This month’s Featured Archive Article:

BODY RESURFACING

to Peel, Heel and Rejuvenate

by Denise R. Fuller

While it is vital to apply skin care treatments to keep your face youthful and glowing, your décolletage, arms, hands, legs and feet all need TLC, too. To achieve brilliant, healthy and radiant skin throughout the body most estheticians use a manual exfoliation technique such as a scrub. Manual exfoliation is an excellent method to remove dead skin cells from the body, which results in softer, more hydrated skin. Sugar, salt and grains are all great ingredients to include in a wet room exfoliation treatment. Yet despite how great these elements may be, skin care and spa professionals are looking for more than just a good scrub down. Body anti-aging therapies have become a focus in spa treatments, as clients are demanding services not just for the face but for the hands, arms and back. They want to combat dry, flaky, wrinkled, hyperpigmented skin and even acne. Body resurfacing treatments are the next generation of exfoliation techniques designed to create a flawless body.

The goal of these peels is to improve the texture and surface appearance of the body’s skin, reduce stretch marks, even out skin tone and eliminate flaky skin.

Body peels can be helpful in reversing and rejuvenating nonfacial sun damaged skin, including the skin on the neck, chest, arms and legs. A series of body peels can help stimulate the growth of fresher, softer and more youthful looking skin.

Treating poikiloderma of Civatte

The goal of body peeling is to reduce mottled skin, that is skin that has blotches of excess pigment. With sun exposure freckles show up, then an overall ruddiness and colored spots appear and a condition called poikiloderma of Civatte follows. The condition is a dermatitis in which skin patches become dry and scaly. As the condition progresses pigment is deposited around hair follicles. The skin disorder was named after Dr. Achille Civatte, a French dermatologist who first described this common skin ailment that affects the skin on the sides and on the front of the neck. Characteristically, it spares the shaded area under the chin. The affected skin turns red brown and has prominent hair follicles. The term poikiloderma refers to a change in the skin where there is thinning, increased pigmentation and dilation of the fine blood vessels (telangiectasia). While the exact cause is unknown, below are some contributing factors that may result in poikiloderma of Civatte:

• Fair skin
• Accumulated sun exposure
• Photosensitizing components of cosmetics and toiletries, especially perfumes
• Hormonal factors

In treating poikiloderma of Civatte, professional peels are used to target the prominent hyperpigmentation until the desired result is reached. At that point, the esthetician determines what needs to be done about the remaining telangiectasia. A referral to a dermatologist at this point may be an appropriate option.

Resurfacing, at your service!

Professional peeling solutions are now available to target large areas. Not sure which one to choose? Well, the best treatment method comes down to a basic skin analysis and an assessment of the client’s desires. What are you treating: acne, wrinkles, hyperpigmentation?
Body peels are usually preceded by an at home pre-peeling phase of salicylic, lactic and glycolic acids that enable the deep penetration of the ensuing professional peel treatments. Body peels are designed to penetrate and stimulate the fibroblasts to produce new collagen in the dermis of the skin, repairing sun damage on the skin of the neck, chest, arms and legs. They are usually administered in series, spaced one or two months apart. Very fine peeling continues to occur over a period of weeks after each session. The goal of these body peels is to improve the texture and surface appearance of the body’s skin, reduce stretch marks, even out skin tone, and eliminate flaky skin that results from sun damage and poor winter skin care.
After applying a body peel, advise your client to use a postpeel cream for three to four days followed by additional daily home skin care regimen to help maintain results. Since the skin on the body is thicker and more resistant to treatment than that of the face, body peels are applied in a different concentration than facial peels.

Peels can be used to renew rough areas of the skin from the knees to the toes.

Body peel treatments dos and don’ts

• Do determine the goal of the client
• Do have the client fill out a consent form
• Do a patch test
• Do follow manufacturers’ recommendations and protocols
• Do provide the client with postpeel home care products
• Do insist on the use of sunscreen
• Do make sure that the client understands the importance of the following postpeel recommendations: stay out of the sun, no tanning beds.
• No hot showers
• No Jacuzzis
• No saunas
• Avoid exercising for 24 hours
• Don’t peel a client who has a sunburn or a windburn
• Don’t peel a client with open sores
• Don’t peel a client who is not feeling well or who has a fever
• Don’t peel a client if she is pregnant or lactating
• Don’t apply a peel to more than 25 percent of the body at one time

Peeling methods

Ellen Clark, founder and president of Control Correctives, recommends the Jessner’s peel be used only on the face, neck, décolletage and upper back. The Jessner’s peel works well on active acne on the back. There are a variety of chemicals that can be used to peel the body, progressively, but Jessner’s will not produce the peel results that you would expect when trying to peel the body. It can take up to 10 days before the client may show signs of peeling. As with a peel on the face, some clients flake more than others—it all depends on the build-up of the dead skin.
Note of caution: do not peel two large areas at one time due to the potential for chemical absorption into the system. When two areas such as the back and face are peeled at the same time, clients can become very lightheaded and dizzy. They could also become ill. While temporary, the sensation can be scary for the client and is not advised.
Cheryl Staurowsky, esthetician in Boca Raton, FL and PCA educator has been offering body peels for clients’ hands, arms and décolleté with great results. She also uses them for clients who have postinflammatory hyperpigmentation, a common condition in which pigment is deposited as a result of surface irritation or abrasion of the epidermis. For long time waxing clients who have pigment problems Staurowsky uses a smoothing body peel that has 45 percent lactic acid, 10 percent TCA and 10 percent salicylic acid. Staurowsky also works on clients who have had a tummy tuck or have loss of elasticity in the cleavage area and flexural friction, which is the darkening of knees and elbows, using a resurfacer to even out the area. She recommends that no more than 25 percent of the body be peeled at one time. It can take seven to ten days before a client will see peeling and the actual peeling may take up to three weeks to complete. Tip: when peeling the hands, Staurowsky recommends stopping at the knuckles because if the knuckles peel the skin cracks, causing discomfort and resulting in irritation.
Staurowsky also suggests the use of home care products with tyrosinase inhibitors such as hydroquinone, kojic acid, lactic acid, ascorbic acid, azelaic acid and arbutin. Melanogenesis is the process whereby the immune system triggers an inflammatory response, which then triggers melanocyte activity to protect the skin from any cutaneous inflammations such as heat, trauma and sun. When the skin produces unwanted pigment as a result of inflammation, tyrosinase inhibitors discourage the process. The other home care must is sunscreen!

After the peel, clients need to wear plenty of sun protection and avoid extreme heat and UV exposure.

Area specific

Biba de Sousa, esthetician, who works at the upscale Kinara Spa in West Hollywood, CA wanted to try a body peel on her elbows. She had those little rolls of extra skin that refused to defy gravity, plus her elbows’ skin was red. The other problem area she had was on the skin of her shins. It was cracked and parched despite the use of quality moisturizers and body lotions. Living in southern California made matters worse, as there skin gets keratinized much faster than in humid climates. She also wore sandals and slippers every day, so the knuckles on her big toes became hardened and ridgy. At 42 years old at the time de Sousa believed she had plenty of collagen in her body, as her skin was soft and youthful in appearance except for the aforementioned areas on her body. She was feeling down about the appearance of those areas but did not know what to do. Until she got a body peel, that is.
For two days after the peel nothing happened. In fact, de Sousa says she almost forgot about the peel. But then, the peeling started. She peeled and peeled and peeled for literally a week or so. She was thrilled because she knew that while she was peeling she was moisturizing her newly growing skin. She loved the result. Her saggy elbows were lighter and tighter, which encouraged her to proceed with the procedure on her knees, shins and toes. She also peeled profusely there, and kept moisturizing during the shedding. Twice in the winter and once in the summer de Sousa repeats the procedure and continues to have smooth elbows to this day. Practicing on herself and seeing such dramatic results made her a believer. Today de Sousa shows her clients the process and creates new body peel followers.

Sun protection a must

As professionals we must recommend the daily use of a broad spectrum sun blocker with an SPF of 15 or greater on any exposed skin. Sun protection is especially important for clients to practice if they want to protect themselves from hyperpigmentation. On a daily basis our skin is continually bombarded by UV rays. Anytime we are outside we are exposed, even if we are in the shade, under an umbrella or are wearing a hat. Even when inside we get additional sun exposure via reflections from nearby water and rays coming in through windows. Of course, the most dangerous times to be out in the sun are the midday hours of 10 a.m. to 2 p.m. Practicing safe sun protection principles is essential for clients undergoing body peels.
Tanning booths are a huge no-no in general, but especially when it comes to clients who come to you for body peels. They must be avoided at all costs. If a client refuses to give up frequent visits to the tanning booth, then you must discontinue the peels. Conducting peeling techniques on a frequent tanner will only worsen his/her hyperpigmentation condition.
Body peeling is more than just an exfoliation method. It will work on thickened and resistant skin to create a beautiful, healthy body that matches the face! A body peel is an easy add-on service for your clients that evens out skin tone, helps firm and tighten the skin and minimizes evidence of sun damage. Body resurfacing is the latest and greatest technique in skin renewal. The treatment is now in high demand among clients as a vehicle to maintain healthy and youthful looking skin throughout their entire bodies. Will you be ready to offer it?

Denise R. Fuller is a licensed esthetician, certified body wrapping instructor for the state of Florida, beauty therapist and author in the esthetics industry. She is the owner of International Spa Importing Specialists and founder of the National Aesthetic Spa Network and now she is the Editor in Chief of Les Nouvelles Esthétiques & Spa magazine. She is happy to answer your questions via email at denise@lneonline.com.