There is an increasing awareness about the role health and wellness play in our lives and the importance of establishing a balance among one’s mind, body and soul. Although many skin care professionals want to embrace wellness, and especially good nutrition, they struggle with how to get started. The spa is a perfect setting for wellness, as people typically come to the spa for relaxation and treatments to enhance their skin and bodies through facials and massage. Even though the spa has not traditionally been viewed as a place to receive nutritional advice, people tend to turn to their esthetician as a source of information in this area.
Encounter: During Intake
During the process of a typical skin evaluation, an esthetician will ask the client questions about their lifestyle, including questions on their typical diet, water consumption, smoking habits, exercise, daily SPF use, sleep habits and stress levels. Many times, the answers to these questions are literally written all over the faces of the clients. Chronic, inflammatory skin conditions are often tied to poor sleep, stressful lifestyle and poor diet; all of which create a fire bubbling beneath the surface of the skin. When an esthetician notices these things, they may offer a recommendation to wear a mineral sunscreen every day to prevent further photo damage, suggest getting adequate rest each night, and trying things like meditation or essential oils to aid in stress relief. These wellness-related recommendations are all acceptable suggestions to make and fall within the scope of practice of the skin care professional as they attempt to evaluate the client from a holistic perspective (holistic = whole person: body, mind and spirit).
How do estheticians know where to draw the line when it comes to offering specific nutritional advice? Most estheticians have not been trained as clinical nutritionists or registered dietitians; therefore, giving nutrition advice falls outside of their scope of practice. That said, there are so many connections between skin health, gut health and nutrition. From acne to rosacea to aging as a result of glycation, there are proven associations that can be made between nutrition and skin. What’s the esthetician’s role here?
I was looking at an esthetician’s chat site on Facebook a few weeks ago, reading a thread about treatment for a particular acne case for which photos were posted along with some very basic information about the client. There was all kinds of specific nutritional advice being offered, and while a lot of it was good, some was not so great. I read that to manage acne one should not chew cinnamon flavored chewing gum, use only basic toothpaste and avoid eating nuts. This is not sound advice in my professional opinion. Maybe in a particular situation for a person with a specific set of circumstances this made sense, but certainly not as a general guideline for any person with acne. Many nutritional supplement recommendations were being made as well. As well-meaning as these skin care professionals were, they were not necessarily helping. In some cases, they may have even caused harm.
It helps to understand what the law says about who can and cannot offer nutritional counseling to the public. This is a tricky area because the laws vary from state to state from extremely restrictive laws regulating nutritional counseling to absolutely no regulation on the books. It is not within the scope of practice of an esthetician to ever prescribe nutritional supplements and treat disease states. In some states, criminal charges can be brought against a person who crosses into a nutritionist or doctor’s territory.
To understand nutrition licensure laws in a specific state, refer to the Center for Nutrition Advocacy (CNA), which works to promote policy and regulations that allow diverse practitioners to practice nutrition to the level of their training, and gives consumers access to the practitioner of their choice. They keep an eye on regulations and policies that matter to what you do and whether it’s legal for you to do it. Their goal is to build avenues for nutrition to transform healthcare. Refer to their website, www.nutritionadvocacy.org, to find out what the laws in your state say about what information you are permitted to share with clients on their nutritional status. In general, estheticians can make general healthy eating recommendations and present nutritional studies for education.
General healthy eating. It is usually legal for someone to provide nutrition recommendations that do not target an individual’s existing medical condition. For example, it is fine to state that a healthy diet includes five to seven servings of fresh fruits and vegetables per day, with limited amounts of refined carbohydrates and added sugars, as opposed to suggesting something like, “people with eczema should take 1.8 grams of omega-3 supplements per day to lower the inflammation associated with the skin condition.” The first is a general guideline for good health, whereas the second statement is a specific recommendation related to a health condition or disease state.
Published studies. On the other hand, it is legal to provide copies of studies and published information about addressing health conditions (like inflammation or acne) in the vein of “studies have shown that taking 1.8 grams of omega-3 supplements per day have shown improvements in eczema.” The esthetician cannot make a specific recommendation, but s/he can reiterate what the literature reports, period. They should then suggest that the client consult their physician before taking any supplements to be sure it is a safe choice for them personally.
The esthetician is positioned perfectly to help clients reach their wellness goals. Given the close physical nature of their work, along with the intimate personal connections that are formed between skin care professional and client, they have the power to help many. The role of the esthetician is to make observations, educate and refer.
Make Observations For example, “I notice that your skin appears dehydrated. Studies show that some factors that can contribute to this are poor omega-3 fatty acid status, inadequate water intake and lack of a quality moisturizer in a nighttime skin care regimen.”
Educate. Keep abreast of the latest published research on nutrition and wellness for healthy skin and create a resource list to share with clients. Be sure to site credible references. GoogleScholar.com is a good place to do research or you can work with a nutritionist, doctor or nurse to create a library of good information.
Refer. Take some time to build a referral list of highly qualified clinical nutritionists or registered dietitians in your geographic area. Two reputable sources are www.nutritionspecialists.org for a clinical nutritionist and www.eatright.org for a registered dietitian.
Promote Healthy Living
Estheticians can and should be ambassadors of wellness for their clients. This begins by modeling the behaviors and lifestyles that support good health and skin, but also includes a role as educator. Understanding the fine line between educator and counselor is an important distinction to make to ensure that an esthetician is working within scope of practice while helping clients live healthy lives.