Case Study:

A 46-year-old female arrives at your spa on a beautiful summer day with temperatures in the mid to upper 80s; she is flushed, sweating and complaining of being too hot. After offering her a cold bottle of water, you guide her back to your treatment room to begin her consultation. Although the temperature outside is high, this client has been coming to see you periodically over the years and you are aware that she has recently started to experience menopause, leading you to believe that her reaction to the temperature outside could be a menopausal symptom. Your theory is supported even further when she begins to explain why she made an appointment to see you – her skin is excessively oily – something she has not experienced since being a teenager. According to the client, her skin is oily, greasy and gross; she is also starting to have breakouts on her T-zone. She can barely moisturize because it makes her skin feel suffocated and, even though she washes her face every morning and evening, it is getting increasingly worse. To exacerbate matters further, she is finding it almost pointless to put on makeup every morning because she feels like it slides off of her face shortly after applying it. The longer the client shares her dilemma, the more upset and frustrated she becomes.

As a skin care professional, what solution do you propose to treat this case study?

Solutions:

Danné Montague-King, president of DMK and DMKCOSMETICS international

“This client does display classical pre-menopausal conditions. The dryness is cuticle build up, which is perceived as dry skin. In actual fact it is just dead skin. Her sebaceous and sudoriferous glands secretions back up behind this, like water behind a dam, and eventually burst through the epidermis – mostly where the skin is tightest to the bone – the so-called T-zone.
She needs an enzymatic type cell removal treatment, also one that creates a plasmatic effect (dilation of facial capillaries to flush them through). Her post-treatment products may vary according to her needs (vitamin C serums for fibroblast production, et cetera) but it should be centered around frequent water misting for real hydration and a low pH cream.”

Lori Ann Griffin, national educator for DermaQuest

“Harmony has been lost. To bring balance, use cosmeceutical products containing palmitoyl tetrapeptide-7, which helps to inhibit the stimulation of blood capillaries, thereby reducing heat. Choose alpha lipoic acid as it is an excellent antioxidant and anti-inflammatory. BV-OSC is the most stable form of vitamin C; it soothes and protects skin from solar heat. Relieve hot skin by spritzing with a toner containing arnica and allantoin. Micronized zinc is a lightweight, physical SPF which deflects heat and UV away from skin, unlike chemical sunscreens. MSM is a natural and non-irritating form of sulfur that reduces oil while assisting in the balancing of hormones. Salicylic acid wipes will also help to eradicate excess oil. I strongly recommend only using mineral makeup which is breathable and oil absorbing. Finally, outline a course of de-stressing therapies incorporating, Shiradhara, marma point, and lymphatic massage to restore proper moisture levels, harmony and balance during menopause.”

Eli Jones, director of education for Mark Lees Skin Care

“This particular case contains psychological and physiological elements – both of which should be addressed for a successful outcome. The first objective is to calm the client, being as frustrating thoughts correlate with heightened circulation, increased body heat, sweat production, and an overall flushed appearance. Providing a soothing treatment along with assurance that the issue is both manageable and not uncommon should, therefore, help relax the client and minimize the skin’s physiological response.
From the homecare and professional standpoints, treatment should focus on products that gently remove excess oil with respect to heat and redness reduction. Product types should include gentle milky cleansers, freshening toners, buffered oil-regulating exfoliants, viscous hydrators (for massage), soothing treatment actives, gel-based masks, and calming moisturizers (with SPF for daytime use). With that said, ingredients to look for include aloe barbadensis (aloe), camellia sinensis (green tea), licochalcone (licorice root), pseudopterogorgia elisabethae (sea whip), and bisabolol, among others.”

Krystin Seiver, licensed aesthetician and education manager for COOLA Suncare

“During menopause, estrogen levels in a woman’s body are decreasing and testosterone begins to reveal itself in the form of excess oil and acne. While there are many natural options to offer this client in the treatment room, she will have to do some homework for optimum results. First, I would cleanse and tone the skin with organic products that contain tea tree oil, cucumber and willow bark. These ingredients assist in oil and acne control while offering an instant cooling effect on the skin. A yogurt mask with lactic acid will help cut through oil to deliver anti-aging benefits. Lastly, I would protect her skin with an organic sunscreen with a matte finish. At home, this client should reduce the amount of dairy and refined sugar in her diet; use professional, organic skin care products daily; take hormone balancing supplements like milk thistle and burdock root; and when all else fails, have a glass of red wine!”

Tina Zillmann, aesthetician and founder of Advanced Rejuvenating Concepts

“Ironically enough, this very scenario presented itself in a client who has received regular treatments from my clinic for nearly 20 years. First and foremost, always assess the skin before administering any treatment – no matter how familiar you are with the client. Her skin is excessively oily but may also be dehydrated, which can lead to breakouts, and a hot flash may have the potential to trigger inflammation and irritation. Aromatherapy, microdermabrasion, massage, steam and chemical peels may all result in an adverse reaction, including oil stimulation. Apply a cool compress while you perform an analysis to offer her some relief, but I do not recommend any type of treatment until she becomes balanced internally. During the assessment, talk to her about her skin care routine and the medical treatment she may or may not be receiving. Once she has received guidance from a physician and has reduced occurrences of hot flashes, gentle ultrasonic treatments every two weeks may be beneficial for her skin and reduce the occurrence of breakouts and blackheads, while offering relief from skin dehydration. At home, light chemical exfoliation and a hydrating hyaluronic acid product may help keep her skin healthy as she is experiencing this change.”