Exfoliants Get Down To Business

by Whitney Johnson (as seen in Dermascope Magazine)

We live in a high-definition, Photoshopped world, where we are bombarded with images of digital perfection, constantly. It's easy to become hypnotized and believe that our favorite celebrities have perfect skin, teeth, hair, or bodies (they don't, whew!). But how to deal with the client who wants to raise the bar on her own skin's performance and appearance?

The answer without a doubt is exfoliation. More sophisticated exfoliation techniques and products offer the key opportunity to us as skin therapists to not only deliver more client satisfaction, but bump up our professional skill level and make ourselves more valuable in our highly competitive market space.

The human skin produces about 36 million new skin cells every day! You would think that this staggering fact alone would mean that our skin is always glowing and moist. But nobody's perfect. Cells become damaged, contaminated with pollutants, congestion builds when cells don't shed properly, and as we age the slow-down of collagen production and cell turnover doesn't help, either. This is where professional exfoliation becomes an even more critical step in any skin health regimen.

An exfoliation program must be tailored to the specific tolerances of the client's skin. Mild exfoliants such as Rice Bran Extract, Corn Cob Meal, and fruit-derived enzymes like Papain (papaya-derived proteolytic enzyme which digests keratin protein) and Bromelain (pineapple-derived enzyme) are ideal for that sensitive-skinned client. More powerful ingredients such as Lactic Acid, Salicylic Acid or Retinol are excellent for those in-betweeners who want to focus on specific concerns, and fight the aging process. The heavy-hitters in exfoliation, when the client seeks a significant and dramatic improvement, are high-tech peptides: Hexanoyl Dipeptide-3 Norleucine Acetate (an encapsulated peptide which facilitates cell sloughing), along with Galactoarabian (a complex sugar molecule which works well with AHA exfoliation), Aminopeptidase (protease enzyme which loosens cell cohesion while stimulating digestion of keratin protein in the epidermis) and of course Trichloroacetic Acid (TCA) -- an oldie, but still a goody.

Cautionary Tips for Exfoliation

Exfoliation is much more than scrubs. And it has to be safe—not to mention legal. For instance, in some states, skin therapists are not allowed to work with certain percentages of acids, or specific acids on the skin. So, we have to begin with education. First, learn what exfoliation options exist, period. Expose yourself to the newest technologies by taking advanced classes and networking with fellow professionals. As you do this, narrow down what will work for you in your market, beginning with any legal restrictions on specific ingredients. Be thorough in your investigation of any additional insurance coverage which may be needed when using acids.

The mastery of exfoliation requires not only a solid understanding of skin health but the knowledge of combining key ingredients all while maintaining a close monitor on pH-balance. To fully appreciate the different effects of exfoliation, and to reduce the likelihood of any unwanted reactions and complications, take special care to research how your client currently maintains her skin. Clients using Retin-A, Renova, or any medically-prescribed exfoliating product should discontinue use of these products at least 48 hours before receiving an intensive exfoliation treatment. Also, clients taking Isotretinoin (Accutane)—or who have taken this drug within the past 6 months—should not receive exfoliation treatments, in order to protect potentially thin and fragile skin. Skin which is already in this compromised condition may respond to professional exfoliation with undesired pigmentation, or simply may be unable to regenerate properly.

Peels: Evolving and Uncovering New Possibilities

This category is where massive strides are being made in ingredient technology, combinations and application methods. Clients already know that peels are an effective way to liberate the skin from a suffocating shell of keratin cell-debris, revealing more supple, vibrant tissue beneath. The new generation of peels present the therapist with a tiered deck of potential options, each with a successively more intense result. There's more demand for this category than ever before, and to safely and successfully deliver the results your client wants—polished, brilliantly fresh skin with minimal discomfort, inflammation, shedding or downtime—requires skill.

To draw upon an analogy from one of our sister professions, hairdressing, hairdressers reference something called "Blonde Fever": the client has decided to go blonde, and there's no turning back. But an experienced stylist will give her a less drastic lightening than she insists she wants, at least the first time. It is easy to go more aggressive on the second or third appointment, but virtually impossible to put the "blonde" genie back in its bottle!

Likewise, tread lightly when planning a chemical peel. Like going blonde, it should not be an impulsive choice, and holding back slightly will safeguard your client from potential damage and regret. Also consider that today's client will not accept post-peel downtime, or the long-term shedding that used to be considered normal. Instead, manufacturers are introducing anhydrous—meaning no-water—textures. Anhydrous textures not only deliver an increase in ingredient potency, as well as higher solubility—but also reduce initial inflammation during the process. While controlled inflammation is required as part of any chemical peel to induce the wound-healing process, the degree of penetration must be tightly monitored. Too much inflammation may trigger unnecessary pigmentation, thinning of the dermis, texture changes or even long term erythema and wounding to the skin.

While high concentrations of Glycolic Acid and Trichloroacetic Acid (TCA) have for a long time been considered medium depth, combining these acids with other ingredients offers greater versatility, enhancing their use and effects. The best example is Lactic Acid, which has a larger molecular structure than other commonly used acids. Combining Lactic Acid with other actives can help slow down the combined acid effect, allowing for better wound-control and more precise application. Remember that combining does not change the properties of how an acid originally behaves, and as always, skin therapists should use the acids with great care and work within their scope of practice. Combining in the hands of a skilled practitioner, however, offers the professional a way to "step up" the use of acids and move toward other advanced formulations.

In The Treatment Room - Power Couples

Safety first—we play by the rules to protect our client's skin along with our reputation. However, with professional skill and expertise, some ingredients may be combined for superior results in ways which are not by-the-book. Of course, proceed with caution and always check with the manufacturer before doing so to prevent adverse effects. Some combinations to test and explore are:

  • Combine a hydroxy masque with a boost of Lactic Acid to create an intense, effective but safe treatment to smooth rough texture before dermaplaning or after microdermabrasion for a splash of regeneration.
  • Layer enzymes with acids for a gentle yet powerful peel. Enzymes can target the bonds of skin cells to change the process of shedding and downtime associated with earlier-generation peels. Ideal for the "overscheduled" client who cannot afford to take several days off around a procedure.

Power On - Electrical Tools to Accelerate Results

Skin health doesn't just stop with exfoliation. Look to incorporate electrical modalities with your exfoliation for greater effectiveness.

  • After exfoliation, follow with a Blue LED (Light Emitting Diode) to assist in targeting bacteria, and to reduce the rate of oil production.
  • Pair your Lactic Acid with Galvanic Iontophoresis to further drive hydrating benefits into skin.
  • Using an oil-based exfoliant? Massage the exfoliant into the skin using Indirect High Frequency to further stimulate circulation—excellent for dry, dull, tired skin

Product Fusions - Empower Client Home Care

Of course, always check with the manufacturer before recommending new ways to mix products for clients at home. Some combinations to test first, then recommend:

  • Power-cleanse the skin with a gentle physical scrub like naturally rounded corn cob particles and the client's usual daily cleanser.
  • Use a clay-based cleanser with a Salicylic Acid serum to boost clearing of breakouts. Could also work as a mini-masque treatment.
  • Use Vitamin C with the usual acne spot-product to dry breakouts and minimize pigmentation that can linger.
  • Have clients combine a Salicylic Acid-based serum with their moisturizer to target hyperpigmentation and congestion without over-drying or irritating the skin. Eventually graduate up to using the serum by itself.

Always keep in mind that the client's skin accompanies her on every adventure, far from the controlled environment of the treatment room. Take special care to evaluate not only the client's current skin condition, but her vacation plans as well! Exfoliation may increase skin sensitivity to the sun and particularly the possibility of sunburn, for example—so advise the client to pre-plan her treatments well before that Caribbean honeymoon or ski getaway. While today's client demands extreme results, our priority as professionals must always be safety first. With the sophisticated array of current products and techniques now available, dazzling camera-ready results are now possible while still maintaining the best practices standards of our industry.

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Exfoliants Get Down To Business