Kids Protect Skin Better After Being Shown Sun Damage Results

Showing middle-school students ultraviolet photographs that reveal the sun damage to their faces makes them less likely to get sunburns in the months following, new research says, encouraging skin care professionals to speak to kids about good sun care.

Researchers recruited 111 students aged 11 to 13 from Quincy, Massachusetts, which had a melanoma rate higher than expected from 1999 to 2003. After receiving a sun protection lecture, 83 students also received a UV photograph of their face that shows pigment changes from chronic sun exposure and an explanation of the damage. Twenty-eight students in the control group heard the lecture but did not have a photo taken.

After two months, 36% of the group shown the photos reported getting a sunburn, compared to 57% of those who didn't have a UV photo taken. After six months, 51% of intervention group reported a sunburn, compared to 64% of the control group.

Students said that the UV photo was a helpful tool in teaching risk factors for skin cancer, and the majority had kept them. The preteens with the highest risk factors for melanoma, such as facial freckles, were more greatly impacted and were significantly less likely to report sunburn at two months and again in six months.

Despite public health recommendations to protect children and preteens from sun damage, studies indicate that most children get at least one sunburn each year and that more than a third have three or more per year, said study author Marie-France Demierre, a professor of dermatology and medicine at Boston University School of Medicine. "The potential of UV photographs in improving sun protection behavior among children and preteens, especially those most at risk for melanoma, is enormous," Demierre said. "Every teen should get an ultraviolet photograph of his/her face in school along with routine vaccinations."

Skin cancer is the most common of all cancers, according to the American Cancer Society. Melanoma, the most serious type, accounts for about 5% of cases. There will be about 47,700 new cases of melanoma in this country this year, according to the cancer society, and 7,700 people are expected to die of the disease.

Skin's "Tipping Point" Identified by P&G Researchers

P&G Beauty & Grooming scientists have identified the "skin tipping point" of skin aging and suggested topical ingredients that may slow this tipping point down.

P&G Beauty & Grooming scientists have identified the "skin tipping point" of skin aging and suggested topical ingredients that may slow this tipping point down. At the 69th Annual Meeting of the Society for Investigative Dermatology in Montreal on May 6-9, 2009, scientists from the company presented research that offers important insight on the skin aging process.

Findings from a recent clinical trial indicate a relatively sudden change in the appearance of skin as it ages, identified as the skin tipping point. A follow-up study conducted to evaluate the efficacy of topical ingredients in delaying the skin tipping point demonstrated significant improvement in skin’s elasticity.

To investigate the skin aging process, the scientists used a multi-layered skin elasticity model to evaluate sudden change in skin appearance. Findings suggested that loss of elasticity causes the skin tipping point, resulting in a sudden visible increase in noticeability of fine lines, wrinkles and sagging.

In the study presented, researchers assessed the validity of the skin tipping point by conducting a clinical trial of 102 healthy, Asian females aged 25 to 55. The scientists compressed the subjects’ skin to varying degrees with a newly developed skin compression imaging system in order to analyze the subsequent skin deformation, or wrinkling. The study found an abrupt change in noticeability of skin wrinkling among subjects in their 30s, with significant differences in wrinkling observed between ages 20 and 30, and 30 and 40.

Researchers then conducted a second clinical trial to evaluate the efficacy of hydrating topical antiaging ingredients in improving skin elasticity. The trial, conducted over an eight-week period in 72 healthy, Japanese females age 35 to 55, showed significant improvement in skin elasticity with the topical application of 0.1% olive oil-derived fatty acids modified with PEG-7, 5% niacinamide and yeast ferment filtrate.

Analyses of the data indicate application of these ingredients delays the skin tipping point between three to four years. “While it is often assumed that skin ages gradually, our research explored this new skin elastic tipping point model, which prior to this time has not been examined in clinical studies,” said lead study author Kukizo Miyamoto, PhD, R&D for beauty and grooming at Procter & Gamble Japan in a company press release. “These clinical study findings confirm sudden changes in skin appearance demonstrated by simulation with the multi-layered skin elasticity model. Furthermore, our research provides critical insight into topical ingredients that are driving new research directions and that will impact future product formulations.”

Sun Care: Man's Best Friend

Men today, particularly older men, are developing and even dying from melanoma at increasingly alarming rates. Some contributing factors are cultural, while others are physiological. Caring for skin, hair and nails with specialty products has traditionally been viewed as a female endeavor and therefore not appealing to men. Unfortunately, this means men traditionally have not used sunscreen, let alone other advantageous skin care products.

The lines between what practices are stereotypically considered male and female are beginning to blur as people live longer and men feel the need to preserve their youthful appearance to survive in an increasingly competitive career landscape. Overcoming these stereotypes is more pertinent than ever, not only to keep skin healthy and looking good, but more importantly to keep male clients from suffering and often dying from this preventable form of cancer.

Skin care professionals need to work toward making the idea of men caring for their skin more common and acceptable. Truly understanding the important differences in the physiology of men’s skin, men’s typical purchasing psychology and the significant statistics on the increasing numbers of melanoma cases in men can help make this paradigm shift a reality.

Physiological differences

To help male clients, it is important to understand the differences in the skin between men and women. Hormones play a significant role. In males, androgens are the dominant hormones and continually increase throughout puberty before leveling off in the early 20s. Higher levels of the androgen testosterone are responsible for increased hair growth and sebum production, and androgen hormones also drive acne, as they increase the size of sebaceous glands and the amount of oil secreted. The enzyme 5 alpha-reductase works within the follicles to convert testosterone to 5-dehydrotestosterone (DHT). Androgen receptors at the base of hair follicles are highly susceptible to DHT, and with increased DHT come higher rates of acne.

In addition to more oil production and the growth of facial hair, men have thicker skin than women. These characteristics serve men well as they work to mask the visible signs of aging. In 2007, the Canadian Academy of Pathology published findings in the journal Laboratory Investigation demonstrating that androgens play an important role in the production of collagen and other matrix proteins. This fact helps to explain the much slower rates of wound-healing in elderly men who have far lower testosterone levels than their younger counterparts.

A healthy and strong matrix gives the skin its shape, resiliency and resistance to wrinkling. Men do not begin to show their age as early as women, making aging easier for them to ignore. This partially explains why men do not seek out skin care products and treatments as early in life as women.

Lifestyle considerations

Daily shaving helps men’s skin retain its youthful appearance as well, as it provides daily exfoliation of excess stratum corneum. This regular removal of build-up keeps the surface smooth and skin cells turning over at a healthy rate.

However, poor shaving habits can lead to dryness and other negative side effects, such as pseudofolliculitis barbae. This condition occurs when coarse hairs are cut off and then lie below the surface of the follicle. As the hair grows, the sharp end of the hair will often grow into the side of the follicle rather than out the opening, causing inflammation, irritation and even infection. This is most common in men with curly and coarse hair. The use of topical anti-inflammatory, antibacterial and hydrating ingredients such as salicylic acid, azelaic acid, bisabolol and squalane are typically effective in alleviating these conditions.

The combination of regular exfoliation, thicker skin and increased collagen, with androgens behind the scenes driving oil production, simply helps men stay looking younger longer. Because of this, the typical anti-aging educational and marketing approaches do not have the impact on men that they do on women. It is necessary to change the dialogue to one of protection from the dangers of UV exposure to capture the attention of male clients and start a conversation about skin health.

The psychology

Women have long dealt with imagery in advertising, fashion and movies that depicts the archetypal “perfect” woman as young, thin and beautiful. As a country, the nation’s population has worked to help young girls overcome these notions of female perfection in favor of a healthy body and facial image.

In the past 20 years, however, these same types of images have begun to reappear, only they are now focused on the ‘perfect’ male image. Younger men now paying more attention to their hair, skin and appearance in general, and although comparing oneself to any manufactured vision of perfection is fruitless and counterproductive, this cultural shift has at least helped to increase the use of moisturizer with sunscreen and antioxidants. It has also opened the door to the possibility of sparing this younger generation from the increasing instances of basal cell, squamous cell and melanoma skin cancers in the future.

American men live an average of 73 years and are now, thanks to a slumping economy, working longer than ever. In this increasingly competitive employment environment, men have begun to seek out cosmetic services more frequently. According to the American Society of Aesthetic Plastic Surgery, there has been a 17% increase in cosmetic procedures for American men. That is more than one million procedures in 2007. And according to another beauty trend report from Information Resources Inc., the men’s facial skin care market hit $76.5 million in 2005. This revenue will undoubtedly increase as the desire for healthy, younger-looking skin grows in importance for men.

As skin care professionals, this knowlegde should be used to your advantage to educate your open-minded male clients on the real dangers of skin cancer and the simple preventive measures they can take to guard against it.

Paradigm shift

According to the National Cancer Institute’s Surveillance and Epidemiology and End Results (SEER) Program, an estimated 34,950 men died of melanoma in 2008. The men at the highest risk of developing melanoma are those aged 55–64, followed closely by those 65–74. This group is made up of the men who grew up with macho cultural stereotypes and are typically less open to the discussions of skin care and sunscreen.

You would then expect men aged 75–84 to be even more deeply entrenched in representations of what is considered masculine, and they are, unfortunately, the demographic with the highest melanoma mortality rates in the United States. These statistics make it clear that the use of daily sun protection should be differentiated from the use of typical age-control products focused on women and younger men.

Recently, men’s hesitancy to visit physicians has been slightly improved due to highly publicized pharmaceuticals for common male diseases. This is an opportunity for physicians, clinicians and skin care professionals to initiate discussions about skin cancer risk factors and encourage clients to take precautionary measures, such as regular broad spectrum sunscreen use, limited midday exposure and routine full-body skin examinations by a dermatologist.

Sun protection products must contain avobenzone, titanium oxide, zinc oxide or encamsule to ensure UVA coverage, as the SPF number on a sun protection product refers only to the amount of protection offered against UVB rays. Many medically focused skin care products available today combine lightweight moisturizers and sunscreens, resulting in products that are not thick and fragranced, as some drugstore sunscreens tend to be. Recommend light sunscreen moisturizers with a matte finish that do not leave behind any residue on the skin. This is a good choice for men and will increase their compliance with daily use.

In order to make using products for skin health an easier leap for men, educational efforts and collateral materials should be designed to speak in the male communication style. Men typically respond positively to messages that are clear, straightforward, and driven by facts and results. Make your discussions short and to the point. Offer products that are designed and packaged specifically for men to make the purchase and use of protective skin care products an easy shift. Using tools in your business to make men’s purchases effortless will increase the likelihood of them becoming comfortable as long-term skin protection purchasers.

Guidelines for better skin

Sunscreen acceptance is one of the most important first steps in getting male clients to integrate skin care into their daily routines. Once this hurdle has been overcome, a good second step is a gentle cleanser to help keep the skin clear of bacteria, excess oil and debris. Men want ease of use, so a product that can be kept in the shower and also used for body cleansing will make this addition to their regimen easier.

As men become comfortable with these categories of skin health products, it is more likely they will believe and accept the benefits of other anti-aging and antioxidant-based products. Adopting a simple yet complete daily regimen will not only strengthen men’s skin and provide increased environmental protection, but will also help them stay looking younger longer.

The health of all of clients’ skin is always the prime objective. Working to convert male clients into believers of products that protect and promote skin health is becoming ever more important, and achieving this change in male perspective toward sun protection products will hopefully help to reduce the staggering numbers of melanoma and other skin cancers in American men.

How to Manage a Spa in Recession Time

The saying, “May you live in interesting times,” has been interpreted as both a curse and a blessing, but no matter how it is intended, it has never been more applicable. These are indeed interesting, turbulent and economically challenging times. During the past months, the nation has been tried and tested, the economy is suffering, consumers aren’t spending and corporations are cutting costs. In such times, you may wonder how can a spa survive, let alone grow and thrive?

Hope for the beauty industry

Among the dismal news, however, there is a ray of hope for the personal care industry. Recently, research firm Mintel reiterated its belief that the personal care industry—in particular, anti-aging skin care sales—will continue to grow, even in the current economic climate. Anti-aging skin care sales in the United States rose 13% to $1.6 billion between 2006 and 2008, outpacing general facial skin care, which was up 11% during the same period. This trend is expected to remain on track even as the economy struggles.

“Anti-aging won’t fall to the recession,” says Kat Fay, senior beauty and personal care product analyst at Mintel. “Looking young is extremely important to many women, especially baby boomers, and it’s not an issue they’re willing to compromise on because of tightened budgets. Many women see anti-aging skin care as a reasonably priced investment in their appearance and well-being.” So even as income levels recede, Mintel expects the anti-aging skin care market to grow approximately 20% at inflation-adjusted prices during the next five years.

Not all good news

Despite the potential resilience of the beauty industry as a whole to a recession, the day-to-day reality in spas is challenging. During the keynote panel at SPATEC in February 2009, it was stated that there is an overall 20–30% decrease in all comparables across spas, and January 2009 looked worse than many expected. Spas are servicing fewer clients and experiencing longer appointment cycles. The West Coast seems to be hit harder than the East Coast and no region of the country has been spared. Most spa experts expect this to continue throughout 2009, with stabilization—not growth—in 2010. Taking this into consideration, how can spas ensure readiness when consumers decide to spend again?

Strategies to succeed

No graduate degree in business is necessary to know that in order to be profitable, only two strategies are possible: increase revenues and decrease costs.

Increasing revenues. In a spa, this means enticing more people through the door and maximizing their average ticket. To make this happen, despite the current trends, try the following.

• Allow your clients to spend more time with you for the same dollar amount.
• If you can’t fill your massage therapists’ schedule, send them to a local high-end department store to do $1-per-minute chair massages.
• Make sure every team member at your spa is selling. Incentivize all to refer friends and family to the spa, and reward them accordingly. Make sure to convert all calls received into sales and to sell to every single client who walks through the door.
• Do not discount; instead, offer extra value, such as a free eyebrow wax with any facial.
• Offer mini treatments, such as a 30-minute facial at a lower price point or a 20-minute chair massage at an impossible-to-resist price.
• Leverage the power of walk-ins and last-minute appointments. E-mail your clients in the morning to let them know about last-minute openings and add “walk-ins welcome” to your signage.
• Offer upgrades when clients check in. Consider following the airline model: You may not purchase a business class ticket, but would you refuse a $50 upgrade at check-in?
• Leverage the fact that appointment cycles are longer by encouraging your clients to use at-home care, resulting in higher retail sales.
• Offer more value. As clients increasingly watch their spending, enable them to trade down, if they so desire—at your spa, not at the drug store. Provide products that cater to a variety of budgets.

Decreasing costs. This starts by making sure you take a close look at your budget every week.

• Review your team’s compensation packages, and freeze any wage increases, stop bonuses and reduce commissions.
• Engage your entire team in the expense-reduction process. Ask them for suggestions about how to minimize expenses, and reward those whose suggestions are implemented.
• Adjust your operating hours. Stay open long enough to match your clients’ schedules, of course, but perhaps opening up at 10 am—even 10:30 am—instead of 9 am may not impact your revenues.
• Focus on inventory. Watch your inventory, reduce your spa’s open-to-buy, and refocus the lines you offer, ending up with a maximum of two or three.
• Work with your vendors to extend your payment terms, and to provide you with free marketing materials.
• Use any non-selling retail products for new reduced-price treatments. No need to purchase additional back-bar for these.

Remember, these changes need to be made within the next 30–60 days. Do not wait to begin making them. It is very important that the process of implementing some of these changes not compromise the atmosphere of pampering and stress relief that defines a spa. After all, that is at the core of what a spa offers.

A good learner

Finally, as American writer Ralph Waldo Emerson said, “Bad times have scientific value. These are occasions a good learner would not miss.” Current economic times offer an unprecedented opportunity to look at your businesses critically, think outside the box, and implement changes that will make you stronger, smarter and better.

Checkout Emerge Labs Inc. For Great Skin Care

Led Light For Anti-Aging And Wrinkles

It seems as if every day new, exciting technologies are created to help slow down the aging process. Traditionally, medical anti-aging and wrinkle treatments have been fairly aggressive. There is now a demand for nonsurgical procedures to treat different skin types and conditions. One of the most exciting fields today is light therapy. To be a little more precise, light-emitting diodes (LED).

Until several years ago, people still thought that LED or light therapy was only good for holistic purposes or household electronic appliances. Everywhere you turn, you can see LED busy at work: clock radios, Christmas lights, cell phones, traffic lights and more. It seems pretty doubtful to most that they can actually affect the skin in any way. Advances in LED and light therapy are moving at light-speed, and people are changing their minds rapidly.

LED is a noninvasive approach to working with light, and during the past 10 years, independent worldwide research from organizations such as NASA has shown that light applied in the correct wavelength stimulates intercellular communication, resulting in skin rejuvenation.

Usage of LED light

LED are semiconductor devices that emit incoherent narrow-spectrum light when electrically biased in a forward direction. This effect is a form of electroluminescence. The color of the emitted light depends on the composition and condition of the semiconducting metal used and can be near ultraviolet (UV), visible or infrared (IR). Electromagnetic waves exist with an enormous range of frequencies. This continuous range of frequencies is known as the electromagnetic spectrum. Visible light is detectable by the human eye and consists of wavelengths ranging from 400 (violet)–700 nm (red). UV and IR are considered to be light, yet cannot be seen by the naked eye. UV light has shorter wavelengths than visible light. IR light has a range of wavelengths, just like visible light has wavelengths ranging from red light to violet. Near infrared light is closest in wavelength to visible light, and far infrared is close to the microwave region of the electromagnetic spectrum. Far infrared waves are thermal.

Intercellular action

Light is both absorbed and scattered by matter. The photon—the fundamental unit of light—behaves like a wave. It takes both particle and wave action to effect absorption and scattering. When light is absorbed by the skin (60%), it is converted into energy as heat. The photon literally gives up its energy to a specific molecule in the material. The photo energy is absorbed by the cells, which increases circulation and oxygen flow while releasing toxins.

Benefits of LED

Not only is LED effective, but it also has the added benefit of being painless and relaxing, with no recovery time required. LED can also be done on all skin types, regardless of ethnicity. It remains cool and comfortable for the client because it uses spectral light instead of heat to activate the skin’s own biochemical healing processes. The photobiological effect is safe and creates no risk of burning the tissue. See LED Skin Benefits for more ways it helps the skin.

LED details

The number of treatments needed varies with different skin types and conditions. As with any skin care treatment, maintenance is highly recommended to ensure lasting results. On average, a maintenance treatment is suggested every four to six weeks. Smoother, more hydrated skin with a radiant sheen can be seen after the first treatment, and the process is safe and effective for all skin types, ethnicities and age groups. These treatments have no undesirable side effects and no downtime for clients. The treatments are gentle, safe and noninvasive, with no UV or IR light.

Day Spa Association to Conduct First Ever Spa Seminar at All Things Organic

The Day Spa Association and the Organic Trade Association have joined forces to introduce the Organic industry to the Day Spa industry.

"We have had a cordial relationship with OTA since 2000, whereas we exchanged memberships in order to keep up-to-date with each other, and explore how we can possibly align ourselves", says Hannelore Leavy, Executive Director of the Day Spa Association. "Now with the ‘green' movement all around us, I think the time has come for these two industries to grow closer together and support each other", adds Leavy. All Things Organic^TM will be held in Chicago at McCormick Place June 16 - 18, 2009.

The Day Spa Association, in addition to be present on the tradeshow floor - booth 1637 in the Health & Wellness Section - will also conduct the following workshop:

Wednesday 6/17 from 12:30-1:30
Looking to enter or increase your sales to the spa industry?
Knowing something about the needs and expectations of spa owners and their clients will help you succeed.
Eric Light, President of the Strawberry Hill Group and a member of the Day Spa Association Board of Advisors will share with you the Association's profile of a spa-goer, as well as preliminary data from their current study of spa-goer retail habits.
This session is a must for those wanting to succeed in the spa market.
DSA's current study on the marketing demographics of a day spa-goer will be available to conference attendees FREE of charge when attending the seminar.

As more and more businesses, and especially spa businesses and their clients are becoming environmental conscious, organic products will have a big influence in products used in a spa setting, as well as attract the right consumer in their 21st Century spa.

They invite all DSA + IMSA members who are planning to come to Chicago, to call our offices or email Barbara@dayspaassociation.comThis e-mail address is being protected from spam bots, you need JavaScript enabled to view it to get their free VIP pass, which will entitle them to visit the exhibit floor and listen to the keynote address - another benefit from the DSA.

Natural Marketing Institute Sees Natural Trends for 2009

The Natural Marketing Institute (NMI) recently released its report of annual trends. These trends are the result of various NMI research sources including the Health & Wellness Trends Database, the LOHAS Consumer Trends Database and Healthy Aging/Boomer Database, as well as analysis of current activities in the marketplace. NMI databases, now including 10 years of data across 500,000+ U.S. consumers, help provide comprehensive information across more than 150 product categories.

Recalibration

The overarching concept across health, wellness and sustainability in 2009 is that of recalibration, and that has formed the basis of all of NMI's trends for this year. According to NMI president Maryellen Molyneaux, "After a decade of dualities, highs and lows, consumers are resetting the scales. Our research indicates that consumers are seeking 'The Middle Way,' which NMI defines as a lifestyle approach grounded in comfort, safety, sustainability and moderation. It's manifesting itself in a rising demand for consistent and nourishing energy as an alternative to the roller coaster of caffeine and sleep aids to a reorganization of family finances. It's all about balance—balanced nutrition, balanced budgets, balanced lifestyles and balanced energy".

NMI's top ten trends for 2009 are:

1. Small steps, big changes

Consumers are beginning to make long-term changes to their lifestyle in a trend that represents realistic and tangible steps rather than sporadic and short-lived initiatives. From walking to work or getting another hour of sleep for better health to recycling or turning down the thermostat for the environment, sustainable, moderate, consistent and practical are the daily mantras of the Small Steps, Big Changes movement.

2. Reconnecting

After a protracted housing boom—which resulted in suburban sprawl, staggering commutes and isolated neighborhoods—consumers are seeking once again to reconnect with one another. From a resurgence in shared community living models, "the new communes," to a renewed interest in volunteerism, community gardens, YMCAs and other community centers, neighbors are looking for new and old ways to connect with other people.

3. Being here--now

From multi-tasking and the never-ending pace of work to the technological tools that constantly catapult you to another place and time, there is a growing recognition that you are being robbed of the present moment. To escape this preoccupation with either the past or the future, consumers are embracing metaphysics, such as Eckhart Tolle’s "A New Earth" or "The Power of Now", and are expressing a growing interest in eco-tourism, slow cooking and experiential consumption in an effort to be in the moment.

4. LOHAS 360

The tipping point of the fusion between personal health and planetary sustainability has arrived. Now more than ever, the distinction between the two paradigms is blurred as consumers include their own personal health as a microcosm and reflection of the health of the planet. Increasingly, consumers' values are resonating with companies that are able to fuse both a personal and planetary perspective into their brand/company offerings.

5. Clean sweep

Consumers are expressing a desire to eliminate anything toxic from their lives and seeking to control things that are within their sphere of influence: their relationships, their lifestyles and their bodies. With increased concern about environmental factors, the phenomenon of detoxification as a way to improve personal health is also growing and manifesting in everything from non-toxic consumer electronics and household cleaning products to spa detox and air filtration systems.

6. Not so alternative

From alternative fuels to alternative apparel, choices and options challenging the status quo across industries are being embraced. With the increased usage of alternative health care practices, physicians, insurers, employers and consumers are embracing a more preventative approach to health. And as consumers continue to search for solutions to global warming, business and government will accelerate the navigation of environmental sustainability. Will the status quo ever be the same?

7. Asking why

Rather than simply evaluating consequences or treating symptoms, consumers are beginning to ask not only "what" but "why?" From increased interest in a company's supply chain—where materials come from and how they’re made—to a recognition that lifestyle, environmental factors, and issues related to vascular inflammation are the fundamental components of aging and disease, consumers are taking a closer and more informed look at the underlying causes of health and sustainability.

8. Beauty shop

A new definition of beauty is emerging, reflecting the growing awareness that beauty comes from the inside, transparent and timeless. This new appreciation for all things authentic is translating across categories including vintage clothing, classic cars and historic renovations. For personal beauty, it is reflected in the new status symbol of naturally looking good at any age without the aid of invasive procedures or plastic surgery.

9. Conservation

Energy 2.0 reflects the emerging desire to conserve energy on both a personal and planetary level. Rather than squandering energy, people realize that their bodies, like the planet, are not an inexhaustible resource. This planetary health is manifesting itself on topics ranging from climate change to land conservation to renewables. On a personal level, consumers are demanding consistent and sustained energy for themselves. They are dissatisfied with the high/low spikes, but interested instead in healthier alternatives to caffeine and sugar.

10. Heirlooms

In all areas of consumption, consumers are choosing to buy less to buy better. This trend reflects a desire for products with greater meaning, and given the economic downturn, is expected to continue to grow across categories. Now more than ever, products that reflect a rich or unique brand story are perceived to be more valuable—from an evolving desire for heirloom, artisanal and varietal foods to treasures found on eBay—it reflects a desire for history, for legends and for legacies.

Look for more information and implications of these trends to be presented by NMI at industry events throughout 2009 and in its upcoming syndicated reports.

Botox Helps Relieve Diabetic Foot Pain

Botox is known for its aesthetic treatments for the face and body, but new research from Taiwan shows it may also aid diabetics experiencing foot pain.

People with diabetes often suffer from chronic foot pain because of nerve damage, but relief may be at hand. Taiwanese doctors have shown that the pain can be reduced substantially by injections of botulinum toxin type A—better known as Botox— into the skin on top of the foot.

Dr. Chaur-Jong Hu, at Taipei Medical University, and associates tested the treatment in 18 patients with type 2 diabetes who had nerve-related pain in both feet. The participants were randomly assigned to get injections of Botox or saline, then 12 weeks later crossed over to receive the opposite treatment.

A local anesthetic gel was applied first, and then the injections were administered into the skin (rather than into muscles) at 12 sites across the top of the foot, the team explains in the medical journal Neurology.

At the start of the study, the average pain score on a scale of 0-10 points was 6.36. There were significant differences in the decrease in pain scores between the Botox and saline injections during each 12-week period. Specifically, at 12 weeks, the score was reduced by 2.53 points with Botox injections compared with 0.53 points with the saline injections.

Moreover, 44% of the subjects had a reduction of at least 3 points in their pain score within 12 weeks after the Botox injections, and an added benefit was that patients are able to sleep much better after the treatment.

Hu's team concludes that intradermal Botox injections "are an effective and safe method of relieving diabetic neuropathic pain in the feet." However, "the detailed underlying mechanisms, optimal dosage, and precise course of therapy require further evaluation."

Holistic Acne and Rosacea Treatment

By: Barry Summers, MD, PhD

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.

Treatment How-to: Acne Skin Facial Treatment At Metamorphosis Day Spa Using Emerge Labs Organic Skin Care

Treatment duration: 75 minutes

Treatment cost: $150

Equipment needed:

Magnifying lamp

Steamer

2 spatulas

High frequency machine

Sterilizer

Sharp box container

Supplies needed:

Consultation form

Nonirritation facial cleanser

Sulfur-based facial mask

Cotton

Sterile cotton swabs

Needle or lancet, where permissable by state law

Astringent

Antibacterial mask

Calming and soothing mask

Mattifying moisturizer

Step 1: After greeting the client and performing a gentle, nonirritating cleansing, begin a 10–15 minute pretreatment consultation. Find out how long the client has had an acne problem and what products she has been using to treat the condition. Ask whether isotretinoin has been used and if she is pregnant. Inquire about health issues and allergies. Also, perform a thorough skin analysis using a magnifying lamp. Check for pore size, type of acne lesions, irritation and sensitivity.

Step 2: Ask the client to lie face up on the treatment table and begin the process of desincrustation, which includes opening the pores using the steamer, followed by a gentle, nonstimulating facial massage. This softens the outermost layer of the skin.

Step 3: Apply a sulfur-based mask that preps the skin for extractions. Remove the mask after 10 minutes.

Step 4: Use a magnifying lamp to locate areas that need extractions. Wrap both index fingers with cotton and use sterile cotton swabs and fingertips to exert firm pressure on the skin surrounding the blackhead, and then lift the blackhead from the follicle gently. If removing milia, where permissible by law, use a sterilized needle or lancet, to pierce the skin from a horizontal direction. When finished, dispose of needle or lancet in a sharp box container. Repeat steps as needed.

Step 5: After the extractions, apply astringent to the client’s skin, paying close attention to the areas that received extractions.

Step 6: Apply an antibacterial mask using a spatula. Keep the mask on for seven minutes and remove using damp cotton.

Step 7: Apply a calming and soothing mask using a spatula for an anti-inflammatory effect. Keep that mask on for 10 minutes and remove using damp cotton.

Step 8: After removing second mask, apply a gentle mattifying moisturizer to the client’s face.

Step 9: To complete the treatment and prevent secondary lesions, use the high frequency machine, making sure the client has removed all metal jewelry, isn’t pregnant, doesn’t have heart problems, asthma and epilepsy, and doesn’t have metal implants, heavy metal dental work or braces.

Step 10: Place index finger on electrode and apply to the client’s face starting at the chin. Remove index finger when electrode makes contact with the skin.

Step 11: In circular movements, move the electrode over the client’s face, beginning at the chin, for 3–5 minutes, sparking the skin by lifting the electrode up and down directly over the acne lesion.

Step 12: To remove the electrode from the skin, place index finger on the electrode and then lift it off the skin. Turn machine off and clean the electrode with soap and water, then spray with alcohol, dry, and place in a sterilization solution for 20 minutes.

Step 13: After the service, discuss a home care program with your client in order to maintain the results that were achieved in the treatment. This program should include the use of a gentle antibacterial cleanser and astringent, a night serum that unclogs pores and controls skin desquamation, a daytime moisturizer that heals and has antibacterial properties, a gentle antibacterial mask to be used up to three times per week and a drying lotion to reduce pustules overnight.

Metamorphosis Day Spa

Emerge Labs Skin Care

Understanding Acne

Nearly 85% of people will experience some form of acne during their lifetimes. According to the American Academy of Dermatology (AAD), acne is the most common skin disorder in the United States, affecting 40–50 million Americans at one time.¹ When people think of acne, they think of teenagers, but acne can affect many people throughout adulthood, as well. Some estimate as many as half of all adult women experience some form of acne due to an increase in androgen and a decrease in estrogen during perimenopause.

Looking good and feeling good go hand in hand—this is why it can be so difficult for clients who suffer from acneic skin. Acne can have a devastating effect on self-esteem and confidence, and many acne sufferers withdraw socially and even experience depression. The good news is that most acne can be treated with outstanding results. Treating acne can be one of the most rewarding experiences for you as an esthetician

Acne is an inflammatory lesion of the sebaceous glands and the first signs usually show up during puberty when there is an increase in the hormone androgen, which is especially active in stimulating the amount of oil produced by the sebaceous glands in the skin. This results in the extra production of sebum that combines with dead skin cells and other debris and becomes trapped, creating a plug that blocks the hair follicle. As the ducts of these glands become plugged with the waxy oil, comedones (blackheads) and milia (whiteheads) form. They are frequently infected with bacteria, causing welts, deeper lumps and pimples.

Sebaceous glands are the glands situated at the root of the hair follicle in the dermis. They can be found all over the body, except on the palms of the hands and the soles of the feet. These glands secrete sebum or oil. When the oil is mixed with perspiration, the skin’s surface becomes slightly acidic. This keeps some bacteria and fungi from embedding in the skin and, at the same time, helps to retain water in the tissue by slowing down evaporation from the skin. When the sebaceous glands are stimulated, a process known as retention hyperkeratosis occurs. This may be triggered by the onset of puberty, hormonal fluctuations, pharmaceutical agents, stress, heat and humidity.

In acne, the dead cells stick together, along with excess sebum and bacteria, to form an impaction plug. This first stage impacted follicle is often referred to as a microcomedone. As the bacteria digest the sebum, they produce fatty acid waste products that irritate the lining of the follicle, causing a proliferation of cells to accumulate in the impacted follicle. At this point, the disease may result in noninflammatory lesions, and simply produce closed comedones. When they eventually turn into open comedones and expel their contents, inflamed lesions may also result, whereby the follicle wall ruptures forming a papule. White blood cells invade the area and inflammation ensues. If the break is close to the surface of the skin, a pustule results—if it is deeper, a nodule forms. In some cases, a membrane entraps the infection and a cyst forms.

There are three factors that cause acne: sebum, bacteria and enclosure. When you encounter these factors together, it creates an environment for inflamed, irritated and congested skin.

Treatments for acne

Today, acne can be treated without the harshness and discomfort of traditional treatments that leave the skin red and irritated. First, to treat any form of acne, you have to deal with the three main factors—sebum, bacteria and enclosure. This can be done by using a three-tiered approach of professional esthetic treatments, a home care program and a healthy diet that includes nutritional supplements. Acne-prone skin can be addressed by controlling the excess sebum production and maintaining a proper moisture level.

Prevention often is not enough to avoid the mainfestation of acne, however, so when it does occur, there are several methods that can be used to remove acne lesions. Desincrustation is the process of softening the keratinaceous horny plug that allows extractions to proceed easily with minimal trauma to the surrounding tissue.

Manual extractions using vinyl gloves and wrapped index fingers are a very effective measure in removing comedones. If they don’t remove immediately when using slight pressure from side to side, use alternating angles to gently lift the comedone. Another gentle and effective way to remove a comedone is with sterile cotton swabs. If the contents are not expelling, simply go to another section and leave it for the next treatment. Remember that comedones did not occur in one day and, many times, it will take more than one treatment to clear up all of them.

Estheticians also can remove closed and open comedones and milia with the use of lancets. The use of lancets, however, is not approved in all states, so check with your local state board to confirm whether it is permissible. However, cysts and nodules must be treated by dermatologists. As an esthetician you can still administer acne treatments that will help cystic skin, but you won’t be able to remove those lesions.

High frequency is an excellent and versatile tool for the esthetician to use when dealing with acne. This electrical unit contains an electrode that uses UVC germicidal rays and has antibacterial properties. The machine also decreases inflammation, allows for faster healing time for lesions and helps prevent secondary infections. Although high frequency is a great tool, it should not be used on clients who are pregnant, who have high blood pressure or a heart condition, who have epilepsy or asthma, or those with braces, metal implants or heavy dental work.

Acupuncture Shown Helpful in Severe Dry Mouth Treatments

Increasing the potential for alternative therapies, acupuncture has been shown to help cancer patients experiencing severe dry mouth issues.

Acupuncture reduces severe dry mouth (xerostomia) among patients receiving radiation for head and neck cancer, a small pilot study suggests.

"The quality of life in patients with radiation-induced xerostomia is profoundly impaired," study senior author Mark S. Chambers, a professor in the dental oncology department at the University of Texas M.D. Anderson Cancer Center, said. "Symptoms can include altered taste acuity, dental decay, infections of the tissues of the mouth, and difficulty with speaking, eating and swallowing. Conventional treatments have been less than optimal, providing short-term response at best."

This study included 19 patients with xerostomia who'd completed radiation therapy at least four weeks earlier. They were given two acupuncture treatments a week for four weeks. Acupuncture points used in the treatment were located on the ears, chin, index finger, forearm and lateral surface of the leg.

The acupuncture treatments resulted in improvements in physical well-being and xerostomia symptoms, the researchers said. "Although the patient population was small, the positive results are encouraging and warrant a larger trial to assess patients over a longer period of time," Chambers said.

The study was published online in the journal Head & Neck. The researchers are planning a phase 3, placebo-controlled clinical trial.

FDA Mandates New Warnings for Botox

Though none of the reported problem cases have involved using the drug for dermatological or cosmetic procedures, skin care professionals should note the newly Food and Drug Administration (FDA)-mandated warnings on Botox and other similar products.

Reports of deaths among people using popular anti-wrinkle injections such as Botox to treat muscle spasms have prompted a change in labeling. Botox and similar products will now be required to carry boxed warnings, the most serious type of label warning, the U.S. Food and Drug Administration announced Thursday.

Most cases involved children given the drug to control muscle spasticity associated with cerebral palsy and adults using it to treat muscle spasticity, migraines and cervical dystonia. "The hospitalizations are very few, deaths are very rare, but they have been reported," said Dr. Ellis F. Unger, acting deputy director of the FDA's Office of Drug Evaluation, said during a teleconference. "We don't want to discourage use of these drugs as patients taking them have significant disability and the drugs are effective to relieve important problems. But people just need to understand the risks that are involved so they can make informed, risk-benefit decisions."

Unger said the deaths have not been clearly attributable to injection of the drugs, as everyone who died also suffered from other conditions. None of the cases so far reported have been associated with use of botulinum products in cosmetic or dermatological procedures, such as clearing furrows between the eyebrows, according to the FDA. Botulinum toxins are not approved by the FDA to treat severe arm and leg muscle spasms, although they are approved for dermatological indications as well as cervical dystonia.

Officials believe that most of the problems occurred when one product was substituted for another without corresponding dose adjustments. "There are now three products approved in the U.S., each with different units, and the units cannot be interchanged," Unger said. "Switching patients from one to another runs the risk of underdosing or, more important, overdosing." The three approved products are Botox, Myobloc and Dysport, which was approved this week. Officials said there have been no post-marketing reports of similar problems with the newest drug.

The injections, which temporarily "paralyze" muscles, are intended to have a localized effect but can pose problems if the compound spreads to other parts of the body. "When given in a particular place, they spread locally, meaning they move into adjacent structures," Unger explained. "We have known that for years, and it can be annoying and somewhat of a significant problem for given patients but does not result in disability or harm. The real concern is when there is distant spread. It is injected at one point and spreads to areas not adjacent."

The FDA issued an "early communication" in February 2008, warning of these adverse reactions. The month before, the watchdog group Public Citizen petitioned the agency to add a black-box warning to the two drugs then on the market in the United States, describing 180 "adverse event cases" related to the drugs, including 16 deaths, four in people younger than 18. Between early 2008 and now, the FDA became "more certain about the cases," Unger said. "We felt we really needed to nail down the scope of the problem before we placed a boxed warning, which is something we take very seriously."

The FDA will also require manufacturers to put in place what it calls a risk evaluation and mitigation strategy—in essence, a comprehensive patient safety guide. "Updating labeling will help patients and health care professionals better understand the risks and benefits," Unger said. "These drugs have benefits, but they also can cause serious problems."

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For More Information Visit OrganicSkinCare.com

Emu Oil in Products

by Tiffany Neumann
Today we are looking for more and more ways to live healthier, longer, and more beautifully. Not only do we watch what we eat but we are also paying more attention to the skin care products we use that seep chemicals into our bodies. Sometimes it takes a reality check to realize the most perfect remedy to almost any skin care problem is right in front of us. Now is the time to rediscover the special benefits of Emu Oil.
For over 1,000 years, Australian Aborigines have known about the amazing healing properties naturally present in Emu Oil. Traditionally this oil was used to relieve inflammation of stiff, swollen joints, to help heal burns and wounds, as a remedy for skin irritations, and to soothe and moisturize dry, cracked skin. Through time, it has become evident that the oil has natural properties that aid in the
anti-aging process.
One hundred percent Emu Oil is made up completely of essential fatty acids including Omega 3 (Linolenic), Omega 6 (Linoleic), and Omega 9 (Oleic). It is the oil that is most like the oil our bodies produce and is the nutrition your skin needs. Every day our bodies are producing 300 billion new cells and each one of these cells needs essential fatty acids to build a strong cell wall.
Studies have shown that the oil penetrates through the epidermal layers of the skin down to the basal layer where it starts repairing, nourishing, and enhancing new cells. It is also antibacterial, hypo-allergenic, and non-comedogenic, so it will not clog the pores.
Omega 3 is a natural anti-inflammatory that is not only for sore muscles and stiff swollen joints, but also aids in reducing inflammation that occurs after many spa beauty treatments or facial surgeries. Surgeons have recommended it to their patients to reduce the inflammation after surgery and to accelerate healing and reduce the possibility of infection and scars. It will actually lighten or eliminate scars up to two years old. A growing number of other users including professional sports teams, chiropractors, massage therapists, aestheticians, and physical therapists are all reporting excellent results from using Emu Oil.
In addition to the soothing effects that the fatty acid esters have on the skin, it is also rich in anti-oxidants, which help slow down the aging process and in some ways will even reverse it. Small wonder, it’s a favorite among skin care and health care professionals

Drug-resistant Bacteria Shifting the Treatment of Acne

As the bacteria that causes acne develops more of a resistance to drugs used to treat it, skin care professionals and dermatologists are increasingly needing to look elsewhere for ways to solve this skin issue.

It sounds like the stuff of teenage nightmares: super strong, freakishly clever, mutant acne. But dermatologists say the bacteria that causes acne is increasingly developing resistance to some commonly prescribed antibiotics, including tetracycline and erythromycin. And while the superbug MRSA is a widely known threat in the general medical community, some patients are surprised to learn that the P. acnes bacterium is equally capable of rebelling against drugs and developing superpowers.

“There’s been so much attention to MRSA and other kinds of resistant bacteria, which truly can kill you, whereas acne doesn’t kill you,” says Dr. Alan Fleischer, a professor and chair of dermatology at Wake Forest University School of Medicine. “And yet we doctors see patients who have resistant acne, and we do need to be cognizant of changes. The bacteria are changing, are adapting and becoming resistant.”

Antibiotics are one of the most frequently prescribed treatments for acne. They target the bacteria and inflammation, and often are key in clearing up the patient’s skin. But as antibiotic-resistant acne becomes a growing concern, dermatologists are moving away from using antibiotics as a primary weapon against acne, fearing that the long-held go-to treatments may be contributing to communal antibiotic resistance.

If they do prescribe antibiotics, it may be for only a limited time, usually a few months, and it's often combined with another medication that can lessen the drug resistance. Previously, patients might have continued on antibiotics for years. “The strong survive, the mutants survive and they become resistant,” says Dr. Jonette Keri, a Miami dermatologist.

Public health threat?

While drug-resistant acne can be devastating, the real danger is that it contributes to deadly drug-resistant staph infections. “The dangerous thing about putting zillions of folks on antibiotics is that this pressures bacteria to develop resistance methods,” says Dr. Peter Lio, a Northwestern University dermatologist. “So while the acne bacteria almost never causes life-threatening infection, the ways that it can be resistant to our antibiotics can be passed over to bacteria that can cause life-threatening infection, which means that our only weapons against the bad guys suddenly do not work anymore. If it became bad enough, it would be like the days before antibiotics, when infection was a common cause of death.”

Acne is a common teenage ailment, afflicting about 75–90% of teens. Even adult acne may be more common than many realize, with about 50% of adults suffering from acne at some degree, dermatologists say. “Acne is a really tough disease,” Lio says. “We can make a big difference with many patients, but it’s a humbling disease; it brings people down. People can be incredibly depressed coming in, so our job is to do whatever it takes to make them better.”

Between 10–30% of acne patients harbor at least some resistant bacteria, dermatologists say. Few studies have been published about drug-resistant acne, but French researchers found in 2001 that more than 50% of the isolates of the bug P. acnes were resistant to erythromycin, a commonly prescribed antibiotic.

When the antibiotics stop working for a patient, the results are devastating. In most cases of drug resistance, the antibiotics initially work, and patients think their skin has finally cleared, maybe for good this time. Then, all of a sudden the acne comes back — in some cases, worse than ever before.

When antibiotics fail

About six months ago, 16-year-old Chris Fields started taking 500 mg of tetracycline once a day, every morning. A month later, his skin cleared and stayed that way for two months. He started to remember what it was like to look people in the face without privately agonizing that they were scrutinizing his.

“I had more self-confidence and stuff,” says Chris, a high-school sophomore who lives in Concrete, Washington. “When I’d go out in public, I’d actually look people in the eye, and not be so worried about how my face looks. Right now, that’s starting to slip away again.”

That’s because a few weeks ago, his acne started to come back. He’s not sure if it’s worse than it was before, or if he’s just imagining that it is, but either way, its presence couldn’t be more unwelcome: Prom is less than three weeks away.

He has a appointment with his doctor next week to figure out what went wrong, but from his own medical Googling and time spent on message boards such as acne.org, he expects he’s developed this antibiotic resistance. But maybe the strangest thing about this particular affliction is that patients never really know for sure that they have it at all. “Most people in private practice do not do a test,” says Keri, the Miami dermatologist. “If they thought [patients] were resistant, they might switch antibiotics or add topical treatment to the mix.”

The P. acnes bacterium can be tested for resistance, but that’s usually done only in clinical trials or study circumstances. When a patient stops responding to antibiotics, most dermatologists assume the bacteria have developed resistance, and doctors simply try something else.

A bevy of effective treatments

Bacteria, resistant or not, is only one contributer to the formation of a zit. Four things have to happen for people to get a pimple: First, oil increases in a pore. Second, the skin cells that line the pore get sticky from the extra oil, creating a clog in that pore. Third, bacteria feasts on all that oil and begin to overgrow. Finally, the body responds to the bacteria, causing the inflammation.

“The fact is, because acne is much more complicated than a simple infection, there really are a wide variety of other approaches that are very useful,” says Fleischer of Wake Forest University. Doctors found that combining benzoyl peroxide with an antibiotic counteracts the drug resistance. And there are plenty of other methods dermatologists use to attack acne, including using anti-inflammatory drugs such as retinoids and isotretinoin.

Fewer dermatologists now rely on antibiotics alone to treat acne. A recent University of Pennsylvania study found that people on antibiotics were about twice as likely to develop an upper respiratory tract infection. And a study Fleischer co-authored in 2005 found a significant shift from dermatologists prescribing antibiotic to non-antibiotic treatments.

When Fleishcher started his practice 20 years ago, erythromycin was the treatment he most commonly prescribed. “Now maybe I have one patient on it, maybe. [Acne] is not a life-threatening situation; it is a quality of life situation. Using drugs that don’t display drug resistance will allow us to make patients look and feel better,” he says.

By Melissa Dah

30 Skin Care Misconceptions

By: Carol and Rob Trow

Skin care professionals and consumers alike are bombarded daily with a myriad of information about skin care, skin science and skin health from the media, manufacturers and an ever-increasing number of physicians, all attempting to justify that what they profess and advocate is the truth and nothing but the truth. Sometimes claims are accurate and sometimes they aren’t. More often than not, the truth may lie somewhere in between.

Everyone from late-night television host David Letterman to mass-market publications proudly announce their top 10 lists. Well, this is no different except that it focuses on 30 skin care myths. The following list offers up a variety of skin care facts—not in priority order—that may well call into question some common beliefs and long-held traditions. See how many you agree with as you review the list.

This list is not meant to be all-inclusive, but hopefully it will inspire thinking about what is real and how you know it is real and also inspire you to question those making a variety of claims about products, ingredients and the science behind them. Your role as a skin care professional has a large educational component that mandates remaining current in the field, as well as providing education on skin health to clients and patients. Sharing these myths with clients will help to strengthen your credibility as a skin care expert. Remember, you are not selling hope in a jar, but rather providing realistic and truthful solutions to help deal with extrinsic and intrinsic aging.

1. Facial exercises tone facial muscles and make a person appear younger.

The face is the only part of the body where muscles are attached directly to the skin; there are no facial ligaments and tissue. Constant facial exercise and tugging contribute to additional lines. Actually, wrinkles often form along expression lines caused by facial movements.
2. Vitamin E minimizes scarring.

Vitamin E is an antioxidant and helps build skin, but there is no evidence that it does anything to help with scarring. There is even some research that suggests it may have a negative effect on scarring.1
3. Cucumbers help reduce puffiness around the eyes.

The principle ingredient in cucumbers is 90% water with the balance being inert fiber. They can be soothing and, with moisture, hydrate skin temporarily. The same results can be obtained from a cold compress.
4. Skin pores open and close.

Pores are openings in the skin that allow oils (sebum) to reach the surface. If pores are larger, this can be due to dead cells, genetics or scarring from squeezing blemishes.
5. The higher the skin protection factor (SPF) rating, the better.

SPF ratings, soon to be revised by the U.S. Food and Drug Administration (FDA), only refer to protection from UVB rays. A person needs sun protection that has chemical and physical blockers, plus antioxidants. A higher SPF also gives a false sense of security and introduces more potentially harmful chemicals to the body. Plus, an SPF of 50 is only marginally more protective than an SPF of 15; an SPF of 30 has only 2% more protection than an SPF of 15, and a 40 has only 1% more than a 30. Sunscreens need to be reapplied every 90–120 minutes.
6. Layering several products with SPF ratings increases protection.

You are only protected to the extent of the higher rating of one product. A foundation with an SPF of 10, moisturizer with an SPF of 15 and a sunscreen with an SPF of 20 does not yield an SPF rating of 45.
7. Topical creams containing collagen can replace collagen.

There is a lack of impartial, empirical evidence that the topical application of collagen or elastin can penetrate the dermis, even when using nanotechnology. They can provide moisturization to the epidermis, but only injections are conclusively effective.
8. Mineral oil is bad for your skin.
Today’s cosmeceutical mineral oil is a far cry from the industrial type that was previously used on skin. It is a very effective ingredient in helping remove excess oil from the skin. Oil attracts oil, and the modern mineral oil formulated for use in skin care has a different molecular weight and will not harm skin or clog pores. Mixed with kaolin—fine clay—it makes a potent cocktail to assist in controlling oil production in problematic skin. Vitamin A is the best ingredient to normalize skin.
# Mineral oil is comedogenic.

Cosmeceutical-grade mineral oil is not comedogenic. The myth is that industrial-grade mineral oil and lubricants are the same as those used in cosmetic ingredients. So-called medicinal white mineral oil has met with stringent safety standards. To remove sebum plugs in the follicles, an oil-based substance is needed. Water-based products cannot melt or remove sebum plugs.
# Preservatives in skin care products are bad.

Preservatives help prevent the growth of bacteria, fungi and other organisms that can not only deteriorate a product’s effectiveness and spoil the product itself, but also allow harmful bacteria to get on or in the skin. Although there is concern about the use of parabens, the research is not definitive that topical application leads to harmful accumulations. Parabens are found throughout nature; for example, many fruits and vegetables, such as strawberries, are naturally full of parabens. But further study is needed.
# Packaging is not important.

Packaging in skin care is vitally important—not for aesthetic reasons—but to protect the efficacy of the ingredients. Wide-mouth jars, transparent containers and pumps that are not airless all pose problems in keeping ingredients safe and potent.
# Chocolate and greasy foods cause acne.

Eating chocolate does not cause acne. Hormonal factors, bacteria and skin cells are at the root of problematic skin, and stress can exacerbate flareups. Some individuals may have allergic reactions to foods that can cause inflammation, as well.
# Natural and organic products are always better.

Buyer, beware! Many natural and organic products are not as they claim. Plus, many times, active ingredients have to be synthesized to be bioavailable and efficacious. Synthetic compounds can actually be identical to those found in nature and be more effective. Natural vs. laboratory-processed should not lead to an up or down decision about whether a product is good or bad. Not all chemicals are bad, and not all natural or organic ingredients are good.
# Using larger quantities of a product will yield better results.

Less is more. Normally, a pea-sized amount of facial product will do the trick. Excessive amounts can cause skin problems and waste money.
# Blackheads are a caused by improperly cleansed skin.

Blackheads or comedones are caused by clogged pores, and excessive scrubbing can irritate and further inflame skin. Blackheads often contain dirt, oil, and dry and dead skin cells that need to be removed. Products that help dissolve sebum are the most effective.
# Drying problematic or oily skin clears up acne.

The opposite is true. When skin becomes overly dry, an environment is created in which the skin is signaled that is too dry and produces more oil. Use drying products sparingly, and look to lightly moisture oily skin. The goal is to keep skin balanced.
# Get a base tan to prevent burning before going on vacation.

Any tan is a scar, and there is no such thing as a healthy, safe tan. Self-tanners are the safest way to obtain tanned skin.
# All sun damage to skin occurs before 18 years of age.
Sun damage continues to occur throughout life, although recent information suggests less than 50% of sun damage happens before a person is 18.2 It is never too late to protect your skin.
# Indoor tanning is safe.

The argument that tanning beds and booths do not cause skin mutations that may cause cancerous lesions to develop is patently false. UVA rays found in indoor tanning lead to deeper, more harmful skin damage. You do not have to have a sunburn to create damage to skin cells.
# Antioxidants reverse wrinkles.

Antioxidants are essential in fighting free radical formation and are important in helping prevent skin damage, but they cannot make wrinkles go away.
# Skin damage and signs of aging can be cleared up quickly.

If a product sounds too good to be true, you can bet its claims are false. The damage did not happen overnight, and it cannot be magically repaired. Expect at least three skin cycles—a cycle can be between 21–40 days, depending on age—to begin to see measurable results.
# All alcohol in skin products is bad.

Some compounds that contain alcohol can act as emollients, which can decrease the skin’s water loss. Cetyl, benzyl and oleyl alcohol are examples of good alcohols. It is important to know what comes before the OH in chemical compounds.
# Sun exposure will improve acne.

Yes, sun exposure can hide the appearance of acne for awhile, but will lead to skin damage, pigmentation and drying that signals the skin to produce more oil.
# Alcohol abuse can cause your nose to become red and bulbous.

The intake of alcohol can temporarily dilate blood vessels and make skin appear flushed, but in most cases, a large, inflamed, red and bulbous nose is a result of rosacea.
# Skin repair only happens at night.

A good night’s sleep is certainly helpful to skin health; however, skin repair is ongoing. Inadequate sleep can cause stress, skin puffiness and can slow the natural development of collagen.
# Skin care products can last three or more years.

Despite a number of claims to the contrary, most skin care products lose a great deal of their potency within 12 months. It is best to use the entire contents within one year because preservatives do not last forever and ingredients can get contaminated with bacteria, or they can evaporate.
# Strong scrubs, soaps and abrasives are good for your skin.

Be careful how you wash your face. Too much scrubbing or too many abrasive products can remove protective oils, create tiny micro tears and contribute to aging, irritated skin. Less is more, and a gentle cleanser and light moisturizer work well for most people.
# Vitamin A thins the skin.
Actually, the reverse is true. Skin can become thin due to the lack of vitamin A because it helps to create new, healthy and normal skin cells. Vitamin A is arguably the most important skin care ingredient, bar none. It is one of the few—if not the only—ingredient that is backed by more than 50 years of objective, scientific research supporting its efficacy.
# The only form of vitamin C that works is L-ascorbic acid.

L-ascorbic acid only remains in its most potent state for a limited time. A new era in vitamin C formulations, one of the best antioxidants for your skin, has arrived. There are several forms that have been developed that are not water-based, which means they can better penetrate the skin and remain more potent for longer periods of time.
# There is one antioxidant ingredient that is the best.

Every year, there is a hot, newly discovered antioxidant that is touted as the best, but this is not true. A cocktail of antioxidants provides better results than just one. Seek products containing a plethora of antioxidants.