October 2007’s Featured Article:

The results-oriented skin care INDUSTRY as we know it now was effectively birthed in the ’60s when Eugene Van Scott, M.D., and Ruey Lu, Ph.D., found a way to stabilize glycolic acid for use on the skin. Quickly, glycolic acid, an alpha hydroxy acid (AHA) that could be used in varying strengths, took over the esthetic marketplace and became “the answer” for many anti-aging estheticians, replacing the more intense peels performed prior to that time, such as phenol, trichloroacetic acid and Jessners.

The use of peels continues to evolve as estheticians become more sophisticated in using them. Acids other than glycolic acid now add variety to the acid peel market, each with its own definition of use. Sharp skin care and spa professionals maximize the use of acids while taking every precaution to avoid skin irritation and hyperpigmentation.

Skin preconditioning, one step at a time

One of the most recent trends in the use of acids is called “skin preconditioning,” in which the esthetician discusses a particular acid treatment with a client and recommends that he/she apply a home care preconditioning treatment before beginning the acid series. Preconditioning helps improve the skin condition, enabling the skin to become more resistant to side effects. Historically, side effects occur more frequently and with greater intensity when a client is peeled without preparing the condition of the skin. Also, home care products used before a peel enhance its results.

How does the skin preconditioning process work? The esthetician chooses preconditioning products according to the skin condition, the skin type and the Fitzpatrick skin analysis system. Chosen appropriately, effective skin care products visibly improve the skin within five to seven days, and strengthen and enhance its texture within three to four weeks.

The necessary time frame for skin preconditioning with home care products depends on the skin’s health and the intended acid. The poorer the skin condition, the longer the recommended preconditioning time. The higher and more aggressive the acid, the longer the recommended preconditioning time.

Manufacturers take note

Preconditioning is now so routine among informed estheticians that treatment companies have developed preconditioning kits. An effective kit is consistent with the client’s skin type, skin care goals and budget, meaning they usually contain smaller sized bottles. The lower price allows for market penetration of the product, enabling the client to check out the results at an acceptable price.

A first-time prep kit for an anti-aging series client may contain a cleanser, a moisturizer that contains loads of antioxidants, a product with dermal stimulators such as peptides and a product with a high SPF. Depending on the client’s skin condition, the product line and the esthetician’s expert opinion, a glycolic acid or retinol product is added to the regimen after one to three weeks. All in all, the products usually last one month.

Clients who rate IV to VI on the Fitzpatrick scale may also benefit from the use of a lightener/brightener. In the meantime, the client comes in every two weeks for an enzyme peel and a hydrating mask until the skin is ready for the acid series. Then, the series is scheduled.

Prep time

The skin of most clients responds well to both professional skin care treatments and at-home care, so the preconditioning period leading to the acid series usually lasts two to four weeks. In the end, the skin shows obvious signs of improvement, making for a happy client. The key to having a satisfied client is in providing education on the skin preconditioning system and its benefits.

Clients who have intense, one-time deep peels also respond well to skin preparation techniques. Deep peels require longer skin preparation time, though, and require more pre-peel facials to produce results and counter potential side effects. All one-time peel clients are put on a lightener/brightener right from the start of the regimen. The higher the Fitzpatrick, the longer the prep time must be to counter hyperpigmentation. The lower the Fitzpatrick, the longer the prep time required for countering intense irritation and damage.

Combination services

Recently, estheticians began combining services, such as applying acids and performing microdermabrasion simultaneously. While combining such services may tempt hyperpigmentation, applying preconditioning techniques may counter potential side effects well. Seasoned estheticians understand that preconditioning enhances safety as well as results, and is especially important in combination services.

Some states do not allow combination services, and they have regulations that prevent them from being performed. Nevertheless, most experts agree that if combination treatments are properly and safely carried out alongside skin preconditioning, their results may be alarmingly effective.

Massage as you peel? Consider acupressure instead

Massaging the face of a client undergoing a facial acid treatment is a huge no-no. The massage overstimulates the skin, causing side effects such as irritation. Nevertheless, estheticians have recently learned that facial acupressure is a great technique to apply during acid treatments, adding a much appreciated spa and relaxation approach. It is performed during the postpeel rehydration mask part of the treatment. (Note: No massage or acupressure should be applied after a deep, one-application peel.) Acupressure is a must learn technique for estheticians using acids—watch for product manufacturers and schools that are now offering classes on the technique.

When you exfoliate, rehydrate

In the old days, a client was peeled, a moisturizer was applied and he/she walked out the door. Now, estheticians know that the skin becomes deeply dehydrated after the acid treatment, and must be abundantly rehydrated to allow the product to perform as it should. Skin care and spa professionals ought to apply a reputable rehydration mask after the peel and allow the skin to drink in the needed moisture for seven to 10 minutes. Reapply if the product penetrates too quickly.

SPF, always

In 1997, the FDA announced the results of a study on the effects of the sun on clients using glycolic acid. The study measured the susceptibility of skin to hyperpigmentation after glycolic acid application. The conclusion was that anyone who uses glycolic acid should apply a sun protection product with a minimum SPF 15. The study also suggested that consumers become informed on how to protect their skin from exposure to the sun. In essence, SPF is an important factor that contributes to meeting the desired treatment results—insist that your clients use a product with a high SPF!

Timing is, indeed, everything

Knowing how long to leave an acid product on the skin is vital. Suitable timing must be defined according to the acid type and percentage, its formulation and the skin condition. Education is key here. For example, most AHAs should be left on for two to three minutes. As the skin strengthens and becomes thicker over time, the amount of time an acid can remain on the skin increases. AHAs require neutralization, no exceptions. Salicylic acid, on the other hand, neutralizes itself after three to four minutes, not requiring neutralization or removal. Since every acid is different, training on application, leave-on time and safety is very important. Instructions on the use of acids must be sought out specifically from the company that manufactures the acids you purchase.

Acids are tricky—they can make an esthetician a lot of money, or send him/her to the poor house—if a client is harmed during an acid treatment. Again, learning the ins and outs of acids is essential. Acids have their place in the skin care and spa industry—respect them, and use them safely.

About Janet McCormick

Janet McCormick is an experienced esthetician, manicurist, former salon owner and spa director. She holds a master’s in allied health management, as well as the CIDESCO diploma. McCormick has written more than 300 articles and shares her expertise in conferences and spa education. Owner of Spa Techniques Consulting, she can be reached at 863.273.9134 or via e-mail at janmccormk@aol.com.

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