Exfoliation is key to maintaining healthy, functioning skin. The skin naturally reproduces cells and brings healthy, new skin to the surface while regularly shedding the dead, outermost layer. As a skin care professional, you know that the benefits of exfoliation include improved texture and tone, lightened pigmentation, unclogged pores, a clearer complexion, a reduction in acne breakouts and in the appearance of fine lines and wrinkles. In addition, exfoliating the skin allows optimal penetration of any active ingredient.
The effects of exfoliation are immediately visible. This makes it very appealing to today’s consumers, who expect every marketing promise to be met. A single exfoliation service is sure to deliver a “wow” factor for your clients.
As a professional skin therapist, you must assess your clients’ skin and determine what form of exfoliation is going to best meet their needs. Verify that the client has not been waxed recently, is not sunburned and has not had any laser, light-based treatment within the last 72 hours. If any of these conditions applies, reschedule the exfoliation treatment. Clients who have recently taken Accutane (Isotretinoin) will need to wait a minimum of six months before undergoing any form of exfoliation. Ask female clients if they are pregnant. These questions are important to determine which form of exfoliation to use, and what ingredients are the most suitable.
Scrubs work just the way they sound—they scrub away the dead skin cells. Sugar, salt, coffee, walnuts and almonds provide the loosening action of the scrub. Oil-absorbing scrubs often contain clays such as kaolin or diatomaceous earth. The vigor of the scrub must be appropriate for the sensitivity level of the skin. A gentler scrub should be used on skin that is prone to flushing or inflammation, or has recently been resurfaced or waxed.
Microdermabrasion, ultrasound, brushes and dermaplaning
Microdermabrasion, ultrasound, dermaplaning treatments and brushes can be referred to as both physical and mechanical forms of exfoliation. Mechanical exfoliation utilizes a tool or machine to remove the buildup of dead skin cells.
Microdermabrasion can be used to polish and smooth the skin. It is ideal for skin with visible sun damage. Microdermabrasion systems utilize pressurized suction. The top layers of the epidermis, which consist of dead skin cells, are removed in microdermabrasion. Manufacturers today combine microdermabrasion machines with water or serums to enhance the infusion of moisture and humectant ingredients into the skin, reducing redness, soreness, flaking and other commonly experienced symptoms. It is important that microdermabrasion is never used on sensitive skin, inflamed pustules, open acneic lesions or rosacea.
Ultrasound or ultrasonic is a type of mechanical exfoliation that uses sound waves to create cavitation, or openings within the corneocytes. Skin cell particles are broken apart, resulting in tiny openings that allow for more powerful penetration of products, resulting in a deeper cleanse, exfoliation or hydration of the skin. This form of technology may be combined with cleansers or chemical exfoliants. With the exception of open or inflamed acne, ultrasonic is safe for all skin conditions. However, it is important to ensure that there is no contraindication to the use of any electrical modality.
Dermaplaning utilizes a small surgical blade to gently remove the uppermost layer of skin. The skin care professional must execute exceptional technical control and precision for this method. Dermaplaning helps even out irregular skin tone and reduces the appearance of scars.
Enzymes, vitamins, acid-free smoothing agents or other active ingredients are often good matches for skin in need of deeper exfoliation, or skin conditions that are contraindicated with physical exfoliation. Enzymes are excellent for all skin types, particularly acneic skin in need of extractions, as well as dry, sensitive skin. They also make a great complement to chemical peels.
Enzymes speed up the skin’s natural exfoliating process by nibbling away at the keratinized protein layer, which forms a hard coating on an aged cell.
Mature skin, which experiences a natural slowing of cell turnover that results in a rough feel or lifeless, dull appearance, is ideally treated with proteolytic enzymes such as bromelain, papain and pumpkin. Most enzymes are activated by water, which makes them effective at maintaining hydration within the skin.
One of the most common types of exfoliation is performed with alpha hydroxy acids (AHAs) and beta hydroxy acids (BHAs). Both acids work by gently dissolving the outermost layers of skin. The difference between them is that AHAs are water soluble and do not penetrate as deeply as BHAs, which are oil soluble. AHAs are generally good at eliminating dead cells on skin’s surface, while the oil solubility of BHAs make them better for clearing up clogged pores. AHAs and BHAs can both be used in the form of serums, exfoliants or professional chemical peels. Their performance is determined by their percentage and their pH. The percentage identifies the product’s strength, while the pH determines how deeply it penetrates. The pH scale is numbered from one to 14, with one being the most acidic and 14 being the most alkaline. Tap water is considered neutral with a pH of seven, and skin has a pH between four and a half and six. Since AHAs and BHAs exfoliate skin due to their acidic component, pH is critical to their performance.
To select a chemical peeling agent for your clients, use the Fitzpatrick classification system, and consider the overall condition of the skin and any related concerns.
Alpha hydroxy acids
AHAs are acids derived from fruits, nuts, milks and sugars. They help promote cell desquamation, and break down the bonds between the desmosomes, which allows for easier exfoliation of dead surface cells. The following is a list of different sources of AHAs:
• Glycolic acid. Derived from sugars, this is one of the most common AHAs. It is appealing due to its small molecular size and multifunctional approach on the skin. It is effective at controlling sebum production.
• Lactic acid. Derived from milk and sugars, this is probably the second most common of the AHAs. It is considered to be a gentler alternative to glycolic acid, due to its larger molecular structure. Lactic acid not only helps soften rough skin by breaking the bonds of the desmosomes, it can also increase hydration, inhibit pigmentation and adjust pH levels.
• Citric acid. Derived from citrus fruits and corn, vitamin C is typically considered a class of its own. It technically belongs to the AHA family. This AHA is also an antioxidant that is used to help brighten the skin and increase epidermal thickness.
• Malic acid. Derived from apples and green grapes, this acid is a multifunctional AHA that also acts as an antioxidant and humectant. It is soothing and beneficial to sensitive skin types that cannot tolerate glycolic acid.
• Mandelic acid. Derived from bitter almonds, this AHA is comprised of a large form molecule that allows for slow and even penetration. Exfoliation with mandelic acid is more gentle and delicate for sensitive skin types. It helps brighten discoloration and contains antibacterial properties that aid in acne control.
• Jessner solutions. A blend of resorcinol, salicylic acids and lactic acids, this combination can effectively target a range of skin concerns such as acneic, sensitive and even irregular pigmentation. Modified Jessner solutions generally are comprised of lactic acid, salicylic acid and either citric acid or other botanical extracts.
Beta hydroxy acids
BHAs function and perform similar to AHAs. Salicylic acid is a BHA derived from willow tree bark, wintergreen oil and sweet birch, which was used as an anti-inflammatory in ancient times. Since it is lipophyllic (attracted to oil) in nature, it has the ability to penetrate through the oils in the skin and clear out follicles of excess debris and skin cells. This makes it especially effective in the treatment of acneic skin conditions. Salicylic acid tends to be less irritating to some skin types, and may be a good alternative for clients who have not tolerated AHAs well.
More than just face value
Each of the exfoliants discussed in this article may be used for more than the face. Any area that needs polishing and refining or suffers from photodamage can benefit from these exfoliants, including the feet, upper arms and back. Exfoliation on the chest and back can be especially helpful for clients experiencing post-inflammatory hyperpigmentation due to acne. The ability to wear a bathing suit or revealing top without being self-conscious is very important.
Exfoliation is a very innovative element to add to your service menu, particularly in the form of chemical peels. Educate yourself and your team about the benefits, ingredients, products, techniques and potential risks of chemical peels, and then educate your clients! It is a great service to boost your business.
Safety should always be your primary concern. As a skin care professional, you are responsible for ensuring that the state boards where you currently practice allow for your ingredient combinations and formulations. Also, verify with the manufacturers of all products to determine if the mixing or blending of exfoliants is applicable. All of these concerns must be researched in advance, and are an important aspect of your treatment design. Exfoliation treatments are not one-size-fits-all. Requirements vary from state to state and client to client.
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