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Medical Esthetic Technology

January 2007 issue of Skin Inc. magazine

We asked several industry suppliers for their take on the topic of medical esthetic technology—a popular phrase in today’s industry. Is it here to stay? What will be the next hot trend? How can spas profit from this technology? Following, they share their responses.

Q: What do you feel will be the next hot technology to reach the medical esthetic market?

“According to the American Society for Aesthetic Plastic Surgery, choices have changed significantly for age-management approaches with respect to surgical modalities. In 2005, more than 11.5 million cosmetic surgery procedures were performed. Of these, 81% were noninvasive, nonsurgical applications due to the demand by our progressive age-management generation, most of whom are baby boomers who want minimal downtime, less morbidity and immediate results. Members of the impending boomer generation are approaching 60, and, due to the commitment to battling aging successfully, they now will be recognized as ‘the new 40,’ and technology will satisfy the need to keep pace with this demanding demographic. The medical esthetic industry provides state-of-the-art nonablative lasers, microdermabrasion, intense pulsed light (IPL) and light-emitting diode (LED)—just to name a few of the wrinkle war instruments developed to combat the effects of aging and lifestyle imbalances.”

Christine Heathman, founder and CEOAdvanced Aesthetics, Inc./GlyMed Plus

“In a market that has been bombarded by at-home quick fixes, the next phase of technology will be equipment that delivers solid, permanent and visual results after one or two treatments. Systems that offer the concept of ‘do no harm’ will be the trend. Using naturopathic principles to create immediate visible results on the face and body will attract the average client who has the disposable income to pay for these services.”

Donna Lope, executive vice president Diamond Systems USA, Corp.

“The hottest technology in the medical esthetic market will be topical wrinkle fillers and skin care creams that will provide the effects of fillers or Botox*, without the needles. The medical esthetic market will continue to see less invasive approaches to skin care.”

Paul Cain, PhD, CEO, BABOR Cosmetics America, Inc.

“It is difficult to accurately predict the next ‘hot’ technology for the medical esthetic market. There are several factors that need to be considered, including ingredients, treatments, carrier agents and equipment such as advanced therapeutic light technology, to name a few. Topical products that are effective and deliver visible results also play a vital role in developing the latest technology that is results-driven. Peptides are the new buzz right now. Research is continual and ongoing to discover the ultimate teaming of effective anti-aging ingredients, advanced technology and carrier agents that deliver these ingredients to the skin exactly where they are needed. The current trend is leaning toward more effective alternatives to typically invasive medical treatments in order to achieve similar results. Although new technologies will be less invasive, they will deliver more benefits to the skin.”

Research and Development Team Pevonia/Medicalia Skin Care

“LED therapy is garnering significant buzz in medical, esthetic and consumer circles. However, keep in mind that not all LEDs are the same. Look for those that have been proven clinically to offer customers a new technological advancement that is an effective way to attain younger, healthier-looking skin. Best of all, these particular LED treatments can be used on all skin types, and are safe, painless and relatively quick.”

Marcel Besse, executive vice president, sales and marketing, Light BioScience

“Technology in the medical esthetic market reaches new heights with the inclusion of clinical instrumentation that can measure precisely many attributes of a patient’s progress. A few examples of this technology include equipment that measures cellular water content—a key factor in creating whole-body/internal and external anti-aging programs; ultrasound machines that help to track improvement in conditions such as cellulite; and clinical photography that evaluates sun damage levels, counts the number of comedones and wrinkles, and measures pore size. All of these provide scientific ways in which the spa can measure treatment results.”

Howard Murad, MD, CEO and founderMurad, Inc.

“In an effort to claim a larger market share, esthetic companies are producing an avalanche of new products, a few of which have merit but many of which are simply marketing gimmicks. Unfortunately, in many cases, these smoke–and–mirror products are so compelling that the consumer—and even the skin care professional—cannot sort fact from fiction.”

Bryan Johns, president and CEO, iS Clinical

“We strongly believe that today, most skin care experts will tell you that the days of traumatizing and thinning the skin are passé. Noninvasive products and technology designed to strengthen and repair the skin are the wave of the future. LED photomodulation represents an important departure from lasers and IPL, which rely on thermally injuring the skin in order to prompt a reaction. You will see more and more LED devices being used and promoted worldwide. In addition, LED will enter a new phase—integrating multiple wavelengths. It’s a question of offering the best possible treatment to your clients every time they walk into the spa.”

Jennifer Brodeur, co-owner and co-founder, Flip4

“Members of the baby boomer generation have walked headfirst into the demographic for facial rejuvenation. They currently are spending billions on skin care, and eight out of 10 are afraid of the current procedures.”

Tony Case, president, Lumiere Light Therapie

“Because patients are active and working, they cannot afford the lengthy treatments that are associated with invasive procedures. The current trend is toward quick procedures that enable clients to resume activities rapidly.

“Today’s clients want immediate results. They also expect to stay younger-looking longer and, accordingly, make better lifestyle choices and implement improved dietary habits. Medical esthetic technology is a natural choice to correct the appearance of their skin because of its noninvasive nature.

“What we are seeing at the medical spa level is the use of Combination Therapy. In this, multiple approaches are layered, delivering not only the specific treatment but also producing a synergy between treatments. Thus, each component works with others, producing significantly enhanced results that are greater than if each were used separately. Typical of these treatments are microdermabrasion, skin resurfacing with phototherapy, transdermal topical delivery to obtain effective results at all skin layers, dermal fillers and the use of microcurrents to tighten facial contour.”

Danielle Tsoklis, director of education and development, Silhouet-Tone USA

“The science of skin care is advancing rapidly. New and exciting delivery technologies are being developed for more effective penetration and increased action of cosmeceutical ingredients. A topical product is only as good as its formulation and penetration, so overcoming the stratum corneum and allowing active ingredients to do their work more dynamically in the skin is an important advance.”

Alison Adams-Woodford, director of product development, PCA Advanced Skin Care Systems

“I feel that the next hot technology to reach the medical esthetic market will be equipment using the far-infrared ray (FIR) technology.”

Lydia Leung, president, Tinny Beauty International

“Objective analysis of the skin is accomplished with a combination of technologically advanced equipment that will take the guesswork out of choosing a skin care program for the client. These newer technologies will be used by the skin care specialist to look at the skin objectively and plan out a corrective program. The client then will better understand and participate in the program, which will lead to greater compliance and return visits. Although not inclusive, some of these technologies include:

  • Simultaneous color, polarized and ultraviolet photography with computer analysis. The eye of the camera can see imperfections of the skin that the skin care specialist may miss.
  • Dermascope examination of the skin. The magnified lens of the dermascope points out slight irregularities in skin moles that could indicate early developing melanomas. An early referral to your associated dermatologist may save a life.
  • TEWL monitors. Transepidermal water loss detectors are available that measure insensible water loss through the skin. The accelerated loss of water through the stratum corneum will make obvious the sensitive skin of the rosacea patient. A normal water loss will uncover clients who are not using their skin care program and are not conditioned enough to develop a good result after a chemical peel.
  • Lactic acid sting test. The documented level of stinging after application of a lactic acid (10%) test on the nasolabial folds will inform the skin care specialist and the client of the level of skin conditioning needed before a chemical peel, and also suggest to the specialist what level of peel will work.”

James E. Fulton Jr., MD, PhD, consultant Vivant Pharmaceuticals

“I believe that our world, as a whole, has reached a level of new sophistication and realization in that we no longer are so desperately seeking the latest, greatest breakthrough to solve all of our concerns in regard to health, wellness and preventive aging. Skin therapists have discovered that knowledge truly is power, and understanding the efficacy and science behind the technology that is applicable and available to us, as well as the knowledge to maximize the benefits of this technology, is key. Progressive manufacturers are answering this demand for knowledge by requiring every new customer to participate and pass a certification course and exam when they purchase new technology. This type of education is also a requirement by many states. In most cases, a day of education at the skin therapist’s location is included in the purchase price and is not optional.

“Whether you look to microcurrent, microdermabrasion, radio frequency or oxygen infusion, some variation of these technologies has been available historically for some time. What is new, and what is hot, are manufacturers of devices that have the science to support the mechanisms of action that allow the benefits of their specific devices. My selection and focus for 2007 is microcurrent—both for the medical arena and the esthetic arena. Very low levels of patented microcurrent frequencies have proven to increase collagen synthesis, elastin synthesis and adenosine triphosphate (ATP) synthesis substantially, as well as to help contour the muscles of the face and encourage product penetration.

“Because of its multifaceted benefits to the overall wellness of the human body, microcurrent allows for the most expeditious and diverse range of results than that of any other technology available to the skin therapist. Layering microcurrent applications with microdermabrasion, oxygen infusion, radio frequency and injectables are all extremely synergistic. New variations of microcurrent also now come equipped with a myriad of different accessories for various applications.”

David Suzuki, president, Bio-Therapeutic, Inc.

“Ultrasound is the new buzz in in-spa skin care treatments. Ultrasonic instruments are used to emit sound waves that stimulate body cells. Traditionally used in medical offices, the cosmetic and therapeutic benefits of this technology are a huge step in esthetic advancement.”

Barbara Salomone, CEO and founder Bioelements and The Conservatory of Esthetics

Q: How/why should spas be putting this technology to use?

“This technology has so many uses within a spa. With capabilities in cell stimulation and the expansion of the cell membrane, it is an amazing vehicle for penetrating products such as alpha hydroxy acids and serums into the skin, making them more effective. The warming effects of ultrasonic instruments are beneficial for post-operative treatment and relaxation. Ultrasound instruments even can be used for instant exfoliation treatments.”

Barbara Salomone, CEO and founder Bioelements and The Conservatory of Esthetics

“Spas should be working with this noninvasive and nonablative technology. Virtually everyone can benefit from a treatment with no downtime or negative side effects.”

Jennifer Brodeur, co-owner and co-founder, Flip4

“Spas should have technology in use with every service that is performed, without exception. Whether used as the epicenter of a service or as an accent, no spa service can satisfy the definition of a ‘complete experience’ without the addition of technology.

“Microcurrent is best known for its traditional five-step service that is performed on the entire neck and face in a series of eight to 10 services. However, progressive manufacturers have developed innovative protocols that focus on specific areas of concern, such as expression aging, transitional aging, and fine lines and wrinkles, all of which can be performed as a one-time service. Additionally, there are many innovative new accessories—many of which are hands-free.

“Microcurrent definitely is among the strongest of noninvasive modalities and is the focal point of most progressive spa menus, layering other devices as accents around the service. Microdermabrasion is the most common and most synergetic technology to utilize with microcurrent and typically is used at the beginning of the service, prior to the microcurrent application. Afterward, oxygen infusion is recommended to assist in plumping and firming fine lines and wrinkles, as well as for complete facial oxygenation and rejuvenation.

“If you work with a cosmetic surgeon or dermatologist, microcurrent is a very strong partner when used side by side with today’s wide array of injectables. It is true that injectables are wonderful; however, they do very little, if anything, for skin condition, skin texture, or muscle contouring. The optimum scenario is to perform a series of microcurrent services, perform the injectable service, and then move forward to a series of microdermabrasion and oxygen-infusion services with periodic microcurrent maintenance.”

David Suzuki, president, Bio-Therapeutic, Inc.

“Today’s spa-goer is well-informed and demands the most effective and results-driven skin care products and treatments available. Spas need to stay abreast of the latest technological breakthroughs in ingredients and application of treatments in order to attract savvy spa-goers, as well as to retain the client base that they already have. An important part of the success of a spa’s growth depends on its popularity, which is based on the number of clients who are attracted to the facilities because of the treatments offered, the diversity of therapies, the level of education of the skin care specialists, the amenities, the location and more. Spa owners should acquire and offer the newest technology and ensure that their professional staff receives adequate training and education in order to deliver outstanding results.”

Research and Development Team, Pevonia/Medicalia Skin Care

“Spas should take advantage of this trend by providing treatments that are aesthetic, such as compression therapy wraps that produce an immediate loss of inches, or a collagen mask that instantly diminishes wrinkles. It’s not enough just to offer a short-term cosmetic treatment anymore; consumers are looking for results-oriented treatments. Spas need to partner with a brand that has the treatments, products, training and support required to be successful in this new age of spas. Spa owners also could partner with local plastic surgeons or dermatologists who can ‘prescribe’ treatments for their patients to enhance the effects of Botox or Restylane**.”

Paul Cain, PhD, CEO BABOR Cosmetics America, Inc.

“Spas would be the perfect setting for a nonevasive procedure. With the calmness and wholeness of this procedure, the client relaxes as the treatments are being delivered.”

Donna Lope, executive vice president Diamond Systems USA, Corp.

“One of the challenges faced by busy spa professionals is keeping up with the changing times and technology, and guiding clients toward treatments that are both effective and in line with expectations. Therefore, it is important to do your research first. There are a lot of LEDs on the market, but not all have the scientific research and clinical studies to support their claims. In today’s competitive world, estheticians need to remain the experts in skin care, and show current and prospective clients that they are up-to-date and well-informed on what the media is buzzing about.

Once the research has been done, incorporating LEDs into a spa menu can be easy, because these treatments are versatile and can fit into several different categories. LEDs are the perfect complement to any anti-aging spa treatment, and, because LED photomodulation sessions have been shown by physicians to help reduce redness and skin irritation, they are the perfect post-treatment for procedures such as facials, microdermabrasion and peels. LED treatments also can be a great add-on to waxing services, because the light can help to calm and soothe waxed skin, causing the redness to subside more quickly than it would on its own.”

Marcel Besse, executive vice president, sales and marketing, Light BioScience

“The aging process occurs at each level of the skin. We begin aging when the epidermis’ hydrolipidic film is impaired. Cell renewal begins to slow, causing the skin to lose its radiance and become dull. The dermis loses its moisture, causing fine lines and wrinkles to appear. Collagen production, as well as the skin’s ability to repair itself, diminish. The results are deepening wrinkles and the loss of elasticity in muscles, causing sagging jowls and deep nasolabial folds. Medical esthetic technology offers true rejuvenating treatments. These are able to target and provide an effective solution that can be focused at each of the layers of the skin where aging problems occur: the epidermis, dermis and muscle level.”

Danielle Tsoklis, director of education and development, Silhouet-Tone USA

“Looking for products with well-rounded formulations and interesting delivery technology will ensure better results for a medical spa’s patients. A favorable treatment result, as well as results from using home-care products, deepen the trust relationship and commitment between the patient and technician.”

Alison Adams-Woodford, director of product development, PCA Advanced Skin Care Systems

“FIR energy has been used widely in the health and wellness industries throughout the world—especially in Germany, Japan, Korea and China. It also is being used in vital equipment in our space program. FIR energy—especially that in the range of 8–14 micron meters—has been found to be a vital source of booster energy for human beings. It penetrates deep into tissues, invigorating their cellular activities and, as a result, improving the overall well-being of the individual.”

Lydia Leung, president, Tinny Beauty International

“At my Inclusive Health Center, we not only incorporate technology in various forms, we take it a step further and use technoceuticals, which defines the use of the very best of cosmeceuticals, nutraceuticals and technology for the ultimate care of the client.”

Howard Murad, MD, CEO and founder, Murad, Inc.

“Consumers are becoming more discriminating and demanding in esthetic product and procedure expectations. Statistically, consumers still are seeking dramatic esthetic improvements with results-oriented products but achieved with less invasive procedures that typically involve a great deal of pain, as well as downtime with a recovery period. Additionally, there is an overwhelming consumer wave of interest in more natural means of caring for one’s health and esthetics. These concerns are driving consumers to take new interest in technologically advanced topical skin care preparations that are results-oriented and deliver on product claims. By offering products that satisfy this consumer need, spas are building trust and loyalty, which translates to repeat business.”

Bryan Johns, president and CEO, iS Clinical

“Testing should be performed before to any products being dispensed to the client. It should be done periodically, so that the client can see the improvement. A battery of objective tests will accelerate the spa to a level above the average and increase the credibility of the services. Clients will develop loyalty and confidence in the treatments that are provided. The rate of referrals will increase.”

James E. Fulton Jr., MD, PhD consultant Vivant Pharmaceuticals

Q: What can medical esthetic technology do for a spa’s bottom line?

“When patients see results, they become repeat purchasers. Happy patients also spread the word through their personal networks, bringing more patients and dollars to a location. Effective, well-rounded and reliable cosmeceutical products that incorporate the latest technologies are an essential revenue stream for any successful medical spa.”

Alison Adams-Woodforddirector of product developmentPCA Advanced Skin Care Systems

“Enhance client satisfaction and attract new business for increased profit margin. Medical esthetic technology can draw first-time clients—both men and women—who are seeking effective alternatives to invasive surgical procedures, and keep them coming back for more. It also will help to retain repeat clients who are satisfied with their results and are looking for more advanced treatments that will be beneficial to them. Offering powerful, results-producing retail home-care regimens that continue the benefits of the professional treatments will lead to an increase in growth, resulting in increased revenue for the spa. The medical spa of the future will blend medical treatments with esthetic facial and body treatments seamlessly, creating an intrinsic balance between body and spirit for improved health, a feeling of well-being and a more attractive physical appearance.”

Research and Development Team Pevonia/Medicalia Skin Care

“Retention is one of the greatest factors in increasing a spa’s bottom line. With all of this cutting-edge technology, knowledge and training are absolutely essential. Clearly, the more technically knowledgeable you are about skin care, the more effectively you can treat the skin. A client won’t jump to seek medical services if they can be treated in their very own spa.”

Barbara Salomone, CEO and founder Bioelements and The Conservatory of Esthetics

“This is a win-win situation for the spa. It is able to offer services that are not available to the consumer at home. These anti-aging services have a high-impact nature that produces the immediate results for which clients are willing to pay. This means additional revenues for the spa because medical esthetic technology does not replace existing services. Rather, it complements the array of treatments that already are being offered. Further, it not only provides expanded service to the spa’s present clientele, but also attracts new customers.”

Danielle Tsoklis, director of education and development, Silhouet-Tone USA

“We use technology in every facet of our world to enhance our effectiveness and quality of life, so why would we deprive our industry and our clients of this potential when it comes to their skin? Purchasing esthetic devices from well-qualified manufacturers who supply proven and efficacious technology, as well as the knowledge and confidence to maximize the potential of this technology, is the best investment that you ever will make.

“Utilizing technology to accent your traditional facial, or layering two or more technologies within one service, will increase your bottom line dramatically. Not only does technology allow you to provide benefits to your clients that you only imagined, it also maximizes your spa’s financial potential, offering as much as 200% above and beyond what can be charged for traditional skin care services.

“In addition to boosting your hourly income, your image as a skin therapist quickly is elevated to becoming a technologist; a skin therapist who is knowledgeable and certified to use esthetic technology. Technologists are perceived differently than the average skin therapist, and, as a result, they are in a commanding position to prescribe a series of services utilizing technologies that ultimately will meet the client’s objective. Just as important as professional prescriptions are technoceutical prescriptions, which essentially support products that work synergistically with the technology services that are being performed. End consumers relate the products to the technology, and therefore have a much stronger reason and need to adhere to the prescriptions set forth by the technologist. This inherently leads to better and more consistent results, customer loyalty, increased product usage and, of course, increased revenue.

“At the end of the day, technology is an essential part of the definition of skin care and esthetics; embrace it, learn about it and maximize it.”

David Suzuki, president, Bio-Therapeutic, Inc.

“Results from LED photomodulation therapy do not happen overnight. In order to achieve fit, younger-looking and more radiant skin, clinical studies and scientific research have shown that these results happen after a series of eight to 10 sessions, followed by monthly maintenance treatments. Therefore, LED photomodulation therapy provides spa owners with an opportunity to ensure repeat customers.

“Spa owners can increase client satisfaction and add to their bottom line if they select the right LED therapy—one with scientific research to support its claims—and they must know how to capitalize on it effectively. For instance, a spa owner can charge an additional $30–50 for facials, microdermabrasion, peels and waxing services when following up these treatments with an LED photomodulation session. As a stand-alone service or an express facial treatment that includes LED therapy, spa owners are charging anywhere between $50–75.”

Marcel Besse, executive vice president, sales and marketing, Light BioScience

“The latest trend in partnering will prove to be very lucrative. The partnership will create a spa culture in which clients will receive treatments almost on a prescription basis. Consumers will visit a spa not just on their birthdays or Mother’s Day anymore; they will become frequent customers to enhance and prolong the effects of their esthetic treatment.

“The spa’s partnership with an advanced technology skin care line is absolutely necessary in order to increase the bottom line. The right brand will provide the spa with popular celebrity treatments and products that usually are displayed in trendy magazines. The brand with which you partner should assist in helping to turn your spa boutique area into a social environment where clients feel comfortable enough to return between treatments—just to purchase product. This easily will double your profits.”

Paul Cain, PhD, CEO BABOR Cosmetics America, Inc.

“Medical esthetic technology can endorse the medical evidence, proving that these treatments do make a measurable difference. Kee Lee Tan, MD, of Australia, has documented studies of numerous patients, all showing inch loss and fat reduction. Here in America, a noted plastic surgeon currently is conducting clinical studies documenting the same results. By increasing the service menu, the spa owner can offer more selections as clients become savvier, and their needs grow for better skin and body care. I believe that microdermabrasion always will be first and foremost the first level of skin care. Microdermabrasion prepares the skin for the next levels of toning and restructuring. Imagine painting a wall that has just been spackled without sanding it down first. Spas are the first place that clients contact for the latest technology. By adding services for body treatments such as fat reduction, body toning and firming, as well as oxygen therapy, your spa can be the one-stop mecca for the ultimate in skin care therapy.”

Donna Lope, executive vice president, Diamond Systems USA, Corp.

“In today’s demanding and competitive esthetic market, consumers are less likely to exhibit loyalty in favor of following the latest technologies. Spas must continually offer new and technologically advanced procedures and products in order to maintain a respected reputation and ensure repeat business.”

Bryan Johns, president and CEO, iS Clinical

“The baby boomers are very conscious of their personal health, wellness and beauty, and are nearing retirement age. They are the most important segment of the spa clientele. Medical esthetic technology can deliver a better and more obvious result than that of conventional spa treatments, thereby boosting a spa’s bottom line.”

Lydia Leung, president, Tinny Beauty International

“1. A great return on investment/repeat customers

2. A selling series

3. Generate new clientele

4. The ability to offer optimal results in a safe alternative.”

Jennifer Brodeur, co-owner and co-founder, Flip4

*Botox is a registered trade name of Allergan, Irvine, CA.

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