Hydration
Drink more water. It seems incredibly obvious and a bit cliche, but it is often true that the simplest methods can make the most impact; this is the case with encouraging clients to drink enough water throughout the day. Drinking enough water benefits the skin in several ways. First, it helps the skin stay hydrated. Hydrated skin is suppler, has better tone, and always appears more healthy and vibrant, regardless of age or condition. While applying topical humectants and protective emollients can help to provide hydration to the outermost layers of the skin and prevent transepidermal water loss, it does not address all possible reasons for dehydration.
If the body is dehydrated, the skin always shows it. On the face, the skin appears lackluster, flaky, and tight; fine lines and wrinkles are more evident and it becomes irritated more easily. On the body, the skin is flaky, itchy, and may even crack. While certain skin ingredients and medications can over dry skin, a dehydrated body is the number one cause of dehydrated skin.
The majority of people are chronically dehydrated because they do not drink enough pure, clear water. Water is the only substance we ingest that does not involve the process of digestion – needed water goes to internal organs, helps maintain healthy blood circulation, and also helps flushes out toxins. Tea, coffee, juices, soups, or any other beverage or liquid food is exactly that – food. It goes through the process of digestion similar to food and much of the water in those foods is used by the body to aid in that process – not to hydrate the other internal organs, help the blood deliver nourishment to the skin, or help the body purge itself of toxins and impurities.
Drinking enough water also helps the skin exfoliate itself naturally. There are differing philosophies regarding the necessity of exfoliation treatments in the spa and as part of a client’s homecare regimen, but I think we can all agree that the more we can do to help maintain a regular 28- to 30-day cell turnover rate, the better for all skin types and goals.

Cell Turnover Rate
The dead cells that make up the stratum corneum are primarily made of keratin – a protein. Enzymes gently digest these proteins when enzyme treatments are performed and clients should be advised to use cleansers and masks at home that contain enzymes like papain or bromelain. Did you know that enzymes already live on the surface of the skin? You might then wonder, if enzymes live on the surface of the skin, then why do they not naturally digest excess corneocytes on their own? Enzymes are inert until they are activated by a catalyst. In some cases, that is another ingredient in a skin care formulation, but in the body’s case, that catalyst is actually water – provided one drinks enough throughout the day! Therefore, encouraging clients to drink enough water will help their skin maintain a healthy cell turnover rate with less need for forced exfoliation.

Water Retention
This might sound counterintuitive because many people associate puffiness with water retention. There are many reasons the body retains water and very few of them are because the body has too much water (though this is the case with certain health conditions). Most often, the body only retains water if it feels it needs to – due to stress or the body’s own innate concern that it might not be rehydrated anytime soon. Think about a cactus plant or a camel – both live in dry, arid climates where water is scarce. Their bodies have adapted to retain water for long periods of time.
In the early days of humankind, there were no grocery stores, water bottles, or plumbing systems. Even in tropical and temperate areas, potable water and other necessary resources were not always readily available, so the human body also developed the ability to retain water (and fat) in fear that it would not find replenishment for several days. While we do not develop humps like camels, we do get bloated and puffy in the face and around the eyes. In most cases, drinking more water helps reduce this puffiness.
Certain foods and other substances cause the body to retain water as well and by drinking more water, the body can flush these substances out faster, taking the retained water with them.

Natural Detoxification
Detoxification is an exciting topic in skin care and even though the majority of this process ideally occurs internally, it is also one of the functions of the skin. The skin helps the body purge itself of toxins and impurities via the sweat glands. While topical measures like dry skin brushing, salt glows, sugar scrubs, body wraps, clay treatments, and hydrotherapy can help facilitate detoxification through the skin, it is important that the internal organs perform their part of the process optimally. Drinking water, along with eating a well-balanced diet and exercising, is essential to the healthy function of the internal detoxifying organs (kidneys, colon, lungs, liver, and bladder). These organs already carry a heavy workload and without adequate hydration, they have to pass off more of the detoxification workload onto the skin, which is already busy enough performing other essential functions. When this happens, more toxins become trapped in the subcutis and must be excreted through the sweat glands.
Sweat has many of the same chemical constituents as urine and just like urine, it is sometimes more concentrated with toxins and clearer other times. These toxins get absorbed into clothing and bed sheets (as well as sitting on the surface of the skin) and can aggravate P.acnes bacteria and yeasts living on the surface of the skin, exacerbating acne breakouts and flare-ups of rosacea, eczema, and even psoriasis. Adequate hydration, paired with proper hygiene, can prevent this.

Dietary Changes
While aestheticians with standard state licenses do not make specific nutritional recommendations, there are certain ones that can be modeled at the spa and offered to clients through partnerships with local holistic health coaches and nutritional counselors. There are also general recommendations that can be made that benefit everyone, but especially benefit people with skin conditions.

Eat More Greens
Dark, leafy greens like romaine lettuce, spinach, collards, chard, dandelion, and mustard greens, as well as cruciferous greens like broccoli, kale, and brussels sprouts, are some of the most nutrient-dense foods on the planet. I consider greens to be their own food group within a balanced diet for clear, radiant skin. They are important and are seriously lacking in most Western diets. Other greens that are great for the skin include watercress, artichokes, and asparagus. They are packed with vitamins, minerals, antioxidants, and other phytonutrients, even protein and essential fatty acids. These nutrients help strengthen the building blocks that form the skin cells from the inside out – in places where not even the best topical delivery system can reach. They are also extremely hydrating, contain abundant amounts of fiber and enzymes, and provide nourishment for healthy gut flora, which is very important for healthy skin. Greens are excellent for aiding the body’s natural process of detoxification by enhancing the function of the kidneys, liver, gall bladder, and lungs, as well as reducing inflammation, neutralizing excessive acid, providing hydration, reducing mucus in the body, increasing blood and lymphatic circulation, and boosting the immune system. Greens also help to lift the mood and provide a boost of energy.1

Smoothies
Because of these factors, greens help do from the inside what aestheticians try so hard to do from the outside – cool, hydrate, detoxify, fight free radicals, nourish, protect, and soothe.
One of the easiest and most convenient ways to encourage clients to eat more greens is to serve smoothies in the spa, add it to their homecare instructions, and give the recipe to each client when they are checking out and making their next appointment. Smoothies can be a mix of fresh fruits and vegetables (preferably organic), and can also include skin-boosting add-ins like collagen powder, hyaluronic acid, additional antioxidants, and protein-rich superfoods, as well as essential fatty acids from foods like chia seeds or flaxseeds. To ensure best taste, I always recommend starting with a ratio of 40 percent greens to 60 percent fruits and other ingredients, making sure you are using a high-speed blender to achieve a smooth, easily-manageable consistency.

Get Moving
In addition to encouraging the body to detoxify itself naturally with hydration, adding fresh greens and fruits to the diet, and utilizing detoxifying treatments in the spa, the best recommendation to make to a client is to incorporate some form of movement into their lifestyle. You might be thinking about sweat differently now that you know how similar it is to urine, but that is not a reason to discourage sweating! Toxins are better out than in and if the body does not detoxify enough through sweating, then the internal organs have to work harder to detoxify via the lungs, colon, and bladder. This can cause internal imbalances the same way as too many toxins on the surface of the skin. Regular exercise of the client’s choice, be it yoga, aerobics, running, Pilates, dance, hiking – whatever the client likes – is a great way to encourage healthy perspiration.
Besides the sweating aspect, physically moving the body helps stimulate the lymphatic system, which is crucial not only for detoxification but also for healthy immune function. The lymph system transports lymph fluid through ever-widening vessels, moving it through 500 filtration and collection points – your lymph nodes. At each successive node, the lymph fluid is filtered and bacteria is removed. If lymph fluid is blocked in one lymph node, it will usually take a detour, but when blockage is extreme it can cause the lymph fluid to back up and cause swelling in the surrounding tissue, a condition known as lymphedema.2 Lymphedema is common and promotes inflammation in the body, which eventually manifests as an inflammatory condition on the surface of the skin.
While other self-care lifestyle methods like dry skin brushing and massage help to stimulate the lymphatic system and promote lymphatic drainage, there is no more effective way to do so than physical activity. Yoga, in particular, is beneficial for the skin because it not only stimulates the lymphatic system and promotes detoxification both internally and via sweating, but it also helps to relieve stress.

HYGIENE
A regular fitness regimen cannot be recommended without discussing the importance of proper hygiene. Aside from fitness, it is very important for aestheticians to educate clients about proper hygiene at home. Having good hygiene is not just about looking presentable and avoiding body odor – it is absolutely essential for clear, healthy skin. Here are some simple hygiene guidelines to recommend to clients.
Shower daily. Whether someone exercises or not, it is important to shower every day to remove accumulated daily perspiration. Just because we do not see, feel, or smell sweat, it does not mean that we did not sweat. It is an autonomic function of the body, the same as breathing. Sometimes we breathe heavier or faster and notice it, but that certainly does not mean that we are not breathing just because we do not notice our breaths. Daily showering is a must for healthy skin. Taking baths might be relaxing, but it is not ideal for cleanliness, especially if it is an herbal or salt bath designed to draw toxins out of the body. If clients are bath-takers, encourage them to shower off after their bath to remove debris from the bath water. After bathing, clean washcloths and towels should be used. I know it is more eco-friendly now to allow towels and washcloths to air-dry between uses several times before washing them, but damp towels attract airborne bacteria and fungi, especially when kept in a humid bathroom. People without skin conditions might be able to reuse towels more than once, but anyone with acne or other skin conditions should use a clean, dry towel every time.
Use of makeup sponges should be avoided and makeup brushes should be cleaned and disinfected weekly. Sponges absorb product and become a breeding ground for harmful microorganisms. It is okay to use them once, then dispose of them, but let us face reality – sponges are used and reused more often than not. It is more cost-effective and sanitary to use clean makeup brushes both at home and in the spa. They should be sprayed with a disinfectant makeup brush cleaner and wiped off with a clean towel after each use, and then washed with gentle soap and water once a week. They should be stored in a closed, dry container and if using a fabric makeup brush roll to store them, these should also be washed weekly. Makeup brush disinfectant makes a great homecare product.
Other guidelines include changing bed sheets at least once a week – more often during the summer. Pillow cases should be changed often and people with acne should change their pillow cases daily. Cell phones and any other device that comes into contact with the skin regularly should be sanitized (at least weekly) by using a soft, lint-free towel and small amount of alcohol.

Exposure to Irritant Substances
A common cause of acne, eczema, rosacea, and extrinsic premature aging is repeated contact with irritant substances, not only in skin and personal care products but also in the home. Household cleaning products contain the highest concentrations of irritant chemical ingredients that come in contact with the skin and mucus membranes via direct contact, indirect airborne contact, and inhalation. This can cause skin irritation and affect the skin’s immune response, which makes it more susceptible to infection and inflammation.
Sometimes reactions are seen immediately and in other instances the symptoms are not as easy to notice. Flare-ups of eczema, rosacea, psoriasis, and in some cases hyperpigmentation, are indicators that there is something in the client’s work or home environment that is not agreeing with them. Some items to consider are detergent residue from a dryer sheet or fabric softener, synthetic fragrance in products or air fresheners, bleach or chlorine in toilet paper or sanitary products, microbes or heavy metals in drinking water, pesticides, acids in skin care products, and
sunscreen ingredients.
It is not necessary to overwhelm a client with all these details, but it might be helpful to ask questions about household cleaning products, water and air filtration, and other potential irritants in a consultation. Your spa can prepare a handout of commonly-known skin irritants that clients with potential overexposure can take home with them.

Stress Management
Clearing out mental and emotional toxins and managing stress can help as well. Stress is one of the greatest contributors to premature aging, acne, and other inflammatory skin conditions. It interferes with every function of the mind and body and directly affects the skin by disrupting its pH balance, preventing absorption of important skin nutrients and damaging the skin’s acid mantle.
It is not always possible to remove or even reduce the amount of stress in someone’s life and often telling someone to reduce their stress causes them even more stress, which is not supportive or helpful at all. It is more important to help someone improve awareness of stress and learn how to react to it in a productive way that does not create more stress. The positive way to do this is by setting the example in the treatment room. This does not have to be a big ordeal at all. It is most helpful to clients to keep it as simple and user-friendly as possible. Here are some recommendations for how to model stress management before, during, and after their treatment:
First, start and end each treatment by asking the client to inhale with you for five seconds, hold for seven seconds, and exhale for nine seconds. You can do this once or twice, but do not overdo it because you or the client could become lightheaded. This helps both of you be present and centered and also sends a signal to the brain that it is time to relax.
Next, discourage negative talk and chatter. If you find that the client is in a “woe is me” state of mind during a consultation (especially if they present with a deep-seated skin condition), do your part in diffusing the negative energy by not encouraging it! This is not the time for a gab-fest or pity party. Do not feed into those types of conversations – be professional and change the subject or reframe the topic by focusing on something positive in which the client is engaged.
After the treatment, ask the client how they feel – the answer is likely calm, grounded, and relaxed. Encourage the client to take a “mental snapshot” of that feeling, so that they can bring it up whenever they feel stressed.

Promoting an overall healthy diet and lifestyle to clients is a great way not only to differentiate your business from competitors, but also to add more fulfillment and joy to your practice. When clients experience faster, longer-lasting results by following simple recommendations, they often experience other positive changes in their overall lives. To be the catalyst of that change – well, there is nothing more rewarding.

References:
Pick, Marcelle, OB/GYN NP, (2014). “Women, Transforming Women’s Health for over 30 Years.” Women to Women Transforming Womens Health Naturally. Women to Women.

Rachael Pontillo is the bestselling author of Love Your Skin, Love Yourself, and co-author of the cookbook, The Sauce Code. She is an award winning AADP board certified holistic health and image coach, certified metaphysical practitioner, licensed aesthetician, natural skin care formulator and educator. She is the creator of the popular blog and lifestyle site, www.holisticallyhaute.com, and the six-week online course, Create Your Skincare™. Pontillo is a recipient of the Institute for Integration®’s esteemed Health Leadership Award and is also a brand ambassador and spokesperson for NeoCell™. Pontillo is currently working towards a Ph.D. in Holistic Life Counseling.