Skin Care

I.  Skin

Our skin is the largest organ of the Human body.  The skin is composed of many different layers.  Within these layers are dead skin cells to protect the surface of our skin, blood vessels, lymphatic channels, nerves, collagen & elastin fibers, oil glands and sweat glands.  To understand the skin takes years of research and experience.  Experts are still learning more and more about our skin’s health and how to delay the aging process. 

Skin is one of the most researched organs because it is so complex.  There are many different skin conditions, treatments, and skin care products available.  In order to properly care for your skin, it is important to understand the history of skin care and how skin has been viewed throughout history.  Skin is a complex organ made up of many different layers.  Understanding the layers of skin and how the skin works to delay aging can help control certain skin conditions, such as Acne.  Acne is one of the most common skin conditions affecting millions of teenagers as well as men and women in the 20s, 30s, 40s, and up.  Acne is the most difficult of skin conditions to treat and it is also difficult to target the cause of acne.

 a) History of Skin Care

When we look at skin care, we think more about its development in the past fifty years.  However, skin care has been around for thousands of years, dating back to the Ancient Egyptians.  In Ancient Greece, athletes bathed in Olive oil and dusted their bodies in fine sand to regulate body temperature and provide sun protection.  Europeans, still known for their extensive knowledge of beauty, are still ahead of Americans in the evolution of skin care.  Today, we use some of the same skin care regimens as our ancient ancestors once did.  We are learning that the most readily available fruits, vegetables, dairy products and fats have been the source of ancient secrets of hygiene, sun protection and anti-aging for thousands of centuries.  Even looking back at our mothers and grandmothers, we can notice that their skin care regimen was so simple, but made a significant difference in their skin appearance. 

 b) Layers of the Skin

Our skin is composed of two main layers.  Within those layers are a variety of different skin cells, sub-layers, blood vessels, nerves, sweat and oil glands, hair follicles, collagen and elastin fibers. 

The first layer of skin is the Epidermis, the outer layer.  The thickness of the Epidermis varies from person to person.  There are four main layers within the Epidermis layer of skin, which are the Stratum Corneum, Stratum Granulosum, Stratum Spinosum and the Basal Layer.  The Stratum Corneum is the top layer of skin and is mostly composed to dead, flat skin cells.  The Stratum Corneum is shed approximately every 2-4 weeks.  The Basal Layer is the base of the Epidermis, where new skin cells are formed and pushed towards the Stratum Corneum.  As the cells move to the skin’s surface, they flatten and eventually die.  As the layer before them is shed, they then become the outer surface of the Epidermis.

The Dermis is the second layer of the skin that lies below the Epidermis.  The Dermis is composed entirely of living cells.  The Dermis layer of skin contains blood vessels, collagen, elastin fibers, lymphatic channels and oil and sweat glands.  There are two main sub-layers within the Dermis: the Papillary Dermis layer and the Reticular Dermis layer.  The Papillary layer contains a thin layer of Collagen fibers arranged parallel to the skin’s surface.  When these fibers begin to diminish, fine lines and wrinkles begin to appear.  The Reticular layer is where thicker Collagen fibers are arranged parallel to the surface, as well as many specialized cells and structures.  Hair follicles with sweat and oil glands, blood vessels and nerves are included in this layer.  This layer is responsible for the ability to regulate temperature and sensations such as itchiness and pain.

 Below the Dermis lies the Subcutaneous Layer, this is mostly composed of fat and connective tissues.  This is where the larger blood vessels and main nerves are located.  In the Subcutaneous layer, fat cells are located and store excess fat when weight gain occurs.  This layer is responsible for insulation of our bodies and will store extra fat when the weather begins to cool down or for cases of trauma or famine. 

 This is only a basic view into our skin, the different layers and how they connect to each other.  Skin is the most complex organ in our bodies and understanding about the skin and how our skin works will help us to protect and prevent any skin conditions and help retard the aging process.  Proper skin care is best understood when you have a basic knowledge of the different layers of skin.  However, also knowing how the skin works is another important step in skin care.

 c) How the skin works

Our skin provides many different basic functions.  Two of the most important functions of our skin are the protection of internal structures against injury and to allow exchange of fluids and gases, such as (oxygen and carbon dioxide) from our body into the environment.  Our skin provides temperature regulation by blood flow and sweat to maintain our body temperature.  Our skin also protects against ultraviolet rays through Melanocytes (cells responsible for melanin production) which give our skin the “tanned” look.  Our bodies are able to process certain sensations by Sensory organs.  Vitamin D is produced through the interaction of UV light present in our skin which stimulates metabolism in our bodies.  The most important function of our skin cells is the ability to protect our body against external bacteria and viruses.  Our skin helps our Immune system by blocking any environmental bacteria from entering our bodies.                                       

Our skin is an amazing organ that protects us from harmful bacteria and viruses, keeps us cool and warm during the seasonal changes, and protects us from the sun’s harmful rays.  Our skin has a memory and remembers everything.  Our skin also has a way of telling us when our internal organs are not working properly.  Our skin also helps purging bad things from our bodies by excreting them directly.  Most skin conditions today are caused by:

• Something internal.

• External agents in our environment we may breathe or consume.

• Improper skin care regimens.

 d) Acne

Acne is the most common skin condition known to teenagers.  Acne also now affects millions of men and women over the age of 25.  Acne Vulgaris is the most common type of acne and includes different types of pimples, including blackheads, whiteheads, papules, pustules, nodules, and cysts.  Blackheads result from a clogged pore, which traps oil, bacteria and dead skin cells.  The black color is a result of melanin reacting to the oxygen in the air.  Whiteheads completely trap the pore, filled with oil, bacteria, white blood cells, and dead skin cells and cause a white appearance on the skin.  Papules are small, red, tender bumps with no “head” and should NEVER be squeezed.  Pustules are an inflammation with a red circle and a white or yellow center.  These are your common “zits”.  Nodules are large, painful bumps under the skin’s surface and should NEVER be squeezed.  Nodules can last for months and if improperly treated, can cause scarring.  Cysts are a pus-filled nodule that cannot be squeezed.  These are painful and if attempted to extract can cause a deep infection and deep scarring.  Nodules and Cysts must be treated by a Dermatologist or Plastic Surgeon. 

 Acne is one of the most difficult skin conditions to treat because its cause is not entirely known.  There are many factors that stimulate the production of acne, including P. acne bacteria, hormones, diet, improper skin care, vitamin deficiency, stress, excessive exercise, and more.  Adult acne, now becoming more and more common in both women and men are being tracked to hormonal imbalances.  Hormones are responsible for oil production in our bodies, which is why most teenagers suffer from severe acne during puberty. 

 Women’s hormones fluctuate more then men.  This is due to the fact that they begin puberty along with menstruation, eventually becoming pregnant (for most women more than once) and after several years they finally develop menopause.  Acne, most likely is influenced by the presence of Androgens, which is the male hormone present in both men and women.  Birth Control pills can help some women to control their acne, in which case, acne is caused by hormonal changes in their bodies.  Unfortunately, this is not the cure for all women.  Some women have dietary and conditions unknown when developing acne.  Dermotologists, OB-GYNs and Plastic Surgeons are working to help keep these “other” causes for acne under control.

 Bacteria play a major role in the formation of acne.  Without these bacteria (P.acne bacteria), acne does not occur.  P. acne bacteria, (short for Proprionibacterium acne) are bacteria normally present in our skin.  When pores become blocked, the pore loses oxygen and the P. acnes begin to grow and multiply.  This attracts white blood cells to help kill the bacteria present.  This causes the inflammation associated with a “zit”.  Everyone has P. acne bacteria present on their skin.  Teenagers are probably mostly affected by Acne due to hormones from puberty, which increases the amount of P. acne bacteria present on their skin. 

II. History of Skin Care

When we think about skin care, we generally think about the past fifty years.  However, skin care has been around for thousands of years, dating back to the Ancient Egyptians.  Skin care has been viewed throughout history as a compliment to beauty and hygiene.  Unfortunately, most of our ancestors did not bathe daily and some viewed cleanliness as bad.  Europeans are known for using perfume to cover their body odor.  Some cultures viewed body hair as bad, while some viewed body hair as beautiful and feminine.

 Skin care has evolved in many different ways and traditions and is still evolving through the newer generations.  Beginning with the Baby Boomers who are at center stage and eager to prevent the aging process.  Newer generations, such as Generations X and Y are beginning to also think about how to prevent aging.  They are spending thousands of dollars each year on anti-aging creams, AHAs and Retinols to “stop the clock”.  All of our “newest” skin care treatments and creams began with the Ancient Egyptians.

 a) Ancient skin care treatments

The Egyptians’ concern for beauty has been studied for thousands of years.  No other culture in history was so concerned with beauty and cleanliness through skin care.  We are finding the best anti-aging methods were first discovered by Cleopatra.  Cleopatra was known for her skin care regimen, including bathing in sour milk, high in Lactic acid for skin exfoliation.  Egyptians recognized beauty and body care and began with cleanliness.  They were conscious of body odors and thought, in order to be attractive, healthy and protected from evil, you must be clean. 

 In Ancient Greece, beauty was determined by being naked.  The desire to see a woman nude was to consummate the act of sex with beautiful women.  Athletes were also identified by their nakedness, which defined the balance between the body and mind.  Greek athletes bathed in Olive oil and dusted their bodies in fine sand to regulate body temperature from the heat and also to provide sun protection to their bodies (to prevent them from aging).  Men and women used honey to moisturize and olive oil for protection to improve their health and appearance.

 In Ancient Roman times, hair removal was popular among men and did not always include facial hair.  The Romans developed methods of shaving, plucking and the use of depilatory creams.  Romans viewed cleanliness as a refined surface, free from hair along with smooth skin.  The Romans lived in a water-rich area and took lots of baths using soaps to lather and cleanse the skin, removing grime and oil left behind.  Scented oils were then applied to the skin to finish the cleansing process.  Bathing was important for the Romans who had public baths and spent large amounts of money developing these bath houses.

 b) How skin has been viewed throughout history

Europeans, who gravitate towards beauty, are still known for their extensive knowledge in beauty, and are way ahead of Americans in terms of skin care.  European women for centuries have bathed in wine bath to achieve smooth and silky skin.  In the Middle Ages, bathing was unheard of not only in Europe, but in Early America as well.  Unfortunately, because of poor hygiene habits, many people suffered from disease and illness.  In the late 19^th century, bacteria were eventually discovered to be the cause of illness and death.  Even today, most Europeans do bathe, but not daily like most Americans do.  Daily baths is an American tradition.  Other countries are beginning to follow in our footsteps.  Beauty and hygiene began in the late nineteenth century, beginning with antiperspirants and deodorants.  From the 1910s to the 1950s, a more regimented program was developed and women began exercise, diet, along with the use of cosmetics, makeup, hair, and body products.  During the World War I, women learned to become independent both socially and economically.  Women became part of the working class and were able to purchase more and more beauty products.  During this time, Hollywood stars’ looks became desirable and women began to copy the looks of their favorite actresses.  In the 1950s when TV became available in almost every home, advertisements were created.  Sponsors of major corporations began to support TV shows and the radio.  Today, the beauty industry is over $20 billion dollars and still increasing each year, and is still sponsored by advertisements on the TV and radio.

c) Skin care within the past 50 years

Today, we use some of the same skin care regimens as our ancient ancestors once did.  We are learning that the most readily available fruits, vegetables, dairy products and fats have been ancient secrets of hygiene, sun protection and anti-aging for thousands of centuries.  Even looking back at our mothers and grandmothers skin care regimen was so simple but made a difference in our skin’s appearance.  Egg whites in the hair and cucumbers on the eyes - these ingredients are beginning to appear in skin care creams, lotions and cleansers for the “newest” anti-aging skin care programs.  Skin care has been used throughout history to help achieve beauty, hygiene and power.

Moving into the era of Anti-aging has begun with the Baby Boomer’s generation who are concerned with preventing the aging process.  Because this trend has become so popular, both men and women from Generations X and Y and beyond have begun to prevent aging as early as their late teens and 20s. 

Plastic Surgery, the most sought after solution for both women and men, has become the biggest industry in anti-aging.  Even the Plastic surgery industry is changing by moving away from more invasive procedures, such as face lifts and moving to less invasive treatments, such as injectable fillers.  Because these “non-invasive” treatments are available, more and more men and women beginning with the Baby boomers into the Generations X and Y are heading into Plastic surgeons offices to look and feel younger.  Laser treatments, Botox, injectable fillers and more are becoming the newest and greatest treatments available among billions of men and women from the 20s and up.  Baby Boomers created this trend and the twenty-somethings are beginning to catch on and follow in their footsteps by preventing aging before it even begins.  Physicians have been involved in creating some of the most innovative skin care solutions in the last ten years.  In fact, one of the hottest new skin care lines is neaclear.  This is being tested as the “ultimate anti-aging regimen.”   Guess who started it?

 A Plastic Surgeon.

III. Skin Care Today

Skin care has come a long way in the past 50 years.  Men and women are concerned with aging and their appearance.  More people are looking for skin care solutions to “turn back the clocks” and some are looking for more advanced skin care solutions.  Skin care products with breakthrough ingredients are being sought after.  Non-invasive face and body treatments are the newest treatments available, including Laser treatments, Botox, Injectable fillers, and other non-surgical procedures. 

a)  Spas and Skin Care

Skin care in the spa industry is changing rapidly.  Spas are not only meant to pamper and relax, spas are joining Physicians to gain knowledge in non-invasive treatments and combine with the relaxation a spa offers.  Wellness spas are being created to enhance the day spa, but not go to the extent of a MediSpa and work with a Plastic surgeon, rather merge with a Holistic physician or Chiropractor to combine Acupuncture, Detox treatments, Colonics, Ayurvedic medicine and more. 

Spas are incorporating more intense facial and body products, to give clients results while pampering and relaxing them.  Therapeutic treatments are becoming the hot, new treatments available. 

IV. Skin Care Products

As we move into the era of Anti-aging, skin care products are developed to help prevent and heal and protect the skin from sun damage, pigmentation, fine lines, and wrinkles.  If we look back throughout history, Anti-aging and skin care products have been around since the Ancient Egyptians.  For centuries, our ancestors have used these products on their faces and bodies in their purest forms.  Most of these skin care products are commonly known from women and men concerned with their appearances.  Newer skin care products are being developed from formulas to help control skin conditions and protect against further damage.

a) AHAs and BHAs

AHAs, also known as AlphaHydroxy Acids, are derived from fruit and milk sugars.  Common AHAs are Glycolic, Lactic, Malic and Citric acids and they possess a special ability to penetrate the skin.    Their main purpose is to exfoliate the top layers of the Epidermis and enhance cellular turnover by stimulating dead skin cells to shed, stimulating new cell growth.  By using AHAs over a period of time, your skin will improve fine lines, wrinkles, smooth darker areas and leave the skin looking firmer.  When using AHAs, it is recommended to avoid sun exposure.  The skin becomes thinner due to exfoliation of the skin which may also result in temporary redness.  When using AHAs, it is suggested to use an SPF of 30 or higher every day.

BHAs, also known as BetaHydroxy Acids, have only one known acid, Salicylic Acid.  BHAs are mostly used to help control acne because of its ability penetrate into the pore and exfoliate dead skin cells within each pore.  BHAs help best to control blackheads and whiteheads.  This in turn helps to control Acne breakouts.  BHAs are derived from aspirin, which has Anti-inflammatory properties.  Even though BHAs are gentler on the skin than AHAs, BHAs also cause sun sensitivity.  People who use BHAs should wear an SPF of 30 or higher every day.

 AHAs and BHAs both help to exfoliate and penetrate the Epidermis by “ungluing” dead skin cells and stimulate new cell growth.  The main difference between the two acids is that AHAs are water-soluble, which means AHAs work best on thick, sun-damaged skin with little or no breakouts.  BHAs are oil-soluble, which means they work best with Acne because they can penetrate into the pores and help to control oil production. 

 b) Retinols

Retinols are another aggressive skin exfloliant, also known as Retin-A or Tretinoin.  No matter which version of Retinol you use, all come from the Vitamin A family.  These Retinol skin care products are designed to help control acne and treat fine lines, wrinkles and sun damaged skin.  Retinols are ONLY to be used at night because they cause sensitivity to the sun.  When beginning any Retinol product, expect your skin to become red, flaky and dry.   If you use waxing for hair removal on the face, stop using Retinols for 3-4 weeks prior to your waxing appointment because you may be left with a sore.  The purpose of Retin-A is to create a superficial peel of the Epidermis.

 Retinoic Acid directly affects the skin cells and sloughs them off to help produce a more youthful appearance to the skin.  All skin cells naturally have specialized enzymes that convert Vitamin A when consumed into Retinoic acid.  When stimulated by the topical application of Retin-A, the amount of Retinoic acid increases in the skin.  Not everyone gets results from the use of Retin-A or Retinols, because certain Retinol-derived products do not deliver a large enough amount into the skin to improve its appearance.  Newer, well designed forms of the Retinol skin care products are being developed to help produce a less-irritating alternative to Retin-A. 

 c) Omega Fatty Acids

Omega’s 3 and 6 Fatty Acids are essential “good fats” needed for healthy stimulation of hair and skin development.  People deficient in Omega Fatty Acids easily develop rashes and skin conditions, such as Eczema and Psoriasis flare-ups, as well as having a lower ability to help fight off infections and heal wounds. 

 The American diet, which is high in Omega 6 Fatty Acids and low in Omega 3 Fatty Acids, causes inflammation in the body, which results in certain cancers, heart disease, asthma, arthritis, and depression.  By consuming the proper amount of Omega 3 and Omega 6 Fatty Acids, you will help your body to reduce inflammation as well as help improve your skin’s health. 

 Omega 3 and 6 Fatty Acids are in certain products we apply to our skins, which include Alpha Lipoic Acid and Alpha Linoleic Acid, which are part of the Omega 3 Fatty Acids.  Linoleic Acid is part of the Omega 6 Fatty Acids and should not be one of the Active ingredients.  It is important to consume Omega Fatty Acids in your diet as well as apply topically to your skin for maximum benefits.

 d) Topical Antioxidants

Antioxidants are a natural defense against free radical damage.  Free Radicals are groups of atoms with an unpaired electron and are formed when oxygen interacts with certain molecules.  Once free radicals are formed, they become highly reactive and begin a chain reaction, damaging cellular components, such as cell membranes.  Antioxidants help to prevent free radical damage because they can safely interact with free radicals and destroy the chain reaction before too much damage has been done. 

 Some common skin care Antioxidants that help prevent free radical damage include Vitamins C and E.  Vitamin C must be consumed by diet or supplements because the body cannot produce its own Vitamin C.  Vitamin C can be consumed through fruits and vegetables, taken as a supplement, or applied topically to the skin.  Vitamin C works best with Vitamin E and produces more benefits when taken together.  Vitamin E prevents oxidative damage and is more available in the form of nuts, whole grains and oil, rather than fruits and vegetables.  Vitamin A is another vitamin that cannot be produced by the body.  The body, however, can convert Beta-carotene into Vitamin A once digested and can be found in colorful fruits and vegetables.  Newer studies are proving that plants contain natural antioxidants, such as cartenoids and flavonoids.  By consuming more than 5 servings of fruits and vegetables daily, we will consume enough to help our bodies fight free radical damage.

e) Newest Skin Care Products

There are many newer skin care products available today.  Some skin care products can be rather costly, which is why we suggest seeing a physician or skin care specialist to discuss your skin care product options and needs prior to purchasing just an expensive eye cream.  Newer names that have entered the skin industry are Oxygen, Idebenone, Grape Seed Extract, Caviar treatments and DNA.  These skin care products have been used for centuries but their components have been studied to prove that their composition helps repair and rebuild damaged collagen and smoothes out wrinkles and uneven skin. 

 Oxygen is the newest and most innovative skin care product on the market.  Patented by a Board-certified Plastic Surgeon, oxygen not only has been converted safely to a liquid form, but is infused with a variety of Vitamins, is Fragrance free and Hypoallergenic, and good for all skin types.  Oxygen is the one of the main reasons why our skin begins to prematurely age.  When Oxygen is replenished in the Dermis layer, our fine lines begin to smooth out and uneven textures of the skin become evened out and free of blemishes. 

 Idebenone, similar in composition to CoenzymeQ10 (CoQ10), is also an Antioxidant.  Idebenone is effective at fighting free radical damage.  Its components are water-soluble, and it has become one of the “newest” breakthroughs in skin care products.  Idebenone delivers protection from free radicals and has anti-inflammatory qualities.  It helps to even the skin tone, similar to Hydroquinone products, without the redness and irritation on the skin’s surface.

Grape seed extract is derived from the skins and seeds of red grapes.  It is high in flavonoids, phytochemicals and acts as an antioxidant.  Grape seed extract helps improve blood circulation by penetrating the blood barrier protecting the brain and nerve tissue.  Studies are proving that grape seed extract might be more powerful than Vitamins C and E combined in fighting free radicals. 

Caviar, once used for the elite and only on special occasions, has made its way into skin care creams and masks in a highly concentrated Caviar extract.  Caviar has helped to smooth fine lines and wrinkles because the cellular structure is similar to skin.  Caviar is mostly water, and the remainder of the composition consists of Proteins, Amino acids, Vitamins A, E, D, Marine extracts, Lipids and Sugar.

DNA skin care is becoming the future of skin because Physicians will be able to take a swab of skin from the cheek to customize skin care products to your skin’s natural composition.  Researchers have identified 28 different genes related to the natural aging process.  By testing which genes are the weakest, skin care products will then be custom designed to prevent the skin from naturally aging.  More research is needed for further information about DNA skin care.

V. Future of Skin Care

Skin care will always be a field of expansion and continue to grow and develop in many different ways.  Physicians and Estheticians have combined practices and developed the MediSpa, which has everything a physician can offer and have the spa environment associated with it.  People do not have to go separately to visit their physicians and estheticians.  Even General Practitioners and OB-GYNS are adding Laser treatments to their offices for Hair Removal and Vein Removal.  The skin care industry is booming at a rate that is bigger than it ever has been.  With the future of skin care will come new laws, rules and regulations.

a) New Laws for Skin Care Professionals

Estheticians have to go to Beauty school to earn their degree in Skin care.  Once their Hours are complete, they go on to apply for and take their Licensing State Board Examination to certify them.  This proves that they have taken the proper courses in school and have enough knowledge to begin working in a Day spa or MediSpa environment.  When working in the MediSpa environment, Estheticians have to continue their education.  They learn Microdermabrasion treatments, more intense Chemical Peels, and Laser treatments.  Some states do not allow Estheticians to use Lasers or deeper Chemical peels even under the direction and facility of a Board-Certified Physician. 

Some states are beginning to wise up to the upcoming trend in skin care and require higher education or a Clinical Esthetician License.  Arizona is one of the first in the United States to require advanced education for Estheticians.  This educational program requires a certain amount of credit hours just like the Esthetician program.  Because this program is more advanced, the knowledge learned from their original school to be added to additional training of Microdermabrasion treatments, deeper Chemical Peels, Laser treatments, Pre- and Post-operative care, Lymphatic Drainage, and how to work with Physicians.  With this higher education behind their belt, Estheticians will be licensed not only with the knowledge of skin care, but advanced education so they will not cause harm to patients, even in the Day Spa setting.

b) Advanced Skin Care Treatments

Skin care has grown from just a basic facial into microdermabrasion, which is no longer even the newest service available in Spas.   Lasers have become the newest, non-invasive treatment producing benefits in all skin types and with all skin colors.  Laser is short for Light Amplification by the Stimulated Emission of Radiation.  Lasers can treat different conditions and these treatments can be designed for each individual patient, because every patient’s needs are different. 

 Newer more advanced laser treatments are even being developed, such as the Fraxel Laser.  This Fraxel laser uses a technology called Fractional Resurfacing, which means only a fraction of the skin receives the laser energy delivered.  Just because a portion of the skin is being treated at a time does not mean the treatment is not just as effective.  This fractional laser treatment stimulates quicker healing of the skin, no downtime, and minimizes fine lines, wrinkles, pigmentation spots, and scars in less time than traditional CO₂ lasers.  These treatments are to be performed only by a Physician, Dermatologist or Plastic Surgeon.

Newest laser energy, the Titan Laser uses an infrared light to stimulate collagen production, while cooling the skin’s surface.  This laser delivers more energy than the Radio Frequency by delivering energy in a more even pulse.  Over 2-3 treatments with the Titan Laser, collagen tightening helps to smooth out fine lines, firm the skin’s texture and give a more youthful appearance to the skin.

 c) Physician-Strength Skin Care

More physicians have begun to develop their own skin care lines for anti-aging, acne, dry and oily skin.  This trend has expanded in the last 5 years, since the development of OBAGI, neaclear^®, and LaRoche-Posay.  Physician-strength skin care lines are becoming easier to purchase and available in some drugstores, beauty stores and physician’s offices.  Physicians have created skin care lines because they feel that their products can deliver results to their clients and better fulfill their clients’ skin care needs.  Physicians work with clients and their needs daily.  Physicians know what clients’ need, which is why Physician-strength skin care products are becoming so successful. 

 neaclear^®, the newest and most sought-after skin care product, developed by a Board-certified Plastic Surgeon, is composed of Liquid Oxygen.  The goal of neaclear^® is to help solve skin care needs as well as being an anti-aging product.  neaclear^® works on all skin types and can even be used by people with sensitive skin.  neaclear^® is infused with Vitamins C & E for anti-aging and Vitamins A & D for prevention against sun damage and environmental pollutants.  neaclear^® products are Hypo-allergenic.

 d) Anti-Aging Skin Care

Almost everyone over the age of 25 is concerned with anti-aging.  The sales of skin care products such as Retinols, AHAs and BHAs have more than tripled in the past few years.  Skin care products are not the only solution to aging.  Men and women are looking for to prevent fine lines, wrinkles, pigmentation, and sun damage in any way possible.  Anti-aging treatments are also multiplying in sales each year.  From the creation of MediSpas to physicians buying and performing Laser treatments, the anti-aging era is here to stay.  Almost everyone uses some kind of skin care product or utilizes some anti-aging treatment available on the market nowadays.

 Every month and every year there will be new and upcoming skin care products and anti-aging treatments available.  The anti-aging trend is one of the biggest trends in the skin care industry.  Everyone is self conscious about something, whether it is on their face or body, someone will always need or want some kind of skin care.

VI. Skin Care and Physicians

The skin care trend is rapidly heading towards the medical field.  Physicians, mostly Dermatologists and Plastic Surgeons, are combining businesses with Estheticians and Spa owners.  Clients are now able to get the “best of both worlds” in a Medical Spa or MediSpa setting.  Clients can come in purely for cosmetic reasons or they can enhance their laser treatments with Spa services.  The sky is the limit for clients in this type of medical/spa setting.

a) Estheticians working with Skin Care Physicians

Estheticians have the power of touch.  They can make their clients feel so loved and make them forget their pain and their problems for their time spent together.  Physicians have a special gift and special touch, but it’s not the same.  Physicians help clients feel better about themselves and their appearance, but not the same way as an Esthetician.  When the two combine in a Medical setting with a Spa atmosphere, clients not only feel good about their appearance, which gets improved by a Physician, but they also forget their pain and leave feeling calm, relaxed and loved, which comes from the Esthetician. 

Estheticians and Physicians both offer powerful services.  Estheticians rely on touch and Physicians rely on making the client feel better.  Both are important aspects in the medical spa, but it comes down to the client.  What are the clients’ needs?  What on their body does the client not like?  What is the client looking to achieve by coming here?  Estheticians can boost the results of clinical treatments, such as Laser, Injections, and Surgery.  Estheticians have knowledge of microdermabrasion, for a deeper exfoliation and to slough off dead skin prior to a Laser treatment for best results.  With injections, Estheticians can soothe and calm the skin with skin care products.  Pre and Post surgical patients can benefit from Cellulite treatments, which stimulate blood circulation and help minimize edema, as well as Lymphatic drainage to the face, after Facial surgeries.  Because of the skills both Physicians and Estheticians possess, clients are getting the best of both worlds in the skin care industry and the long-term results have improved as well.

b) Lasers and Skin Care

Laser treatments have become more popular within the last 5 years.  Estheticians have done well with skin care treatments by making their clients feel and look good while having more advanced skin care procedures available to them.  Some Laser treatments can only be performed by a Physician, while newer, more advanced Lasers can be performed by Estheticians and Nurses, as well as Physicians.  Estheticians are now able to combine Microdermabrasion treatments with Laser treatments, which work together to give the best results each patient can achieve with skin care.

FotoFacials are becoming more sought after skin care treatments and are widely available in Day Spas, MediSpas and Physicians offices.  This Laser treatment can now be performed during a lunch break.  This treatment offers wonderful benefits to clear up uneven skin, Rosacea and redness without the downtime of more intense Laser treatments.  This treatment takes less than 1 hour and only requires 5 treatments every 3 - 4 weeks apart. 

FotoLift Laser treatments target patients suffering from the early signs of sagging skin, fine forehead lines, Acne scars and jowls.  This treatment uses Radio-Frequency waves combined with Laser technology to stimulate Collagen production.  Over the next 6 months, you notice your skin becoming smoother, acne scars become less prominent and your overall appearance becoming more youthful.  This treatment can also be performed during a lunch break, because it offers great benefits with no downtime.

III. Types of Spas

Skin care has come a long way in the past 50 years, especially in the way of spas.  Fifty years ago, the word spa was unheard of and now they are on pretty much every corner and in every strip mall.  The skin care industry has created its own field, separate from the Cosmetology industry.  Spas are even developing from the medical industry by joining doctors, nurses, and aestheticians and creating a newer industry - the Medical Spa.  This is further evolving to create the newest and most upcoming spa industry filled with Yoga, ancient practices, spa and wellness - called the Wellness Spa. 

 The word Spa has become a universal word, mostly relating to relaxation and beauty but has branched out among the different health and wellness industries, as well as the world of medicine.  Where it began, was in the Day spa, which began as a hair salon, then grew from there into a full service salon. 

 Skin care has become associated with a spa-like setting.  Most clients can get advice, buy products, including physician-strength, AHAs and BHAs, Retinols, Herbal supplements, and more advanced body creams, washes and scrubs.  Depending on the type of atmosphere you are looking for when purchasing skin care products or even pampering yourself for a day, there are a variety of spas to choose from and each spa fits everyone’s “special” needs.

a) Day Spas

Day spas are a full-service Salon, which includes hair services, waxing, facials, nails, massage, and makeup services.  Day spas were created from bathing in hot springs and mineral baths dating back to the ancient Greeks and Babylonians.  Today, massage and facial treatments are the treatments of choice when looking for a day spa.  The first day spa was created by Elizabeth Arden in the early 1900s and offered a range of treatments from waxing services, manicures and facials.  Today, going to a spa is no longer for the elite and wealthy, but for every man and women concerned about their appearance. 

Women are known for spending the day getting pampered at the spa, which is where the name day spa originated.  Day spas offer a variety of facial treatments targeting different skin types and different skin concerns.  Facial treatments have developed into Microdermabrasion treatments and more invasive Chemical peels.  Massage treatments have developed from basic Swedish massage treatments into Hot Stone, Shiatsu Sports and Deep tissue massages, Body wraps, which include Herbal, Algae, Mud and more.  Waxing treatments have remained the same, but newer spas are introducing Laser hair removal into their facilities.  Some day spas even work with Physicians to come in once a month for Botox and Injectable fillers, such as Radiance and Restylane. 

b) MediSpas

MediSpas are very advanced spas.  A true MediSpas are usually owned and operated by a Plastic surgeon or Health care practicioner, who specializes in Cosmetic surgery.  There should always be a Physician and Nurse on staff overlooking all procedures.  In the MediSpa environment, the luxury of a day spa is available offering a wide-variety of anti-aging facial treatments, including Microdermabrasion, Chemical Peels, Oxygen facials, as well as Laser treatments.  Body treatments include Massage, Lymphatic Drainage, Cellulite reduction treatments, and Salt, Algae and Mud wraps.  Some MediSpas offer waxing, but most offer Laser hair removal treatments, which have become popular treatments.  Nail and Hair treatments are not usually found in the MediSpas, because of a lack of demand. 

The Medical Spa is more advanced because patients can come in for a day at the spa and finish with a more invasive treatment, such as Botox, Injectable filler, or Laser treatment.  Newer research has found that facial treatments compliment the more invasive procedures when performed prior to and in a series of treatments.  Some of the procedures performed include, Botox, Injectable fillers (such as Radiance and Restylane), Laser hair removal, FotoFacials, Laser Vein treatments, Liposuction, Breast Augmentation, Face Lifts, Acne treatments, Chemical peels, Microdermabrasion, Massage treatments, and more.  More MediSpas are beginning to offer a wide-range of treatments both invasive and non-invasive to attract clients with every need and desire to prevent the aging process.

c) Wellness Spas

The Wellness spa is beginning to develop into a more popular spa option.  A few years ago, women had to go on a retreat to visit a Wellness spa, but now local Hotels and Resorts are beginning to add them to their facilities.  A wellness spa is a day spa, which is meant for relaxation, but also includes Yoga and Pilates, special dietary meals, meditation, and a way to get away for a week or even a weekend.  Now, these special spas are incorporating Ayurvedic treatments and Accupuncture with a Holistic Physician, and some Wellness centers even include cleansing treatments, such as Detox treatments and Colonics.  Anywhere in the United States, to Mexico and the Caribbean, you can book a Wellness retreat.  These retreats are designed for individuals, couples, or a weekend retreat for a group of friends.

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