Reading your patients’ minds

Have you ever wondered what someone is really thinking when you speak to them?  Unfortunately, we can’t always know what someone is thinking, but there are a few words that are regularly used in the aesthetic industry that can create different pictures in our patients’ minds that are completely different from what we are trying to explain to them……

Chemical Peel – We as professionals have a good idea of what this means, but think about what is going on in the patient’s mind.  Just the word “chemical” conjures up all kinds of images from rusty drums of who-knows-what oozing into a river; swimming pool chemicals, or a cupboard full of hazardous cleaning supplies.  What scary thoughts when you’re trying to explain what you may be putting on someone’s face.  Be sure to explain what you are truly speaking about (ingredients, application method, etc.) and remind your patient that water is also a “chemical.”

Peel – Now add the word “peel” to the word “chemical,” and you have a whole other picture going on in patients’ minds – anything from “peeling like a banana” to “peeling like a snake” or the image of Samantha from the Sex in the City episode that appeared to be more of a phenol-like peel versus the lunchtime peel that she was expecting.  Be sure to keep plenty of “before,” “during” and “after” photos of your previous patients’ treatments on hand to give an exact idea of what your patient can expect.

Oil – Yipes!  This one is a big trouble-maker, especially when you are speaking with acne patients.  When they see that word as an ingredient in the products you are recommending for them, all they see is a cup of vegetable oil, and the thought of putting that on their skin is NOT an option.  Be sure to educate your acneic patients on the properties of many types of oils that are good for the skin, such as borage seed oil, jojoba seed oil, grape seed oil, etc.  Remind them also, that their own sebum is comedogenic, and by applying products that are formulated with these beneficial oils, it will assist in reducing the amount of sebum produced by their own skin.

Burning or stinging – These two words are used often when applying peels and products to the patients’ skin.  Both of these words can be daunting, since both a “burn” and a “sting” are not pleasant.  Try using the words “active,” “tingling” or even “stimulating.”  Instead, these words have a more pleasant meaning to them that may make the difference in how the patient views what they are really feeling from an active ingredient or treatment.

Just by paying attention to what we say in our industry combined with the awareness of what the patient may be thinking can make a difference in their entire experience.  Have you had an experience similar to those mentioned above?  Please feel free to share them with us!

antioxidants: multifunctional ingredients – part two

Although the human body has its own native antioxidant defense sytem, daily use of topical antioxidants dramatically increases your skin’s protection against the visible signs of facial aging.  Following are some of the most effective antioxidants to add to your skin care regimen.

L-ascorbic acid is the only true form of vitamin C, and it is the only ingredient to provide all of vitamin C’s topical benefits, including collagen stuimulation. Topically applied L-ascorbic acid serves as a primary, secondary and co-antioxidant that fights free radicals in the skin.

Glutathione is part of the body’s natural antioxidant systems.  Many of the most commonly used antioxidants work by regenerating glutathione.  It is a primary antioxidant that neutralizes current and prevents future oxidation.  Glutathione also works as a co-antioxidant that supports L-ascorbic acid and vitamin E.

Green tea is the source of several potent polyphenol antioxidants. Epigallocatechin gallate (EGCG) thought to be responsible for green tea’s primary antioxidant, anti-inflammatory and skin cancer prevention benefits.   EGCG has been shown to prevent the formation of several highly damaging free radicals.

Genistein is an isoflavone derived from soybeans that increases the activity of the skin’s own antioxidants.  Studies suggest that genistein prevents free radical production.  Genistein also interferes with DNA damage and mutation due to UV exposure. Studies show genistein provides short- and long-term UV damage prevention, including redness, skin cancer and visible skin aging.

Resveratrol is found in berries, grapes and red wine.  It is a potent polyphenolic antioxidant that has been shown to suppress the production of a variety of  free radicals. Studies have also shown the resveratrol has a preventative effect on tumor formation within the skin.

Silymarin is a powerful flavanoid antioxidant found in milk thistle whose most active component is the silybin.  Research shows that silybin inhibits lipid peroxidation, free radical production and increases the amount of the skin’s natural antixoidant glutathione.

Caffeine is considered a primary and secondary antioxidant that is capable of scavenging a variety of damaging free radicals. Studies comparing caffeinated and decaffeinated beverages showed a marked increase in the antioxidant activity of those containing caffeine. Research also suggests that topical application of caffeine can reduce the potential of developing skin cancer by forcing damaged,  UV-exposed skin cells into apoptosis [cell death].

Ergothioneine is newer to the skin care market, but research demonstrates strong primary antioxidant, free radical scavenging capabilities. Skin cancer prevention has also been suggested with topical ergothioneine use.

All of these antioxidants can be found in a range of PCA SKIN daily care products and professional treatments.

antioxidants: multifunctional ingredients – part one

As one of the important systems in the body, the skin strives for a state of balance (homeostasis). Oxidative stress occurs as a result of many internal and external factors and disrupts this homeostasis.  Free radicals are molecules or ions with unpaired electrons that create oxidative stress and contribute to aging and disease. Our own cells’ mitochondria create free radicals as a result of normal cell metabolism.   UV rays, pollution and chemotherapeutic drugs are just some of the external sources that can also create oxidative stress in the skin.  Although our bodies contain their own natural antioxidant defense system, supplementation is typically necessary to fight oxidative stress and the resulting skin damage. Topically applied and orally administered antioxidants provide this needed protection.

 There are several levels of antioxidant function: primary antioxidants, secondary antioxidants and co-antioxidants.  Primary antioxidants act by donating an electron to disarm a free radical.  Secondary antioxidants chelate metal ions that are rich with electrons.  These metal ions are capable of triggering oxidation by donating or taking an electron.  By removing these metals, secondary antioxidants eliminate potential radical initiators.  Other molecules function as co-antioxidants.  These function by facilitating the antioxidant activity of other compounds.  Most antioxidants have a primary mechanism of action, but may have multiple functions.

UVB rays from the sun are the primary cause of a decrease in the antioxidant levels naturally found in the skin as well as an increase in reactive oxygen species (ROS), a particularly damaging free radical to the skin.  Because of this, regular use of broad-spectrum UV protection along with diligent application or topical antioxidants is necessary to help the skin’s system fight off oxidative stress.  This strategy will help protect skin from the premature aging caused by the sun as well as minimizing the chances of skin cancer.  PCA SKIN strongly believes that antioxidants are important for total skin health.

Next week we will outline some of the best antioxidants for your own skin care regimens.

don’t let winter get the best of your skin: part 3

UVB rays from the sun are thought to be responsible for the majority of UV-related skin damage, partially because of the immediate visible changes they produce. Although the inflammation and redness caused by a sunburn are the obvious downsides, it’s what’s happening inside your skin that is the most troublesome. UVB radiation is responsible for a series of events that take place inside the epidermal skin cells, including increased levels of the damaging free radical reactive oxygen species (ROS). Radicals are compounds with unpaired electrons. This lack of electron balance creates highly reactive atoms and molecules. There are many types of free radicals, but ROS have been widely studied because of their particularly damaging effects in the skin. Of the wide variety of environmental offenders, UV radiation is one of the top contributors to the overproduction of ROS free radicals and stress in the skin. ROS include hydroxyl radicals, nitric oxide, peroxynitrite, superoxide anions, peroxide, triplet oxygen and singlet oxygen. 

ROS are widely known for their ability to cause damage to cellular proteins, fats and even our DNA. The important factor for avoiding this oxidative stress and damage is keeping the skin’s radical and antioxidant levels in balance. Exposure to UV rays increases the production of ROS and upsets this balance (homeostasis) in the skin.  Using topical antioxidants in your daily care regimen is important all year but especially during the winter months when skin is dehydrated and vulnerable to damaging free radicals. In addition, UVB rays cause a reduction of the skin’s natural antioxidant levels, making it even more susceptible to DNA damage and mutation. It is this UV-induced DNA mutation that is the number one cause of skin cancers. This inevitable chain reaction in the skin is the reason the use of sunscreen ingredients alone is not enough. Sunscreen formulations should include antioxidants to help prevent the initial over-production of ROS and to support our natural defenses. Certainly, the use of SPF and antioxidants is important year-round, but it is a particularly helpful support to dry, dehydrated winter skin.

Multiple antioxidant ingredients have demonstrated benefits for reducing the incidence of ROS-induced skin cancers and premature aging. While there are thousands of topical antioxidants that are worthy of further study, one category of antioxidants worth noting is botanically sourced phenolic antioxidants.

Look for sunscreens and topical formulations with the following ingredients to boost antioxidants within the skin and protect it from UV damage:

• green tea
• resveratrol
• genistien
• ergothionene
• coffea arabica
• cocoa
• caffeine
• mangosteen
• silymarin

Many of these important ingredients can be found in all of the products in the PCA SKIN suite of sun protection products.

don’t let winter get the best of your skin: part 2

A common misconception is that more protection from UV exposure is needed in the summer than in the winter. Although the strength of the sun’s UVB rays diminish slightly in the winter months, the UVA rays remain constant throughout the year, making overexposure still a threat to healthy skin. The fact that snow can reflect up to 80% of the sun’s rays, while sand only reflects 15% and water only 10%, makes a moisturizer with broad-spectrum protection against UVA and UVB rays a must in every winter skin care regimen. Skin that is already stressed, dry and dehydrated may be more susceptible to the damage caused by UV radiation and more in need of even better protection.

The sun is the primary source of ultraviolet (UV) radiation. UV rays are broken down into UVA, UVB and UVC according to their wavelength:

• UVA – 320-400 nanometers

• UVB – 280-320 nanometers

• UVC – 200-280 nanometers

Skin cancer is the most common form of cancer in the United States with an estimated 1,000,000 new cases of non-melanoma skin cancers reported in 2008. Many people associate skin cancer with sun bathing and dismiss the UV risk during the winter months. This is not a safe assumption.  Get in the habit of wearing a broad-spectrum sunscreen with an SPF of at least 15 every day, all year.  Also, because UVA rays are constant throughout the year, be sure that your sunscreen contains one of the following UVA protective ingredients:

• avobenzone
• titanium dioxide
• zinc oxide
• encamsule

Also, don’t leave your wide-brimmed hat at home just because it’s cold outside.  With the sun being the number one cause of visible aging in the skin, avoiding unnecessary sun exposure and wearing broad-spectrum sun protection and hats daily will not only keep your skin safe, but will keep you looking younger.

don’t let winter get the best of your skin: part 1

This is the first of a three-part series on why our skin suffers in winter and what steps we can take to protect it.

Winter weather is not kind to human skin. The combination of lower humidity, increased winds and cold temperatures creates the perfect storm for leaving skin dry, dehydrated and more susceptible to damage. So what can we do to keep our skin healthy and hydrated throughout the winter months? Protection. Lots of factors contribute to developing the dreaded ‘winter skin.’ By avoiding moisture loss, unprotected sun exposure and free radical damage you can keep your skin healthy and beautiful.

THE FIRST LINE OF DEFENSE

The outermost layer of the skin is called the stratum corneum (SC), and is the first line of defense against the outside world. The SC contains mostly dead skin cells and is often described as the brick and mortar of a wall. The bricks are these dead skin cells (corneocytes) that contain a complex combination of lactic acid, urea, salts and amino acids that is collectively referred to as the skin’s natural moisturizing factor (NMF). The mortar is made up of groups of important fats (lipids) that organize themselves into layers creating a natural water-binding barrier for the skin.  If there is breakdown in either these ‘bricks’ or ‘mortar’ our skin loses its ability to hold onto moisture and becomes dry and sensitive.

Moisture is all-important for keeping your skin healthy at any time of year. Having enough water in the SC allows our skin to be soft and flexible. Moisture also plays a role in desquamation, which is the intricate process by which our cells turnover and are shed away from the SC. Without the proper moisture levels, the process breaks down, and dead skin cells build up on the surface, making it dull, dry and flaky. This buildup of dead cells on the skin’s surface traps dirt and debris and reduces the penetration of any topical products you apply.  This creates an even worse situation for already stressed and dehydrated skin.

Here are easy some steps you can take to keep your skin hydrated all winter:

1. Avoid using traditional soaps as these strip the skin of necessary oils and increase moisture loss and dryness.  Instead, use pH-balanced, gentle cleansers.  Those in particularly cold climates may want to switch to a cream-type cleanser for winter. A good choice is PCA SKIN creamy cleanser with gentle cleansing ingredients and an anti-aging boost form rose hip seed oil.
2. Apply moisturizers that contain both humectant ingredients to draw moisture into the skin and occlusive ingredients to trap it within.
3. Look for topical products that contain urea and glycerin, as these are the two ingredients, in addition to water, that are shown to hydrate cells internally. PCA SKIN hydrating serum contains these and other humectants and occlusive ingredients and is a great addition to any regimen.
4. Use a cool mist humidifier indoors to increase humidity levels.
5. Maintain water intake, even though the weather is cooler.

what is a peptide?

A peptide is a compound consisting of two or more amino acids, the building blocks of proteins. Peptides act as transmitters from the brain to the body, telling muscles and nerves to perform specific functions. There are multiple peptides available that will achieve different topical results.  The number following the name does NOT indicate the number of amino acids in the chain.  That is indicated by the “di”, “penta”, “tetra”, etc., such as:

• A dipeptide has two amino acids.
• A tripeptide has three amino acids.
• A tetrapeptide has four amino acids.
• A pentapeptide has five amino acids

The following are examples of different peptides and how they function in the skin:

 

Palmitoyl Oligopeptide stimulates collagen production and glycosaminoglycan syntheseis, hyaluronic acid in particular.  It is used blended with palmitoyl tetrapeptide-7 in Matrixyl^™ 3000.Found in PCA SKIN’s Total Strength Line & Pore Minimizer

Palmityol Pentapeptide-4 (Matrixyl^®) is a peptide consisting of five amino acids that provides an increase in the synthesis of collagen I, collagen IV and fibronectin. Found in PCA SKIN’s eyeXcellence

Palmitoyl Tetrapeptide-7 is a peptide consisting of four amino acids that improves skin firmness and elasticity and decreases inflammation.  It is blended with palmitoyl oligopeptide in Matrixyl™ 3000. Found in PCA SKIN’s eyeXcellence, Total Strength Line & Pore Minimizer

Dipeptide-2 is a peptide consisting of two amino acids that improves lymphatic circulation to more effectively remove toxins in the skin. Found in PCA SKIN’s eyeXcellence

Acetyl Hexapeptide-8 (Argireline) is a peptide consisting of six amino acids that works by relaxing the facial muscles that cause repeated facial expression wrinkling (crow’s feet, laugh lines, etc.). Found in PCA SKIN’s ExLinea^® Peptide Smoothing Serum

Palmitoyl Tripeptide-38 promotes collagen and hyaluronic acid production. Found in PCA SKIN’s Peptide Lip Therapy

Palmitoyl Oligopeptide – Palmitoyl Tetrapeptide-7 (Matrixyl^™ 3000) is a blend of two peptides which activates the synthesis of the skin’s extracellular matrix and provides visible anti-wrinkle activity.

Copper Peptides stimulate the synthesis of collagen and elastin.

Polypeptide is a single chain of amino acids (general term).

Oligopeptide is a polypeptide less than 50 amino acids long (general term).

Protein is a polypeptide more than 50 amino acids long.

Niacinamide and the skin

Although it is the only non-living layer of our epidermis, the skin’s stratum corneum (SC) has the critical job of providing a shield from the outside world.  The SC is made up of three vital components: the corneocytes, or dead skin cells; the lipid bilayer; and a combination of lactic acid, urea, salts and amino acids that is collectively referred to as the skin’s natural moisturizing factor (NMF).  When functioning properly, the lipids act like plastic wrap that surrounds the corneocytes, sealing in the NMF and keeping this outermost barrier healthy and hydrated.   Unfortunately, this barrier system is relatively easy to disrupt, leading to transepidermal water loss (TEWL), or the evaporation of our NMF.

The terms TEWL, impaired barrier function and skin dryness are often used interchangeably.  When TEWL occurs, several essential functions, including desquamation, are not possible. This often instigates or worsens skin conditions. The most obvious characteristics of impaired barrier and TEWL is dry, flaky skin; however, a dull complexion may also be an indicator.

The best and most comprehensive way to improve and protect skin suffering from barrier issues is to use products that include both humectants (ingredients that draw moisture into the epidermis from the dermis) and occlusives (ingredients that trap moisture within the epidermis). One well-known occlusive is petrolatum. Think old fashioned petroleum jelly.  Yes, it is effective as it traps 99% of moisture within the skin, but its greasy and heavy feel makes it an unpleasant option for facial use.  Silicones like dimethicone and cyclomethicone are better options as they have a light cosmetically elegant feel, but their moisture-trapping action and powdery finish are their only benefits.  This leads us to niacinamide.

People sometime mistakenly equate niacin and niacinamide.  Although they are related members of the vitamin B family, they have different actions.  Niacin, or nicotinic acid, is converted into nicotinamide in the body.  This conversion process is actually what causes the infamous flushing that occurs from topical and internal niacin use. When used topically, niacinamide does not need to convert an therefore does not cause the negative vascular responses of topical niacin. Additionally, niacinamide has been shown to increase the skin’s important essential free fatty acids, ceramics and cholesterol, further improving dry skin.

Our longtime PCA SKIN favorite ReBalance now contains niacinamide – and all of its benefits.  This excellent occlusive and antioxidant ingredient simply adds to the recognized efficacy of ReBalance.

show me the real answer?!

1.  My patient asked about Topical Botox
2.  My patient says his/her sunscreen is a ‘waterproof SPF 70’

Question number 1:

First of all, there is no such thing as Topical Botox.  This is the result of some very clever marketing.  By the time this false statement was removed, it had reached just about every type of media available.  The correct name for this ingredient is acetyl hexapeptide-8, or Argireline.  When Argireline is applied topically it inhibits the neurotransmission process that causes muscles to move or contract.  While this is a fabulous peptide that helps with the prevention of fine lines and wrinkles, it in no way is equal to an injection of Botox.  When explaining the differences to your patients, you can say that Botox temporarily places the neurotransmission highway that causes muscles to move under “construction” and the message cannot get from the brain to the facial muscles.  When Argireline is applied, the “highway” is fogged in…. the message will get there, but it’s much slower.  PCA SKIN®’s ExLinea ® Peptide Smoothing Serum is formulated with Argireline and a host of hydrating and antioxidant ingredients.

Question number 2:

Yes, another myth that gives our patients a false sense of security.  Currently, the SPF number on a sunscreen product ONLY pertains to the UVB protection provided by the product. (This will soon change).  Secondly, there is no such thing as a ‘waterproof’ sunscreen.  They all wash off and must be reapplied every two hours.  Explain to your patients to look for broad-spectrum UVA and UVB protection.  Also, explain to them that no SPF product provides 100% protection.  We relate the SPF number with the amount of protection and the amount of time that we are protected.  The truth is that an SPF of 15 provides 93% protection, while an SPF of 30 provides 97% protection.  An SPF higher than 30 only increases the percentage of protection by a tiny amount.  Again, inform your patients that they should use a minimum SPF of 30, with broad-spectrum UVA and UVB protection and reapply every two hours.  All of PCA SKIN’s broad-spectrum SPF products are formulated with antioxidants and skin-friendly ingredients and carry the Skin Cancer Foundation Seal of Approval.

 

Understanding ingredient mechanism of action and product formulation in the skin health industry will enable the clinician to communicate with their patients on all levels.  This in turn will build credibility and long-standing relationships when your patients know they can turn to you for the real answers.  PCA SKIN offers education for aesthetic students, licensed medical professionals and aestheticians all over the country.  Call our team at 877-722-7546 for more information.

AHA, BHA and PHA.. what are they and what is the difference?

AHA (alpha hydroxy acids) are acids that are derived from fruits, nuts, milk or sugars. They are hydrophilic (attracted to water) and break down the bonds between cells (desmosomes) to allow for easier exfoliation. The most commonly used AHA are:

glycolic acid (derived from sugars) is degreasing and is effective for controlling sebum production.

malic acid (derived from apples) is hydrating, soothing and increases tissue respiration.

tartaric acid (derived from grapes) is antioxidant.

mandelic acid (derived from bitter almonds) helps control pigment.

citric acid (derived from citrus fruits and corn) is anti-aging, brightening and increases epidermal thickness.

lactic acid (derived from milk and sugars) is antimicrobial, hydrating, inhibits pigment and adjusts pH.

Alpha hydroxy acids are commonly used in skin care to brighten the skin by increasing exfoliation. Citric and lactic acids are beneficial in that they are both biocompatible and have multiple benefits.

 BHA (beta hydroxy acids), the most common of which is salicylic acid, is derived from willow tree bark, wintergreen oil or sweet birch. Because salicylic acid is lipophilic (attracted to oil) and keratolytic, it is able to penetrate the oils in the skin and clear out follicles of excess debris and skin cells, making it especially effective in  the treatment of acneic skin conditions.

PHA (poly hydroxy acids) function the same as AHA, but cause less irritation due to their larger molecular size. They are especially beneficial in treating sensitive skin types that may not be able to tolerate AHA.  They provide anti-inflammatory and antioxidant benefits as well as assist with exfoliation. Some common PHA are:

 lactobionic acid (derived from lactose found in cow’s milk) is humectant, antioxidant and soothing.

galactose is a sugar utilized in glycosaminoglycan and collagen synthesis, and cell migration, which may enhance wound healing.

gluconic acid (a naturally occurring ingredient in cells), also known as gluconolactone in skin care products, is antioxidant and anti-inflammatory, while possessing AHA properties

 AHA, BHA and PHA are beneficial ingredients to the skin and can be found in many PCA SKIN daily care and professional treatments.  When used in harmony, they can be beneficial to all skin conditions and skin types.