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Getting the Facts Straight

Mark Lees, PhD January 2010 issue of Skin Inc. magazine
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Editor’s note: This article is based on “Real vs. Rumor: The Truths and Myths of Skin Care,” the author’s presentation at Face & Body® 2009 Spa and Healthy Aging Conference and Expo in San Jose, California.

The skin care industry has always been plagued with rumors and myths. In order to dispel some of these many fallacies, a special class was designed to help clear up frequent misconceptions, as well as discover how many estheticians knew the truth about these common understandings—or misunderstandings, as it may be.

At the Face & Body® 2009 Spa & Healthy Aging Conference and Expo in San Jose, California, 68 estheticians were presented with a questionnaire listing 12 commonly held beliefs about skin care and were then asked to identify these statements as true or false. The purpose of this survey was to determine whether the estheticians attending this educational session actually knew the correct information. The results of the survey follow, along with an explanation of the correct answers.

True or false? Mineral oil causes clogged pores.

31% answered true; 69% answered false

This is a very common erroneous belief among both estheticians and consumers. The simple truth is pharmaceutical-grade or cosmetic mineral oil is noncomedogenic. In many studies, mineral oil has been shown not to form comedones, and in one study, it has been shown to actually decrease inflammation in acne patients. However, the fact that mineral oil has an oily texture may be objectionable to those with already oily skin.

True or false? Breakouts after facials are an indication that the skin is purging itself of toxins.

49% answered true; 51% answered false

Breakouts and pimples that seem to surge after a facial are inflammatory or irritant reactions to the methods or products used in the treatment. The skin has no physiological mechanism to purge itself of toxins. Inflammation occurs within the follicle during the facial treatment and causes swelling of the follicle walls, which impairs oxygen from reaching the bottom of the follicle. Acne bacteria are anaerobic, and thrive in an environment void of oxygen.

To avoid breakouts after facial treatments, use correct extraction techniques and properly soften areas to be extracted with a good desincrustant product. Also, use a soothing serum after extractions, avoid highly fragranced products and excessive massage or excessive extractions, and eschew any overdrying masks that could cause irritation.

True or false? Eating greasy foods will not flare acne.

40% answered true; 60% answered false

Even though eating excessive amounts of fried foods is not a healthy nutrition habit, there is no scientific evidence that greasy foods cause or worsen acne. However, there is evidence that working in a greasy environment, such as a fast-food restaurant, may worsen acne due to the skin being exposed to airborne grease from frying foods.

True or false? Sun helps dry up acne lesions.

46% answered true; 54% answered false

The ultraviolet rays of the sun do kill acne bacteria and help to dry up acne lesions. Additionally, natural pigmentation from tanning can help hide the redness of acne. However, the same rays cause inflammation and long-term damage to the skin that might eventually lead to premature aging or even skin cancer. There are better—and much safer—ways of drying acne lesions using effective skin care.

True or false? Natural products are less likely to cause breakouts.

15% answered true; 85% answered false

There is no evidence that skin care products of natural origin are less likely to cause breakouts than those made with synthetic ingredients. In fact, many natural skin care products contain natural oils that may be broken down in the follicle when applied, ending up as fatty acids, many of which are known to be comedogenic or acnegenic.

Synthetic ingredients such as silicones and polymers do not break down or create fatty acids. Additionally, essential oils can be stimulating and irritating to the follicles, and many frequently used carrier oils for aromatherapy are known to be comedogenic.

True or false? Acne breakouts concentrated in the chin and jawline areas are likely caused by hormone fluctuations.

82% answered true; 18% answered false

Premenstrual acne flares are very common in the chin and jawline areas. They have been associated with the hormone variations common with normal menstrual cycles; the beginning or discontinuation of hormonal therapy, including birth control pills; and potentially even gynecological illnesses.

If a client has chronic chin and jawline breakouts that are not controllable with topical esthetic care, refer the client to a dermatologist or an endocrinologist for analysis of individual hormone levels. There are drug therapies that can help with these fluctuations and their resulting acne flares.

True or false? Benzoyl peroxide often works for a while, but eventually acne bacteria become resistant to it.

50% answered true; 50% answered false

Acne bacteria do not become resistant to benzoyl peroxide (BPO). BPO is both antibacterial and keratolytic, helping to rid the skin of dead-cell buildup on the surface and in the follicle. When a client begins using BPO, there is usually a fairly fast response, resulting in substantially clearer skin. Clients sometimes then stop using the BPO, thinking they are clear and do not need it any longer. Of course, acne is a chronic condition and lesions will reoccur quickly if the medication is stopped.

Clients also sometimes overuse BPO, applying it more often or heavier than recommended. Because BPO is a peeling agent, it can be an irritant, especially if overused. The follicles can become irritated from overuse, resulting in perifollicular inflammation, and therefore causing acne flares. Benzoyl peroxide is a wonderful medication for clients with acne, and estheticians should take the time to educate their clients and coach them on its correct use.

True or false? You should avoid products containing any form of alcohol, because it dries the skin.

38% answered true; 62% answered false

The term alcohol is a chemical term, and it takes many forms in cosmetic chemistry. Certain forms of alcohol such as isopropyl, ethyl and SD alcohols are volatile alcohols and should be avoided in skin types that are dry or sensitive. However, oily and combination skin types may actually benefit from small amounts of volatile alcohols, helping to disperse excess sebum on the skin’s surface.

SD alcohol is sometimes also used as an evaporating agent, added to quickly dry products. Other forms of alcohols are actually moisturizing ingredients, such as cetyl alcohol, which is used in lightweight moisturizers.

True or false? Skin dryness and dehydration is a primary cause of wrinkles.

37% answered true; 63% answered false

Skin dryness and dehydration can certainly make wrinkles and aging skin look worse, but wrinkles are primarily caused by facial expression and cumulative sun exposure. Using a daily moisturizer with hydration agents that also contains a broad-spectrum sunscreen is a great way to help wrinkles look better and prevent the daily exposure that actually causes damage to the dermis making skin wrinkled.

Also, daily use of some the newer peptide products, along with agents such as alpha hydroxy acid and retinol, can actually have long-term benefits in making the skin look much less wrinkled.

True or false? 100% all-natural products are chemical-free.

3% answered true; 97% answered false

Nothing is chemical-free. Everything, including plant extracts, skin care products and even the human body is made up of chemicals. Without chemicals, people could not move, think or live. Natural substances can contain hundreds of chemicals that are naturally present, and in fact, one-third of all prescription drugs are made from plant sources.

True or false? Allergic reactions are the No. 1 type of reaction caused by skin care products.

54% answered true; 46% answered false

The No. 1 type of reaction to skin care products are irritant reactions, mostly caused by overexfoliation, which damages the barrier function of the skin, causing both inflammation and dehydration. Overuse of foaming-type cleansers or using cleansers that are too strong for the skin type can also cause irritant reactions.

Irritant reactions can also affect anyone who overexfoliates or overuses stripping products, or even overstimulates the skin. Allergic reactions only occur in people who have a strong immune reaction to the product.

True or false? Drinking alcohol causes phymatous rosacea, or rhinophyma.

29% answered true; 71% answered false

Drinking alcohol can be a trigger for rosacea flares and sudden redness in people who already have rosacea, as can heat, sun, stress, spicy foods and even exercise. None of these actually cause rosacea however, and not all triggers affect all rosacea patients.

Rosacea, including phymatous rosacea, which causes the bulbous nose condition known as rhinophyma, is believed to be hereditary. Rosacea patients should avoid triggers that flare their condition, as continual flaring can make it worse.

While it is encouraging that many estheticians already knew the correct answers to these questions, it’s important for all skin care professionals to be skeptical about any statements they hear regarding skin care. The true answer to preventing myths and erroneous information is to keep from spreading it in the industry and to clients by learning the correct information at continuing education classes.

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