more individualized intake of information makes for a more relevant consultation. • A greater ability to send out relevant information to clients enables you to engage them further. • Having more time allows you to increase the number of clients served. There is no doubt that the trend of marketing in waiting rooms through technology is going to grow exponentially, and the ability to customize the marketing directly to your guests makes it that much more valuable to the success of your business. Make the most of this opportunity—the future is already here. n
Alison Howland is president of Spa Success Consultants, Inc. She develops spas and their businesses, helping them with marketing and branding strategies, management, education and sales. Howland has successfully opened spas in nine countries, writes articles for a variety of industry publications and frequently speaks at trade events. www.LNEONLINE.com • Page 85
by Dori Soukup
business|
6 steps to a profitable acne program
targeted treatments six steps, which explain how to develop, position and market your acne program to increase guest satisfaction and generate more revenue.
1. Identify your acne program’s target market The largest segment of spa industry clientele is women between the ages of 40 and 60. Many of these women have children in their teens. This is a huge target market that is often missed. The mothers, who are your current clients,
already like and trust you. They have children with skin problems that you can help. Identify these clients who have teenage children by doing a “getting to know you” survey. This provides a list of target clients to whom you can market your teen acne program.
2. Develop your acne program Identify which equipment, results-driven products and usage frequency is necessary for participants of your acne program. Spas that have implemented acne programs have found that the programs work best when the teen visits the spa twice per month. In addition to the spa visit, they will need to adhere to a home care regimen, which should be part of your program. Keep in mind that this is not a “turn down the lights” type of experience. It is a clinical, results-driven program. The price must be reasonable in order for parents to want to invest in a monthly program for their children. Depending on the location of your business, you can charge anywhere from $99 to $149 per month. This amount is automatically charged to a credit card on a monthly basis.
3. Create your marketing material Now that you have developed your program, you need to create your marketing material. It requires preparation to properly launch a new treatment and/or products. You need a flyer, email blast, continues Page 86 • www.LNEONLINE.com Les Nouvelles Esthétiques & Spa • February 2013
photo: Yuganov Konstantin/Shutterstock.com
ACNE IS ONE OF THE BIGGEST missed opportunities within the spa industry. This potentially huge revenue stream is rarely explored in spas. On most spa menus, you will find a deep cleansing facial or teen facial, which is typically positioned as one à la carte treatment. The problem is that acne cannot be solved with one treatment. To clear up acne, the client must participate in an acne program that lasts many months in order to achieve and maintain the results they are looking for. This article shares
IN 3 01 JAN. 2UE! S IS
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business
Set a target goal for the number of members you would like to achieve, and make sure you are doing all the marketing necessary to reach your goal. posters, buttons, website update and postings on social media. Come up with a name for the program and an entire marketing strategy to grab your clients’ attention. Entice them to learn more and sign up for your acne program.
The success of your acne program lies in the hands of your team. They must be very skilled at performing acne treatments, and they should be able to promote them. Have them wear buttons that say: “Want clear skin? Ask us how!” This invites a conversation, allowing team members to discuss the program and sign clients up. You may want to offer a team bonus based on the number of programs sold.
should be fun and educational. The tagline can be something like this: “Bring your teen and their friends to discover how to have blemish free skin.” An event like this is a great opportunity to explain the program and get people registered.
5. Launch your acne program
6. Measure results and refine your plan
Once you have all marketing material, treatment protocols, products and your system set up, you are ready to launch. You can begin promoting through your marketing mix, and also by hosting an event to introduce your acne program. Your event
Measuring results ensures your program’s success. It is wise to document progress and obtain testimonials from the results you were able to achieve. You will be able to use the positive testimonials to help promote the program on an ongoing basis. The other important fact to measure is your member count. How many people do you want in your program? Fifty? One-hundred? More? Set a target goal for the number of members you would like to reach, and make sure you are doing all the marketing necessary to reach your goal. If you are looking for ways to boost your income in 2013, implementing an acne program or other programs targeted to specific skin conditions can increase client satisfaction and retention, ultimately boosting your revenue! Take a cue from Beth Pestotnik, CEO of Skin Essentials. She launched her acne program six months ago, and she now has more than 75 members paying $95 per month. That’s more than $7,500 of guaranteed income per month from the program alone! Get rid of the à la carte mentality in 2013, refocus your attention on targeted programs and have your best year yet! n Dori Soukup is an executive coach, author, professional speaker and the founder of InSPAration Management. She speaks at conventions all over the world and hosts public and private seminars. Her Spa BizTools and strategies have helped thousands of spa professionals experience exponential growth and profits. She can be reached at info@insparationmanagement.com.
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photo: Deklofenak/Shutterstock.com
4. Train your team in technology and sales
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business DO YOU REMEMBER THE FIRST TIME YOU used a mobile phone? For me, it was 1985. The phone was referred to as a “brick” because it literally looked like a brick and weighed about the same as a brick. The actual name of the phone was the Motorola DynaTAC 8000X, and at the time it was one of the most amazing creations that our culture had ever seen. Finally, we had the ability to talk on the phone to anyone, anywhere, and from any location! It was nothing short of amazing. The brick weighed in at a full two pounds, was more than a foot in length and nearly four inches in depth. Although it was coined as the first “mobile” phone, its size and shape made it nearly impossible to fit it into a purse or briefcase. It allowed you to have a full 30 minutes of talk time per eight hours of charge time, was priced at $3,995, and came with airtime costs that would be equivalent to $2.00 per minute today! Although the cost of the phone and airtime were a bit restrictive, the brick marked the beginning of a technology revolution that would change our culture forever.
How technology has shaped our world Today, 80 percent of people on the planet own and use a mobile phone (over five billion users). Mobile phones now significantly outnumber land lines, with less than half of the households in most parts of the world having or using land lines at all. At the pace that we are moving, land lines will be a thing of the past very soon. Of the five billion mobile phone users, more than 20 percent of them are smartphone users. The following is a snapshot of smartphone usage by age:
TECHNOLOGY
INVENTION, EVOLUTION AND EFFICIENCY
Ages 13-17: 18% Ages 18-24: 54% Ages 25-34: 62% Ages 35-44: 53% Ages 45-54: 39% Ages 55-64: 30% Ages 65+: 38%
These are interesting statistics, in that nearly all generations—including the 65 plus group— have firmly embraced technology. The lower numbers of the younger generation are likely only due to their budget restrictions. Fifty-three percent of people aged 18 to 44 use smartphones in their daily lives, and this statistic grows stronger every day.
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photo courtesy of Bio-Therapeutic
BY DAVID SUZUKI
• • • • • • •
business Redefining Regardless of age or location in the world, technology has shaped our culture and redefined the way that we do things. This means that although our objectives have not changed, the way and means that we go about achieving them has, and many new opportunities have come with these new pathways. The world of skin care is no different. For example, the idea and benefits of exfoliation have been known since the beginning of time, and continue to be a primary focus in skin care today. However instead of using pumice or curdled milk, we now have the latest in ultrasonic peeling technology, as well as wet/dry microdermabrasion that expedites the exfoliation process, leaving the skin pure, smooth and refined. The process is assertive and quick, taking no more than five minutes, and leaves the skin in perfect condition without any downtime at all. Not only have these two technologies maximized the efficiency of this basic objective in skin care, they have done so safely, effectively and quickly, allowing for a multitude of other opportunities to take place within the same facial.
Question our environment ... The evolution of mobile phones and technology as a whole led to an evolution of our environments—where and why we did what we did. When the only way to communicate was via a land line, we were forced to carve out time specifically to speak on the phone at home or in the office. Our homes, businesses and the dynamics of our days were controlled by these restrictions. In today’s world of technology, you can be on the phone with a friend halfway around the world while you are working out, driving or grocery shopping. You can be actively doing work for your business from your kitchen table, an airplane or a coffee shop. Although this does not completely eliminate the need for a physical office or planning for dedicated, focused phone time, in today’s world of technology we are allowed an incredible amount of flexibility in terms of when and where we do what we need to do. In the world of skin care, we have historically worked in dimly lit rooms, where we have had access to our repertoire of large technology devices, tables and products. For all practical purposes, this has been our office. As technology has become smarter, more compact and in many cases battery operated, we have the opportunity to work in just about any environFebruary 2013 • Les Nouvelles Esthétiques & Spa
AS TECHNOLOGY HAS BECOME SMARTER, MORE COMPACT, AND IN MANY CASES BATTERY OPERATED, WE HAVE THE OPPORTUNITY TO WORK IN JUST ABOUT ANY ENVIRONMENT.
ment. It brings into question whether we need treatment rooms at all, as opposed to just areas that can be adjusted and contoured as needed. In short, it allows us the flexibility to perform a treatment anywhere, anytime. Sound familiar?
Efficient services As traditional skin care services were not originally technology based, you really needed the full 60 to 90 minutes to do what you needed to do in the treatment room. Part of this process was the pampering, relaxation and nurturing, which I believe will be valued by human beings forever—and a service that will always have a place. As with all facets of life, technology has had an enormous impact on our ability to expeditiously and effectively meet our objectives, and skin care is no exception. With scientific studies and a precise understanding of key mechanisms of action, forward thinking manufacturers have developed more effective, efficient and compact technology, which has been made available at very affordable pricing. Because of the speed at which a well trained skin therapist can apply effective forward thinking technology, it allows for multiple technologies to be used in a single service lasting no longer than 30 to 40 minutes. The time saved allows for a higher volume of very satisfied customers to flow through the business every day, more retail opportunities and smarter service pricing. This makes your services attainable to a broader base of customers, which further enhances the long term growth of the business.
Knowledge is king Every morning when I wake up, I pick up my smartphone and check my email, the weather, my appointments for the day, traffic and so on. This allows me to instantly determine the most strategic way to go about my day. This information gives me the ability to proactively make more precise continues www.LNEONLINE.com • Page 91
business|technology
choices, equating to a more efficient and higher level of success. While in most cases, the choices may only be 10 to 20 percent different than their original alternative, it is this attention to detail that makes all of the difference in the world. Daily efficiency, compounded through the weeks, months and years, will always aggregate to a much higher level of success and happiness. Having quick and scientifically proven tools onhand to study and assess the skin in real time, in any environment, gives us as skin therapists
tive to source and find the best manufactured technology on the market, while only working with companies who believe in perpetual ongoing education and service that allow you the opportunities to maximize the full potential of your investment. While many companies market themselves as followers of this principle, very few actually live it! Technology has had a profound effect on our culture as a whole, including the world of skin care. It has shaped what we define as skin care today and created a new venue of skin care
HAVING QUICK AND SCIENTIFICALLY PROVEN TOOLS ONHAND GIVES US AS SKIN THERAPISTS THE KNOWLEDGE TO MAKE MORE PRECISE DECISIONS THAT EQUATE TO ACHIEVING BETTER LOOKING SKIN FASTER AND MORE CONSISTENTLY.
Great technology —better service! The bulk of people who use a smartphone primarily use it for three tasks: phone calls, texting and the Internet. As they use the technology, they learn from friends, begin to download applications and realize they have more questions about the technology. In short, they evolve and become more effective, eventually utilizing the full capabilities of the device after learning about it bit by bit. Forward thinking, well designed skin care technology is the same, in that there are usually many ways to use the technology differently, and in some cases more effectively than you are using it now. Skin care technology is different than mobile phones in that it is a very niche market. With this being said, it is impera-
that is now the norm and expectation—effective, expeditious and attainably priced services. Partnering with forward thinking manufacturers who will always assist you with gaining the most out of every technology that you invest in is key. Working with manufacturers who believe in fair pricing for their technology and products is essential. Embracing change and the new culture available to you and by you is true freedom. n
David Suzuki, president of Bio-Therapeutic, Inc., has been an active licensed member of the esthetics industry for more than 18 years. He is an authority on technology and regulatory issues, including FDA submission and acquisition. Suzuki serves as an advisor to institutions and state boards, writes for numerous industry publications and journals and conducts educational seminars and classes. E-mail him at dsuzuki@bio-therapeutic.com or visit www.bio-therapeutic.com.
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photo courtesy of Bio-Therapeutic
the knowledge to make more precise decisions that equate to achieving better looking skin faster and more consistently. Small moisture analysis tools that quickly assess the skin hydration levels, self-lit vision visors and hand held mini mag lamps with up to five times magnification, white light LED and UV lights to assess skin damage all allow us to understand the details needed to make precision decisions!
Say you saw it in LNE & Spa and circle #149 on reader service card
hospitality IN THE MEDICAL SPA
BY PATTI BIRO
CALL IT CUSTOMER SERVICE, HOSPITALITY or even bedside manner. Today’s medical spa may be missing the connection to the human side of medical esthetics. As the number of medical spas continues to grow, practitioners and businesses must meet the challenge of integrating customer service “best practices” from day spas, salons and the hospitality industry into the medical spa. Providing outstanding customer service and creating an exceptional experience for the medical spa guest benefits the businesses in a multitude of ways. Not only does it help to set your practice apart from competitors, it can also lead to greater client satisfaction. Client satisfaction drives word of mouth referrals, positive online reviews and repeat customers. Americans spent nearly $10 billion on cosmetic procedures in 2011.* Since 1997, non-surgical procedures have increased by 356 percent! Sixty percent of those non-surgical procedures are performed in office facilities—and that’s where the hospitality link is most critical to your success. Many medical spas were initially developed as an add on to existing medical services or as part of a transition from a more general practice. Some have emerged as a merger of medical practitioners who desired to grow and expand their business model into the more sustainable “cash and carry” market of elective medical spa procedures and treatments. Sometimes the medical spa business growth has happened by chance; leaving the branding, identity and hospitality elements to chance as well. Whatever the origin, the average medical office is probably the worst model of hospitality from which to develop a guest services approach. I recently had the opportunity to mystery shop for a new medical spa that opened as part of a larger surgical practice in a major medical center. After purchasing a “daily deal“ for a treatment, I called and made my appointment. They got high marks for having appointments readily available. However after arriving on the day of my appointment, I nearly left when I found the waiting area dark, full of old magazines, a surly receptionist and old, scuffed and worn out furniture. I was shocked when I was brought into the medical spa suite, which was filled with warm tones, beautiful black and white photographs and soft music. The contrast was jarring. However they received high marks for the qual-
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photo: Blend Images/Shutterstock.com
A MISSING LINK?
business ity and knowledge of the treatment and the attitude of the physician. Then as I checked out, I discovered that the receptionist had failed to tell me that my parking would not be validated. Worse yet, they only took cash payments! This was compounded by the lack of any follow up after the appointment. The “daily deal” was supposed to include a telephone follow up. It never happened—nor did I get an email, text or letter correspondence. Would you return?
History In traditional medical spa offices, the individuals served are called patients. In spas and salons, they are called clients or guests (in some places this is a legal requirement). Stop for a minute and consider the different emotional impact of calling a paying client a guest versus a patient. You invite guests to your home; hotels offer guest services, even fast food restaurants today focus on guest satisfaction. The medical spa guest is making a discretionary purchase. In most cases they can take or leave your services. Take on the challenge of changing your language, and see how it changes your business. Is your medical spa driven by an attitude of excellent customer service and hospitality? Attitude is everything in developing a culture of hospitality. It starts at the top and must be embraced by every partner, practitioner and associate. In medical spas that started as traditional medical practices, some staff may not take the esthetics treatments seriously, or possibly even regard them as downright “fluffy.” The guest picks up on this attitude. The staff may have little or no training in guest relations or hospitality, and may not fully understand the connection to the financial success of the business. This is an opportunity for education. Embracing the value of customer service goes way beyond the concept that “the customer is always right” to creating an exceptional experience for them.
Discretionary dollars drive greater expectations Today’s 50+ woman is clearly driving the market in medical spa services. Her buying power is 2.5 times greater than the average American. This significant “purse power” has helped to drive the demand for medical spa services. But make no mistake—this guest has high expectations and puts considerable research time into selecting a medical spa. The level of hospitality this guest receives can drive referrals and create a February 2013 • Les Nouvelles Esthétiques & Spa
long term fan of the medical spa. Men are a fast growing target market for medical spa services and have the potential to be a significant driving force in market growth.
Hospitality happens before, during and after the appointment Whether the guest arrives as a result of a referral, a daily deal special or simply by finding your website, they should all be treated with equal importance. Guests desire the human element in a medical spa, just as they expect it from a day spa or salon. Review your guest experience using the model of a warm welcome, an exceptional experience and appropriate follow up. It can help you determine the missing elements in your approach to hospitality.
Before the appointment • Call in guests should always be greeted warmly, as inquiries can turn into appointments. Allow adequate time to answer questions for first time guests. Being put on hold or rushed are hospitality killers. • Most hotels, days spas and many salons offer online booking. If your medical spa does not offer this service, you may be losing repeat guests simply because of the time it takes for them to call for an appointment. • Offer the ability to download guest information forms and releases directly from your website. This will save time and added paperwork before the appointment. • Include tips and suggestions for making the appointment a success. On many day spa websites, information regarding spa etiquette or what to expect at the spa is provided. You can do it too! • Once the appointment is booked, send a welcome email. Better yet, call the new guest to let them know you are looking forward to meeting them, review any additional questions they have and provide parking and location information. • Make confirmation calls to guests the day before their appointment to reduce the number of no shows. • Track the average time a guest waits before an appointment, and work to reduce it if this is a problem area. continues
THE LEVEL OF HOSPITALITY THIS GUEST RECEIVES CAN DRIVE REFERRALS AND CREATE A LONG TERM FAN OF THE MEDICAL SPA.
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business|hospitality in the medical spa
OFFER A BEVERAGE TO THE GUEST AS THEY COMPLETE INTAKE FORMS OR WAIT FOR THEIR APPOINTMENT TO BEGIN.
Give your facility a little test. Enter your medical spa just as a new guest would. If this means parking in the garage, then do that and time the walk to the spa. Look at the waiting and reception areas through the eyes of a new guest. Be realistic. What is the first impression? Is your guest turned off before they even get started? After this test, you will probably see the value of providing the following elements of hospitality. • Be sure to greet each guest. A warm welcome requires a smile and recognition. • Offer a beverage to the guest as they complete intake forms or wait for their appointment to begin. • Provide a comfortable and tasteful environment for waiting. This waiting space provides you with an opportunity to share your story through before and after photo albums, current magazines and guest information regarding the variety of services offered. • Music, lighting and pleasant smells do much to set the mood in the medical spa, just as they do at a great restaurant.
Throughout the appointment and during every repeat visit Communication is the one item that can make or break your guest’s perception of your hospitality. Creating a partnership with your guest is critical to making a lasting impression and turning them into a loyal fan. • Listen, listen and listen more to what your guest wants! The Internet and magazines are full of advice regarding medical spa treatments. Your guest may have arrived with a laundry list of the issues they have and the treatments they feel they need. Whether you agree with them or not, you must hear them out before recommending treatments or procedures. • Develop a plan based on desires, expectations and reasonable outcomes. Guests who can participate in their service plan have a better sense of “buy in” and are more likely to return to the medical spa. • Empathize. • Thank them for choosing you, and be sincere about it. Share your passion for what you do and how you can help them realize their desire for firmer skin, a smaller waist or whatever it may be! • Write down the plan. Make it personal, and don’t be afraid to recommend a schedule and products for home care.
Great results lead to great customer satisfaction, and one way to achieve that is to improve the results with home care products.
At checkout • Thank the guest for coming, and inquire if everything was as they expected. • Offer to rebook their next appointment. • Review retail and home care items that have been recommended to improve their results in between visits. • Send the recommendations home with the guest. Even if they do not buy anything today, they may tomorrow. • Ask if they would like a follow-up phone call, and what is the best time to reach them.
Following up • Send a thank you note (preferably handwritten), and include business cards. • Offer a chance for feedback with an email note of thanks. • Call only if the guest says it is permitted. Some medical spa guests do not want to receive calls, or are trying to keep a low profile. Honor their request. • If a personal call is made, inquire if they have additional questions or have experienced side effects. Creating a culture of hospitality in the medical spa may be one of the best marketing efforts you can make for your business. Committing time, energy and education to the effort will bring rewards in terms of happy repeat customers and ambassadors for your medical spa. n *Statistics courtesy of the American Society for Aesthetic Plastic Surgery Patti Biro has more than 25 years of experience designing and implementing professional education and client education programs. She is the creator of Elder-ssage™, a massage therapy program focusing on the needs of aging adults, and the owner of Patti Biro and Associates, a professional education consulting company. Biro is a frequent lecturer for the International Medical Spa Association.
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photo: Yuri Arcurs/Shutterstock.com
At the first appointment
NEW FACILITY
GIVING BACK The Care for Skin Foundation led a team of 17 medical personnel to Peru in early December of 2012, offering reconstructive surgery to children who have suffered skin loss due to accidents, tumors, burns, scars or genetic abnormalities. Marc Ronert, M.D., Ph.D., a board certified plastic and reconstructive surgeon, was among the physicians who donated his time and experience to the mission. “Utilizing my skills as a plastic surgeon on patients who are unable to afford necessary treatments is one of the most gratifying moments in my profession,” he shares. Dr. Ronert is the president and medical director of IMAGE Skincare, a major contributor to the Care for Skin Foundation. The Care for Skin Foundation’s mission is not only to provide reconstructive surgery to those in need, but to donate money to like-minded organizations as well. www.careforskinfoundation.org www.imageskincare.com February 2013 • Les Nouvelles Esthétiques & Spa
TIMELY REFERENCE Alluredbooks, a division of Allured Business Media, announces the debut of the book Health Challenged Skin: The Estheticians’ Desk Reference by Morag Currin. The easy-to-read reference book is written to help skin care professionals better serve clients who are suffering from diseases and disorders. Currin wrote this book due to the increasing expectation of clients to receive the best spa treatments for their specific needs and health conditions. This book alphabetically lists conditions ranging from arthritis to diabetes to scleroderma. Currin provides an overview of each disease, along with information on how it affects skin cells and appears on the skin’s surface, how to recognize diseases, and how to use spa and facial treatments for those conditions. www.alluredbooks.com
BIZNEWS
Industry education leader PCA SKIN® hosted an educational event with members of the beauty media titled “Treating Skin Through Conclusive Science” on January 24, 2013 at the Harvard Club of NYC. Attendees learned about proven ingredients and formulations for treating various skin conditions, as well as the importance of chemical peels in achieving healthy skin. www.pcaskin.com
PETER HURLEY PHOTOGRAPHY
EDUCATIONAL EVENT
Ellen Marmur, M.D., an internationally recognized leader in the field of dermatology, has founded Marmur Medical, which opened October 12th in Manhattan. Marmur Medical is the flagship location of Previse Skincare, created by Dr. Marmur. Marmur Medical offers a full range of dermatologic services, including Mohs surgery, skin cancer screening and removal, acne scar removal and a variety of laser treatments. Patients share their personal goals in consultations with a nutritionist and attend educational events on subjects such as chemical-free skin care. www.marmurmedical.com www.previsecare.com
COMMERCE, TRADE, INDUSTRY AND PEOPLE MORE NEWS
www.LNEONLINE.com • Page 97
NEW CHIEF MARKETING OFFICER
BIZNEWS
Murad is pleased to announce the appointment of Suzanne Dawson (previously the vice president of global innovation at Estée Lauder Group) as the chief marketing officer to oversee all global marketing. This includes brand development, advertising, public relations, creative and education for products, services and new market opportunities. She is responsible for driving brand growth and equity through global initiatives, identifying new market opportunities, driving product development, increasing consumer engagement and brand profitability and developing an overall growth strategy for the company. www.murad.com
COMMERCE, TRADE, INDUSTRY AND PEOPLE
LENDING A HAND Thanks to Jennifer Devlin and her Florida-based company, Celtic Complexion, many of the women in the Rockaway region of New York whose homes and family belongings were destroyed by Hurricane Sandy are receiving donated skin care products. Devlin committed to donating $10,000 worth of skin care products to the women of Rockaway. To raise the funds to produce these products, Devlin offered her customers a deep discount for purchasing products immediately through a special website coupon named “Sandy.” Devlin raised a sufficient amount to produce and donate 200 two-ounce jars of her Celtic Complexion Creme. Celtic Complexion is a luxury organic skin care company that specializes in sensitive, dry skin, including skin afflicted with rosacea. www.celticcomplexion.com
CELEBRITY SWAG Ilike Organic Skin Care partnered with Red Carpet Secret Room Events to gift the stars and presenters of the 64th primetime Emmy Awards with their new Age Defense Bioflavonoid Eye Cream. The premium product was included in the Red Carpet Celebrity Luxury Lounge Gift Bags given to nominees. The long list of celebrities who received the gift bag included big names such as Jon Hamm, Sophia Vergara, Glenn Close and Christina Hendricks, to name a few. www.szepelet.com
PODIATRY PARTNERSHIP The American College of Foot & Ankle Orthopedics & Medicine (ACFAOM) has partnered with Medinail Learning Center, an online training system, to offer a comprehensive training and certification program for Clinical Podiatric Medical Assistants (CPMAs). The Clinical Podiatric Medical Assistant program was developed by Medinail Learning Center. The CPMA program issues the certificate and oversees the educational program. Nail technicians graduating from the MLC Medical Nail Technician program are also eligible for ACFAOM certification. www.medinails.com
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organic & wellness top 10 trends by Camille Hoheb
HEALTH OPENS THE DOOR TO A whole new world, and the forecast for 2013 predicts that consumers will expand their perceptions of wellness and seek to improve their quality of life. The forecast is based on an analysis of numerous factors, including consumer and B2B surveys, site visits and feedback from travel suppliers, destinations and sellers.
Wellness takes flight To draw more passengers and increase revenue, airport renovations are featuring sleek, ultramodern designs, incorporating natural light, art installations and a plethora of health, spa and fitness offerings to create an atmosphere of “terminal bliss.”
Health focused hotels and resorts Hotels have realized the need for guests to maintain healthy lifetsyle tactics during travel. Now some hotel rooms are designed to alleviate altitude sickness, reduce jet lag, induce better sleep and eliminate bacteria, waterborne chemicals and allergens as they purify and humidify the air. Vitamin C-infused showers, dawn simulating alarm clocks and melatonin-producing lighting are other notable features. Guests also have access to healthy lifestyle education and take-home programs.
Digital detox The World Travel Market Global Trends Report listed digital detox as one of the next big trends to hit the hospitality industry in 2013. Surrendering laptops, tablets and smartphones at check-in is already part of the “un-plug” programs in several hotels. Some destinations are February 2013 • Les Nouvelles Esthétiques & Spa
also creating technology-free vacation campaigns as a way to market their rustic settings.
breathing new life into long forgotten, ancient or undervalued rituals.
Reconnecting through nature
In light of the economic downturn, companies are seeking peak performance and maximum efficiency. Meeting planners are seeking destinations that align with corporate initiatives for maximum return on investment. Most U.S. companies plan to increase the dollar value of the incentives they offer employees for participating in health improvement programs in 2013, according to a recent employer survey.
Natural assets are the most critical component of wellness tourism product development. Destinations are beginning to fully leverage their landscape in response to the human need to explore and relax outdoors. “Deprivation holidays” are a growing trend, in which guests choose outdoor boot camp to improve their fitness and induce weight loss by pushing themselves to the extreme.
Sleep at the forefront Many people today are too tired to function and have little chance to rest. A lack of sleep impacts the immune, brain and metabolic systems. Sleep has gone from being ignored to being significant in spas, hotels, airplanes and airports. Micro-naps in urban spas create a respite from the frantic pace of cities.
Spiritual seekers Interest in non-religious spiritual practices is growing around the world. An increasingly secular global society that seeks meaning and purpose opens the door to spiritual pilgrimages, retreats, temple stays and workshops.
Indigenous healing traditions As the world has become more globalized, many spa brands have placed a spotlight on authentic healing traditions. This is important on several levels. The abundance of travelers seeking health and healing traditions at their place of origin contributes to cultural conservation and sustainability, in some cases stimulating economic growth and
Rewarding wellness travel
Celebrity instructor retreats Wellness travel is a way to jumpstart a new health regimen or deepen one’s healthy lifestyle practice. Spa destinations and resorts that offer specialized, themed getaways now feature “rock star” instructors.
Intergenerational family travel Multi-generational family travel has been growing steadily in recent years. Grandparents are more active and fit, and vacationing with the grandchildren creates memories. The travel industry has designed programs to bring families together to learn, love and play. n Camille Hoheb is the founder of Well ness Tourism Worldwide (WTW), whose mission is to improve well-being and economic growth through travel. Hoheb has held advisory board positions with several associations. She speaks on the topic of wellness tourism all over the world and is a contributing writer for numerous publications. For more information, visit www.wellnesstourismworldwide.com, www.wellnesstraveljournal.com or www.camillehoheb.com. www.LNEONLINE.com • Page 99
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organic & wellness
acne prescriptions ALTERNATIVES TO
GOING TO A DERMATOLOGIST’S OFFICE and getting a prescription for topical and/or oral drugs is the logical first choice for many acne sufferers. Acne patients are given oral antibiotics, topical antibiotics and/or prescription retinoids to try. When this approach fails, the dermatologist will likely prescribe a new antibiotic ... and then another. A cycle of isotretinoin is often recommended if those treatments fail. Unfortunately, prescription drugs and topical products sometimes fail to clear the acne, and can even cause dangerous side effects.
Oral antibiotics
photo: micro10x/Shutterstock.com
An antibiotic for acne is, at best, a temporary solution, if it is a solution at all. Antibiotics do not address the root cause of acne. Renowned acne expert James E. Fulton, M.D., Ph.D., writes, “Even if some magic antibiotic could control 100 percent of the bacteria, you would have attacked only a fraction of the acne problem. I would estimate that oral antibiotics at best provide only 20 to 30 percent of the needed acne solution.” Antibiotics do not address the root cause of acne, which is the retention hyperkeratosis that needs to be proactively managed to get and keep acne at bay. Retention hyperkeratosis is the tendency of the pore to shed dead skin cells inside the pore at a much higher rate than normal pores. The dangers of antibiotics are: 1. Methicillin-resistant Staphylococcus aureus (MRSA). If you haven’t yet heard of this superbug, you need to know that it is a very dangerous type of staph infection. One main reason why MRSA is so dangerous is that it is resistant to most antibi-
otics. Doctors may run out of options for treating it, and the result can be death. Experts believe that MRSA evolved because of the overuse of antibiotics. Dermatologists treating acne with antibiotics is also a primary contributor. 2. Acne bacteria is becoming drug-resistant. Resistant acne bacteria won’t kill people, but it does make acne much harder to control, and also makes it more difficult to achieve or maintain clear skin. 3. People who use antibiotics are more than twice as likely to catch colds, according to a study in the September 2005 Archives of Dermatology. 4. According to a study published by the Journal of the American Medical Association, heavy use of antibiotics may increase a woman’s risk of developing breast cancer. The study looked at 10,000 women over eight years and found that those who took the highest amounts of antibiotics for the longest time faced twice the risk of developing breast cancer than those who did not.
Topical antibiotics The FDA warning for clindamycin includes this statement: “Orally and parenterally administered clindamycin has been associated with severe colitis, which may result in patient death. Use of the topical formulation of clindamycin results in absorption of the antibiotic from the skin surface. Diarrhea, bloody diarrhea, and colitis (including pseudomembranous colitis) have been reported with the use of topical and systemic clindamycin. Studies indicate a toxin(s) produced by clostridia is one primary cause of antibiotic-associated colitis.“ continues
BY LAURA COOKSEY
www.LNEONLINE.com • Page 101
organic & wellness|alternatives to acne prescriptions
Just as with oral antibiotics, topical antibiotics are really only a temporary solution for acne. They don’t resolve the dead skin cell problem, and are therefore ineffective as a long-term solution for acne management.
Retinoids While there are no reported “dangerous” side effects of topical retinoids, there are problems with using it for acne. The cream form of Retin-A includes isopropyl myristate, a highly comedogenic ingredient. Even if the patient is prescribed an appropriate retinoid, the retinoid often makes their skin so sensitive and irritated that they stop using it before it has a chance to become effective.
The alternative to drugs Having successfully cleared the skin of thousands of acne clients since 1990, I can confidently state that no prescription drugs are needed to do so. As Dr. Fulton pointed out, although acne bacteria is present, it is a symptom of the true cause of acne, which is retention hyperkeratosis. That is an inherited tendency of the pores to shed dead skin cells more quickly than normal pores (up to five times more quickly). So, when you have your clients use products that keep the pores free from excessive cell buildup, they will clear up. Exfoliating serums like mandelic, glycolic and/or salicylic serums (depending on the type of acne) used in combination with benzoyl peroxide get the job done. Recommending the correct
JUST AS WITH ORAL ANTIBIOTICS, TOPICAL ANTIBIOTICS ARE REALLY ONLY A TEMPORARY SOLUTION FOR ACNE. THEY DON’T RESOLVE THE DEAD SKIN CELL PROBLEM, AND ARE THEREFORE INEFFECTIVE AS A LONG-TERM SOLUTION FOR ACNE MANAGEMENT.
The FDA posted an alert in 2005 that said all patients taking Accutane should be closely watched for serious psychological symptoms including: • • • • •
Depression Suicidal tendencies Short temper Loss of social interaction Psychosis
In 2009, Roche decided to pull Accutane off the U.S. market after juries had awarded millions of dollars in damages to former Accutane users over inflammatory bowel disease claims. It can cause other severe physical side effects, including: • • • • • • • • • •
Crohn’s disease Central nervous system injuries Skeletal damage Liver damage Cardiovascular injuries Muscle loss Ulcerative colitis Pancreatitis Immune system disorder Birth defects
products is vital, but just as important is how the products are used. Clients need to start slowly with the strongest products their skin can tolerate, and slowly increase the frequency of product use. For example, my clients use their exfoliating serum every other day in the beginning. In two weeks, they increase their usage to every day. Two weeks after that, they increase it to twice a day. Also, have your clients use benzoyl peroxide at night, starting with just a 15 minute period, and working up to overnight use in two weeks’ time. Sometimes you will need to adjust their home care routine to incorporate a stronger serum or benzoyl peroxide. I want to push the skin to clear, not allowing it to over adapt to product use; but not strengthening their routine so much that the skin becomes very irritated. Under this system, it takes about three months for most people to get completely clear skin. Use of these products, along with some lifestyle changes, works incredibly well for acne clients. The only thing they have to fear is some temporary dryness of their skin, which is undeniably better than the health problems they may encounter with prescription drugs. n Laura Cooksey is an acne specialist and educator. She is also the owner of the Face Reality Acne Clinic near San Francisco, CA. She became an acne specialist due to her own struggle with acne and has 21 years of experience as a licensed esthetician. Contact her at 866.477.3077 or info@facerealityacneclinic.com.
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photo: Uros Zunic/Shutterstock.com
Isotretinoin
by Anne C. Willis
|
organic & wellness REVOLUTIONARY AND EVOLUtionary changes that shape a better future don’t happen overnight. Such changes are made by people coming together to collaborate and share fresh ideas and knowledge, with a common new vision for a better way of being. New possibilities are created by people coming together with a passion to make the change. Lifestyle disease is now the largest cause of abnormal skin changes, and because it can be prevented by making better choices, wellness has become a necessity.
photo: gosphotodesign/Shutterstock.com
Changing course So, how do we shift the scope of practice to become more relevant? Changing course begins with education. Have a toolbox that is stocked with protocols and products that represent your newfound practice. Begin exploring wellness for yourself. You have to walk the walk and talk the talk in order for your clients to feel that you are authentic in what you teach. The good news is that the public is becoming increasingly cognizant of the importance of proactive health behavior, and individuals are seeking assistance from health care professionals in their pursuit of wellness. Many people are engaged in some form of body wellness. The media has been reporting on wellness practices for a little more than a decade. The Internet enables consumers to investigate and research information on all topics of health and beauty. The bottom line: the consumer is waiting for you to make the leap. February 2013 • Les Nouvelles Esthétiques & Spa
integrating wellness
How to transition to relevance The first step is to change how you view skin. We can no longer assess skin based on the vague categories of oily, dry and combination skin types. We can no longer treat skin by merely suppressing symptoms. Recent developments in skin function research demonstrate that suppressing symptoms inhibits natural detoxification, initiates an increase in inflammation and bloats cells. Skin treatments that support functionality yield the highest success. “Healthy” skin function results in tissue repair, regulation and energy. If you are not repairing, regulating or energizing your skin/ body optimally, your skin/body fails, and then your health fails. Supporting functionality not only allows skin to repair itself, it also allows skin to recover more quickly the next time there is a change to its equilibrium. So let’s look at one of the most common skin conditions and compare the approach of standard skin care versus holistic therapies. The standard skin care approach to treating hyperpigmentation includes: • Inhibiting melanin • Removing affected skin cells through skin peels • Activation and stimulation through habitual application of glycolic or AHA • Sunblocks The holistic approach treats hyperpigmentation by: • Reducing inflammation • Modulating immune response
• Increasing cell turnover through topical enzymes • Rebuilding skin’s ecosystem • Applying topical brighteners Why is the standard skin care approach not effective? Irritated or inflamed skin increases cellular secretions, which are involved in the production of melanogenesis/dendritogenesis of human epidermal melanocytes. Prostaglandins are produced and released from human keratinocytes by the stimulation of proteinase-activated receptors, which stimulate the dendritogenesis of human epidermal melanocytes. Therefore, as a champion of having a more holistic approach to skin care and therapies, I believe skin peels may initiate prolonged inflammation. There are many factors that influence melanocyte dendricity. Several common drugs can stimulate hyperpigmentation in human skin, such as certain antibiotics (sulfonamides and tetracyclines), diuretics, nonsteroidal anti-inflammatory drugs, pain relievers and some psychoactive medications. Heavy metals can also elicit hyperpigmentation, which can arise after the extensive use of drugs containing arsenic, bismuth, gold or silver. The metals are believed to act by binding, and thereby inactivating, sulfydryl compounds in the skin that normally inhibit tyrosinase (TYR) activity. Removal of this inhibition stimulates melanogenesis. Some chemotherapy agents can also cause hyperpigmentation, the most continues www.LNEONLINE.com • Page 103
organic & wellness|integrating wellness common ones being cyclophosphamide, 5-fluorouracil, doxorubicin, daunorubicin and bleomycin. Their mechanisms of action are currently unknown, but may involve direct toxicity, stimulation of melanocytes and/or inflammation.
Integrating holistic therapies into your practice/spa Before you introduce a holistic approach to your clients, begin with yourself. Develop a self-care program that communicates the message to your body that you are valuable. Be sure to schedule professional treatments for yourself, even if it is on a quarterly basis. Nurture a more creative viewpoint of your practice and your treatments. Clearly define the benefits of a holistic practice to your clients by structuring a program that is realistic for them. Let them know that holistic skin treatments work because they do not cause discomfort or trauma to the skin or cause bloating to cells, which can lead to inflammation
and aging. Holistic skin treatments do not involve machines, needles or noise, and do not promote the overactivity of one’s senses. Let the client know that the treatment will trigger the relaxation response and lower anxiety; provide gentle nurturing support. One way to achieve this is through topical hydrotherapy. There are numerous proposed mechanisms of action of hydrotherapy, depending on the specific technique used. Hydrotherapy practitioners and texts propose that wraps and compressions may serve to detoxify the skin. Alternating compressions is suggested to alter blood circulation, enhance the immune system and improve absorption of nutrients. There are many other holistic techniques to learn, which is why education is paramount. As we all strive to adopt healthier, more rewarding practices, exploring the evolution of holistic therapies and how they differ from conventional therapies can define your work and what you can offer the public. This is the most exciting
time to be an esthetician. The opportunity to foster a more creative viewpoint and provide treatments that meet the needs of your community is one you cannot afford to miss. n Anne C. Willis, a licensed es thetician and worldwide lead er in holistic and medical skin therapies, is the founder of De la Terre Skincare. She is an accredited skin care instruc tor and the director of Oncology Skin Therapeutics™, bringing more than 30 years of experience and knowledge to the new generation of skin therapists. Willis is a contributor to The Esthetician’s Guide to Working With Physicians, and has been featured in numerous publica tions. For more information, contact her at info@delaterreskincare.com or visit www.delaterreskincare.com.
Biomani Advanced Medical Aesthetics & Laser Institute Fathi G Fam, M.D, M.S 855-238-8333 Medical Aesthetics Certification Biomani is the vital difference that brings your skin to life Biomani SkinCare products provide the latest, most advanced ingredients for the protection of skin against the effects of time and environment. Biomani advanced bio-formulation of moisture smoothes fine lines, hydrates with a touch that stays light and protects from the daily effects of dryness. The results are impressive, younger-looking skin with visible renewed texture and an after glow that lasts. Try Biomani today and you will receive compliments galore. www.biomaniskincare.com
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Laser Certification Program ( Financing is available) The Biomani Laser Certification Institute has the programs that focus in depth and has truly qualified and certified aestheticians, cosmetologists, nurses and doctors to practice laser skin techniques such as laser hair removal, tattoo removal, IPL & others . Biomani offers a large state-of-the-art tools and resources. Our classes are limited in size to allow for individual attention for each student. The primary objective of the highly trained and experienced faculty at the Biomani Laser Certification Institute is to make sure each student is capturing the knowledge he/she needs to utilize their full potential in the medical aesthetics profession and Laser skin care, allowing them to achieve their new exciting goals and career. www.biomanilasercertificationinstitute.com
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Mustela® announces the new addition of the Stelatopia Lipid-Replenishing Balm to its clinically proven DermoPediatrics product range, which is formulated to address the needs of babies with vulnerable skin. Stelatopia is formulated with Mustela’s natural patented ingredient, sunflower oil distillate, creating a rich texture perfect for addressing skin conditions like eczema or extreme dryness. www.mustelausa.com
MULTI-TASKING MASK The unique botanical Enzyme Mask from SAIAN is specially formulated to liquefy and remove dead cells and impurities that accumulate on the surface of the skin. The gentle, natural clay mask helps pull out oils, reduce pore size and minimize the appearance of sun damage and wrinkles. It lightens the skin, activates cellular function, increases circulation, fades discoloration and leaves skin feeling and looking fresh, smooth and healthy. It is excellent for soothing skin conditions such as rosacea, eczema, rashes, psoriasis and acne. www.saian.net
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February 2013 • Les Nouvelles Esthétiques & Spa
The MudPot from Black Rock Mud Company is a natural beauty mud mask hand harvested from the Black Rock Desert. The mineral rich illite clay contains over 50 natural elements that promote healthy skin. It is 100 percent natural and completely free of chemicals, dyes, fillers, preservatives and scents. It leaves skin feeling clean, energized, refreshed and revived. www.blackrockmud.com
ORGANIC & WELLNESSNEWS
BABY BALM
ECOFRIENDLY SKIN AND SPA PRODUCTS AND THERAPIES MORE NEWS
www.LNEONLINE.com • Page 105
ORGANIC & WELLNESSNEWS
SOOTHING SENSATION
ECOFRIENDLY SKIN AND SPA PRODUCTS AND THERAPIES
GENTLE RECOVERY Rescues Wounded Skin Care System by De la Terre Skincare helps the skin return to a healthy, enhanced function and appearance. It promotes the production of collagen, strengthens capillaries and provides the skin with effective doses of essential vitamins and minerals. Products are acceptable for oncology patients undergoing radiation therapy. www.delaterreskincare.com
The new Botanical AHA Peel from ilike organic skin care is an intense organic peel formulated with the anti-aging benefits of hollyhock and lemon oil. It is packed with a blend of bioflavonoids, vitamins B and C, tannins and lemon peel to increase skin cell turnover on the surface of the skin, producing smoother looking, more vibrant skin. The natural alternative to a chemical peel, microdermabrasion and other skin resurfacing procedures is a non-irritating product that combats acne, prevents breakouts, fades sun damage and hyperpigmentation, and reverses the signs of aging for a younger, brighter and healthier appearance. www.szepelet.com
BOTANICAL HEALER
EYE OPENER The MAX™ eye crème from IMAGE Skincare is a revolutionary day and night eye crème that contains high concentrations of growth factors derived from plant stem cells to protect skin cells and prevent aging caused by free radical damage. This rejuvenating corrective peptide blend contains grape, alpine edelweiss and apple stem cells. It reduces puffiness, inflammation and the appearance of fine lines and wrinkles, says the company. www.imageskincare.com
Hilda Demirjian Laser and Skin Care, a new research based skin care line, introduces a Collagen Elastin Gel with fruit stem cells for younger looking skin. It is formulated to stimulate the growth of protein collagen in the epidermis, tightening the skin, reducing pore size, smoothing scars and eliminating dullness. The gel can be used anywhere on the body, and has been proven effective at healing and rejuvenating damaged skin following cancer treatments, including masectomies, says the company. It is completely derived from botanical sources. www.hildademirjanlaser.com
Page 106 • www.LNEONLINE.com Les Nouvelles Esthétiques & Spa • February 2013
image
for the eyes—one brush for the lighter eye colors and one for the darker eye shadows. The reason for this is that they are easier to clean and reuse if they are used for same type of colors. Don’t rely on sponge applicators, as they soak up more oils from the skin.
sunken eyes
by Tommy Parsons
Procedure O N E O F T H E V E RY F I R S T “models” I ever applied makeup to was my grandmother. Her eyes were so deep-set and sunken back into her head that a standard application just did not “look right,” and thus my quest to learn how to “fix” sunken eyes began. The term “sunken eyes” describes eyes that are set back into the orbital fossa (eyeball hole) a little farther than others. This sunken eye usually becomes more noticeable as age progresses, and/or as a result of excess fatty tissue around the upper part of the eye. The sunken eye cannot be hidden by a normal eye shadow application. But it can be contoured so that the normal shadow formed over the top of the eye is used to our advantage. We do this by using the darkness of the crease of the sunken eye, caused by the deep-set eye in the socket. By using a combination of eye shadow, the natural shadow formed by the contour of the eye and a complementing eye color, we end up with a beautiful eye. If you look at your own eyes, you will notice and feel a bone around the entire eye socket area. The eye shadow normally goes under the upper bone. Experts tell you that a darker color (eye shadow) will go in that crease right below the upper bone. If someone with sunken or deep-set eyes places eye shadow in that crease, it makes them appear even worse! It forces the eye farther back into the socket. Notice that the “sunkeness” on the top of the eye makes a natural shadow, but it will be semi-circular around the top of the eye. You will also notice that much of the eyelid is apparent, but it may have disappeared into the fold, going over the top of the eye. Your eyelid is still there, but it’s almost as if it is inside the fold (in challenging cases). I have seen cases in which February 2013 • Les Nouvelles Esthétiques & Spa
simply adding eye color would do the job to some extent. In other more dramatic cases, adding eye color only made the eye look as if the color was from the eye liner, and you could not see very much of the eye color on the lid of the eye. 1
Holding a wider eye brush sideways allows you to place eye shadow directly into the crease of the eye. Photos courtesy of Joe Blasco Cometics 2
Eye shadow is blended over the bone across the top part of the eye and inward from the outside portion of the eyelid.
Put eye color on the lid only. Use a color that accents and brings out the color of the eyes. Apply an orangish rusty color. It enhances blue, green, hazel and brown eyes, and has been a standard color used in Hollywood for years and years. Next, with an eye shadow color such as a medium to darker brown, place the brush sideways so the thinner part is applying a smaller line at the crease. If the crease is inside the eye, this step is not necessary. See figure 1. Next, using your brush on the wider side, blend the eye shadow above the crease, starting at the inside part of the eye and blending farther above the outer part of the eye. Blend from the outer corner of the eyelid as well. See figure 2. If your client’s eyes are really deepset, then blend above the bone, and not inside the crease. You can always experiment with this process and the color selection. When you use a lighter color for the eyelid, the selection of a darker color is far more extensive. For example, using light lavender on the lid and a medium to dark lavender in the crease works just as well, and creates a unique and beautiful look. n
Tools you will need • Eye shadow • Eye colors • A good eye color blending brush, about ¼” wide for light colors • A good eye shadow blending brush, about ¼” wide for darker colors • A good eye primer Your eye primer can be a product specifically designed for priming the eye. A sheer application of cream foundation using a powder puff will do the trick nicely. By working with two brushes
Tommy Parsons is the director of DMK Cosmetics, where he works with the company’s international team of distributors in marketing, education and training. Parsons has an extensive background in the makeup industry. He has been a makeup artist for various entertainment corporations, and has worked with a multitude of major celebrities including music stars, politicians and pageant contestants. Parsons has also designed colors for numerous professional cosmetic brands. www.LNEONLINE.com • Page 107
image
youthful hands BY JENNIFER LINDER, M.D.
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photo: NatUlrich/Shutterstock.com
Treatments for
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HANDS ARE SEEN BY THE WORLD ALMOST AS MUCH as the face, yet they are typically neglected when it comes to skin care products and professional treatments. It is unusual for patients to consider applying serums or sunscreen to their hands, let alone seek out injections, chemical peels, microdermabrasion or other types of treatment modalities to improve their hands. We routinely attend to the skin on our patients’ faces while neglecting their hands. Once their facial skin is rejuvenated and health is improved in the more routinely treated areas, neglected hands may look even older than they did before as the contrast becomes more apparent. Hands give a person’s age away almost more quickly than their face does. Every day the hands are exposed to harsh cleaning products, as well as the drying effects of water, hand sanitizers and harsh soaps. They are also exposed to damaging UV rays while driving, playing sports and walking, among other activities. Approximately 90 percent of the aging markers on our hands, such as wrinkles, brown spots and a dry, leathery appearance, are due to overexposure to harmful UV rays. Skin cancer of the hands is another important consideration. Squamous cell carcinoma (SCC) is the most common type of skin cancer on the hands, according to the American Society for Surgery of the Hand, followed by basal cell carcinoma (BCC) and melanoma. The fingernails are another part of the hands that must be protected as well. Because the tissue under the nail is metabolically active, it is susceptible to melanoma and SCC.
Educating the patient As a clinician, there are measures you can take to help your patients protect their hands. When they are applying their specialty products for aging or hyperpigmentation (or both) to their faces and necks twice a day, suggest they dispense a little extra for their hands. Also make sure that in the morning, they don’t forget to apply a broad spectrum sunscreen formulation with a minimum SPF of 30 to their hands. If their sunscreen is not formulated with antioxidants, an antioxidant serum should also be applied prior to sunscreen to prevent the oxidative stress and free radical damage that can occur due to UV exposure. Although it is recommended that sunscreen be applied every two hours, more frequent reapplication is extremely important, as sunscreen is removed each time the hands are washed. Another suggestion to make to patients is to be aware of the positioning of their hands when driving. UVA rays pass through glass, making the hands highly susceptible to exposure when they are on the steering wheel, especially on the left side. Suggest positioning them out of the direct sunlight, but only if it does not impede their ability to drive safely. Those prone
February 2013 • Les Nouvelles Esthétiques & Spa
to skin cancers may even consider wearing driving gloves. There are several companies that manufacture SPF-treated gloves, in addition to other types of UV protective clothing.
Have patients coat their hands with products that contain hydrating ingredients such as glycerin, urea and hyaluronic acid each evening before bed. Keeping the hands hydrated In addition to the onslaught of cleaning products, soaps and other aggressive agents that our hands come in contact with each day, they also have fewer sebaceous glands, leading them to become dry much more easily. To counteract this dryness, have patients coat their hands with products that contain hydrating ingredients such as glycerin, urea and hyaluronic acid each evening before bed. The use of nonabsorbing spa gloves creates occlusion and increases the absorption of these beneficial ingredients into the hands. Alpha hydroxy acids (AHA) assist with gentle exfoliation to reveal healthy cells from below the dry, impacted surface. Lactic acid is one of the better choices, as it not only functions as an AHA, but also possesses tyrosinase-inhibiting properties, as well as providing hydration to the skin. Patients should also be mindful during the drier winter months, since fine lines and the ropy looking veins on the hands are more exaggerated when the skin is dry. The hands look more youthful if skin is hydrated. Suggest always wearing gloves when leaving the house. Not only do they keep hands warm, but they protect them from cold winds that can deplete their natural moisture, leading to impaired barrier function, increased dryness, and painful cracking of the skin in more extreme cases.
What skin care clinicians can do Most professional treatments that are done on the face can also be performed on the hands. The next time your patients come to you for a monthly chemical peel, facial or microdermabrasion, ask them about having their hands treated at the same time. Chemical peels will stimulate collagen and elastin production, as well as treat the visible signs of aging commonly seen on the hands, while improving the overall texture and health of the skin. Microdermabrasion treatments are also effective at stimulating collagen and elastin, as well as facilitating the penetration of serums and professional treatments. Many of continues
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image|treatments for youthful hands
today’s chemical peel formulations may be applied directly after microdermabrasion, making this a quick, yet effective treatment option that may be done on a monthly basis with relatively no downtime. For some of the more stubborn UV-induced hyperpigmentation spots on the hands and collagen production stimulation, intense pulsed light (IPL) treatments can also be performed.
What physicians can do Of course, annual full body skin checks are recommended, including the skin on the hands. Make sure to impress upon your patients the opportunity they have to ask about other options that may be available for improving the appearance of their hands. One exciting option includes certain types of injectables. Most people are aware of the benefits injectable treatments provide for the face, but many of these treatments are also suitable for plumping the hands and making them look more youthful by minimizing the appearance of visible tendons, bones and veins. As with any injectable filler, there are some risks of the development of nodules, which may last months or even years. Bruising is also a risk, but not as long lasting. Be sure patients discuss all options and contraindications with their physician. Hyaluronic acid-based fillers, such as Juvederm®, Restylane® and Perlane are beneficial, as hyaluronic acid is biocompat-
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ible and helps to restore the lost hyaluronic acid within our skin. Some physicians favor using these options first, because if patients are not happy with the results, hyaluronidase can be injected into the treatment area to help eliminate some of the previously injected filler. Other options include collagen-building fillers, such as Sculptra® and Radiesse®. Sculptra consists of poly L-lactic acid, a biocompatible substance approved for volume restoration. It has been in use since 1999. Because Sculptra causes no harm to the body, it does not require allergy testing before treatment. The mechanism of action in Sculptra triggers the body’s collagen production over time. Some may consider this a drawback, as it does not provide instant results but instead takes several months—and possibly several injections—to achieve the desired effect. As with Sculptra, Radiesse does not require any sort of allergy testing. It is composed of smooth calcium hydroxylapatite (CaHA) microspheres in a sodium carboxymethylcellulose gel carrier, which is metabolized by the body over time. One of the main differences between this product and Sculptra is that Radiesse provides an instant effect, which may be better for the impatient patient. Both Sculptra and Radiesse can be performed on an outpatient basis, and may take anywhere from 15 to 30 minutes, depending on the severity of the area being treated. Patients are not restricted in any way. However bruising and slight swelling may occur.
Prevention is the best medicine Hand rejuvenation procedures may be costly, depending upon the procedure(s) chosen and the severity of damage to the skin on the hands, but there are many easy and cost effective practices that you can help your patients incorporate into their daily regimens. Remind patients that their best anti-aging product is sunscreen, keeping in mind the necessity to reapply it to the hands more frequently than they would on the rest of their bodies. As one of the hardest working and most visible parts of our body, the hands deserve to be treated with care. In the end, your patients will be rewarded with youthful looking, healthy hands. n
Jennifer Linder, M.D., is a boardcertified dermatologist, a fellowshiptrained Mohs surgeon and one of the foremost U.S. experts in the use of the cosmetic filler Sculptra. A biomedical engineer and chemist, Dr. Linder holds a clinical faculty position in the department of dermatology at the University of California, San Francisco. Dr. Linder is chief scientist for PCA Skin.
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by Alyssa Adams
image|the ugly truth psoriasis in the nails ABOUT 150,000-260,000 NEW CASES of skin psoriasis are diagnosed every year. Psoriasis is a disorder that can also affect the fingernails and toenails, causing pitting, thickening and irregular contour of the nail. Other symptoms may be: • Nail discoloration • Loosening of the nail • Crumbling of the nail • Vertical black lines
ited), immunologic and environmental factors. Most people who have psoriasis of the nails also have skin psoriasis. There is no cure for psoriasis of the nails. The goal of treatment is to improve the function and appearance of the nails. If the nails have a fungal infection, a doctor will prescribe an antifungal medi-
cation. PUVA is recommended for extreme cases; this is a combination of the prescription drug Psoralen and exposure to ultraviolet light. I suffer from nail psoriasis myself, and as a licensed nail technician I have learned to live with this disorder. It is continues
top to bottom: ©2013 Jupiterimages Corporation; before and after pictures by Alyssa Adams
Psoriasis is not contagious. It is not completely known how psoriasis of the nails develops, but it appears to result from a combination of genetic (inher-
As licensed providers, it is important to understand various disorders, and to know what is contagious and what is not.
February 2013 • Les Nouvelles Esthétiques & Spa
www.LNEONLINE.com • Page 111
image|the ugly truth
genetic for me; I have had nail psoriasis since birth and my daughter also suffers from it. Among people who have skin psoriasis, 10 to 55 percent have psoriasis of the nails (also called psoriatic nail disease). As part of the only five percent of people with psoriasis of the nails that do not have skin psoriasis, I have always found myself trying to hide and disguise my disorder. While most people will simply suggest going to a nail salon and having the nails covered in beautiful acrylic nails, they do not realize the strange looks and questions a person with nail psoriasis must face when we go with that option. Most salon personnel just take one look at my nails and say they do not know how to apply enhancements to them. Others just ask why I bite them (which I never do). Throughout elementary school and part of middle school, I had to deal with other students staring and commenting
on my fingernails, and finally I decided I was just going to use press on nails forever! That is, until the day I decided that I was going to try to apply acrylic nails myself. They looked horrible! In fact, they looked worse than they would if I just walked around blatantly displaying my ugly disorder. Yet I didn’t give up. I kept trying and practicing. At age 14, during my freshman year in high school, I finally got to the point where I could pull off a decent set of acrylics, as long as I just polished over them. I was able to get through high school without anyone knowing what was really going on under my nails. I also have hid it from just about everyone—from my friends, coworkers, classmates and even my fiancé ... until now. After acquiring my nail technician’s license, I can confidently admit I have a disorder of my nails, and gladly help others who suffer from psoriasis of the nails. Clients don’t ever need to feel
hesitant or embarrassed about their nails. As licensed providers, it is important to understand various disorders, and to know what is contagious and what is not. Offer a listening ear, share up to date suggestions and solutions and be confident in your application and service. n
Alyssa Adams is a licensed nail technician and esthetician in her native state of Florida. She is the original creator and administrator of www.Facebook.com/ NailsByAlyssa. Adams hopes to spread the word on nail disorders, and how it is possible to camouflage them and build confidence with the right nail technician.
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CleanSpa: A NEW KIND OF SPA
FOOT SPAS ARE THE MEDSPAS OF PODIATRY. They are patterned after the medspas that are opened by physicians, who then hire estheticians to perform cosmetic skin care services (facials) on current patients to attract new ones. Following their example, podiatrists are hiring nail technicians to perform foot care. As with medspas, foot spas provide cosmetic-level care (pedicures) and attract new patients, but an additional focus is on safety due to potential dangers in foot care services. CleanSpa, a foot spa in Chesterfield, MO, is owned by Michael Horowitz, DPM, a podiatrist who refers his “normal” patients from his podiatry offices, Feet for Life Centers, to his foot spa next door for safe pedicures. Conversely, the spa sends clients with abnormal conditions to Dr. Horowitz for evaluation and treatment. Dr. Horowitz pondered opening a foot spa for years. “I see many clients that have infections, and one common factor with many of them is pedicures,” he explains. “So, why not send them to a spa where infection control is considered mandatory, including the use of an autoclave? Why not open my own spa?” He opened his foot spa in February, 2012 in Chesterfield, MO, a suburb of St. Louis, and it continues to grow in success. It is designed for patients with chronic illnesses who are seeking safe pedicures, and for all clients who have concerns about safety during pedicures.
Design CleanSpa is 1,000 square feet of pure luxury, with floor to ceiling windows to bring in sunshine. It has gleaming floors, beautiful décor, and five comfortable, Italian-made spa pedicure chairs. Additionally, there are two zero gravity chairs that are especially popular with male clients. “These chairs produce perfect relaxation through weightlessness; men love that feeling, as do women,” says spa director and medical nail technician (MNT) Denise Baich. “This amount of high-end luxury is rarely found in nail salons/spas, nor is the level of infection control.” CleanSpa uses a medical-level autoclave for implements. An opening between the waiting rooms of the foot spa and the practice allows spa clients to make an appointment to see the podiatrist; podiatry patients can make a spa appointment; or the podiatrist can be called to the spa to evaluate a client’s feet if the results of a pedicure are questionable. The manicure department at CleanSpa is separate from the pedicure stations. “Most nail salons put the manicure and pedicure stations close together either simply because ‘its just that way,’ or to save money or square footage,” says Dr. Horowitz. “We believe they must be separate because of the potential for an unknown pathogen or spore becoming airborne during filing, continues
BY JANET MCCORMICK
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February 2013 • Les Nouvelles Esthétiques & Spa
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image|clean spa: a new kind of spa
allowing it to be introduced to other surfaces close by. Custom high suction extraction systems are built into the manicure tables that will remove any airborne debris and microbes and transport them to the outdoors. Separation of the services prevents unneeded cross contamination.”
The CleanSpa difference CleanSpa is different than many foot spas. “Most foot spas are a salon-licensed room within a podiatry office where a nail technician performs pedicures and other cosmetic services,” Dr. Horowitz says. “That works well, but ours is a separate facility conveniently located next door to our Chesterfield Feet for Life Center. We have five nail technicians, and we are adding more as we grow.” While pampering is an important component of the services, safety is a definite area of focus at CleanSpa. “We take (on time) clients on a tour of the spa before their first service,” says Baich. “During that tour, we show them the autoclave, and this gives us the opportunity to introduce our safety philosophy and to communicate that we do everything possible to keep our facility infection-free. We want them to know we are committed to keeping them safe.” Horowitz and Baich feel that once clients
autoclave
know what it takes to be safe in a nail salon, they will never go elsewhere for a pedicure or other nail services. “Survival is the highest instinct in humans, and safety taps into that instinct,” says Dr. Horowitz. Aseptic techniques, the performance of services without the transfer of infection to employees or between clients, are more subtle than the message the autoclave makes. The towels are removed from the premises and washed, steamed and sterilized in a professional laundry that practices asepsis. Further, at the end of each day, the lights are turned off and the facility is scanned with black lights that illuminate fungal spores. “We go continues
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image|clean spa: a new kind of spa
on a search and destroy mission to ensure that any fungal spores have been eliminated,” says Baich. “We check the nooks and crannies, the chairs and surfaces of the spa to ensure our environmental infection control has been complete.” Dr. Horowitz’s belief in the importance of aseptic techniques includes wearing gloves during every service and, when appropriate, wearing masks and eye protection. These protect technicians from infection.
Foot spas may influence change in nail salons across the country due to clients demanding higher standards of safety.
with a respect we never experienced elsewhere,” says Alla Zumgard, MNT. “They trust us because of our additional training, and ask our opinion on their needs, although we never offer medical advice. We wear our MNT pin while we work and our certificates are up on the wall to prove our education; they like that and show us they do.” Office-based foot spas and stand-alone foot spas like CleanSpa provide nail technicians new resources for positions. But these are not technicians who want to build artificial nails and perform nail art all day (although CleanSpa does offer artificial toenails for those who need them). “These nail technicians are different. They are interested in helping people and enhance their skills to support that,” Zumgard explains. “They want to do what they love in a medical setting. When interviewing them, I can always feel their passion for the position. They are special techs and the ones we want at CleanSpa.”
The future of CleanSpa The training at CleanSpa is comprehensive and provided by the spa. Training may be on gels, gel polishes or other services, but one course the new technician must complete (or have already completed) trains them on the safety philosophy that Dr. Horowitz accepts as true. “All our technicians complete the Medical Nail Technician Program on www.medinails.com, and I provide the internship,” says Horowitz. “According to the Centers for Disease Control and Prevention, over 11 percent of Americans are diabetic, and another nine percent have other chronic illnesses. Many of our clients fall into these groups and need special care by technicians who are trained in aseptic techniques and in important service precautions. This course provides that training.” These technicians are trained in how to perform or not perform services on clients with chronic illnesses. The technicians hired at CleanSpa and other foot spas must understand that they are working in a new concept of spa. “Foot spas are new, so until the concept is established, they will usually be working in a start-up business,” says Baich. “They must understand this and the challenges it presents, but they must also recognize the potential of this new concept.” One difference in working in a foot spa versus a regular salon or spa is that clients treat the nail professionals differently. “The clients treat us
Podiatrists often call Dr. Horowitz to ask questions about opening foot spas, which are very new and interesting to them. They soon learn he is passionate about the future of CleanSpa and the foot spa industry. “CleanSpa is the first of 125 foot spas across the country and is the prototype for them,” he says. Dr. Horowitz also believes that foot spas may influence change in nail salons across the country due to clients demanding higher standards of safety. “They will have to step up or lose clients to foot spas,” he says. “Bringing salons to aseptic technique, one by one, can only be good for the nail industry.” n
Janet McCormick is a CIDESCO Diplomat, certified medical nail technician, trainer and a former spa director and salon owner. She has written more than 400 articles for beauty industry magazines and books. McCormick is the co-owner of Medinail Learning Center, a provider of modular online and school courses about safe techniques for nail technicians. She can be reached at janetgmccormick@aol.com or 863.273.9134.
Page 118 • www.LNEONLINE.com Les Nouvelles Esthétiques & Spa • February 2013
photos courtesy of CleanSpa
CleanSpa nail technicians
by Jenny Flanagan
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liability in the nail department
keeping technicians and clients safe HOW DO YOU PROTECT YOUR business from the risk of injuring a client? The costs of such an incident can be major, even without considering the impact on your reputation and future business. Just as with car ownership, where even the safest driver knows that situations outside his or her control can possibly lead to an accident, a twopronged approach is best: take steps to reduce the chance of an injury, and carry insurance so you can be confident that you will be protected if the worst happens.
photo: AISPIX by Image Source/Shutterstock.com
The three types of risk The three areas of liability are general, product and professional liability. It is important to make sure your insurance policy covers you in all three of these areas. Understanding the differences will also help you think about potential risk areas in your nail department that might benefit from some changes. General liability is often described as “slip and fall.” These are accidents that are not directly caused by your services, but because they happen on your business premises, you can still be held liable. A client may slip on ice on the sidewalk or trip over a loose power cord when walking through the salon. Sharp edges, slippery or uneven flooring, rugs that slide, damaged surfaces that can snag skin or clothing, flimsy or rickety chairs and wet spills … these are all things to February 2013 • Les Nouvelles Esthétiques & Spa
Be diligent about keeping the floor dry around pedicure tubs.
watch out for. Be diligent about keeping the floor dry around pedicure tubs. Product liability covers incidents such as clients suffering an adverse reaction to a product used during a service. This might happen because of an allergy, or simply because a harsh product is used on sensitive skin. Almost any product can potentially cause a reaction, even if it’s marketed as “gentle” or “natural.” For example, some people are sensitive to citrus or peppermint. Clients may not even know they have an allergy or sensitivity until it’s too late. You can reduce risk in this area by making sure all products are used only as the manufacturer intended, and paying attention to expiration dates. Make sure technicians are trained on the correct protocols for using each product. Keep material safety data sheets (MSDS) on file for every product used in your salon.⎯In addition to being a quick reference tool if a problem occurs, it is required by law. Professional liability is what medical professionals call “malpractice.” This means that a client was injured as a direct result of a service she received,
because of the negligence of the technician or salon. The lawsuits and medical horror stories that we’ve all heard usually fall into this category. It is important to realize that the full impact of these incidents that lead to cases often develop later, from what may seem like a very minor incident at the time. It could⎯perhaps be something that the technician did not even think was worth mentioning to her employer, since the client didn’t seem bothered at the time. Infections arising from manicures and pedicures are a common example, especially with the rise of “superbugs” such as methicillinresistant staphylococcus aureus (MRSA), which can cripple or even kill. A recent example is a case in Ventura County, CA, in which a client’s fingertip was accidentally punctured with a nail tool. This otherwise minor wound became continues www.LNEONLINE.com • Page 119
image|liability in the nail department
Risk reduction checklist 1. Use client forms. An intake form should be completed for each new client, noting any health conditions, known allergies or other situations that you should be aware of. Ask if anything has changed on repeat visits, and if so, make a note of the changes. Keeping a record for every client, even those who walk in for a simple polish change, is one of the best things you can do to protect your business.⎯A client database is also the foundation for your marketing efforts. 2. Research your state’s rules for disinfection procedures, and make sure you are following or exceeding those stan-
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dards. All states have rules about what you should be doing, and some even specify what cleaning products to use. 3. Walk through your business premises (including outdoors) and take note of ways that an accident could happen. If something needs fixing, don’t put it off! 4. Purchase a liability insurance policy, or check your existing policy to make sure you understand the coverage.
Questions to ask: • Is your policy “shared master aggregate” or “individual aggregate?” In a shared master aggregate policy, the annual policy limits are shared among all of the insurance company’s customers; if your insurance provider has a particularly high number of claims in one year from their other customers, the total amount available to you is reduced. In an individual aggregate policy, the full annual policy limit is available to you, regardless of how many other claims the company receives that year. • Is it a “claims-made” or an “occurrence-form” policy? Claimsmade policies are cheaper, but do not cover you for any claim that is reported after the policy expires. In most states, many professional liability lawsuits are not filed until the statute of limitations draws near⎯two years. This means that a client may file a claim against you 23 months after the original incident, when it is less likely that you will be able to provide evidence or witnesses in your defense. Occurrence-form policies cover you for claims arising from any incident that happened while you were insured, even if the claim itself is filed years later. • Are legal defense costs included in the aggregate limits, or in addition to them? Legal costs are a major component of most claims, and if they are included in the aggregate limits, this can cut heavily into the funds available for covering the actual claim. Stay safe and happy by being meticulous and avoiding negligience! n
Jenny Flanagan is director of membership for Associated Hair Professionals (AHP), which provides business resources, marketing materials, networking opportunities and liability insurance to individual hair and nail professionals. AHP’s sister organizations, Associated Bodywork & Massage Professionals and Associated Skin Care Professionals, have 25 years of experience insuring the salon, spa and wellness industry. Reach Jenny at jennyf@insuringstyle.com and learn more about AHP’s member benefits at www.insuringstyle.com.
Page 120 • www.LNEONLINE.com Les Nouvelles Esthétiques & Spa • February 2013
photo: Anthony Hall/Shutterstock.com
infected with MRSA, and developed into a very complex case that involved infectious disease specialists, cardiologists and orthopedic surgeons. It was proven in court that the nail salon had been negligent in its disinfection practices. This client was awarded $124,260 in damages. The importance of giving constant, meticulous attention to maintaining the highest standards of hygiene cannot be overstated. All spa employees and independent contractors must be empowered to speak up when any type of accident occurs. Appropriate first aid can prevent even worse harm, and a caring response can prevent an injured client from becoming angry as well.
Try a new twist on the classic blue! Anticipated to be a hot color this season, glominerals’ creamy Blue Suede Eye Shadow is great for accessorizing! This dark shade gives off a sophisticated, chic finish. Glide on across the lids to make any eye color pop. www.glominerals.com
LUSCIOUS LIPS The ultra hydrating Lip Oils from RAMY beauty therapy deliver minimum makeup for maximum impact! The deep conditioning oils are made with almond, jojoba oil and collagen to moisturize even the driest lips, says the company. It is available in three flavors: mint, rose and orange. www.RAMY.com
HAPPY FEET The Tuscan Citrus & Herb Pedicure Fizz from Cuccio Naturalé makes the perfect pre-pedicure soak. The tablets replenish moisture, soften and condition the skin and help whiten the nails. Drop tablets into the water and soak feet for several minutes before the pedicure. It is also great for an entire body soak! www.cuccio.com
February 2013 • Les Nouvelles Esthétiques & Spa
PERFECT COVERAGE Put the perfect finish on your clients’ look with CAILYN’s BB Cream, which hides imperfections and evens and mattifies skin tone with a non-oily, perfectly powdered finish and a lightweight, velvety texture. Apply it with the BB Perfector, a vibrating foundation application device that covers and blends the formula on the skin. www.cailyncosmetics.com
IMAGENEWS
BLUE HUES
MAKEUP, TOOLS AND TRENDS MORE NEWS
www.LNEONLINE.com • Page 121
COLORFUL COVERAGE
IMAGENEWS
RAZZLE DAZZLE! China Glaze® introduces the new generation of chunky glitters for the nails with the Glitz—Bitz ‘N Pieces collection, featuring six edgy, 3D glitters to suit any taste and style. These include Mosaic Madness, Bling it On, Scattered & Tattered, Graffiti Glitter, Razzle Me, Dazzle Me and the namesake Bling it On. www.chinaglaze.com
STUDY SUPPORTS UV NAIL LAMP SAFETY A new study published by The Journal of Investigative Dermatology has found that the UV lamps commonly used for drying nail polish are safe and do not increase one’s risk of getting skin cancer. The study compared the UV rays emitted from three popular brands of nail lamps to low risk phototherapy devices used in dermatology treatments. Researchers found that a salon client would need approximately 250 years of weekly manicures that involve the use of UV nail lights to develop the same risk of exposure as just one round of phototherapy sessions used to treat various skin conditions. Based on these results, researchers concluded that nail lamps do not significantly increase the risk of getting skin cancer. www.probeauty.org/nmc/
The Beautiful Colours 4 Piece Nail Polish Kit from Elizabeth Grant has all your clients’ color needs covered for the cooler months, as well as a triple threat 3-in-1 Treatment to battle cold weather damage on fragile nails. The diverse trio of shades includes Purple Pearl, Red Pearl and Peach. www.elizabethgrant.com
MIGHTY MANICURE ME by Dermelect Cosmeceuticals® is a range of beautiful nail shades coupled with a remarkable manicure extending formula. Infused with ProSina, a pure protein peptide extracted from New Zealand sheep’s wool, the lacquers deliver a fast drying, high gloss shine while providing an unequaled level of strength for stubborn nails to grow longer and more resistant to chipping, peeling and splitting. There are nine sensational anti-aging colors in the range. www.dermelect.com
Page 122 • www.LNEONLINE.com Les Nouvelles Esthétiques & Spa • February 2013
Say you saw it in LNE & Spa and circle #162 on reader service card
WEST | CENTRAL | EAST
CALENDAR OF EVENTS
West FEBRUARY (ONGOING) Advanced Chemical Peels with Skin Assessment by A Natural Difference. Encinitas, CA. 888.568.3150. Advanced Chemical Peels with Skin Assessment by A Natural Difference Skincare. Long Beach, CA. 888.568.3150. Advanced Chemical Peels with Skin Assessment by A Natural Difference Skincare. Seattle, WA. 888.568.3150. Antiqua Prima Level I Introductory Classes by Laura L. Root. Webinars held every Monday and Friday. 866.358.1694 Ext. 4. Distance learning available.
Full-Spectrum Reiki for Beauty Professionals: Integrated Reiki Spa Treatments by Linda Bertaut at Bertaut Beauty. Pasadena and San Francisco, CA. 626.405.0424. HydroPeptide Product Training Seminar by HydroPeptide. Webinars held Mondays at 10 a.m. PST. www.hydropeptide.com/webinars. Seasonal Peels and Unusual Actives by A Natural Difference Skincare. Encinitas, CA. 888.568.3150. Seasonal Peels and Unusual Actives by A Natural Difference Skincare. Long Beach, CA. 888.568.3150. Seasonal Peels and Unusual Actives by A Natural Difference Skincare. Seattle, WA. 888.568.3150.
FEBRUARY 4 Advanced Peeling Techniques for Complex Skin Conditions: A Hands-on Course by PCA Skin. San Diego, CA. 877.PCA.SKIN. Advanced Peeling Techniques for Complex Skin Conditions: A Hands-on Course by PCA Skin. Seattle, WA. 877.PCA.SKIN.
FEBRUARY 5 Sanitas Product Knowledge Training by Sanitas Skincare. Louisville, CO. 303.449.1875.
FEBRUARY 10 Skin Biology & Chemical Peel Seminar by PCA Skin. Denver, CO. 877.PCA.SKIN. Skin Biology & Chemical Peel Seminar by PCA Skin. Newport Beach, CA. 877.PCA.SKIN.
Page 124 • www.LNEONLINE.com Les Nouvelles Esthétiques & Spa • February 2013
West Central East International
FEBRUARY 10-11
FEBRUARY 12
FEBRUARY 17
Advanced Professional Skincare Education by Circadia by Dr. Pugliese. Phoenix, AZ. 602.682.7598.
Advanced Speed Sugaring by Sanitas Skincare. Louisville, CO. 303.449.1875.
Skin Biology & Chemical Peel Seminar by PCA Skin. Las Vegas, NV. 877.PCA.SKIN.
FEBRUARY 11 Advanced Peeling Techniques for Complex Skin Conditions: A Hands-on Course by PCA Skin. Scottsdale, AZ. 877.PCA.SKIN. Advanced Speed Sugaring by Sanitas Skincare. Louisville, CO. 303.449.1875.
map: ©iStockphoto.com/Malcolm Romain
The Bt-accent Line (Webinar) by Bio-Therapeutic. Seattle, WA. 11 a.m. P.S.T. 800.976.2544. Peel Fundamentals: A Hands-on Course by PCA Skin. Denver, CO. 877.PCA.SKIN. Peel Fundamentals: A Hands-on Course by PCA Skin. Newport Beach, CA. 877.PCA.SKIN. February 2013 • Les Nouvelles Esthétiques & Spa
Bio-Ultimate Platinum Continuing Education by Bio-Therapeutic. Seattle, WA. 800.976.2544.
FEBRUARY 13 Bio-Brasion Wet/Dry Microdermabrasion System Continuing Education by Bio-Therapeutic. Seattle, WA. 800.976.2544.
Skin Biology & Chemical Peel Seminar by PCA Skin. Seattle, WA. 877.PCA.SKIN. Skin Biology & Chemical Peel Seminar by PCA Skin. Walnut Creek, CA. 877.PCA.SKIN.
FEBRUARY 18 FEBRUARY 14 Bio-Synthesis Continuing Education by Bio-Therapeutic. Seattle, WA. 800.976.2544. Extraction Lab by Sanitas Skincare. Louisville, CO. 303.449.1875.
FEBRUARY 15 Bio-Oxygen Continuing Education by Bio-Therapeutic. Seattle, WA. 800.976.2544.
Peel Fundamentals: A Hands-on Course by PCA Skin. Las Vegas, NV. 877.PCA.SKIN. Peel Fundamentals: A Hands-on Course by PCA Skin. Seattle, WA. 877.PCA.SKIN. Peel Fundamentals: A Hands-on Course by PCA Skin. Walnut Creek, CA. 877.PCA.SKIN. continues www.LNEONLINE.com • Page 125
calendar|west
CALENDAR OF EVENTS Pro Master Bridal Makeup by Sanitas Skincare. Louisville, CO. 303.449.1875.
FEBRUARY 19 Reflexology Technique Lab by Sanitas Skincare. Louisville, CO. 303.449.1875.
MARCH 3 Skin Biology & Chemical Peel Seminar by PCA Skin. Los Angeles, CA. 877.PCA.SKIN. Skin Biology & Chemical Peel Seminar by PCA Skin. Scottsdale, AZ. 877.PCA.SKIN.
MARCH 4 FEBRUARY 24 Skin Biology & Chemical Peel Seminar by PCA Skin. Riverside, CA. 877.PCA.SKIN.
FEBRUARY 25 Inside the bt-nano (Webinar) by Bio-Therapeutic. Seattle, WA. 11 a.m. P.S.T. 800.976.2544. Peel Fundamentals: A Hands-on Course by PCA Skin. Riverside, CA. 877.PCA.SKIN.
Peel Fundamentals: A Hands-on Course by PCA Skin. Los Angeles, CA. 877.PCA.SKIN.
Peel Fundamentals: A Hands-on Course by PCA Skin. Albuquerque, NM. 877.PCA.SKIN.
MARCH 12 Bio-Ultimate Platinum Continuing Education by Bio-Therapeutic. Seattle, WA. 800.976.2544.
MARCH 13 Peel Fundamentals: A Hands-on Course by PCA Skin. Scottsdale, AZ. 877.PCA.SKIN.
Bio-Brasion Wet/Dry Microdermabrasion System Continuing Education by Bio-Therapeutic. Seattle, WA. 800.976.2544.
MARCH 10 Advanced Peeling Techniques for Complex Skin Conditions: A Hands-on Course by PCA Skin. San Francisco, CA. 877.PCA.SKIN.
Sanitas Chemical Peel Training by Sanitas Skincare. Louisville, CO. 303.449.1875.
Skin Biology & Chemical Peel Seminar by PCA Skin. Albuquerque, NM. 877.PCA.SKIN.
FEBRUARY 26
MARCH 11
Advanced Hyperpigmentation Treatments by Sanitas Skincare. Louisville, CO. 303.449.1875.
Get Your Kit On! Successful Retailing of bt-Ceuticals (Webinar) by Bio-Therapeutic. Seattle, WA. 11 a.m. P.S.T. 800.976.2544.
MARCH 14 Bio-Synthesis Continuing Education by Bio-Therapeutic. Seattle, WA. 800.976.2544.
MARCH 15 Bio-Oxygen Continuing Education by Bio-Therapeutic. Seattle, WA. 800.976.2544.
MARCH 17 Skin Biology & Chemical Peel Seminar by PCA Skin. Portland, OR. 877.PCA.SKIN.
Page 126 • www.LNEONLINE.com Les Nouvelles Esthétiques & Spa • February 2013
calendar|west|central
Skin Biology & Chemical Peel Seminar by PCA Skin. San Diego, CA. 877.PCA.SKIN.
HydroPeptide Product Training Webinar by HydroPeptide. Webinars held Mondays at 12 p.m. C.S.T. www.hydropeptide.com/webinars.E
FEBRUARY 25
FEBRUARY 17
MARCH 17
Skin Biology & Chemical Peel Seminar by PCA Skin. Dallas, TX. 877.PCA.SKIN.
Skin Biology & Chemical Peel Seminar by PCA Skin. San Antonio, TX. 877.PCA.SKIN.
Peel Fundamentals: A Hands-on Course by PCA Skin. Peoria, IL. 877.PCA.SKIN.
MARCH 18 Peel Fundamentals: A Hands-on Course by PCA Skin. Portland, OR. 877.PCA.SKIN. Peel Fundamentals: A Hands-on Course by PCA Skin. San Diego, CA. 877.PCA.SKIN.
MARCH 24 Skin Biology & Chemical Peel Seminar by PCA Skin. San Francisco, CA. 877.PCA.SKIN.
MARCH 25 Peel Fundamentals: A Hands-on Course by PCA Skin. San Francisco, CA. 877.PCA.SKIN.
Central FEBRUARY (ONGOING) Advanced Chemical Peels with Skin Assessment by A Natural Difference Skincare. Dallas, TX. 888.568.3150. February 2013 • Les Nouvelles Esthétiques & Spa
MARCH 18 FEBRUARY 18 Peel Fundamentals: A Hands-on Course by PCA Skin. Dallas, TX. 877.PCA.SKIN. Skin Biology & Chemical Peel Seminar by PCA Skin. Chicago, IL. 877.PCA.SKIN.
FEBRUARY 24 Advanced Peeling Techniques for Complex Skin Conditions: A Hands-on Course by PCA Skin. Minneapolis, MN. 877.PCA.SKIN. Skin Biology & Chemical Peel Seminar by PCA Skin. Peoria, IL. 877.PCA.SKIN.
Peel Fundamentals: A Hands-on Course by PCA Skin. San Antonio, TX. 877.PCA.SKIN.
MARCH 24 Peel Fundamentals: A Hands-on Course by PCA Skin. Chicago, IL. 877.PCA.SKIN. Skin Biology & Chemical Peel Seminar by PCA Skin. Houston, TX. 877.PCA.SKIN.
MARCH 25 Peel Fundamentals: A Hands-on Course by PCA Skin. Houston, TX. 877.PCA.SKIN. continues www.LNEONLINE.com • Page 127
calendar|east
CALENDAR OF EVENTS East
Knowledge is Power Series by A Natural Difference Skincare. Cooper City, FL. 888.568.3150.
FEBRUARY (ONGOING)
Seasonal Peels & Unusual Actives by A Natural Difference Skincare. Atlanta, GA. 888.568.3150.
Advanced Chemical Peels With Skin Assessment by A Natural Difference Skincare. Atlanta, GA. 888.568.3150. Advanced Chemical Peels with Skin Assessment by A Natural Difference Skincare. Columbus, OH. 888.568.3150. Advanced Chemical Peels with Skin Assessment by A Natural Difference Skincare. Fort Lauderdale, FL. 888.568.3150. Advanced Chemical Peels with Skin Assessment by A Natural Difference Skincare. Philadelphia, PA. 888.568.3150. Advanced Chemical Peels with Skin Assessment by A Natural Difference Skincare. Wilmington, DE. 888.568.3150. Antiqua Prima Level I Introductory Classes by Laura L. Root. Webinars held every Monday and Friday. 866.358.1694 Ext. 4.
Seasonal Peels & Unusual Actives by A Natural Difference Skincare. Columbus, OH. 888.568.3150. Seasonal Peels & Unusual Actives by A Natural Difference Skincare. Fort Lauderdale, FL. 888.568.3150.
FEBRUARY 10-12 Advanced Skin Care Training: Skin Support for Oncology Patients by Oncology Skin Therapeutics. Charlotte, NC. 828.252.8400.
FEBRUARY 11 Peel Fundamentals: A Hands-on Course by PCA Skin. Indianapolis, IN. 877.PCA.SKIN.
FEBRUARY 17 Seasonal Peels & Unusual Actives by A Natural Difference Skincare. Philadelphia, PA. 888.568.3150. Seasonal Peels & Unusual Actives by A Natural Difference Skincare. Wilmington, DE. 888.568.3150.
FEBRUARY 4-6 Calm, Cool & Clear - Treating Reactive & Sensitive Skin Types & Electrotherapy - Master Class With Lydia Sarfati (3-Day Academy) by Repêchage. Secaucus, NJ. 800.248.SKIN.
Skin Biology & Chemical Peel Seminar by PCA Skin. Atlanta, GA. 877.PCA.SKIN.
FEBRUARY 18 30 Minutes to Beauty Express Treatments to Grow Your Retail Sales by Repêchage. Secaucus, NJ. 800.248.SKIN. Peel Fundamentals: A Hands-on Course by PCA Skin. Atlanta, GA. 877.PCA.SKIN.
FEBRUARY 24 HydroPeptide Product Training Webinar by HydroPeptide. Webinars held Mondays at 1 p.m. EST. www.hydropeptide.com/webinars.
FEBRUARY 10 Skin Biology & Chemical Peel Seminar by PCA Skin. Indianapolis, IN. 877.PCA.SKIN.
Advanced Peeling Techniques for Complex Skin Conditions: A Hands-on Course by PCA Skin. Washington, DC. 877.PCA.SKIN.
Page 128 • www.LNEONLINE.com Les Nouvelles Esthétiques & Spa • February 2013
calendar|east
Skin Biology & Chemical Peel Seminar by PCA Skin. Charlotte, NC. 877.PCA.SKIN. Skin Biology & Chemical Peel Seminar by PCA Skin. Orlando, FL. 877.PCA.SKIN.
FEBRUARY 25 Get Rid of Age Spots & Sun Damage With Professional Solutions for Hyperpigmentation & Anti-Aging by Repêchage. Secaucus, NJ. 800.248.SKIN. Peel Fundamentals: A Hands-on Course by PCA Skin. Charlotte, NC. 877.PCA.SKIN. Peel Fundamentals: A Hands-on Course by PCA Skin. Orlando, FL. 877.PCA.SKIN. Skin Biology & Chemical Peel Seminar by PCA Skin. Washington, DC. 877.PCA.SKIN.
MARCH 4 Advanced Peeling Techniques for Complex Skin Conditions: A Hands-on Course by PCA Skin. New York, NY. 877.PCA.SKIN. Peel Fundamentals: A Hands-on Course by PCA Skin. Dayton, OH. 877.PCA.SKIN.
MARCH 10 Skin Biology & Chemical Peel Seminar by PCA Skin. New York, NY. 877.PCA.SKIN. Skin Biology & Chemical Peel Seminar by PCA Skin. Richmond, VA. 877.PCA.SKIN. Skin Biology & Chemical Peel Seminar by PCA Skin. Tampa, FL. 877.PCA.SKIN.
February 2013 • Les Nouvelles Esthétiques & Spa
Advanced Peeling Techniques for Complex Skin Conditions: A Hands-on Course by PCA Skin. Charlotte, NC. 877.PCA.SKIN.
TRADE SHOWS Sponsored by Les Nouvelles Esthétiques & Spa and Dermascope
The International Congress of Esthetics and Spa, Miami Beach 2013 April 7-8 • Miami Beach, FL 1.800.471.0229
MARCH 11 Peel Fundamentals: A Hands-on Course by PCA Skin. New York, NY. 877.PCA.SKIN.
The International Congress of Esthetics and Spa, Long Beach 2013 September 29-30 • Long Beach, CA 1.800.471.0229
MARCH 3 Skin Biology & Chemical Peel Seminar by PCA Skin. Dayton, OH. 877.PCA.SKIN.
MARCH 25
The International Congress of Esthetics and Spa, Dallas 2013 May 5-6 • Arlington, TX 1.800.471.0229
FEBRUARY 26 Peel Fundamentals: A Hands-on Course by PCA Skin. Washington, DC. 877.PCA.SKIN.
Peel Fundamentals: A Hands-on Course by PCA Skin. Tampa, FL. 877.PCA.SKIN.
Peel Fundamentals: A Hands-on Course by PCA Skin. Richmond, VA. 877.PCA.SKIN.
The International Congress of Esthetics and Spa, Philadelphia 2013 October 27-28 • Philadelphia, PA 1.800.471.0229
www.LNEONLINE.com • Page 129
advertisers’ index Page Number
Reader Service No.
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Control Corrective................................................... www.controlcorrective.com............................................ 272 132............. Darphin................................................................... www.darphin.com.......................................................... .159 110............. Dermafile................................................................ www.dermafile.com....................................................... 296 117............. DermAware............................................................. www.dermaware.com..................................................... .256 27............... Dr. Grandel.............................................................. www.grandel-usa.com.................................................... 109 88............... Dr. Jeff..................................................................... www.dr-jeff.com............................................................. .248 21............... Edge Systems........................................................... www.HydraFacial.com.................................................... 201 2-3...............Éminence Organic Skin Care.................................. www.eminenceorganics.com............................................ 157 131............. Equipro................................................................... www.equipro-bty.com...................................................... 242 113............. HairMax................................................................... www.hairmaxsalons.com.................................................. 285 19............... Hydropeptide.......................................................... www.hydropeptide.com................................................... 278 30-31......... 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PCA Skin.......................................................................www.pcaskin.com........................................................... 110 7................. Phytocéane...................................................................www.phytoceane.com.................................................... 176 87............... Poo-Pourri.....................................................................www.poopourri.com....................................................... 219 6................. Professional Program Insurance Brokerage..............www.medispa-ins.com................................................... 208 93............... Rejuvi Laboratory...........................................................www.rejuvilab.com......................................................... 149 9................. Rhonda Allison...............................................................www.rhondaallison.com................................................. 190 82............... Saian........................................................................ www.saian.net................................................................ 165 35............... Satin Smooth/Conair................................................. www.satinsmooth.com................................................... 304 29............... Scalar America.......................................................... www.scalaramerica.com................................................. 247 17............... Shira...............................................................................www.shirausa.com.......................................................... 249 47............... Silhouet-Tone.......................................................... www.silhouet-tone.com.................................................. 192 112............. Tecniche.........................................................................www.tecniche.com......................................................... 153 25............... WishPro/Esthetique Solutions................................. www.mywishpro.com..................................................... 339 *Les Nouvelles Esthétiques & Spa/American Edition has all publishing rights reserved. Reproduction in part or in whole without written permission by the publisher is prohibited. *Les Nouvelles Esthétiques & Spa/American Edition is protected through Trademark registration in the United States and in foreign countries where Les Nouvelles Esthétiques & Spa/American Edition circulates. The publishers cannot accept responsibility for unsolicited manuscripts. 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