More importantly, what types of equipment will give your clients results and keep them rescheduling? Through practice and experience, many of you have found what works for your clientele, while many are still in the struggle of finding what works. First and foremost, keep it simple. Chemical peel treatments offer great results for maintaining healthy skin while addressing the common issues of anti-aging, rosacea, acne, sun damage, and hyperpigmentation. Peels are available in different percentages and pHs with added antioxidant protection that benefit the skin. Should your client need or desire a more accelerated approach with exfoliation, you can combine a scrub prior to the peel and/or follow with microdermabrasion for more tolerant skin types. For those with thin, sensitive, or inflamed skin, or for those concerned with skin firming, ultrasound is an excellent treatment that will address these needs, when it is used with the proper ingredients. In most cases you can combine all three of these treatments to administer the ultimate facial for results that will keep your clients in the books; making you more money through long-term gains and client referrals.
Before administering any treatment, consult with your client. Find out what skin care products they’re currently using, prescription medications, current physical conditions, and what they want to see when they look in the mirror. Product knowledge is the most valuable asset to any aesthetician. It is important to know skin care ingredients and oral medications/prescriptions to help you find a cause for many skin conditions or give you the red flag when it comes to treatment. Treatment on persons using Accutane©, Retin-A©, Renova©, or any other alpha hydroxy acid (AHA) or retinol products could give undesirable results and may harbor you in legal issues. Prescription and OTC medications in some cases could be the source of the skin concern. For example, hormones in women generally lead to hyperpigmentation. With women who are prescribed hormones, there is a slim chance that the discoloration can be removed. Hyperpigmentation cannot be combated in the treatment room or with hydroquinone on pregnant women until after the baby is delivered. After understanding these conditions, you can treat hyperpigmentation. Have your client on a bleaching program that contains natural herbal lighteners, kojic acid, azelaic acid, lysine, or cystine (hydroquinone is optional) two weeks prior to treatment and be sure they’re using sun block. Proper ingredients for acneic skin include sulfur, benzoyl peroxide, salicylic acid, AHAs, and tea tree oil. These ingredients will help kill bacteria, reduce oil, and help prevent scarring of the skin. Mature skin will benefit from the use of AHAs, ascorbic acid, lactic acid, alpha lipoic acid, and hyaluronic acid (hyaluronan), in addition to, vitamins A, C, and E, peptides, amino acids, and other commercial ingredients that have been patented for skin firming and elasticity. Every skin type from dry to oily needs an effective cleanser, toner, moisturizer, exfoliatiant, nutrition, and sun protection. Each of these products should address the concerns and results your client wants to see. Home care makes up 70 percent of your clients results. Without effective home care, your clients are running up a perpetual mountain, and may never see the top. In addition, selling retail items to your clientele can bring in more money to the facility and the aesthetician in the form of commissions.  Now that home care has been administered, it’s time for you to decide what treatment option or combination will best suit your client. Keep their budget in mind and remember that you will gain long-term with effective treatments. Deep cleansing facials are great for maintaining clean skin, but do not offer the exfoliation and results that chemical peels can obtain. When performing chemical peels there is no need to use steam. Performing extractions after a peel is easy because the oil and dead skin blocking the pore has been dissolved. Using steam in conjunction with a peel could aggravate the skin. Keep in mind when choosing a peel that there are many forms of acids that all have one main goal: exfoliate the skin. Acids come in many sizes and strengths: buffered, unbuffered, various percentages and pH levels, and the addition of other ingredients that offer nutrition or antioxidant protection. Glycolic acids will benefit most skin types and, when used in lower percentages, can be used in conjunction with microdermabrasion. Salicylic acid is great for oily skin because it attacks the pilosebaceous gland, reducing oil production while refining the pores. Lactic acid is a great preparatory peel to microdermabrasion because the molecules that compose lactic acid are larger, making penetration less rapid than glycolic and citric acids. Once you have determined the acid to best suit your client, perform a second check for contraindications or skin tolerance. We all remember the Fitzpatrick Scale from basic aesthetics: the method of skin typing individuals on a range of one to six based on sun sensitivity. Your one and two skin types will be more sensitive and may not tolerate a high percentage or low pH. When peeling skin types five and six (your dark skin types that are rarely affected by the sun) you should also use a mild peel because you cannot see the visible signs of overexfoliation. Ideal acids would be a low percentage lactic or glycolic acid. During the treatment, communicate with your client on what he/she is experiencing; this will determine the level of tolerance for the peel. Never use hydroquinone products on skin types five and six and never conduct a peel on inflamed acne or rosacea as the inflammation will only worsen. Remember, the most important factor in any peel service is to be prepared with all supplies, especially water to neutralize the acid. Any damage that could occur as the result of a peel treatment can be virtually eliminated by neutralization. Communicate with your client and look for signs of redness on the skin.
Once you have completed the peel process you may either close the service or proceed to microdermabrasion. As you may know, there are two types of microdermabrasion: with or without crystal. Crystal microdermabrasion uses a mineral known as corundum. This method of exfoliation benefits combination,
oily, or acneic skin due to the fact that these crystals are drying and help destroy bacteria. When performing microdermabrasion, an effective technique to use is cross-hatching. This method involves the steady movement of lines across the face, then another set of steady lines that run perpendicular to the first set. It is important to keep the handpiece in motion when it is in contact with the skin. Holding the suction in a single position or moving too slowly will result in the surfacing of capillaries on the skin that produce red/pink splotches over areas of the face that will need to heal over two to four days depending on the severity. Once the passes over the skin have been completed, use a small amount of cleanser and water over the skin to help ‘pick up’ the excess crystal and refine the exfoliation process. For those clients with dry or mature skin types, use microdermabrasion without the crystal. Corundum crystal is naturally drying; performing microdermabrasion without crystal uses a stainless diamond-tipped abrader that uses the same technique, but without excess crystal to remove. More importantly for dry skin, there is minimal downtime associated with the exfoliation and the discomfort of overly dry skin. After each crystal-less microdermabrasion, it is advisable to penetrate moisture into the skin. And as always, maintain communication with your client. If he/she is experiencing discomfort or pain, stop the treatment and apply a healing balm.
Ultrasonic treatments are beneficial in exfoliating the skin and penetrating topical ingredients. When performing an ultrasonic treatment alone, it is best to exfoliate the skin with the scrubber. This treatment is beneficial for thin, sensitive, or inflamed skin because there is no trauma involved to exfoliate the skin. When performing this treatment after a chemical peel or microdermabrasion, do not use the scrubbing mode, only penetration. When working with acneic skin it is best to penetrate a 5 percent hyaluronic acid complex into the skin to help hydrate and tea tree based lotions to help kill bacteria within the skin. When penetrating tea tree, focus on acneic cysts. The combination of tea tree and heat from the hand piece will help dissolve the cyst. Penetrating an anti-inflammatory lotion or serum into the skin as your final step in this treatment will help calm the skin and reduce redness. Mature or dry skin will experience great benefits from the combination of peel, microdermabrasion without crystal, and the nourishing benefits of ultrasound. For these skin types, it is best to start with a hydrating 5 percent hyaluronic acid, followed by a fatty acid or lotion-based vitamin C for nutrition. The final step in this treatment is the penetration of an amino acid complex to help block the communication between the nervous and muscle cells to help diminish contractions which, in turn, helps diminish fine lines and wrinkles. An additional step to your ultrasound treatment is the penetration of amino peptides and vitamins around the eye and lip area. This will help promote a more youthful appearance by tightening and plumping these problematic areas. Ultrasound penetration is highly effective for all skin types and offers great ending results while giving the skin a break from the aggressive work of peeling and microdermabrasion.
Bring your service to an end with a clean herbal mask. While the client is masking, treat them to a relaxing face, neck, shoulder, arm, and hand massage, or a hand treatment. After the mask sets, clean the skin and apply a good coat of sun block over the face. When combining all of these treatments, the client should follow a strict post-peel guideline, then return every four or six weeks, depending on their desired results and skin tolerance. An alternative to the four to six week waiting period would be a two week post-treatment, straight and simple, cleansing, nourishing, and hydrating ultrasonic treatment. The combination of effective treatment and home care products will yield desirable results for your client. Keep your appointment book full and gain positive client referrals. The solution is simple: chemical peels, microdermabrasion, and ultrasound, when used with the proper ingredients, will give your client the best of exfoliation and nutrition while maintaining minimal expenses from your equipment and products. If your client cannot tolerate all three, the use of one will be beneficial and effective. Keep your client in mind; do not perform treatments that are out of your clients’ budget and you will gain long-term from effective treatments by re-bookings as opposed to minimal treatments with a high dollar price tag.