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					   Specialty                                                                                         Care
Official Publication of the            Debra Yates, Editor • Jeannine L. Dabb and Karen Davis, Assistant Editors                                           Fall 2010
S O C I E T Y              O F       P L A ST I C                 S U R G I C A L                  S K I N   C A R E            S P E C I A L I STS

  From                                                 New Website for Aesthetic Community:
                                        A                                                         Susan M Wells, RN, MS
                                                             s skin care specialists, we actively live
                                                      with the knowledge that plastic surgery is not
                                                      the only solution to achieving your beauty
                                                                                                                site took almost two years to develop and
                                                                                                                was extensively researched and surveyed by
                                                                                                                consumers. The site provides consumers

                                                      goals. There are a multitude of specialties               with videos on everything from breast
                                                      that consumers and patients reach out to when             augmentation to makeup and fashion
                                                      attempting to determine what will improve                 trends. The videos are entertaining,

90% treatment effect within
           his morning I was going to my              their particular attributes—whether it’s                  informative and positions plastic surgeons
  favorite café for coffee and the woman              physical fitness, hair, skin or fashion. Luckily,         and their qualified staff as the “go-to”
  in line behind me asked if I’m Debra                a special committee at the Aesthetic Society,             specialty. A great example is the video on a
  Yates. She said “I thought that was you.            headed by Dr. Daniel C. Mills, II, recognized             Medical Facial, which goes through all of
  I’ve been meaning to call you and do                a gap in the information that we were                     the steps a trained skin care professional

  24 hour Light, portable
  something with my skin.” I told her I               providing the public and wanted to                        takes in making sure the patient’s skin is
  would love to see her and gave her my               revolutionize how we spoke to them.                       treated properly.
  business card. The week before, I was          , a consumer “”                                          Continued on page 2
  giving a Look Good…Feel Better session
  at Hershey Medical Center and one of the

     and easy to use
  lovely ladies going through chemotherapy
  brought along her daughter who, after
  the session was over, asked for my
  number and was interested in discussing
  permanent makeup and skin care.
       Being part of your community, out
  and about whether it’s a trip to the store
  or volunteering, you never know when
  you will make that special connection.
  Another connection for me, that has
  been successful, is networking with
  various business women’s groups in the
  area. I belong to the American Business
  Women’s Association, which supports
                          Continued on page 2

                SPSSCS Mission                                                        SPSSCS Board of Directors 2010–2011
     The Society of Plastic Surgical Skin Care        Susan M. Wells, RN, MS          Donna Sollima, RN      Abbey Helton, BSN, RN, CPSN Sandra M. Day
Specialists is a voluntary, non-profit organization   President                       Treasurer              Member-At-Large            Immediate Past President
dedicated to the promotion of education,              Stephanie Holden, RN, BSN       Susan Tognazzini       Elena Reyes, RMA, RST      Richard A. D’Amico, MD
                                                      President-Elect                 Secretary              Member-At-Large            ASAPS Advisor
enhancement of clinical skills and the delivery of
safe, quality skin care provided to patients within   Karen Davis                     Angela Frazer, RN      Jill Neibaur, ME           Renato Saltz, MD
                                                      Vice President                  Member-At-Large        Parliamentarian            ASAPS Advisor
the office of a Plastic Surgeon certified by the
American Board of Plastic Surgery or the Royal             SPSSCS Central Office • 11262 Monarch Street, Garden Grove, CA  92841 •
College of Physicians and Surgeons of Canada.                   562-799-0466 or 800-486-0611 • Fax 562-799-1098 • email:

                                                   THE PRESIDENT’S MESSAGE
                                                   Susan M. Wells, RN, MS

                    W                     hile
                            many in America
                            were enjoying a
                                                   now about attending the 2011 meeting in
                                                   Boston, and its importance for practice
                                                   enhancement. If you were not able to
                                                                                                      you began communicating with your
                                                                                                      patients via social media?
                                                                                                          We all know that involvement in the
                            leisurely summer,      attend the last meeting due to recession-          SPSSCS has tremendous value to our
                            your board             related constraints, requesting early might        practices. We just need to be sure to
                            members were           increase the likelihood that you could             communicate it! ▲
                            busy strategically     receive CE funding.
                            planning new
directions and projects for the Society—
                                                       If you were able to join us this year,
                                                   reinforce the impact it had on the practice's
along with innovations in professional
education. Specifically, Stephanie Holden,
                                                   success by identifying specific clinical or
                                                   organizational changes you made that were
RN and the members of the Program
Committee are assembling exciting
                                                   directly associated with information you
                                                   gleaned from the meeting. Were clinical
content for the 2011 Annual Meeting—as             outcomes improved by you adding a                        Update your Calendar
sophisticated and diverse as the articles you      treatment to the menu of services that has                          NEW MEETING DATES!
will find in this issue of the newsletter! It is   markedly increased patient flow and
                                                                                                                 May 4 –7, 2011

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not too early to be proactive in planning          decreased hyperpigmentation? Was there
your professional development for the year.        an exponential return on investment when                                      Boston, MA
Approach your manager and surgeon                  print ads and mailings decreased because

  24 hour Light, portable
Continued from Cover
New Website for
Aesthetic Community:
                                                   billion videos were watched every month.
                                                   Project Beauty is primed for this market and
                                                   will continue to grow along with demand
                                                                                                      Continued from Cover
                                                                                                      From the Editor’s Desk

     and easy to use
                                                   for enhanced viewing and anti-aging                                  procedures.                                        women personally and professionally. Look
                                                        Launched at the 2010 Aesthetic Meeting        for these business groups in your area—
                                                   in Washington DC to the members and                sometimes they are looking for speakers,
     These videos not only offer a broader
                                                   select media, was                and you can update them on the latest
look at “beauty,” but also add value to a
                                                   recently blasted out and marketed to the           makeup and skin care trends, at the same
surgeon’s practice by having first-hand
                                                   health and beauty community. This young            time creating exposure for your business.
patient testimonials of cosmetic procedures
                                                   site already has over 50 videos and receives            Have you seen this new website,
performed by ASAPS doctors. Patients
                                                   over 18,000 hits a month. It continues to The American
openly discuss the reasons behind their
                                                   grow a steady following as the site expands        Society for Aesthetic Plastic Surgery
choices, the research behind their final
                                                   to include a blog, a health and beauty             recently launched this website. There are
selection and how their decision has forever
                                                   forum and a monthly newsletter to all              tips on beauty, fashion, skin care, makeup
impacted their lives. These are the stories
                                                   subscribers.                                       and, of course, plastic surgery, all through
we hear in doctor’s offices and from our
                                                        As members of the Skin Care Society           video. The SPSSCS is proud to support this
friends, but never over an exciting, new
                                                   and leaders in our field, it is pertinent for us   new venture and we have been asked to
platform that can reach millions.
                                                   to embrace this website and new digital            contribute by providing content for the
     According to Forrester Research, “The
                                                   medium. We need to subscribe and link to           “Notes from a Skin Care Specialist” page.
days of thinking of online video as mostly a
                                                   Project Beauty, send out videos to our             See the article on the cover of this
YouTube phenomenon are officially over.
                                                   patients, contribute ideas for new videos          newsletter. Please sign in and tell your
Instead, the Internet-connected PC has
                                                   and leave comments to increase the                 patients about the value of the site.
become another TV set in people’s lives,
                                                   dialogue and provide factual information                If you have an article or something of
one that fulfills all the same needs that the
                                                   (which is sadly lacking on the internet).          interest you would like to contribute to the
still-beloved TV set in the living room does
                                                   This is an exciting new product from               SPSSCS newsletter, please contact me at
— only this screen is more convenient and
                                                   ASAPS and our community will only         ▲
more compatible with consumers’ lives than
the old one.” Additionally, market research        benefit from the accurate information,
firm comScore, Inc reported that there             education and patient safety provided on
were 178 million internet users watching  ▲
video last year and approximately 33.2

Member Profile:
                          Venezia-Weiler, LE

                    V                  ery early on in my young career,
                            I was lucky enough to hit the skin care
                            professional ‘jackpot’. I was a few years out
                            of Arizona State University, managing a
corporate-run salon and spa. Sixty-five or 70 hour work weeks
consisted of squeezing in skin care treatments between conference
calls and team-member one-on-one’s. I learned a lot during those
years that an art major doesn’t get to learn in school: including how
to read a P&L, what EBITDA is, and how to manage cost of goods
sold. Though I was getting paid for this practical education, I felt
like I was going to develop a stress ulcer at a young age. How does
one find excitement, professional development and mental

90% treatment effect within
stimulation with out working until 3AM? It was a mystery to me.
     Then the answer came. I had heard through the ‘grapevine’ that
a local medical group, consisting of over 200 doctors at the time,
was going to open a new medical spa and aesthetic surgery center,

  24 hour Light, portable
to be named “The Institute of Aesthetic Surgery.” I quickly did my
homework and found that the physicians to be opening the practice
were very talented and well respected. I sent my resume over and
hoped for the best; this could be the opportunity of a lifetime. I
soon got a call and began the 3 month interview process. They

     and easy to use
took their time, considering the actual building was still under
construction. They needed someone with business savvy that could
build their medical spa from the ground up, and then hand over the
reins and begin performing services. I was thrilled to find out that I
was the lucky candidate. I had won the aesthetic lottery.
     In the beginning, I spent most of my time designing the service
menu, learning from the doctors, and providing my practice
manager with break-even analyses of new equipment that I thought
we’d need. After we opened our doors in October of 2006, my role
changed to primarily performing skin care for our patients. I thought
it would bother me at first, letting go of the business side of
aesthetics. But with all there is to learn in our constantly changing
landscape of aesthetic practice, I am constantly thrilled and
stimulated by all there is to master and perfect… and I haven’t
looked back to my salon/spa days once. One part of keeping up on
that constantly changing landscape is attending the SPSSCS
meetings, where I come away with skill-sharpening information
every time. This year in Washington DC was fabulous, and I was
lucky to connect and reconnect with experienced and talented
members. I am always so thrilled to be a part of the meetings, and
then return to work refreshed and energized with new inspiration
and ideas.
      There is a lot to be thankful for in life. I was lucky enough to
come in to a new practice and help build it from the ground up;
from helping to develop the business cards to developing the patient
base. And ever since we opened, every time I walk out the doors
after a busy week of practice, I make sure to thank my lucky stars. ▲

90% treatment effect within
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     and easy to use

                        The Gift of Giving
                                                           Cindy Wrocklage, RN

           A                         t 4:53 pm
                              on January 12,
                              2010, a magnitude

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7.0 earthquake hit the country of Haiti; its
epicenter just 10 miles west of the capital of
Porte-Au-Prince. In its wake, 230,000              rarely deal with this side of medical care. I    into the wards and cared for their orphan
people were killed, more than 300,000              had thought the transition to such critical      friends because the rest of their families had
seriously injured and over a million people        care would be difficult. It definitely was,      died in the earthquake.

  24 hour Light, portable
were left homeless. To its credit, the United      but I found that compassion and care are              I have also seen compassion and care on
States and the international community             universal. It transcends what kind of medical    the part of many Americans and other
mobilized and provided food, water, shelter        care or service you are providing. It is those   nationalities from all over the world toward
and medical relief. The American media             personal qualities of empathy and truly          those less fortunate and in need. These
focused almost non-stop television coverage        listening to your patient that ultimately        doctors, nurses, clinicians, physical therapists

     and easy to use
on the disaster. However, the media’s              matter. Though what we were able to give         and emergency workers will never receive
attention span is short and almost five months     to the Haitian people during the week we         much recognition or acclamation. That is
later, as I write this article, very little        were there amounts to a teardrop in an           not why they have disrupted their lives and
coverage is being given to the aftermath of        ocean of need, I know we all feel really         families, or given of their time and money.
the earthquake and the continued plight of         positive about our mission.                      They want to make a difference in our
Haiti and its people.                                   The real message I want to convey in        world; to make it a better place. And they
     I’ve just returned from a medical mission     this article is not what was given by me as      certainly have. It is these people who will
to Porte-Au-Prince and the desperate need          part of an American medical team, but            change the hearts and minds of the future
of Haiti and its people remain unchanged. It       rather what I received in the process. I         generations. It’s hard to be pessimistic about
is difficult as an American to imagine just        witnessed grace, kindness and patience on        our world when you have seen so much
how devastating the earthquake was to the          the part of the Haitian people in the face       compassion on the part of so many.
infrastructure of a country where previously       of the most dire of circumstances. Could              I would like to thank the American
no real construction standards were in             anyone ever get angry over waiting in            Society Plastic Surgeons, the LEAP
place. People continue to live in tents. Little    the express lane at the supermarket when         Foundation and Dr. Richard Zeff for
has been done to begin the rebuilding              you’ve witnessed someone waiting patiently       facilitating our medical mission to Haiti.
process. Many buildings remain precariously        for medical care in sweltering heat from 7       Imagine my surprise to find that I was the
unstable, including the presidential palace.       o’clock in the morning until 5 o’clock in        one who received the greatest gift in this
Haitians go about their lives in the midst of      the afternoon? It was always without             process of extending a hand in friendship
destruction and danger. Our team, which            anger, only gratitude after being seen.          and help. Keep this in mind the next time
included a plastic surgeon, an anesthesiologist,   Our translators stayed alongside us all day      you are asked to help someone.
two nurses, a surgical technician and one          for very little pay, not only facilitating
student, dealt with injuries in both adults        communication, but bringing their guitars             Cindy Wrocklage is an RN, Certified Plastic
and, most emotionally difficult, children.         and singing songs for us and the patients. I     Surgical Nurse and Certified Nurse Injectionist at an
Our focus was on reconstruction of massive         received sincere smiles and laughter at my       ambulatory cosmetic surgey and laser center in
wounds deficits, skin grafting over electrical     poor attempts at Creole. I saw families          Stratham, NH where she has been employed for the
burns, and even an amputation from a crush         caring for their loved ones, providing food,     past eight years.. ▲
injury. We are an aesthetic practice and           love and comfort. Even street children came

Synergistic Relationships
Meeting Your Patients Needs—
Exceeding Expectations
Meets Organic
Myong Chong

                    A                     s skin
                           care awareness by
                           the general public
                                                   an extract from a specimen that did not.
                                                   Furthermore, it has been proven that the
                                                   ingredients with the smallest molecule size
                                                                                                     effective for testing product efficacy. Using
                                                                                                     HSTE, scientists are able to document how
                                                                                                     far into the tissues ingredients penetrate, as
                           increases, so do        are the ones that penetrate deepest into the      well as, which ingredients are present in the
                           the expectations        tissues. Among alphahydroxy acids, glycolic       tissues any number of days after the
                           for more                acid penetrates further than lactic acid          application. While this research method is

90% treatment effect within
                           scientifically          because of its molecule size. Transdermal         costly for the company producing the
                           advanced                delivery is at the forefront of skin care         formulation, the rewards come with having
formulations. Consumers and patients alike         ingredient selection. For optimal results,        document proof of safety and efficacy.
want to be assured that the products that          high concentrations of key ingredients must       Patients who use the skin care products that
they are using are created with the latest         penetrate into the living tissue. Products        have been tested on the human skin tissue

  24 hour Light, portable
technology. Moreover, they want to be              that sit on the top layers of the skin do not     equivalent may have greater confidence in
educated on why that particular product is         provide the same level of benefit as those        the formulation because of the intense
right for them. This is especially evident in      with a transdermal delivery system. More          research that went into its development. At
commercial media. Television and print             than ever, patients are looking for organic       point of sale, the price of such formulations
advertising now contain more and more              ingredients that will provide results for their   rarely becomes a factor. Patients, who have

     and easy to use
verbiage and supporting graphs, charts and         skin conditions. It is our responsibility to      been thoroughly educated on the scientific
diagrams explaining everything from the            seek out and provide solutions for our            research and testing, will purchase with
length of a UVA ray to the molecular               patients that not only meet their needs, but      confidence.
structure of the antioxidants in grape juice.      have also been scientifically proven to be             As a result, the needs of the physician,
In addition, the awareness of “organics” and       safe and effective.                               nurse or aesthetician have been met because
products that are “eco-friendly” and “green”                                                         they were able to find a solution for the
                                                   TESTING FOR SAFETY AND EFFICACY—
is also at an all-time high. As physicians,                                                          patient. The patient’s needs were met due to
                                                   HUMAN SKIN TISSUE EQUIVALENT
nurses and aestheticians, we have an                                                                 the confidence that was instilled in them by
                                                        Following along with the trend of what
incredible opportunity to educate our                                                                the provider. This synergistic relationship
                                                   is environmentally responsible is the desire
patients on the science behind natural                                                               between provider and patient is then
                                                   to eliminate animal testing. The public
ingredients that are beneficial to the skin.                                                         nurtured and will continue to grow, even
                                                   outcry for this has been heard loud and
More and more people are seeking a holistic                                                          after treatment is complete. Through return
                                                   clear by manufacturers. So much so, that it
approach to the health of their skin but                                                             visits for maintenance and the patient
                                                   has become a common fixture on labels and
want to be shown the science that supports                                                           referral process, both parties will continue
                                                   other marketing. The most accurate method
the benefit.                                                                                         to benefit from the education, ingredient
                                                   of testing uses a patented research tool
                                                                                                     choice and testing methods that were
INGREDIENT CHOICES                                 known as the Human Skin Tissue Equivalent
                                                                                                     involved in making a skin care system
    There is a plethora of options when it         (HSTE). This human skin equivalent is
comes to ingredient choice. From botanical         constructed entirely from human skin cells
to chemical and vitamins to amino acids,           grown into three-dimensional sheets of skin
                                                                                                          Myong Chong is the founder and owner of
the combination possibilities are endless.         in the laboratory. The skin equivalent
                                                                                                     Hanna Isul® Skin Therapy, Inc. She is the inventor
The main factor to set ingredients apart is        undergoes differentiation into the normal
                                                                                                     of the premium anti-aging skin care system,
their origin, method of extraction and             layers of skin and can be used for
                                                                                                     SOVAS-5™ A licensed aesthetician since 1982, she
molecule size. Origin and method of                transplants. HSTE allows researchers to test
                                                                                                     has devoted her time to extensive scientific research to
extraction are especially important, when it       the safety of ingredients without risk to an
                                                                                                     create the safest, most effective formulations possible.
comes to botanicals. For example, lavender         individual or using controversial animal
                                                                                                     Myong can be reached at 866-307-4331 or
extract from a plant specimen that has been        testing. Moreover, the human skin tissue
grown in ideal conditions will be superior to      equivalent has been shown to be the most

90% treatment effect within
  24 hour Light, portable
     and easy to use

                           How to Maximize Profits
                           with Vendor Support
                           Sarah Burns Eggenberger
                           PART II
                           Please refer to our Winter, 2010 issue for Part 1

M                ARKETING     SUPPORT
     Experienced graphic artist and marketing
teams spend hours creating branding and
                                                       they purchase the product they were
                                                       sampled. This increases the chance the
                                                       client will purchase the product.
                                                       GIFT WITH PURCHASE (GWP)
                                                                                                        COOPERATIVE ADVERTISING
                                                                                                             Co-op advertising offers support in
                                                                                                        marketing the product line specifically.
                                                                                                        Most companies give an allotted dollar
                                                                                                        amount to go towards co-op advertising,
messaging. Most medical offices do not have                 One of the first things that goes
                                                                                                        typically they will pay 50% of the bill up to
marketing departments or time to create                through a woman’s mind when you hear gift
                                                                                                        $500. You create an advertisement and send
marketing materials. Rely on the cosmetic              with purchase is the packed department
                                                                                                        it to the company to approve, as the
companies’ professional skills to equip your           stores giving away their ugliest, oldest
                                                                                                        advertisement needs to properly represent
business with high-end marketing.                      lipstick if you purchased $100 in products.
                                                                                                        the brand. Once the ad is approved, it may

90% treatment effect within
     On a daily basis we are exposed to over           That was the original use of the program, to
                                                                                                        be placed. The product company will credit
1,500 trademarked brands, which means you              get rid of overstocked items. The idea has
                                                                                                        the account for the percentage they are
need to compete with all the other options             evolved to a brilliant marketing plan. Gift
                                                                                                        reimbursing. That credit can then be used
available to your clients. Strategically place         with purchase programs push the client to
                                                                                                        for future purchases. Many companies offer
brochures, posters, counter cards, sell sheets,        purchase a little more so that they receive
                                                                                                        support in co-op advertising but very little

  24 hour Light, portable
and PR mentions throughout your business.              the free item. Many people will participate
                                                                                                        take advantage of it. Create an advertising
Every single room, hallway, entrance and               in the excitement of receiving a free gift.
                                                                                                        budget and discuss your campaign strategy
bathroom is a marketing opportunity.                   Everybody loves to get a present!
                                                                                                        with your product company. There is a
Consistently request marketing collateral                   Ask the product companies to assist you
                                                                                                        good chance they will support you in your
from your vendors to properly merchandise              in contributing the gift for the program.
                                                                                                        efforts to get their product line locally

     and easy to use
the products and stay fresh with seasonal              Most companies will support this program
                                                                                                        marketed. You have the potential of saving
and new materials. Most companies will                 for an event, but ask for more. Request that
                                                                                                        $500 per advertisement!
work with you on creating customized                   the GWP program last 1 week. This ensures
                                                                                                             We are operating in difficult times.
artwork with your logo. This is a customer             higher retail sales and more clients can take
                                                                                                        Creative methods in savings are crucial to
service feature that has no price but                  advantage of this amazing offer.
                                                                                                        business success. Enlist the support of the
personalizes all your marketing collateral.
                                                       GRATIS                                           cosmetic companies to receive all possible
     Newsletter, eblast and virtual communi-
                                                            Gratis is retail product at no charge.      benefits. If you do not ask, you may not
cation from the vendor are platforms for
                                                       There are copious ways of using gratis.          receive. Communication with your sales
marketing and education. Request to be on
                                                       • It can be given to the employees to            consultant is important to discovering all
all these communications and if pertinent
                                                          experience the products so they can           the options that are available to you.
you can send directly to your clients. Many
                                                          represent by personal stories.
of the education materials the company can
                                                       • Gratis can be used as a contest incentive.          Sarah Burns-Eggenberger has authored a book
provide are: Ask the Expert, Top 5 Must
                                                       • Gratis can be passed onto elite clients as     named “Guide to Product Selection.” by PCI
Have Products, 6 Ways to Improve Your
                                                          a thank you.                                  Publishing and authored a chapter “Make-up
Skin, etc. These are valuable tips to be
                                                       • Gratis can be donated.                         Application” for “Tic, Tock Stop the Clock.” She is
shared with your clients. You are not just
                                                       • Gratis products can be just for you!           the founding member of Advanced Aesthetic
selling cosmetics, you are a source of
                                                            Most consultants will have a gratis         Education Association and is currently the acting
information. Your clients will appreciate the
                                                       budget so make sure you are allotted a           president of the organization. She is an editor for the
knowledge and feel committed to you.
                                                       portion to support your activities. Set sales    PCI Journal, reviewing studies and writing abstracts.
SAMPLING                                               goals with the consultant to receive free        Sarah has also written articles for a variety of trade
    Most companies will base the sample                items. Explain to the consultant how you         publications, including Skin Inc magazine. Sarah is
allotment on sales volume. A percentage of             want to use your gratis and they will be         reviewer evaluating publications for Milady’s,
the sales amount will go towards marketing,            more likely to give you the free product.        Delmar Learning. She is a supporting member of
which includes samples. It is important to             Gratis used as an incentive to increase retail   several industry organizations.
have a high return on your investment with             sales is always a good use of free product.           Sarah is Brand Manager for gloProfessional, a
samples. The best practice on the use of                                                                skincare and cosmetics distributor and manufacturer,
samples is to give your clients a discount if                                                           for the last ten years. ▲

                                                   Beyond Acne 101
               The Latest Acne Treatments
                                                                Pamela Hill, RN

                                                  common prescription treatment for acne             ways for the acne patient to see what can
                                                  utilizes topical or oral antibiotics including     be immediate results. Typically the patient
                                                  Clinamycin (often used in conjunction with         comes once a week for 12 weeks. The
                                                  benzoyl peroxide). However, antibiotic             treatments will last anywhere from 10 to 25

         A                      cne is by no
means an unfamiliar skin concern to
individuals who work in an aesthetic
                                                  resistance has spawned the need for newer
                                                  acne therapies. Among these the use of low-
                                                  dose long term use of oral isotretinoin
                                                  regimens, insulin-sensitizing agents, 5
                                                  alpha-reductase type 1 inhibitors,
                                                                                                     minutes depending on the equipment and
                                                                                                     the company recommendations.
                                                                                                         Next in the light and laser category is
                                                                                                     the Intense Pulsed Light. Treatment with
                                                                                                     the IPL is thought to destroy the P.acne
environment. In fact, it is the most              photodynamic therapy, new combinations             bacteria and also shrink the sebaceous
widespread skin concern for all individuals       of topical formulations, dietary                   glands decreasing oil and sebum production.

90% treatment effect within
spanning race, age, and sex. While                interventions when appropriate and anti-           Green and yellow light is also used to treat
advancements are always being made, there         inflammatory agents such as lipoxygenase           the inflammation of acne in combination
still exists no cure for acne. However, newer     inhibitors (Zileuton)1.                            with IPL or as a stand alone treatment.
acne treatments are proving to produce                 While the following topicals are well         Finally, diode lasers are thought to destroy

  24 hour Light, portable
more and more reliable results. The               known to us: retinoids, tretinoins                 the sebaceous glands in the dermis, leading
daunting fact remains there are many              (Accutane), benoxyl peroxide and azelaic           to obvious decreased sebum production and
different treatment approaches. With so           acid, new drugs are making their appearance        acting similar to Accutane but without all of
many acne treatments available today the          in the marketplace. YAZ, a birth control           the side effects.
question that is paramount in the mind of         pill, is now FDA approved for the treatment            With all of these treatment options it is

     and easy to use
the clinician is, “Which treatment and for        of acne. Still basic to the topical routine is a   an exciting time for those of us that care for
which patient?” The treatment approach is         good cleanser preferably with salicylic acid       the acne patient. The secret to success is
often patient dependant. Therefore,               or benzoyl peroxide (also known as                 making sure that the treatment programs
understanding the pathogenesis of acne is         Benzac). If the acne is mild, a topical            you choose are right for the skin type you
fundamental to treating the individual            antibacterial is still thought to be a good        are treating. This is what we will be
patient.                                          choice—Cleocin T, for example. If the              discussing in our next article, so stay tuned.
      As we know, the hair follicle is attached   condition is more aggressive, a topical used
to the sebaceous gland and when sebum is          to unclog the pores will be necessary. The               Pamela Hill received her nursing diploma from
produced it naturally travels up the hair to      most common of course is tretinoin, but            Presbyterian Hospital and Colorado Women’s
lubricate the hair and skin. The problem          new drugs such as adapalene, azelaic acid          College, Denver, Colorado and has practiced as a
comes into play when too much sebum is            and tazarotene might be popular, depending         registered nurse for more than thirty years. Her
produced. The sebum along with dead skin          on the patients reaction to tretinoin.             background includes 18 years of operational and
cells can plug the follicle and solidify. This         Once the client is on a good home care        leadership experience in the medical spa, medical skin
solidification contains the bacteria known as     routine, cleanser, medication and SPF,             care and aesthetic educational sector. Passionate
P. Acne and typically inflames the area.          clinical treatments can be considered. The         about the education of aestheticians in the medical spa
      Simply put acne begins with the             most exciting clinical treatment for acne is       setting, Ms. Hill began a relationship with Milady
following basic problems:                         the use of photodynamic therapy. Laser and         Cengage Learning, in 2003. This relationship
• Excessive sebum production;                     light therapies definitely have an emerging        launched Ms. Hill’s authoring of the Aesthetician
• Abnormal follicular keratinization;             place in acne treatment. LED Light therapy         Series; a thirteen book series dedicated to the education
• The presence of the Propionibacterium           once done with just blue light is now being        of medical aestheticians.
   acnes or P. acnes bacterium; or                combined with red light for better results. It
• Inflammation                                    is believed that the lights destroy the P.
      Acne can be caused or exaggerated by        acne bacteria clearing the skin of breakouts.      1 (Dermatologic Therapy 2008 Mar-Apr (2):86-95).
environmental factors such as stress,                  Furthermore, there are now products
prescribed medications, or hormonal               that can potentiate the LED result. This is
imbalances to name a few. The most                among the easiest and most inexpensive

                      Maximizing Results with
                       Chemical Peels
                                                           Jennifer Linder, MD

                   C              hemical
                            peeling is one of
                            the oldest and
                                                 impactions will allow for deeper, more even
                                                 topical absorption of active ingredients for
                                                 faster results. Tricholoracetic acid, alpha
                                                                                                       Salicylic acid is often referred to as a
                                                                                                   keratolytic agent, meaning it dissolves
                                                                                                   impacted keratinocytes. Its lipophylic
                            most reliable        hydroxy acids, salicylic acid, phenol,            nature allows it to effectively penetrate into
                            methods of           retinoids and blended
improving the health and appearance of the       acid peels all provide
skin. The topical application of various         unique benefits.
acids assists in the regulation of the skin’s    Detailed knowledge of
natural cell turnover process—a complex          these secondary effects
system that ultimately leads to the shedding     will aid in ideal,
of cornified cells. This intricate process       customized treatment
can be easily disrupted, and improper            selection.

90% treatment effect within
desquamation leads to a dull complexion               Trichloroacetic acid
and is a key contributor to many of the          (TCA) is a safe and
most common skin concerns. Developing            versatile agent that is
an in-depth understanding of how                 among the most widely
chemoexfoliation benefits the skin and the       used acids in skincare.

  24 hour Light, portable
individual benefits of each skin-appropriate     TCA can be used in
acid will assist the clinician in making         various percentages
informed decisions on which peeling              (6%-50%) to provide a
solutions will be appropriate for each of        variety of depths, from very superficial          sebum-filled follicles, ridding the skin of
their patients.                                  exfoliation limited to the stratum corneum        breakouts. Salicylic acid also provides anti-

     and easy to use
    In addition to enhancing the skin’s          up to medium depth exfoliation, reaching          inflammatory benefits making it suitable for
natural exfoliation mechanism, chemical          the papillary dermis. TCA is ideal for the        sensitive skin conditions, such as rosacea
peels have been shown to stimulate the           treatment of textural imperfections, such as      and a great exfoliating option for all
production of collagen and glycosaminoglycans.   wrinkling, keratoses and scarring, and the        Fitzpatrick skin types.
Regardless of a peel’s depth of penetration,     exfoliation provided will also effectively lift
interaction exists between the epidermal         pigmented keratinocytes, lightening
and dermal layers leading to synthesis of        hyperpigmentation. This acid can be used
structural proteins, such as collagen.           on all Fitzpatrick skin types; however,                HENOL WAS ONE OF THE FIRST ACIDS TO
Furthermore, chemical peels are able to          percentages above 10% should be reserved          BE USED TOPICALLY, ALTHOUGH ITS USE IS
accelerate results by increasing corrective      for types I-III.                                  BECOMING LESS COMMON BECAUSE OF A RISK
product penetration. The removal of surface           Alpha hydroxy acids (AHA) are a group
                                                                                                   OF TOXICITY AND OTHER UNDESIRABLE
                                                 of carboxylic acids that include lactic acid
                                                 and glycolic acid, among others. AHA are          COMPLICATIONS.

IN ADDITION TO ENHANCING THE SKIN’S              used in percentages ranging from 10% to
                                                 70%. These gentle exfoliating acids are
NATURAL EXFOLIATION MECHANISM, CHEMICAL          suitable for Fitzpatrick skin types I-VI and
PEELS HAVE BEEN SHOWN TO STIMULATE THE           can be used to reduce the keratinization               Phenol was one of the first acids to be
PRODUCTION OF COLLAGEN AND                       involved in the pathogenesis of acne and to       used topically, although its use is becoming
                                                 reduce the appearance of visible aging and        less common because of a risk of toxicity
                                                 hyperpigmentation. Different AHA offer            and other undesirable complications. The
PEEL’S DEPTH OF PENETRATION, INTERACTION         specific skin health benefits. Glycolic acid is   most common phenol treatment is the
EXISTS BETWEEN THE EPIDERMAL AND DERMAL          best for oily, acneic skin, whereas lactic acid   Baker-Gordon, which combines 88% phenol
LAYERS LEADING TO SYNTHESIS OF                   offers humectant benefits for patients with       with croton oil and Septisol® to enhance
                                                 dehydrated skin, antimicrobial benefits for       penetration. This level of peel provides
                                                 acne patients and additional melanogenesis        deep exfoliation, reaching the upper
                                                 inhibiting properties for hyperpigmentation       reticular dermis; therefore, it is only to be
                                                 reduction.                                        used on Fitzpatrick skin types I-III.

INDUCING LARGE AMOUNTS OF INFLAMMATION                       About Your Skin Care Practice:
                                                                     Is It Worth Your Time and Energy?
LIMIT DOWNTIME AND SIDE EFFECTS.                                                           Michael J. Powers

                                                                                                       PROVE YOUR EXPERTISE
                                                                                                            Is something happening in the news
     Retinoids encompass all forms of vitamin
                                                                                                       that you would like to address? Your blog
A, including retinoic acid and retinol.
                                                                                                       is a great place to share your thoughts

These agents reduce corneocyte cohesion
                                                                                                       and prove your expertise in skincare and
and encourage cellular turnover. In
                                                                                                       the field of aesthetics. You can also refer
addition, retinoids inhibit the
                                                              O                                        to your credentials and memberships as
melanogenesis process, stimulate collagen
                                                        YOU BLOG?                                      necessary.
production and reduce keratinization within
                                                             If you
the follicles, making them beneficial for all                                                          PUBLISH IN REAL TIME
                                                        answered “yes,”
skin types and conditions.                                                                                 Blogging offers a quick and
                                                        then it is
     The modified Jessner’s solution was the                                                           convenient way of publishing on the
first blended acid chemical peel. The                                                                  Internet through such systems as

90% treatment effect within
                                                        that you are knowledgeable about blogs,
combination of 14% lactic acid, 14%                                                                    WordPress and Blogger. You can even
                                                        and understand how and why blogging
salicylic acid and 14% of the keratolytic                                                              blog or “tweet” (micro-blogging via
                                                        is a powerful social marketing tool. If
resorcinol provides multifaceted results for                                                           Twitter™), from your Smartphone, PDA,
                                                        you do not blog, then it may be the
the treatment of acne, hyperpigmentation                                                               or Blackberry®.
                                                        right time for you to learn about this
and visible aging. The Jessner’s solution can

  24 hour Light, portable
                                                        phenomenon as it can greatly enhance           COMMUNICATE DIRECTLY WITH YOUR
be used on Fitzpatrick skin types I-VI.
                                                        your practice’s marketing effort.              READERS
     Blended acid chemical peels are an
                                                             A blog (short for “Web log”), which           What you write will attract
excellent way to treat the skin, as additional
                                                        was previously considered an alternative       prospective patients, and they are bound
ingredients are able to target specific skin
                                                        method for promotional use, is now             to have their own thoughts regarding

     and easy to use
concerns. The goal of a chemical
                                                        undeniably worth the time and effort of        your articles. This means that when they
exfoliation should be to create change
                                                        physicians and specialists. Blogging is        comment, you may instantly respond to
without inducing large amounts of
                                                        now a standard Internet marketing              them and directly address their concerns
inflammation and complications. Blended
                                                        method, which will contribute to the           or questions. This creates a real-time
chemical peels contribute to healthy skin
                                                        growth and success of your practice.           dialogue, allowing you to reach out to
and limit downtime and side effects. Look
                                                             Even if you already have a website,       the public and share your voice.
for ingredients such as hydroquinone and
                                                        which offers an aesthetically focused
kojic acid for reducing hyperpigmentation                                                              SHOW BEFORE AND AFTER PHOTOS,
                                                        showcase of your work and information
and nutritive algae and almond oil for                                                                 VIDEOS, AND PODCASTS
                                                        regarding the fundamentals of your
increasing hydration and reducing irritation.                                                              In addition to having your media
                                                        practice, a blog is of additional value.
     The consistent and reliable results                                                               section on your main website, imagine
                                                        Consider a blog an extension of your
provided by chemical peels are a welcome                                                               having it on your blog as well! This will
                                                        main website—a new property that
addition to all skincare practices. By                                                                 highlight your achievements and only
                                                        shares the same goals and largely focuses
choosing multiple solutions, including                                                                 add to your credibility in the
                                                        on a user-friendly experience.
blended treatments and various percentages                                                             “blogosphere.”
                                                             All of these areas of blogging will
of different acids, the clinician is able to                                                               Communication is constantly
                                                        contribute to your marketing program
cater to the needs of each patient, creating                                                           evolving. From newspapers and radio to
                                                        and profitability because it increases your
customized treatment plans and                                                                         television and the Internet (including the
                                                        online exposure:
outstanding outcomes.                                                                                  Smartphone, PDA, and Blackberry®), we
                                                        VOICE YOUR PERSONALITY                         as marketers must continue to adapt to
     Dr. Jennifer Linder, a board-certified                 A blog is essentially a journal; it is a   the new technology of our times. I am
dermatologist and fellowship-trained Mohs skin          place where you can be yourself and            so excited to see what the future holds
cancer surgeon, is an assistant clinical professor of   speak in a tone that allows visitors to feel   for us.
dermatology at the University of California,            comfortable and apt to continue reading.
San Francisco. Dr. Linder is currently in private       Blogging is personal, so this is your              Michael J. Powers is the CEO of Plastic
practice in Scottsdale, AZ and is Chief Scientific      chance to write as little or as much as        Surgery Studios. Please e-mail
Officer for PCA SKIN. Dr. Linder can be reached         you wish.                             or call
at 480-946-7939. ▲                                                                                     (909) 758-8383 for more information. ▲

                                                 The Chemistry
                                                  Of Better Skin Care
                                                                  Dana Perdue

M                        uch like a recipe,
the chemistry of skin care is a process. For
best results, not only must the finest
                                                  producing the desired effect. Largely
                                                  inactive (and, in some cases, harmful)
                                                  “incorrect” molecules only dilute a product
                                                                                                        Essential for bone, vision and skin
                                                                                                   health, Vitamin A has the ability to
                                                                                                   stimulate the growth of healthy, new cells
ingredients be used, but each must be             and weaken its effectiveness.                    and increase old cell turnover, especially
introduced and combined in just the right                                                          when applied topically. However, just by
                                                  USING THE RIGHT AMOUNT
amount and at just the right time. Anyone                                                          doing its job, this key ingredient has the
                                                       While skin care companies are required
who’s ever had a cake fall flat can appreciate                                                     potential to irritate.
                                                  by law to reveal the contents of their
the delicacy and precision of the process.                                                              While Vitamin A is still found its
                                                  products in percentage in descending order
However, while a botched recipe may hold                                                           original form in many products, scientists
                                                  on the packaging, they are not compelled
dire consequences for your cooking ware                                                            have since found ways to cope with its
                                                  to disclose the actual amount of each
(and occasionally your stomach), a poorly                                                          signature irritation through innovative
                                                  ingredient used. Given the myriad products

90% treatment effect within
formulated skin care product can wreak                                                             formulation. One such way combines
                                                  developed to address common skin
havoc on your complexion.                                                                          retinol (a form of Vvitamin A) with chirally
                                                  concerns, it is not uncommon for two or
                                                                                                   corrected arabino-galactan protein
CHOOSING THE RIGHT INGREDIENTS                    more to display similar, sometimes even
                                                                                                   conjugates from wine. Known as AGP
     Depending on the product’s intended          identical, ingredient lists. However, even
                                                                                                   Complex, this combination of retinol and
purpose, ingredients can range from               if two different products list the same

  24 hour Light, portable
                                                                                                   skin-sensitive proteins and amino acids
exfoliants to cell stimulators to antioxidants    ingredients in the same descending order,
                                                                                                   helps neutralize irritation, allowing for
and beyond. Often, cosmeceutical products         they can produce entirely different results.
                                                                                                   higher concentrations of retinol in a formula
combine different types of ingredients to              Consider two products with the
                                                                                                   that’s far gentler to the skin.
treat multiple aspects of a condition.            following ingredient list: water, arbutin
                                                                                                        To gauge the effectiveness of skin care

     and easy to use
However, simply mixing raw ingredients            (a skin brightener) and lactic acid (an
                                                                                                   products, such as those containing AGP
will deliver limited results at best, even if     exfoliant). With 90 percent water, seven
                                                                                                   Complex, one has only to consider the
they are the best ingredients available.          percent arbutin and three percent lactic
                                                                                                   time, effort and care put into each step of
     For a product to achieve its desired         acid, product A is a powerful skin brightener.
                                                                                                   the formulation process. From ingredient
result, every aspect of handling, storing and     Meanwhile, with 88 percent water, six
                                                                                                   purification and combination to product
combining its ingredients must be taken           percent arbutin and six percent lactic acid,
                                                                                                   handling and storage, each factor plays a
into careful consideration. Are the               product B gives more exfoliation and is
                                                                                                   crucial role in determining how successful a
ingredients cold processed or cooked? How         thicker. Such slight variations in processing,
                                                                                                   product will be and how happy your clients
long are they cooked? How long are they           concentrations and percentages can mean
                                                                                                   will be with their results.
stirred? Each factor must be carefully            the difference between a product that
measured and monitored throughout the             delivers results and one that falls short.
                                                                                                         Dana Perdue, National Director of Education
formulation process to ensure optimal
                                                  THE RIGHT COMBINATION                            for CosMedix, oversees the Inspiration Through
product efficacy.
                                                       In order for a product to have a positive   Education program for both CosMedix and Results
AN ISSUE OF PURITY                                effect on the skin, the ingredients must first   Rx brands, supplying skin care professionals
    How pure an ingredient is will also           be able to interact and communicate with         throughout the United States with accurate, in-depth
affect product efficacy. While most ingredient    each other. While it is important to know        information on product dynamics, emerging
manufacturers “purify” their products by          what is in a product, if the formula’s star      technologies and industry advances. Before joining
removing common pollutants, many                  ingredients don’t cooperate as intended, the     the CosMedix team, Perdue spent over a decade
scientists stress the need for more intensive     results can be disappointing and, sometimes,     working for leading plastic surgeons and
screening that looks at a substance’s             uncomfortable.                                   dermatologists. She has executive level experience in
molecular makeup. Since many ingredients               Take Vitamin A, for example. The            the field of marketing and public relations, in addition
are made up of chiral compounds—a state           industry standard for skin rejuvenation,         to being a dermatological nurse and skin care
in which two molecules of the same                Vitamin A poses a challenge to product           specialist. A native of Tennessee, Perdue earned her
substance have opposing “spins,” each             developers due to its caustic nature. While      Bachelor of Science degree in Health from Belmont
producing a separate effect—unfiltered,           low doses render it almost ineffectual, high     University in 1996. ▲
“raw” ingredients are only partially effective,   doses of the ingredient can cause significant
with only the “correct” spinning molecules        irritation.

                                                 The Science
             Of Liquid Topical L-Ascorbic Acid (Vitamin C)
                                                           Mostafa Omar, PhD

                                                      Until 1995, a stabilized L-Ascorbic Acid       developed for acne treatment when Vitamin
                                                 in liquid form had been developed; a series         E and A are in water-soluble format besides
                                                 of scientific studies had been conducted and        the maximizing the antioxidant protection.
                                                 granted by National Institute of Health                 Many other formulations that were
                                                 (NIH) and National Cancer Institute (NCI).          tested clinically focus on treating various
                                                 These grants created the new era of stable          skin problems and made a variety of

                   T               opical L-
Ascorbic Acid, also known as Vitamin C, is
an excellent antioxidant which can protect
                                                 topical liquid L-Ascorbic Acid and also a
                                                 new chapter of antioxidant.
                                                      These studies indicate that to penetrate
                                                 the skin in large amounts, Vitamin C needs
                                                 to be in the form of L-Ascorbic Acid with a
                                                                                                     Vitamin C different formulations in
                                                                                                     combination with other natural products
                                                                                                     such as Hyaluronic Acid, Arbutin, Peptides,
                                                                                                     Kojic Acid, different essential vitamins and
                                                                                                     Centella Asiatica, etc. in order to help in
against and minimizes the harmful effects        low pH level and has to be in high enough           reducing fine lines and wrinkles, smoothing
caused by sunlight rays (UVA & UVB) such         concentration. Once in the skin, L-Ascorbic         skin, lightening the skin and reducing the

90% treatment effect within
as photo aging and skin cancer. Topical          Acid has the following effects; L-Ascorbic          stretch marks and scar tissues, and
Vitamin C works by neutralizing reactive         Acid is an extremely effective antioxidant          maximizing the result of anti-aging.
oxygen free radicals, the highly reactive free   which can capture and neutralize reactive
radicals produced when UVA and UVB               oxygen free radicals, such as superoxide
                                                                                                     • “Prevention of UV Photoinjury in Skin by
interact with cell membranes and other           anion. It also forms a barrier function at
                                                                                                       Antioxidants”, personal communication,

  24 hour Light, portable
components of skin tissue.                       epidermal in order to protect UVA and
                                                                                                       MM Omar, to be published re NIH, NCI
     Unlike sunscreens, Vitamin C penetrates     UVB damage, provides photo-protection,
                                                                                                       grant #1 R43, CA83538-01A1, 2004
the skin and cannot be washed or rubbed          remains in the skin for up to 72 hours and
                                                                                                     • “UV Photoprotection by Combination
off. Clinical research has shown that            prevents UV Immunosuppressant.
                                                                                                       Topical Antioxidants Vitamin C and
L-Ascorbic Acid is the only form of              Therefore, Vitamin C has to be applied in
                                                                                                       Vitamin E”, JY Lin, MA Selim, CR Shea,

     and easy to use
Vitamin C which can be utilized by the           the morning in order to perform its
                                                                                                       JM Grichnik, MM Omar, NA Monteiro
body. L-Ascorbic Acid has been a critical        protection properties against UVA & UVB.
                                                                                                       Riviere, SR Pinnell; Journal of the
component of cosmetic ingredients for the             On the dermis and epidermis level,
                                                                                                       American Academy of Dermatology
last 15 years. However, it is difficult to       Vitamin C stimulates collagen synthesis. It
                                                                                                       48:866-74, 2003
                                                 is an essential cofactor for collagen structure
                                                                                                     • “Topical L-Ascorbic Acid: Percutaneous
                                                 and induces collagen gene transcription. It
                                                                                                       Absorption Studies”, SR Pinnell, H Yang,
                                                 tightens skin layers to maintain healthy skin
                                                                                                       MM Omar, N Monterio, HV DeBuys, LC
U  NLIKE SUNSCREENS,   VITAMIN C                 and it enhances the elasticity of skin in order
                                                                                                       Walker, Y Wang, M Levins, Dermatology
PENETRATES THE SKIN AND CANNOT BE                to reduce the appearance of fine lines and
                                                                                                       Surgery 27:137-142, 2001
                                                 wrinkles. Furthermore, it lightens the skin as it
WASHED OR RUBBED OFF. CLINICAL RESEARCH          inhibits tyrosinase and blocks the formation
HAS SHOWN THAT L-ASCORBIC ACID IS THE                                                                     Dr. Mostafa Omar, the President of
                                                 of melanin pigment in the skin cells.
                                                                                                     PhytoCeuticals, Inc., is a highly respected developer
ONLY FORM OF VITAMIN C WHICH CAN BE                   Continued research indicates that a
                                                                                                     and manufacturer of proprietary skin care
UTILIZED BY THE BODY.                            combination of topical Vitamin C, E and A
                                                                                                     formulations, and is the inventor of the stabilized
                                                 is better for UV protection to skin than an
                                                                                                     liquid L-Ascorbic Acid (Vitamin C) in 1995. ▲
                                                 equivalent concentration of Topical Vitamin
                                                 C or E or A alone. In 1997, researchers also
stabilize the liquid form of L-Ascorbic Acid     have shown that synergistic photoaging
and this has prevented it from being used in     protection can be formed when Vitamin C
cosmetic formulations. Many companies use        is combined with other vitamins, as Vitamin
derivatives such as Ascorbyl Palmitate or        C can regenerate Vitamin E whenever it is
Magnesium Ascrobyl Phosphate in order to         oxidized in this combination. In addition,
avoid issues of stability. These derivatives     this combination provides protection
must penetrate the skin and then be              against thymine dimer formation and
converted to L-Ascorbic Acid, which is an        suitable for dry and oily skin-treatment. In
inefficient process.                             2001, combination of Vitamin C, E and A

                                                         Corner                             Sandra M. Day

CONFESSIONS OF A “BEAUTIFIER”                        he simply replied, “Fiery automobile             consultation with me is complimentary.
                                                     accident.” Would I be the first casualty with    Since I am the skin care specialist, during
                                                     scarring in our skin care center? Two months     that time I can act as a liaison and go over

F        irst of all, I’ve already admitted that I
love the career path that led me to
                                                     of cortisone applications finally corrected
                                                     the marks. It taught me yet another
                                                     lesson—I stress to my clients over and over
                                                     when I do a chemical peel of that depth,
                                                     whatever solution applied, the importance
                                                                                                      the various alternatives available to them at
                                                                                                      our skin care center. By recommending a
                                                                                                      treatment protocol to meet each person’s
                                                                                                      individuality, I further confess that it
                                                                                                      generally begins with a clinical treatment by
becoming a medical aesthetician almost 18            of cutting your food in small bites, talk as     me. I provide them with information,

90% treatment effect within
years ago. The specialty field was then              little as possible and avoid excessive           brochures, prices, samples, and typically
relatively unknown to the public, but the            expressions of smiling…or crying.                schedule their first appointment.
media latched onto the “new” peels and                    I still have, and often review, the first        A recent learning experience happened
touted their benefits. It was the greatest           two books I purchased in 1992 on chemical        quite unexpectedly during a consultation.
advance in the battle against photoaging             rejuvenation of the face. It delighted me        The woman told me she had a problem with

  24 hour Light, portable
since Retin-A, and industries were born.             to read in Dr. Kotler’s book that toward         acne kept under control with minocycline,
     When I first began performing corrective        the end of the nineteenth century, the           that she had been on it for years. After
skin care, my treatment modalities were              upper classes flocked to cosmeticians or         talking with her about her primary concern,
dermaplaning, glycolic acid, a comedone              “beautifiers,” who had an armamentarium of       spots, I examined her under my magnifying
extractor, and cryogenic therapy. It didn’t          wonderful cosmetic procedures to improve         lamp. The hyperpigmentation I saw was not

     and easy to use
take long for me to realize that “cookie             the appearance of visible wrinkles and           brown, but bluish in color. I confessed to
cutter” approach didn’t produce the optimal          pigmented spots. The history of chemical         her that I’d never seen anything like that
results for everyone. Including me—I was an          peeling since early times is fascinating.        before, and since I err on the side of
early casualty of being overly aggressively               My thirst for learning more and             conservative, refused to offer any treatment
micropeeled, resulting in an unexpected              more is still not quenched. Over the             options here and suggested that see a
burn that healed slowly over three weeks.            years, advanced technology has added             dermatologist. Since our consultation was
As our doctor said, “The good news is, it            microdermabrasion, photorejuvenation             short, I had time to address my ‘to do’ list
was Sandra, and the bad news is, it was              via intense pulse light, ultrasound, high        which included calling NewBeauty and
Sandra.” No lasting problem, but we learn            frequency treatments for benign lesions and      restarting our subscription since we had
from our mistakes.                                   telangiectasiae, sophisticated lasers,           recently moved. While on hold, I began
     Another close call I had during the third       injectable therapies for muscle relaxers and     flipping through the pages of an older issue
year occurred when I performed a Jessner’s           wrinkle fillers and more. Even though as         and an article under ‘beautybrief’ was ‘If you
Peel on myself on a Saturday. The next day,          aestheticians, we cannot use all those           have Hyperpigmentation.’ I quote the first
my mother called from my home state of               modalities to practice within our scope of       paragraph, “YOU SHOULD AVOID
Mississippi to tearfully tell me that her            bounds, we must be knowledgeable to help         minocycline—a prescription strength
husband had died. I immediately booked               our clients achieve their goals.                 antibiotic used to treat acne and skin
my flight to be with her. By the time the                 Keeping up with product knowledge           infections. One of its side effects is that it
funeral arrangements were made, amidst               and the ingredients that work and why is         can give you long-lasting dark spots that
tears and much talking, there were radiating         challenging, but part of our obligation is to    can be bluish in color.” Thank you, Dr.
spokes of painfully split raw skin all around        know the science behind the product. Why         Ciraldo—what serendipity!
my mouth and chin. By the day of his                 is this one more appropriate for me than              It’s so gratifying to identify that right
burial, I had to wear a hat with a veil. At the      that one? We know it depends upon a              combination of customized care that makes
gravesite, one of the funeral home attendants        number of factors, including their level of      each client’s skin look its best. The rewards
asked my uncle, “Whatever happened to the            photodamage, lifestyle, genetic background,      are the word-of-mouth referrals when your
tall blonde lady wearing the hat?” My uncle          and, yes, I confess, the amount of money         regular clients tell their friends about your
was reluctant to explain that I had injured          they are willing to invest in themselves to      knowledge, professionalism and abilities.
myself by not following proper post                  achieve optimal results.                         Keep learning…and as Usher says, “These
treatment protocol after a chemical peel, so              At the present time, a 30-minute            are my confessions” (maybe not all!) ▲

                                                   Revolutionary Ideas
                                                   In Plastic Surgical Skin Care

                                                                                   SOCIETY OF
                                                                                PLASTIC SURGICAL
  Skin                                                                        SKIN CARE SPECIALISTS
                                                                                       17th Annual Meeting

  2 treatment effect within
90%0 1 1
                    May 4 –7 201  1                                                                                ,
                         Boston, MA
                                                                                                             The Westin
  24 hour Light, portable
                                                                                                 Boston Waterfront Hotel

        and easy to use
    Members in the

 U            nlike medi-spas, which often have little else than a consulting
  physician’s name on the door to differentiate them from a run-of-the-mill spa,
                                                                                             Abbey Helton, BSN, RN, CPSN
                                                                                             Chair, Membership/Mentor Committee

  doctor’s offices are where genuinely effective tools—surgical blades, aggressive
  peels, needles—take center stage. They’re also where you’ll get the benefit of             Welcome
  both medical guidance and well-honed technique. “If you want something that’s
  truly corrective and makes a long-term difference, you go to the doctor’s office,”         NewMembers
  says Susan Wells, president of the Society of Plastic Surgical Skin Care                   Priscila M. Campbell—Dallas, TX
  Specialists. “A good, effective facial completely removes the top, dead layer of           Valerie Griffin, LE—Baltimore, MD
  the epidermis so healthier skin is exposed and at-home products are able to                Lyndsay Thom—Cincinnati, OH
  actually penetrate,” says Adam Kolker, a New York plastic surgeon who employs
  a full-time aesthetician. “We have a deep and comprehensive toolbox to do
  that.” ▲

 11262 Monarch Street, Garden Grove, CA 92841-1441 •

90% treatment effect within
          “THE BUZZ”Z Z
                                                  Saunda (Sam) Wolfersberger, RN

T 24 hour Light, portable
         he search continues for new options
 to effectively treat melasma and
 hyperpigmentation. Studies from Japan are
                                                    Plastic Surgery Center, Ltd.

                                                                                                 skin around the eyes. The thin skin exposes the
                                                                                                 blood vessels resulting in blue or black shadows.
                                                                                                 The so-called smokers lines of the lips may not
     and easy to use
 finding that a combined therapy of                                                              necessarily be caused by smoking, many believe
 tranexamic acid topically and laser genesis,                                                    it is due to hormone loss as we age. Since the
 a unique microsecond 1064 nm laser, may                                                         skin around the eyes and lips are similar they
 be an option worth considering. Studies                                                        Zcan benefit from some of the same topicals.
 have shown there is a relationship between                                                      Many experts agree that retinol and peptides
 melasma and pronounced telangiectatic                                                     Z     yield the most gain. It is best to advise patients
 erythema within the lesions of melasma.                                              Z          to prep the lip area with a treatment balm in the
 Laser genesis on its own is used for                                            Z               morning prior to applying any lip color or
 improving pore size and texture, diffusing                                ZZ                    plumping product.
 erythema and poikiloderma, and the                                                                    Item of interest: Dr. Yates has always advised
 improvement of fine lines and reduction of                         Z                            our patients that skin cancer is more prevelant
 scars. In our practice, it was not utilized to improve        Z           on the left side of the face and left arm due to the time we spend
 hyperpigmentation. We are now taking a second look at this
                                                          Z                in our cars each day. I recently saw that there is a “new” study
 treatment modality. The advantages are that laser genesis is safe for     confirming what he has been saying for my thirty years with his

 all skin types, provides minimal discomfort, no downtime, and can         practice. Car window glass protects against uvb that causes sunburn,
 be done year-round. Tranexamic acid was originally used to prevent        but it does not protect against uva. Remind your patients that sun

 excess bleeding in menstrual bleeding, hemophilia or cardiac surgery      protection is important as a part of your daily skin care regimen.
 and was used as a microinjection into the melasma lesion. In 2006, it         In a study published in the European Journal of Cancer Prevention,
 was combined with a serum using tranexamic acid topically in a 3%         those who drank even a single daily cup of caffeinated coffee

 concentration combined with ascorbic acid. Very few products              reduced their risk of developing nonmelanoma skin cancer by about
 contain tranexamic acid, a few examples are Shiseido Haku                 10 percent. Caffeine basically kills precancerous and ultraviolet-
 Melanofocus EX, UNT Tranexamic Acid and Dermasurface                      damaged skin cells by blocking a protein that they need to divide,
 Brightening Complex. It will be interesting to watch the progress         according to Paul Nghiem, MD, PhD, of the University of
 since melasma is so difficult to treat.                                   Washington Medical School. Even though the effects of caffeine on

      The most common concerns generating questions from our               skin are modest, it does not mean it is a reason to start drinking

 patients recently have centered on wrinkles around the eye area and
 the upper lip. Eyes and lips are the first features people notice, they
                                                                           coffee, maybe just enjoy it if you already do.
                                                                               Any products mentioned in the above submission are for informational
 are the focus of the face. Signs of aging tend to appear first in the     purposes only. ▲

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