Chapter 13 - Advanced Topics and Treatments

The acid needs to have a pH lower than the skin's pH to be effective

1. A spa level of 30 percent concentration of glycolic acid is usually formulated to have a pH of 3 if it is buffered properly 2. Physician peels have a higher percentage concentration and lower pH 3. Over the counter (OTC) AHA home care product formulations contain from 2 to 15 percent acid 4. AHA home care product formulations sold by spas range from 5 to 10 percent acid 5. Physicians carry home care products with higher percentages of acid.

Estheticians should study and have a thorough understanding of advanced topics and treatments because:

1. Advanced machine technology is always being developed and improved upon, and some of these technologies are expansions from the original formats 2. Offering advanced treatments will keep technicians competitive in the marketplace 3. The esthetician's professional expertise in analyzing the skin and recommending the best program helps make these procedures safe and effective

When to Use and Effects of Laser Technology

1. All lasers and light therapy methods use selective photothermolysis. 2. Thermolysis means heat effect. 3. Lasers emit light waves of the same wavelength, while nonlaser photo devices, such as IPL, use a spectrum of different wavelengths. 4. For skin rejuvenation, heating and damaging the dermal tissues stimulates fibroblasts to repair and rebuild tissue such as collagen 5. 755 Alexandrite Laser is known as the gold standard laser for hair reduction in lower Fitzpatrick clients 6. Types of lasers include the alexandrite, diode, and Nd:YAG. Another treatment is referred to as photodynamic therapy and is best for primarily treating actinic keratoses. 7. Combined energy technology targets and heats connective tissue to stimulate collagen production and produce a firming effect. Radio waves of a certain frequency penetrate and are absorbed by the tissues. It is also effective for hair removal and used for cellulite reduction

Contraindications and Best Practices of AHA and BHA Peels

1. Before a chemical exfoliation service, discuss potential issues and contraindications during the client consultation. Explain the procedures, expected outcomes, and realistic goals. 2. In a diagnostic facial of skin analysis before scheduling treatments, note on the client intake form the condition of the skin, including dehydration, hyperpigmentation, open lesions, and any other skin conditions. Choose the type of exfoliant based on the condition of the client's skin and the desired results 3. Always keep in mind the manufacturer's instructions throughout the process and while performing the peel consultation 4. Eyewear is always recommended to protect the client and technician. OSHA requires that any time a corrosive agent is used, the technician must wear protective eyewear with side shields. An OSHA-approved emergency eyewash station is also required 5. Other precautions may be taken such as applying occlusive barriers to the corners of the eyes, the mouth, and around the nostril area 6. Because the sun is stronger during the summer and outdoor exposure is more frequent, chemical exfoliation and other exfoliation procedures (e.g., microdermabrasion) should be used with extreme caution during those months and should be avoided in some cases where the client is not willing to take precautions to avoid inadvertent exposure during their daily activities. 7. The manufacturer will provide instructions on the application and removal process. General application for basic peel involves cleansing, toning, applying the peel, processing according to the manufacturer's instructions, neutralizing if directed by the manufacturer, rinsing, and applying moisturizer and a product with SPF 8. During the application there will be slight stinging and tingling and you may want to provide clients a fan to cool the face during the application 9. During the neutralizing or rinsing step, the peel may temporarily reactivate for a few seconds due to the water rehydrating the peel, and the client may experience an increased tingling or stinging sensation. 10. Immediately after application the client will have a rosy glow and even mild erythema of the skin 11. With BHA peel, there may be salicylic crystal residue present, which should not be confused with frosting from a Jessner's or TCA peel. When 30% BHA is used the client may experience frosting around thinned skin such as under the eyes, at the corners of the eyes and mouth, or even around blemishes (which is why some manufacturer's recommended using an occlusive barrier in some areas) 12. Sometimes a Wood's lamp is used with BHA applications to view the accuracy and evenness of the peel application, as the peel can be illuminated by the lamp

Ingredients found in enzymes include

1. Bromelain, which is derived from pineapples 2. Papain, which is derived from the papaya fruit 3. Pancreatin and trypsin, which are derived from meat by-products

When to Use AHA Peels

1. Consider the following factors: skin type, sebaceous gland activity, skin conditions, the client's philosophy of sun exposure, their cosmetic and other product use, and whether they are using Retin-A, and/or other acids/AHAs, or acne drugs such as Tetracycline or Doxycycline 2. It is preferred (but not required) that clients begin a home care regimen to prepare the skin the peels, but not every client is willing to commit in this way. Pretreating assists in providing optimal outcomes because you are beginning the plan with a more acclimated and prepared skin surface. 3. Home care plans that work in tandem with the in-office clinical treatment plan are very important 4. Treatment plans begin with a series of treatments to jump-start progress. A series can consist of six to eight peels administered once a week over six to eight weeks. 5. In the maintenance phase, you maintain the results by administering a monthly maintenance peel. 6. Some technician's treatment plans work on a graduated peeling system where you start with the mildest level peel, such as 2% lactic acid, for the first couple of peels in the series and then move up to a low-dose glycolic acid, working up to a 20% glycolic acid and then ending with a 30% glycolic acid 7. Stronger superficial peel treatment plans are administered to clients who skin is cleared for this level of peeling and to those who want to achieve faster results or have conditions that are better addressed with a stronger superficial peel such as severe sun damage, more in-depth age-related skin issues, or hyperpigmentation. Client input is paramount

Factors influencing the CRF

1. Genetics 2. The natural environment 3. One's medical history 4. Lifestyle 5. Personal care 6. Exfoliation Methods The keratinized corneum layer is composed of approximately 15 to 20 layers and varies in thickness in different body areas

AHAs include

1. Glycolic acid is derived from sugar cane and is the strongest AHA 2. Lactic acid is derived from milk 3. Tartaric acid is derived from grapes 4. Malic acid derived from apples 5. Citric acid is derived from citrus fruit (citric acid is now considered an AHA rather than a BHA) 6. Mandelic acid is derived from bitter almond

Best Practices and Safety Considerations for Microdermabrasion

1. In a diagnostic facial or skin analysis before scheduling treatments, note on the client intake form the condition of the skin, including dehydration, hyperpigmentation, open lesions, and any other skin conditions. Also choose the level of exfoliation with the microdermabrasion treatment based on the client's skin condition and the results desired. 2. General application steps for microdermabrasion involves cleansing, toning, proceeding with microdermabrasion treatment, rinsing or additional cleansing, and applying moisturizer and a product with SPF 3. It is preferred clients begin on a home care regimen to prepare the skin for microdermabrasion. A home care plan should include, at minimum, a cleanser, retinol and/or AHA cream, vitamin C, and a product with SPF 4. Treatment plans begin with a series of treatments to jump-start progress. A series can consist of six to eight microdermabrasion treatments administered once a week over six to eight weeks

When to Use Jessner's and TCA Peels

1. Jessner's peels are primarily used on clients with oilier skin and acne but are also used to address sun damage. The Jessner's solution is usually applied in several layers, according to the manufacturer's directions. Much stronger peel, will administer the peels only once every three to four or more weeks. Clients will notice flaking and peeling, so it is important to mention in consultation 2. TCA peels are used primarily for clients experiencing aging and sun damage. Usually applied in several layers. 3. It is advisable to start with a lower strength and work up once you have a baseline for the client's reaction to the procedure 4. Series can be implemented according to your client's goals and the outcomes achieved 5. The maintenance phase begins once the goals have been met and you and the client want to maintain the results

Beneficial Ingredients to Combine with Chemical Exfoliation

1. Mature and/or sensitive skin: Glycolic acid, lactic acid, ceramides, hyaluronic acid, phospholipids, linoleic acid, aloe vera, allantoin, kojic acid, licorice root, peptides 2. Hyperpigmentation: Glycolic acid, kojic acid, licorice root, mulberry extract, bearberry extract, azelaic acid, ascorbic acid 3. Acne: Glycolic acid, lactic acid, salicylic acid, azelaic acid, citric acid

Contraindications and Best Practices for Jessner's and TCA Peels

1. Other precautions may be taken such as applying occlusive barriers to the corners of the eyes, mouth, and around the nostril area 2. Because sun is stronger during the summer and outdoor exposure is more frequent, chemical exfoliation and other exfoliation procedures (e.g. microdermabrasion) should be used with extreme caution during those months and should be avoided in some cases in which the client is not willing to take precautions to avoid inadvertent exposure during their daily activities 3. The general application process for Jessner's and TCA peels involves cleansing, toning, applying the peel, processing according to the manufacturer's instructions, rinsing if directed by the manufacturer, and applying moisturizer and a product with SPF protection 4. During the application process there will be more stinging and tingling than is experienced with AHA and BHA peels 5. Immediately after application the client will have mild erythema, pink or reddening of the skin, and there may be areas of frosting of the skin or an overall light frost (depending on depth of the peel) due to protein coagulation 6. A few hours later and especially the next day, the skin will become bronzed and will tighten over the next few days 7. Flaking or peeling will begin over the areas of the face that move the most, then all other areas will experience the same 8. Once the peel process has been completed and the skin has normalized, clients can return to their normal skin care products

Contraindications and Precautions for Microcurrent

1. Pacemakers 2. Wait two weeks after the injection procedure

Contraindications and Precautions for Microdermabrasion

1. Pregnancy 2. Hyperpigmentation tendencies 3. Fragile skin, couperose skin 4. Improper use of microdermabrasion can cause hypopigmentation and hyperpigmentation. It can also lead to sensitivity and other problems. Any strong exfoliation procedure requires sun abstinence and daily sunscreen

When to Use BHA Peels

1. Pretreatment and home care guidelines are the same as for AHAs, but you may add in products specifically for clients with oilier skin and with acne, for example, and acne and blemish serum 2. BHAs are used primarily on clients with oilier skin and with acne. You will find these peels usually come in strengths of 20 o 30 % and are much stronger than AHAs, so you will most likely administer the peels only once every two or more weeks. Clients will notice flaking and peeling, so it is important to mention this in the consultation 3. It is advisable to start with a lower strength and work up once you have a baseline for the client's reaction to the procedure 4. A series can be implemented according to your client's goals and the outcomes achieved 5. The maintenance phase begins once the goals have been met and you want to maintain the results

Contraindications and Best Practices for Enzyme Peels

1. Remember to always consult the manufacturer's instructions 2. Eyewear is always recommended to protect the client and technician. OSHA requires that anytime a corrosive agent is used, the technician must wear protective eyewear with side shields. An OSHA-approved emergency eyewash station is also required. Not all enzymes are categorized as corrosive, so you must consult the SDA sheet provided by the manufacturer for full information 3. The manufacturer will provide instructions on the application and removal processes. The general application process for basic enzyme peel involves cleansing, toning, applying the enzyme peel, processing according to the manufacturer's instructions, rinsing, and applying moisturizer and a product with SPF 4. Some areas of the face may process sooner than others and you may need to perform spot removal on those areas. Some clients' entire face may process sooner than the manufacturer's recommended minimal processing time, in which case you will need to remove the entire peel immediately. 5. The best rule of thumb as a newer esthetician, who may not yet have mastered efficient application and removal processes, is to be prepared to remove the peel just prior to reaching the end-point to ensure you can complete neutralization and removal before the client becomes overprocessed. It is also recommended to have a closed container of extra 4" X 4" moistened esthetic wipes available for use if needed, as you will need them readily accessible.

Peels administered by physicians make use of the following chemicals:

1. Resorcinol 2. Phenol (carbolic acid, also called Baker's peel) 3. Trichloroacetic acid (TCA) 4. Glycolic acid (50 percent or more) 5. Jessner's peel; 4 to 10 layers, which contains lactic acid, salicylic acid, and resorcinol in an ethanol solvent 6. TCA, a medium-depth peel that removes the epidermis down to the dermis 7. Phenol, a highly acidic deep peel that peels down into the dermis. This peel is not commonly used, but is still important to be aware of

Describe chemical exfoliation and peels

1.Peels and chemical exfoliation services are efficient and take less time than the more relaxing, in-depth facials. 2.Peels and chemical exfoliation services yield more significant results, help produce a clinical change in the skin, and are commonly used to address photoaging, acne, and hyperpigmentation, in addition to other conditions. 3. Protocols vary depending on the product line, but the basic process consists of applying the product, neutralizing, and removing it within a few minutes

Microdermabrasion

A machine-based exfoliation treatment that uses crystal spray or diamond tips to gently polish dead skin cells from the skin's surface.

Trichloroacetic Acid (TCA) Peels

A strong peel used to diminish sun damage and wrinkles.

Explain Advanced Skin Care Topics and Treatments for Licensed, Trained Estheticians

Advanced treatments have expanded the esthetician's repertoire to include more results-driven treatments such as chemical exfoliation and microdermabrasion, microcurrent, ultrasound, and light emitting diode (LED)

What is an AHA Peel

Alpha hydroxy acids (AHAs) are mild acids that come in different percentages and pH levels and help to dissolve the desmosomes between cells to keep skin cells exfoliated. AHAs penetrate the corneum via the intercellular matrix and loosen the bonds between the cells. Intercellular matrix consists of ceramides, lipids, glycoproteins, and active enzymes. 1. Glycolic acid, a commonly used AHA, can penetrate the epidermis more effectively because it has the smallest molecular size of the AHAs 2. Most AHA peels you will use will not be at a level that will yield any peeling or flaking.

Blepharoplasty

An eye lift. It removes the fat and skin from the upper and lower lids making them less baggy and crinkled looking. sagging eyelids impede a patient's ability to see, it is a medical condition that may be covered by insurance

When to Use Microcurrent

As we age impulses slow down, causing the skin to sag

What is a BHA Peel

BHAs work under the same premise as AHAs bur are better suited to dissolve oil and are primarily used for oily skin and acne. 1. BHA peels are usually stronger than AHA peels, but will depend on the chemical formulations. 2. You may encounter some slight flaking or mild peeling, depending on the strength of the BHA peel. 3. BHAs include salicylic acid, which is derived from sweet birch, willow bark, and wintergreen and has antiseptic and anti-inflammatory properties

Chemical Exfoliation Contraindications Include the following

Can result in burns that may require medical attention and can scar a client 1. Recent cosmetics surgeries, laser resurfacing, chemical peels, or dermabrasion 2. Recent injectables, fillers, or Botox 3. Use of Retin-A or other medications that exfoliate or think the skin 4. Allergies or sensitivities to products or ingredients 5. Pregnancy 6. Active herpes simplex 7. Hyperpigmentation tendencies 8. Inflamed rosacea or acne 9. Infectious diseases 10. Open sores or suspicious lesions 11. Sunburn or irritated skin 12. Photosensitizing medications (make skin very sensitive to sun) 13. Other contraindicated drugs or medication To prevent skin damage, warn your clients to avoid sun exposure, scrubs, rubbing, pulling dead skin, depilatories, waxing, benzoyl peroxide, and exfoliating or glycolic acid products for at least 24 to 48 hours before or after any chemical exfoliation procedure. Recommend a longer period of time if client's condition warrants it.

Ayurvedic

Concepts are based on three doshas, or mind and body types. three body/mind types: pitta, kapha, and vatta. Shirodhara is an ayurvedic treatment that consists of running warm oil on the third-eye area of the forehead for 30 minutes

Intense Pulse Light

Devices are similar to lasers. IPL devices use pulses of multiple wavelengths (versus single in lasers) to reduce pigmentation, remove surface capillaries, and rejuvenate the skin. Intense pulse light emits light absorbed by hemogloblin (vascular), melanin (pigmented lesions), and hair follicles (hair removal). Photorejuvenation is another term used for the growing technology that utilizes light therapy to enhance the skin

Effects of Microdermabrasion

Diminishes the following conditions: 1. Fine lines and wrinkles 2. The vacuum mechanism stimulates cell metabolism and blood flow

What is an Enzyme Peel

Enzyme treatments are often referred to as enzyme peels or an enzyme mask. Whereas physical exfoliants work to slough off dead cells sitting on the surface of the skin, enzymes are proteolytic in nature and work to digest the keratin (protein) in dead skin cells on the surface of the skin. Enzyme treatments, depending on their composition and your client's skin, can be gentle enough to repeat once a week. Enzymes can also be combined with microdermabrasion (may be referred to as microdermabrasion peel combination), LED, and many other advanced treatments to prepare the skin to yield greater results and/or enhance exfoliation

Pre- and postoperative care

Estheticians perform pre- and postoperative treatment and provide patient education before cosmetic surgery. important for faster patient recovery time. Preoperative care focuses on preparing the skin for the procedure. Increasing the skin's metabolism and reducing cellular debris on the surface are part of conditioning the skin Postop care included providing skin care for rapid wound healing and the avoidance of infection Permanent makeup, sometimes referred to as micropigmentation, is another technique utilized in clinical esthetics

Effects of an LED Treatment

Green Light: 500-525 nm Lessens hyperpigmentation Reduces redness Calms and soothes

Reiki

Japanese technique for stress reduction and relaxation that also promotes healing

Light-Emitting Diode

LED (Acronym); a device used to reduce acne, increase skin circulation, and improve the collagen content in the skin. LED technology is nonthermal, meaning it does not use heat. LED technology works on the premise of nonthermal, nonablative cellular stimulation called photomodulation

Explain the Benefits and Types of Light Therapy

Light therapy is the application of light rays to the skin for the treatment of wrinkles, capillaries, pigmentation, or unwanted hair. Light therapy uses different types of devices, lasers, intense pulse light (IPL), and light-emitting diode (LED) technologies. The range of wavelengths used in the light therapy are visible, infrared, and far infrared

What is Infrared Light and When do You Use it

Light therapy with the use of infrared heat has been used for years to treat physical conditions such as pain and to promote healing. They are also used in spas and saunas for relaxation and warming up muscles, detoxifying the body, and reducing pain. There are uses of near infrared light for signs of aging (such as for wrinkles), wound healing, and increasing circulation as it has the longest wavelength of all of the light therapies and thus can penetrate the deepest into the skin. Green is calming

Lasers

Medical devices used for hair removal and skin treatments. Laser is an acronym that stands for light amplification stimulation emission of radiation. 1. Other light therapies, such as intense pulsed light (IPL), have multiple colors, depths, and wavelengths and the light may be scattered. 2. Lasers and IPL are strong machines that are rated as Class IV medical devices by the FDA. LED is rates as a safer Class I or II device and is regulated less strictly.

Timing and Technique

Microdermabrasion treatments are quick 30 minute services that can be offered alone or as part of a facial as well as part of an advanced treatment such as LED Proper use of the hand piece, rate of crystal flow, and vacuum setting all contribute to a successful treatment. The treatment is performed in the area of stretched skin between the thumb and pointer finger, also called the action zone The number of passes used during the treatment will be determined by the client's skin type and condition, the presence of erythema, and how the client tolerates the treatment. Typically passes consist of horizontal, vertical, and diagonal directional applications. The cross-hatching method involves using only two passes, can be used to complete the treatment quicker, and is one of the more popular approaches Higher vacuum settings, time in contact with the skin, and more passes yield more aggressive treatments. The endpoint for a microdermabrasion treatment is the presence of erythema.

Sclerotherapy

Minimizes varicose veins (dilated blood vessels) and other varicosities by injecting chemical agents into the affected areas or by laser treatments.

Botox

Neuromuscular-blocking serum (botulinum toxin) that paralyzes nerve cells on the muscle when this serum is injected into it.

Microneedling

Or dermal rolling. cosmetic and medical rolling is a form of collagen induction therapy (CIT). Procedure causes tiny needle pricks across the skin from rollers or electronic handpieces that induce collagen formation during the wound healing process

Contraindications for Ultrasound

Pacemakers

Nano Infusion

Popular technology used by estheticians in states that do not allow microneedling in scope of practice. Needle-free Nano Tips versus standard microneedling tip that has needles that puncture the skin and can penetrate to the epidermal or dermal level, depending on how aggressive you are with the microneedling handpiece settings. Do not penetrate into the dermis

Crystal Microdermabrasion

Procedure is achieved by spraying high-grade microcrystals, composed of corundum powder, aluminum oxide, or a similar abrasive material across the skin's surface through a hand piece Crystals are first sprayed on the skin through the hand piece, and then are vacuumed off simultaneously. Considered messy. Crystals can also be used manually without the machine - this process is considered gentler on the skin and is called manual microdermabrasion

Hydradermabrasion (Wet Microdermabrasion)

Procedure similar to microdermabrasion, noninvasive and nonirritating procedure combines mechanical and liquid exfoliation with serum penetration and hydration via a machine similar to the closed loop system as found with a crystal microdermabrasion machine. Serum is expelled through a hand piece that has interchangeable tips

Jessner's Peel

Stronger superficial peel. Light to medium peel of lactic acid, salicylic acid, and resorcinol in an ethanol solvent

Injectable fillers

Substances used in nonsurgical procedures to fill in or plump up areas of the skin

Light, Medium, and Deep Peels - What is the difference?

Superficial peeling removes cells from only the stratum corneum. Superficial or light peels (chemical exfoliators) are esthetician administered and and generally include enzymes, glycolic acid (30 percent or less), lactic acid (30 percent or less), and is some cases Jessner's solution and low percentage TCA (one to three layers). The term chemical exfoliation is sometimes used in place of the word peel to differentiate between the medium and deeper clinical peels and the lighter chemical exfoliation used in spas Physicians use high strength peel formulations that are designed to penetrate deeper into the skin (the dermal layer). These peels are commonly referred to as medium or deep peels Medium-depth peels are performed primarily with stronger TCA concentrations by physicians to remove the entire epidermis and part of the papillary dermis

Crystal-Free Microdermabrasion

Technique consists of a diamond-tip applicator that gently polishes away the upper layers of the skin without the use of messy crystals and has gained popularity over the crystal option as it yields the same results without the clean-up or expense of crystals

Common conditions treated with IPL and photorejuvenation

Telangiectasias or small spider veins

When to Use Microdermabrasion

The difference between AHAs and microdermabrasion is that AHAs are chemical in nature and penetrate the epidermis, whereas microdermabrasion is a surface-level mechanical method of exfoliation. Microdermabrasion as a more effective tool for surface exfoliation and AHAs are more effective below the surface

Effects of an Enzyme Peel

The results are very superficial, temporary, and provide a refreshed dewy complexion but none of the in-depth clinical changes such as those seen with AHA, BHA, Jessner's, or TCA peels 1. Because most solutions will be in the form of a mask, you may be unable to see the skin's response and you will rely on information obtained from the client to determine if the mask is processing according to expectations. (There should be no reaction beyond very light tingling or the absence of any tingling.) 2. If you are applying a mask you can see the skin through it, it is expected to initially see the skin experience a very light erythema or even turn pink. The client may experience minimal or no tingling while the solution is actively processing. You are looking for pinkness, not redness, as this is an enzyme peel

Thalassotherapy

The use of seawater as a form of therapy

What is a Designer Peel?

To yield more targeted results, additional ingredients may be added to formulas, including pigment lighteners, acne ingredients, and moisturizers or hydrators

Endermology

Treatment for cellulite that helps stimulate the reduction of adipose tissue by a vacuum massage that combines a vigorous massage along with suction

Balneotherapy

Treatment of physical ailments using therapeutic water baths. mineral, mud or fango, dead sea salt, seaweed, enzymes, or peat are used in the baths (balneum is Latin for bath)

Body scrubs

Use of friction and products to exfoliate, hydrate, increase circulation, and nourish the skin. exfoliation treatments are also called polishes and glows

Contraindications and Best Practices for LED

Used in facials for approximately 15 minutes

Dermal fillers

Used to fill lines, wrinkles, and other facial imperfections. as age dermal collagen, hyaluronic acid, and fat are lost and skin loses its shape. synthetic sources are silicone and hyaluronic acids. the newest trend is to use both nonanimal (Restylane) and animal-based (Hylaform) hyaluronic acid fillers

Microcurrent

Wave therapy; devices mimic the way the brain relays messages to the muscles. Standard technique utilizes two hand-held probes placed on facial muscle groups

When to Use Enzymes

When determining whether a treatment is appropriate for a client, consider the following factors: skin type, sebaceous gland activity, skin conditions, the client's philosophy of sun exposure, their cosmetic and product use, and whether they are using Retin-A, other acids/AHAs and/pr acne drugs such as Tetracycline or Doxycycline Enzyme peels can be applied once every one to two weeks but are usually used in conjunction with a clinical facial or to prepare for an advanced treatment such as microdermabrasion ultrasound or LED.. Enzymes are not typically used prior to a chemical peel

Chromophore

a color component within the skin such as blood or melanin. The LED color of light is also seeking color

Cell Renewal Factor (CRF)

also known as cell turnover rate, is the rate of cell mitosis and migration from the dermis to the top of the epidermis. This process slows down with age. The average rate of cell turnover for babies is 14 days; for teenagers, 21 to 28 days; for adults, 28 to 42 days; for those 50 and older, 42 to 84 days.

Cellulite

appears a dimpled or bumpy skin caused primarily by female hormones and genetics. is visible when dermal fat cells are closer to the surface of the skin. epidermis is weakened or dehydrated, cellulite is more visible. to repair cells and connective tissue need to be strengthened and hydrated through nutrients and water intake. cells have to be able to hold onto the water. detox diets, liposuction, and muscle-stimulating systems do not minimize cellulite

Body wraps

are treatments where product is applied on the body and then covered or wrapped up. inch-loss wraps have a diuretic effect and are controversial in their effectiveness

Ultrasonic

equipment is based on high-frequency mechanical oscillations produced by a metal spatula-like tool

Mammoplasty

is breast surgery that enlarges the breasts or reconstructs them. procedure is also referred to as breast augmentation, or implants

Reconstructive surgery

is defined as that which restores a bodily function. type of surgery is necessary for accident survivors and those with congenital disfigurements or other diseases

Foot reflexology

is the technique of applying pressure to the feet based on a system of zones and areas on the feet that directly correspond to the anatomy of the body

Acid, Alkaline, and pH Relationships

pH is an especially important consideration in peel products. 1. Acids have a pH of 0 to 6; neutral is 7 2. Alkaline range from 8 to 14 3. The average pH of skin 5.0 (typically between 4.5 to 5.5) 4. A pH of less than 3 is not recommended for salon peels, and most states do not allow use of a lower pH. 5. Buffering agents are ingredients added to products to help make them less irritating

Nonablative

procedures do not remove tissue. Wrinkle treatments use intense pulsed light to bypass the epidermis and stimulate collagen in the dermis to promote wrinkle reduction

Body masks

remineralize and detoxify the body using primarily clay, mud, or seaweed mixtures

Sonophoresis

sends waves through the skin to assist in product penetration

Hydrotherapy

spa treatment that uses water in its three forms (ice, steam, and liquid)

Manual lymph drainage

stimulates lymph fluid to flow through the lymphatic vessels

When to Use Manual Lymph Drainage and Effects of this Modality

technique helps to cleanse and detoxify the body. used both before and after surgery because it expedites healing and enhances cell metabolism

Ultrasound

technology in esthetics can be used for product penetration and for cellulite reduction. Penetrates deeply - it stimulates tissue, increases blood flow, and promotes oxygenation. viable choice for clients with sensitive skin conditions or rosacea versus other exfoliating services

Glabella

the area between the eyebrows where the muscles causes creasing from squinting or frowning

What is chemical exfoliation

the process of removing excess accumulations of dead skin cells from the corneum layers of epidermis as superficial peeling, exfoliation, keratolysis, and desquamation. The process can be accomplished mechanically (microdermabrasion), manually (scrubs), or chemically by the use of specific products (enzymes, alpha hydroxy acid (AHA), beta hydroxy acid (BHA), light Jessner's, and light trichloroacetic acid (TCA) peels) formulated to achieve this result

Effects of Microcurrent

used primarily to tone and stimulate facial muscles. improves blood and lymph circulation and can also assist with product absorption

Iontophoresis

uses electrically charged ions so an electrical charge is needed from electrodes