It’s no secret that when people look good, they feel good; however, the reverse is often true. By combining lifestyle changes, dietary counseling, proper supplementation, and modern services and technologies, patients are experiencing dramatic results. This is especially the case with those seeking help for acne and rosacea. By treating the whole body with a combination of clinically advanced skin care treatments, Eastern-inspired practices and holistic healing, patients feel and look better, and live healthier lives.
The whole picture
Before any treatment begins, it’s important for patients to sit down with a skin care professional for a one-on-one consultation to determine goals and discuss the changes they would like to see in their skin. During this personalized skin analysis, the esthetician should collect a detailed client history to pinpoint the most effective treatment plan.
Questions to ask include:
* How long has the patient been suffering from this condition?
* What kind of breakouts do they experience: papule, pustule, comedone or cyst?
* What kind of prescription medication do they take, including birth control pills?
* Do they wash their face in the morning and/or in the evening?
* What types of cleansing and moisturizing products do they use?
* Do they use a washcloth?
* What types of prescribed topical products have they used in the past?
* How often do they change their pillowcase?
* Do they pick at their pimples?
* Do they use sunscreen?
* Do they have any product sensitivities?
Precise as they are, these questions only cover part of the treatment. In addition, the patient’s eating habits, stress levels and exercise regimen should also be discussed to help determine what is going on inside the body.
From the inside out
After the initial consultation, patients should be offered the option of seeing a practitioner who specializes in health and lifestyle counseling, and who ideally is housed in your office. If you don’t have a nutritionist on staff, then find one you feel comfortable recommending, preferably in a nearby location. After meeting with several nutritionists, choose one or two you trust to provide internal support for your clients, and make sure they have a thorough understanding of what you are doing for the skin. The practitioner you work with needs to also take a holistic approach to nutrition and have a history of treating patients with acne or rosacea through diet and pharmaceutical-grade supplements. Also, find out their rates, whether they take insurance and what hours they are available to see clients. Some nutritionists are willing to offer 15-minute complimentary consultations if you are able to send them multiple referrals.
A pharmaceutical-grade supplement program is one of the first recommended additions or changes clients should incorporate in order to see improvements with their skin. Patients with digestive problems—often an issue for those with acne and rosacea—experience changes in their skin by taking probiotics and digestive enzymes. These help to maintain a healthy balance of intestinal, digestive and immune support. Probiotics are especially important if your client is or has been taking antibiotics. The fatty acids in evening primrose oil and fish oil have been found to reduce inflammation when taken internally. Be sure your clients are aware that, in order to achieve continuous results, the supplements should become part of their daily routine, making them healthier from the inside out. In addition, some clients opt for a more detailed evaluation that can include testing for food sensitivities or imbalanced hormone levels. However, it is important not to overwhelm your clients with too much information at once. Part of the education process is to engage the client and work with them to be successful.
Pharmaceutical-grade skin care products—including glycolic cleansers and moisturizers recommended for skin cell turnover, and benzoyl peroxide to reduce inflammation—should also be offered. From a business perspective, home care products are great for increasing the bottom line, while at the same time providing clients with what they want.
On the surface
When it comes to healing the skin from the outside, an important component of acne and rosacea treatment is photopneumatic therapy, which utilizes a vacuum that gently loosens dirt and oil from pores in conjunction with a broadband IPL light that kills bacteria. Unlike other light therapies for acne, this treatment, which can be performed by an esthetician, registered nurse or physician, is very comfortable for patients. (Editor’s note: It is always wise to check with your state board to make sure you are operating within your state guidelines. Contact information for every state’s cosmetology board.
To prepare skin for photoneumatic therapy, glycolic acid should be used at home by the client for 7–14 days before the treatment to begin the exfoliation of dead cells from the surface of the skin. During the first appointment, the skin is prepped with a 30% nonbuffered glycolic acid, which yields the best results with the light therapy since the pores are open and the dirt and oil are more easily vacuumed. Photopneumatic therapy is acceptable to continue while on antibiotics, although not encouraged. This is not the case with all IPL systems, so be sure to check with the manufacturer before performing any IPL treatment on individuals taking antibiotics. Isotretinoin use should be stopped three months before the service.
Severe acne vulgaris. Severe acne vulgaris, which consists of nodules and cysts, is deeply rooted in the skin and does not respond well to the vacuum on this IPL. If the inflamed lesion is deep and severe, it will, when squeezed or vacuumed, burst inside the skin tissue instead of at the surface. This will actually create scarring instead of making the acne better. These clients should avoid the photoneumatic therapy; they will experience the most benefits from food changes, taking supplements and using the proper home care products.
Pustular and comedonal acne. The protocols for pustular and comedonal acne are exactly the same. First, the face is cleansed with a mild glycolic cream cleanser, then hot towels are applied for one to two minutes in order to open the pores. The client’s eyes are protected with ocular shields and the light therapy begins. Two passes are performed over the infected areas, and then one to two spot treatments are performed. If there is inflammation, the client will feel some discomfort in those areas. Typically, there is minimal pain; it is very comfortable and all that is felt is a pinch and heat.
After the light therapy is completed, the skin is cleansed again with a gentle cleanser. Finally, hydrating and SPF lotions are applied, and the treatment is complete. The skin will be red and feel similar to a mild sunburn, but within 30 minutes to two hours, the skin looks and feels normal. Twenty-four hours after treatment, there will be noticeable improvement in the skin tone and levels of inflammation. Clients need to be advised against any extended sun exposure. For normal activities outside, the client needs a zinc oxide- or titanium dioxide-based sunscreen. A gentle cleanser and hydrating moisturizer should be used the night after the treatment. Glycolic products can be continued 24 hours after treatment.
Rosacea. This treatment works slightly differently for rosacea. It still utilizes the vacuum and IPL, however the heat from the light pulse reduces redness by using thermal energy to heat the skin’s surface to encourage blood flow. This strengthens the capillary wall and pushes the hemoglobin in the enlarged capillaries down to lower vascular structures where they cannot be seen. Extreme diffuse redness requires IPL therapy, whereas specific areas of bolder redness with defined borders may be treated with a long-pulsed laser. After several treatments, the client will have reduced redness and inflammation. The protocol for rosacea is the same, except a gentle cleanser is used during the first cleansing and no hot towels are applied to the face.
A noticeable improvement
The number of recommended treatments varies from 6–12 sessions, one every week. Because every client responds differently, there is no way to predict exactly how many will be needed. A general guideline to follow would be the worse the acne, the closer to the 12 treatments a client will need. After the appropriate amount of skin treatments has been completed, the client should return one month later for a followup visit, followed by another visit two months after that. At that point, instruct them to return as soon as they start to get a breakout in order to keep the acne under control. Some people need to come in once a month and others only twice per year to maintain the results.
Regardless of how many treatments the client ends up requiring, by combining holistic nutrition and photopneumatic therapy, most see noticeable improvement in post-inflammatory hyperpigmentation, less oily skin and a decrease in redness and the number of breakouts within 48 hours.
Wednesday, April 29, 2009
Monday, April 20, 2009
Improper Use of Sunscreens Can Harm Skin
Unless it's continuously reapplied, sunscreen can actually attack the skin and leave it vulnerable to ultraviolet (UV) radiation, concludes a University of California, Riverside study.
The researchers found that, over time, molecules in sunscreen that block UV radiation can penetrate into the skin and leave the outer layer susceptible to UV, CBC News reported.
The study appears in an upcoming issue of the journal Free Radical Biology & Medicine.
"Sunscreens do an excellent job protecting against sunburn when used correctly," Kerry Hanson, a research scientist in the university's department of chemistry, said in a prepared statement.
"This means using a sunscreen with a high sun protection factor and applying it uniformly on the skin. Our data show, however, that if coverage at the skin surface is low, the UV filters in sunscreens that have penetrated into the epidermis can potentially do more harm than good," he said.
The researchers found that, over time, molecules in sunscreen that block UV radiation can penetrate into the skin and leave the outer layer susceptible to UV, CBC News reported.
The study appears in an upcoming issue of the journal Free Radical Biology & Medicine.
"Sunscreens do an excellent job protecting against sunburn when used correctly," Kerry Hanson, a research scientist in the university's department of chemistry, said in a prepared statement.
"This means using a sunscreen with a high sun protection factor and applying it uniformly on the skin. Our data show, however, that if coverage at the skin surface is low, the UV filters in sunscreens that have penetrated into the epidermis can potentially do more harm than good," he said.
Botox Alternative Found to Be Safe, Effective
Botox Alternative Found to Be Safe, Effective
A new type of drug called Reloxin appears safe and effective in reducing forehead wrinkles, a new study finds.
The use of Botox to reduce forehead wrinkles and frown lines has long been a mainstay of cosmetic medicine. The medication works by preventing face muscles from contracting, an effect that lasts for several months.
As an alternative to Botox, Reloxin is now approved in 23 countries outside the United States to smooth wrinkles, the researchers noted. The drug has also been used outside the United States for more than 15 years to treat neurological disorders.
One of the differences between Botox and Reloxin is that Reloxin has less protein in its formula, noted Kamran Jafri, MD, from Jafri Craniofacial Plastic Surgery, New York City. Reloxin also contains fewer antigens, which cause the drug to break down more quickly, said Jafri, who was not involved in the new study. "Theoretically, because Reloxin has less of a protein load, the body will break it down at a slower rate. That means from a clinical perspective that it should last longer than Botox," he said. "However, some of the early trials are showing that Botox actually lasts longer than Reloxin."
Another difference between the drugs is that Reloxin defuses more in the tissue than Botox, Jafri said. "Botox typically defuses in about a one centimeter radius. Reloxin can go anywhere from one to three centimeters," he said. "That's a good thing for the forehead, where you can give fewer injections, but it's a bad thing for, say, crow's-feet, where unless you are an experienced injector and you know the muscles very well, it could spread to other muscles and cause a droopy eyebrow or droopy eyelid," he explained.
In this phase III trial, Reloxin's wrinkle-smoothing effects lasted more than 13 months. And although the drug is still awaiting approval from the U.S. Food and Drug Administration, it could someday become a serious competitor to Botox, the researchers said.
"Reloxin is as safe and it works as well as Botox," said lead researcher Ronald Moy, MD, from the Moy-Fincher Medical Group in Los Angeles. "Many of our patients are happier and got a more natural look with the use of Reloxin. I think this will be as popular as Botox, which is the most common cosmetic procedure in the United States."
But not all plastic surgeons are as enthusiastic, with some citing a heightened incidence of drooping of the eyelid and/or brow with Reloxin vs. Botox. "With this study, I don't see a clear advantage over Botox," said Jeffrey C. Salomon, MD, an assistant clinical professor of plastic surgery at Yale University School of Medicine.
The report, which was funded by the drug's maker, Medicis Pharmaceutical Corp., is published in the March/April issue of the Archives of Facial Plastic Surgery. For the study, Moy's team treated 1,200 patients with injections of Reloxin (Clostridium botulinum toxin type A-hemagglutinin complex) in five sites in the forehead. Patients kept diaries of the effects of the treatment and were surveyed a week to 10 days after treatment. In addition, patients were reexamined two weeks and 30 days later, and then each month after treatment.
Among the 1,052 patients who completed the 13-month study, there were 2,838 adverse events among 880 patients. Of these, 28% were probably related to the treatment. These included problems at the injection site, nervous system disorders such as headache and eye problems including ptosis, a drooping of the eyelid or brow. Only one patient withdrew from study due to the side effects of the drug, the researchers say.
Patients reported the drug started working within a day after treatment. After a week, as many as 95% of the patients reported showing a response to the medication. At 30 days after treatment, as many as 91% of the patients had a response, according to the researcher's assessment.
Brent Moelleken, MD, a plastic and reconstructive surgeon in Beverly Hills and Santa Barbara, California, noted that Reloxin has not yet been compared head-to-head with Botox. "The safety profile appears similar to Botox, but perhaps more drooping than is usual with Botox," Moelleken said. "The big question about how Reloxin works, the volume of distribution, was not addressed, or technical differences, which may account for the greater drooping than most injectors see with Botox."
For his part, Salomon said he is concerned with the increased incidence of ptosis [with Reloxin] and the lack of specificity of that ptosis—brow versus lids. "If it is all lid ptosis, then I would consider it as an unintended spread of the material beyond the desired treatment area. That would not be a helpful or predictable component in the product's use," he said.
A new type of drug called Reloxin appears safe and effective in reducing forehead wrinkles, a new study finds.
The use of Botox to reduce forehead wrinkles and frown lines has long been a mainstay of cosmetic medicine. The medication works by preventing face muscles from contracting, an effect that lasts for several months.
As an alternative to Botox, Reloxin is now approved in 23 countries outside the United States to smooth wrinkles, the researchers noted. The drug has also been used outside the United States for more than 15 years to treat neurological disorders.
One of the differences between Botox and Reloxin is that Reloxin has less protein in its formula, noted Kamran Jafri, MD, from Jafri Craniofacial Plastic Surgery, New York City. Reloxin also contains fewer antigens, which cause the drug to break down more quickly, said Jafri, who was not involved in the new study. "Theoretically, because Reloxin has less of a protein load, the body will break it down at a slower rate. That means from a clinical perspective that it should last longer than Botox," he said. "However, some of the early trials are showing that Botox actually lasts longer than Reloxin."
Another difference between the drugs is that Reloxin defuses more in the tissue than Botox, Jafri said. "Botox typically defuses in about a one centimeter radius. Reloxin can go anywhere from one to three centimeters," he said. "That's a good thing for the forehead, where you can give fewer injections, but it's a bad thing for, say, crow's-feet, where unless you are an experienced injector and you know the muscles very well, it could spread to other muscles and cause a droopy eyebrow or droopy eyelid," he explained.
In this phase III trial, Reloxin's wrinkle-smoothing effects lasted more than 13 months. And although the drug is still awaiting approval from the U.S. Food and Drug Administration, it could someday become a serious competitor to Botox, the researchers said.
"Reloxin is as safe and it works as well as Botox," said lead researcher Ronald Moy, MD, from the Moy-Fincher Medical Group in Los Angeles. "Many of our patients are happier and got a more natural look with the use of Reloxin. I think this will be as popular as Botox, which is the most common cosmetic procedure in the United States."
But not all plastic surgeons are as enthusiastic, with some citing a heightened incidence of drooping of the eyelid and/or brow with Reloxin vs. Botox. "With this study, I don't see a clear advantage over Botox," said Jeffrey C. Salomon, MD, an assistant clinical professor of plastic surgery at Yale University School of Medicine.
The report, which was funded by the drug's maker, Medicis Pharmaceutical Corp., is published in the March/April issue of the Archives of Facial Plastic Surgery. For the study, Moy's team treated 1,200 patients with injections of Reloxin (Clostridium botulinum toxin type A-hemagglutinin complex) in five sites in the forehead. Patients kept diaries of the effects of the treatment and were surveyed a week to 10 days after treatment. In addition, patients were reexamined two weeks and 30 days later, and then each month after treatment.
Among the 1,052 patients who completed the 13-month study, there were 2,838 adverse events among 880 patients. Of these, 28% were probably related to the treatment. These included problems at the injection site, nervous system disorders such as headache and eye problems including ptosis, a drooping of the eyelid or brow. Only one patient withdrew from study due to the side effects of the drug, the researchers say.
Patients reported the drug started working within a day after treatment. After a week, as many as 95% of the patients reported showing a response to the medication. At 30 days after treatment, as many as 91% of the patients had a response, according to the researcher's assessment.
Brent Moelleken, MD, a plastic and reconstructive surgeon in Beverly Hills and Santa Barbara, California, noted that Reloxin has not yet been compared head-to-head with Botox. "The safety profile appears similar to Botox, but perhaps more drooping than is usual with Botox," Moelleken said. "The big question about how Reloxin works, the volume of distribution, was not addressed, or technical differences, which may account for the greater drooping than most injectors see with Botox."
For his part, Salomon said he is concerned with the increased incidence of ptosis [with Reloxin] and the lack of specificity of that ptosis—brow versus lids. "If it is all lid ptosis, then I would consider it as an unintended spread of the material beyond the desired treatment area. That would not be a helpful or predictable component in the product's use," he said.
Spring Cleaning for the Body
“Many people ask why it is important to cleanse your body, and I tell them it’s like asking why it is important to clean your house? When you see a dirty home, it’s irritating and most people feel more calm and at peace when it is clean,” says David from http://OrganicSkinCare.com. By doing a body cleanse, all nervous system irritants are flushed away, allowing for less symptoms to express themselves. Cleansing opens you up to more creativity and spontaneity, as well as eases emotions and mood. Cleansing creates more space for healing, regeneration and self regulation to occur.”
* Hydrate. Most people drink less water during the cold season and forget that there is less moisture in the air during winter, which can cause dehydration. The mind and body relies on water for its survival. Rule of thumb: You must drink at least half your weight in ounces. For example, if you way 180 pounds, your water consumption should be at least 90 oz. It is best to drink most of your water by 4 p.m. to prevent evening trips to the bathroom.
* Alkalize. The mind and body are most healthy and at optimal performance in an alkaline environment. Alkalinity means that you have enough mineral reserve to create a solution in your body that is not acidic. An acidic body is corrosion, degeneration and oxidation from the inside out. Great sources for this include consuming organic or farm-grown fruits and vegetables. It is suggested that people eat more from the vegetable side, especially the green, leafy vegetables, such as kale, swiss chard, spinach and arugula.
* Vitalize. Many people overcook their foods. Eating more raw foods that are properly prepared and seasoned with herbs and spices, such as parsley, tumeric, cayenne pepper, curry powder and Himalayan salt, revitalizes and nourishes the mind and body. There is a liveliness and energetic aspect of raw foods. The body naturally registers whole, fresh food and utilizes them more efficiently.
* Nutritional support. You can help your body out with additional nutritional support. Probiotics help rebalance the good flora in your gut; digestive enzymes help give more attention in breaking down food for greater assimilation (this will also put less stress on the digestive system); chlorophyll helps remove toxins, alkalizes the body and heal the colon; and plant-based trace minerals help create a more alkaline environment and provide the trace minerals for cells to go about their metabolic processes.
* Don't overstimulate. Nicotine, caffeine, simple carbohydrates, processed sugar and animal protein are foods and substances that are stimulants to your body and should be cut down or eliminated completely to enhance the effects of cleansing.
* Hydrate. Most people drink less water during the cold season and forget that there is less moisture in the air during winter, which can cause dehydration. The mind and body relies on water for its survival. Rule of thumb: You must drink at least half your weight in ounces. For example, if you way 180 pounds, your water consumption should be at least 90 oz. It is best to drink most of your water by 4 p.m. to prevent evening trips to the bathroom.
* Alkalize. The mind and body are most healthy and at optimal performance in an alkaline environment. Alkalinity means that you have enough mineral reserve to create a solution in your body that is not acidic. An acidic body is corrosion, degeneration and oxidation from the inside out. Great sources for this include consuming organic or farm-grown fruits and vegetables. It is suggested that people eat more from the vegetable side, especially the green, leafy vegetables, such as kale, swiss chard, spinach and arugula.
* Vitalize. Many people overcook their foods. Eating more raw foods that are properly prepared and seasoned with herbs and spices, such as parsley, tumeric, cayenne pepper, curry powder and Himalayan salt, revitalizes and nourishes the mind and body. There is a liveliness and energetic aspect of raw foods. The body naturally registers whole, fresh food and utilizes them more efficiently.
* Nutritional support. You can help your body out with additional nutritional support. Probiotics help rebalance the good flora in your gut; digestive enzymes help give more attention in breaking down food for greater assimilation (this will also put less stress on the digestive system); chlorophyll helps remove toxins, alkalizes the body and heal the colon; and plant-based trace minerals help create a more alkaline environment and provide the trace minerals for cells to go about their metabolic processes.
* Don't overstimulate. Nicotine, caffeine, simple carbohydrates, processed sugar and animal protein are foods and substances that are stimulants to your body and should be cut down or eliminated completely to enhance the effects of cleansing.
Spring Cleaning for the Body “Many people ask why it is important to cleanse your body, and I tell them it’s like asking why it is important to clean your house? When you see a dirty home, it’s irritating and most people feel more calm and at peace when it is clean,” says David From http://ping.fm/kvJUa By doing a body cleanse, all nervous system irritants are flushed away, allowing for less symptoms to express themselves. Cleansing opens you up to more creativity and spontaneity, as well as eases emotions and mood. Cleansing creates more space for healing, regeneration and self regulation to occur.”
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