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Medical Esthetics Treatments
Are You Choosing the Right Exfoliation Method for your Client?
By: Terri Wojak
Posted: May 28, 2013, from the June 2013 issue of Skin Inc. magazine.
A rough-surfaced instrument is used to polish the skin during the performance of microdermabrasion.
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Dermaplaning. During dermaplaning, a skin care professional removes dead skin and vellus hair with a scalpel. Although the procedure may seem straightforward, it does not mean it is an all-around simple procedure to perform; in-depth training by a reputable company or educator is a must before providing this treatment. The legalities of esthetician usage regarding this treatment are somewhat controversial. Even though dermaplaning only removes dead skin on the superficial layer of the epidermis, the use of a medical instrument raises a question. Check with your licensing state to see if it is legal for you to perform dermaplaning. (Editor’s note: For a complete list of contact information for each state, log on to www.SkinInc.com/education/statelicensing.) Legality aside, it is advisable to only offer this procedure if you are working under the direction of a physician.
Superficial chemical exfoliation
The most common superficial chemical exfoliation methods include alpha hydroxy acids (AHAs) and beta hydroxy acids (BHAs). AHAs include glycolic, lactic, malic, tartaric, mandelic and citric acids, and many AHAs, specifically glycolic and lactic, are widely used in chemical peeling agents. These can be used on their own or combined with other acids. AHAs work by dissolving the intercellular lipids and proteins that hold dead skin cells to each other. The percentage for use by skin care professionals is as high as 30% and as low as a pH 3.0 in most states. The common BHA in superficial peeling agents is salicylic acid. Salicylic is known for its lipid-soluble properties, making it a great option for oily and acne-prone skin. Estheticians should not go higher than a 20% acid when applying only one layer. Salicylic has a keratolytic effect; it assists in the break down of comedones by reducing the dead skin accumulation in sebaceous follicles.
Superficial to medium-depth exfoliation techniques
Superficial to medium-depth peeling treatments often include Jessner’s and trichloroacetic (TCA) acid. These two peels have been used by physicians for many years. Modified and blended versions of these peels are now available for skin care professionals; however, it is still recommended to check with your individual state guidelines. Estheticians must use caution as excessive amounts of these peels can cause side effects and even permanent damage. Always follow the manufacturer’s instructions on application techniques. As a general rule of thumb, if someone is concerned with photodamage and doesn’t mind the possibility of visible peeling, then these peels are more commonly used. It is vital to remember that no other treatment should be performed with these peels. This includes omitting pre-treatment exfoliation, such as microdermabrasion, dermaplaning or post-treatment facials, extraction and massage.
Managing client expectations is a difficult, but important task. Before proceeding with any treatment, you must become very familiar with your clients’ goals. Regardless of how effective the treatment is, clients will not be satisfied if their hopes for the treatment are not met. This is all part of the consultation process. Following are answers to questions that commonly come up during consultations with clients who are interested in receiving an exfoliating treatment. These will help in not only gauging your clients’ needs, but also in distinguishing if the treatment recommended will ultimately meet their goals.
Does the client want to see visible peeling to validate results? Skin care professionals know that exfoliation occurs at a cellular level and there is no need to see visible peeling, but your client may feel differently. Educate her on the exfoliation process and, if the client is a candidate for a stronger exfoliation, this will likely make her happier in the end. On the other hand, if the client wants a full facial including extractions and massage, you can always boost the facial by adding a superficial exfoliation including AHAs or BHAs, or even a light pass of microdermabrasion or dermaplaning.