The skin sheds about one million cells a day – most of your house debris probably consists of dead skin.
Shedding slows as we age, so extra sloughing on a regular basis helps to keep skin healthy, youthful and vibrant. And there are lots of options available to get rid of those cells more quickly. Here are the three main categories: mechanical, digestive/chemical and proliferating.
Mechanical methods include nut scrubs, polyethylene balls, micro-fine pumice and more aggressive protocols like microdermabrasion, dermaplaning and skin resurfacing.
Chemical methods include digestive fruit acids like AHA and BHA’s, enzymes from papaya, pineapple and pumpkin and deeper peeling protocols like TCA (trichloroacetic acid) and enhanced Jessner’s solutions.
Proliferators speed up the cell renewal process as well as encouraging the production of collagen and elastin. This includes the retinoid family derived from Vitamin A – and used regularly, these products can really improve the appearance of fine lines and wrinkles.
TIP: The products in these categories degrade quickly in sun and when exposed to oxygen so use at night only and if irritation occurs stop using until the skin is calm again.
All these methods work really well and make a difference to the appearance of the skin. Ask your facialist what would be best for your skin condition.
Many of my clients pick their skin. This is an addictive habit exacerbated by extreme or chronically stressful situations and the worst of it is that there is more to pick when we are stressed! Psoriasis, eczema, acne and dry flaky skin can all be partially attributed to the excess cortisol that is produced as a stress response. Hormones, neuropeptides and other signaling molecules also released during these times can be as aging as sunlight because they break down proteins and DNA. All this disruption drives many clients into the bathroom in a quest to somehow fix or ’cleanse’ the situation.
I recently had a client tell me that she ‘prepares’ her bathroom for a picking session. She brings in a magnifying mirror, comfortable chair and box of Kleenex and then works at her skin for an hour or more. She told me it gives her a sense of control, relief, and emotional release. It is also the opinion of Ted Grosshart, an assistant clinical professor of psychology at Harvard Medical School, that the compulsion to pick can be intensified by drugs taken for ADD and ADHD. Of course, after picking and the ensuing irritation and scabbing, most clients feel shame and less social because of their appearance. This form of isolation severely affects their self-esteem. It is a deeply psychological problem and needs to be handled with patience and compassion.
So how can we begin to break the cycle? Keeping the skin surface smooth with exfoliants and regular facials that include the use of AHA’s, BHA’s and other light peeling agents will get rid of little bumps and surface unevenness that might tempt fingers to go to work. Become aware of when you pick – at your desk, in the car, at home when you are watching television, when you have to deal with new environments? Iona Ginsburg, associate professor of psychiatry in dermatology at Colombia University has a useful tip. She suggests her patients put a Band-Aid around the fingers that do most of the picking. We encourage our clients to wash their skins’ by candle-light and time themselves in the bathroom. No more than five minutes to cleanse, tone and hydrate.
We also offer complimentary zaps in between spa visits to keep the skin and the client under control. Once the skin begins to clear and the client is no longer ashamed of how she/he looks, their demeanor and confidence grows. Confucius once claimed: ”True quality of life comes from a lasting harmony between body and mind.” Clear skin is that, plus a great facialist to guide the healing and an easy to follow home care regime that keeps the skin clear and healthy. Then there is no need for picking.
Dealing with pigmentation continues to be a struggle but as we learn more about the condition, we are adding some useful tools. Here are some of them.
An estimated six million women throughout the US are currently affected by melasma (also known as chloasma). This is a specific type of pigmentation problem thought to be caused by stimulation of the pigment-producing cells (melanocytes), and by the hormones estrogen and progesterone, when exposed to the sun and/or heat. Melasma is often referred to as the “mask of pregnancy” as the skin often darkens at this time, but the birth control pill and HT (hormone therapy) can also trigger a response. Other factors implicated in this annoying skin condition are certain medications that can cause photosensitivity, and cosmetics and fragrances that contain alcohol.
There are actually two kinds of melasma: epidermal, which is the most common and treatable type, and dermal, which is seen less often. Dermal melasma is light brown in color and has ill-defined borders. It is best treated topically with mandelic acid (an AHA derived from bitter almonds) and can often turn darker if treated with IPL (Intense Pulsed Laser) or laser protocols. Epidermal melasma generally has well defined borders and is dark brown in color.
There are several popular topicals currently being recommended for this type of melasma, primarily tyrosinase inhibitors but including bleaching and lightening agents. Tyrosinase is the enzyme responsible for catalyzing melanin, so inhibiting the action of tyrosinase is quite effective in reducing pigmentation issues.
The tyrosinase inhibitors are:
Kojic acid, derived from fungus
Arbutin, derived from the leaves of uva-ursi, the bearberry plant
Liquorice extract, taken from the root of the plant
Rumex extract, derived from the field dock
Niacinamide, also known as Vitamin B
Mulberry leaf extract
Other topical agents:
Vitamin C, a skin lightener and antioxidant derived from ascorbic acid
Tretonin, a skin exfoliator prescribed as Tazarac or Retin-A
Azelaic acid, a bleaching agent derived from barley, wheat and rye grains
Hydroquinone is still the most single effective bleaching treatment for melasma, but there are side effects attributed to this topical and some countries have banned its use. In fact, the FDA is now considering banning the sale of 2% OTC (over the counter) hydroquinone in the US and making it available by prescription only. If you are using it to treat melasma, watch for any irritation, redness and unusual discoloration.
The advantage of using topicals on the above list is that when combined properly, they can outweigh the benefits of hydroquinone and they have no side effects when used correctly.
At SkinSense, we have found that ultrasound used with some of these topicals, particularly Vitamins C and A, during a facial treatment, helps to fade the pigmentation more rapidly by aiding penetration. Modified chemical peels alternated with regular applications of AHAs also speed results.
The client needs patience and persistance when tackling this condition because results are gradual. We recommend postponing spa treatments until the cooler weather sets in. As mentioned earlier, heat alone can cause pigmentation, so wait until fall and winter to start treatments. During the summer, we recommend deep-cleaning facials, lots of sunscreen, shade and wide-brimmed hats.
When consulting with clients on their visits to my spa, lifestyle takes up a big part of our initial conversation, particularly what they are eating on a daily basis. It is no secret at this point, that consuming a blend of fresh fruits, vegetables and clean protein, plus drinking the right amount of water does translate into a clear and vibrant skin most of the time.
However, two additional recommendations I have been making to my clients more recently to keep their skins youthful and healthy are to try and keep their overall food intake as alkaline as possible and to take regular courses of probiotics.
In the skin care business, it is not unusual to talk about the pH of a product. The letters pH stand for potential hydrogen, as hydrogen is the element that controls the levels of either alkalinity or acidity in a formulation. Acidic products range from 0 – 6.9 and are often used to exfoliate or peel the skin; alkaline products range from 7.1 – 14 and can be used in cleansers or to neutralize acidity and very often moisturizers are formulated to be neutral (a pH of 7) to bring the skin back into balance. Too much acid or alkalinity is irritating for the skin so the pH is always carefully calibrated.
More recently, the principle of pH balancing has been applied to our bodies. This holistic approach believes that the foundation of a strong digestion is built on a simple eating system that maintains an ideal acid/alkaline (pH) balance in the body.
How do we do that?
The suggested pH ratio would be a diet of two-thirds alkaline and one-third acid-forming foods. This takes some adjustment. So, to take a step in the right direction, let’s outline a few alkaline foods that we can incorporate in greater quantities and some acidic foods we can eliminate.
Raw, green leafy vegetables like chard, kale and spinach are all excellent at maintaining a more alkaline system. So are avocados, celery, cucumbers, tomatoes, peppers, broccoli, coconut, cherries, grapefruit, lemons and watermelon. Obviously, exercise and relaxation are essential and as already mentioned, drinking the right amount of water.
Men need more water than women on a daily basis, but if you eat plenty of the above listed vegetables and two or three fresh fruits a day, you can fill half your required fluid quota. A healthy way to start and end each day for example, would be with a cup of warm water flavored with half a fresh lemon.
Things to avoid would be white flour, red meat, processed food, coffee, too much alcohol and artificial sugar. These create a lot of acidity in the body. Too much acidity triggers eczema, acne, cysts, rosacea and wrinkles – so all of these conditions could be greatly improved by a diet that contains alkaline-rich foods.
At this point most of us have heard the term probiotic or have noticed the words lactobacillus and acidophilus listed on our dairy products – particularly yoghurt containers. But did you know that about two hundred trillion of these microscopic organisms- bacteria, viruses, and fungi – are swarming inside you right now and are part of a vast organism called a microbiome?
A microbiome is, in essence, the sum collection of all the microbes found in or on people. Currently, about 9 million adults in America are taking probiotics in one form or another. It has built up to a billion dollar industry. Results are as difficult to predict as the actual microbiome is hard to understand and unravel but some tests have shown dramatic results. In the Intensive Care Nursery at Duke University Medical Center, the Preemie Microbiome Project has become an important step in understanding how we achieve a healthy, balanced microbiome in the first place. Researchers know that infants acquire about 100 species of microbes in the birth canal and others come from the mother’s skin after birth. Microbes can also be found in the mouth, lungs, between our toes and eyelashes, and even living in and around our tummy buttons. Our nose, mouth and eyes are also obvious entry points for germs. Tears and mucus contain an enzyme (lysozyme) that breaks down the cell wall of many bacteria. Saliva is also anti-bacterial. Since the nasal passage and lungs are coated in mucus, many germs not killed immediately are trapped in the mucus and soon swallowed. So your body has a regular artillery of defenses that it would seem logical to support as much as possible.
Scientists feel that understanding and controlling the diversity of our germs could be the key to a range of future medical treatments as well as maintaining our general health – diversity provides resilience in our bodies as it does in our environment and our local communities. Biologists at Washington University in St. Louis have done studies that suggest that the microbiome may play a significant role in affecting the ability of the body to digest properly, extract energy from food and to deposit it as fat and it has long been thought that the gut is the seat of the immune system. Imbalances in the microbiome in this part of the body might be linked, for example, to allergies, IBS, Krohns, diabetes, obesity and generally poor digestion. So it is becoming clear that managing the microbiome might be far more preferable to pummeling it with antibiotics. Which of course brings up the issue of the increased use of antibiotics not only through prescription but also in our food chain – especially in chicken and cattle feed. It has been established that continued use of antibiotics will eradicate certain strains of friendly bacteria that never fully repopulate certain areas of the body. So buy organic as much as possible. In the fullness of time we will understand how our genetic make-up, lifestyle, health and disease, influence the metabolic composition of our gut, and how this in turn influences, and is influenced by, our gut microbiome. And perhaps the next time you feel yourself getting hungry, or are feeling lethargic, you might ask yourself whether it’s really you, or is it the residents of your gut? As scientist Lynn Margulis commented in the April edition of Discover magazine,”We couldn’t live without bacteria. They maintain our ecological physiology. There are vitamins in bacteria that we can not live without. The movement of gas and feces would never take place without bacteria. There are hundreds of ways our bodies wouldn’t work without them. Bacteria are our ancestors.”
As any good aesthetician knows, the skin is an important part of the body’s immune system and will reflect inner stress and poor lifestyle. Topically, the skin produces antimicrobial peptides that keep bacteria in check. But when certain conditions are present, like psoriasis, acne, atopic dermatitis and rosacea, the skin’s defenses are over ridden and bacteria and fungi proliferate. Harsh cleansers, highly acidic formulas and prescription medications, both oral and topical, often exacerbate the problem, so correct analysis and product recommendations at this stage are vital. At SkinSense, we take a two step approach to skin health and wellness.
After counseling the client about diet and lifestyle we suggest a spa routine that is corrective without being too aggressive. Skin that is dehydrated or broken out won’t respond well to immediately aggressive peels or exfoliating treatments so we balance the skin with enzymes and aromatherapy before attempting anything more advanced. Meanwhile the client uses a home care routine that is also gently re-balancing including vitamins A, C, and B5 with plenty of ceramides and hyaluronic acid to calm and hydrate. Consistent and diligent morning and evening routines are always important but never more so than at this particular stage.
It is also interesting to note that probiotics have now started showing up in product formulations for topical use where they can encourage cell renewal, improve barrier function and retain surface moisture. This builds new tissue and gives the skin a glow. We also have a list of alkaline foods compiled from “The Acid Alkaline Food Guide” by Dr. Susan Brown that many of our clients find very useful and we recommend specific brands of probiotics that are easily purchased locally.
The secret to staying healthy and keeping skin youthful it seems, might be in keeping your germs healthy and your bodies pH balanced too. This way we can reflect both inner and outer health on a daily basis.
In the skin care business, it is not unusual to talk about the pH of a product. The letters pH stand for potential hydrogen, as hydrogen is the element that controls the levels of either alkalinity or acidity in a formulation. Acidic products range from 0 – 6.9 and are often used to exfoliate or peel the skin; alkaline products range from 7.1 – 14 and can be used in cleansers or to neutralize acidity. Very often moisturizers are formulated to be neutral (a pH of 7) to bring the skin back into balance. Too much acid or alkalinity is irritating for the skin, so the pH is always carefully calibrated.
More recently, the principle of pH balancing has been applied to our bodies. This holistic approach believes that the foundation of healthy digestion is built on a simple eating system that maintains an ideal acid/alkaline (pH) balance in the body. Seventy per cent of the immune system is based in the abdomen and 90% of the tryptophan needed to make serotonin for the brain – essential to ensure we feel good – is made here. So in order to live a long and happy life it obviously pays to keep our abdomens happy!
How do we do that? The suggested pH ratio would be a diet of two-thirds alkaline and one-third acid-forming foods. This takes some adjustment. So, to take a step in the right direction, let’s outline a few alkaline foods that we can incorporate in greater quantities and some acidic foods we can eliminate.
Raw, green leafy vegetables like chard, kale and spinach are all excellent alkaline-rich foods. So are avocados, celery, cucumbers, tomatoes, peppers, broccoli, coconut, cherries, grapefruit, lemons and watermelon. A healthy way to start and end each day with an alkaline system for example, would be with a cup of warm water flavored with half a lemon.
Things to avoid would be white flour, coffee, red meat, too much alcohol and artificial sugar.
And how does all this reflect in the skin? Well, too much acidity triggers eczema, acne, boils, rosacea and wrinkles – so all of these conditions could be greatly improved by maintaining a more alkaline system. Obviously, exercise and relaxation are essential and drinking the right amount of water. Men need more water than women on a daily basis, but if you eat plenty of the above listed vegetables and two or three fresh fruits a day, you can fill half your required fluid quota easily.
There are several books that discuss this subject at great length. For recommended reading material and a list of nutritionists who recommend pH balancing contact us.
Does your spa keep good records on your visits? Do they know if you have any allergies? What medications and vitamins are you taking? It is very important that your facialist knows if you are using any Retinoids, for example. I’ll explain why later. I know these days we tend to be a little suspicious about divulging too much personal information but for you to have a really beneficial result with each facial it is essential that your facialist is well informed.
Obviously some of the data contained on these forms is solely for marketing purposes and you have the right to withhold those particular details. Bear in mind, that by doing this you may miss out on some great specials. For the more essential information, however, here is a list of the key categories that you should look for and feel comfortable about filling out.
1. Pre-existing medical conditions. e.g. Acne, Diabetes, Epilepsy, Asthma, HIV Positive, Excema.. All these conditions effect the skin’s appearance and its response to specific facial protocols. NO electrical procedures should be performed on epileptic clients, for example. It could trigger a seizure.
2. Allergies. e.g. Food, Pollens, Animals, Product ingredients, Medications etc. A reaction can range in appearance from a rash to full blown hives.
3. Medications – with the aging baby boomer population and the plethora of medications taken for preventative reasons, chronic illness, insomnia, anxiety and depression, it is essential to tell your facialist all that you are currently taking. Many medications effect results because they tend to make the skin more sensitive, cause dryness and at the other end of the spectrum, they can also cause acne.
4. Prescription skin care products taken or used regularly. e.g. Retin-A, Differin, Tazarac, are all part of the Retinoid family that cause skin proliferation. It is essential for this reason that any client using these topicals not be waxed. Accutane, an oral acne medication, carries the same contra-indication. This is because the waxing process will remove the skin in the areas being waxed as well as the hair. It is also important to tell your facialist if you have a history of microdermabrasion, chemical peels or plastic surgery. These procedures raise the skin’s sensitivity to other protocols
5. Lifestyle. Stress can cause general skin crankiness but a healthy lifestyle can really make a difference to how severely it affects you. Let’s break it down;
Fluids – drink at least half your body weight in ounces every day. For example, if you are 130 lbs., drink at least 65 ounces of water daily. It will keep the skin clear and hydrated. Avoid
Sodas – too much sugar, and minimize coffee and alcohol – both can dehydrate and sensitize the skin.
Smoking – decreases 50% of the oxygen content in your blood, quite apart from the cancer and other health risks it poses to the body. This can make the skin look dull and yellowish.
Exercise – stimulates the circulatory and lymphatic system, keeps you toned and agile, and releases important hormones and chemicals into the blood stream that keep your mental outlook healthy. Physical exertion also helps you to sleep better.
Sleep – while you sleep your skin goes to work so get enough hours. The benefits of a good night’s sleep can not be over stated. And remember, missed sleep can never be caught up on.
6. Hormones – because the hormonal break-out zone on the face is the chin and lower jaw, breakouts generally occur there during period time, pregnancy and menopause. Very stressful times and irregular cycles can also cause acne to appear on the chin as well. When using or changing birth control pills, it can also take the body 3-6 months to adapt, and break-outs can also appear at this time. Tell your facialist if you are dealing with any hormonal issues.
7. Home care routine – what you are using at home and how consistently can have a huge impact on how you age. What you spend on skin care these days too, both in time and money, because cosmetic chemistry has made so many advances in the last twenty years, can really make a difference. The absolute basic routine for at home care should include cleansing and toning morning and night, eye cream twice daily, a moisturizer with SPF 30 during the day and a treatment cream with anti-oxidants and other anti-aging ingredients at night.
8. Skin care concerns and expectations – finally, after you have given all this data to the technician, state clearly what you would like to change about your skin and what results you are looking for. Ask questions about the protocols and products that are being recommended and always remember to inform the facialist of any changes in your skin or lifestyle between visits.
A good facialist, high quality skin care line and a consistent daily home care routine can knock years off your appearance! Call or e-mail us with any questions.