How old would you be if you didn’t know how old you are?
Since the advertising of "age-defying" skin care solutions are everywhere today, it's vital to have a full understanding of what an aesthetician can honestly offer an educated, oftentimes, inundated consumer. In order to do this, let us re-examine the skin and the factors that determine how it looks.

Why Does Your Skin Age?
Two main factors contribute to the aging of the skin. These are extrinsic and intrinsic factors. Intrinsic or "internal" aging is biological occurring naturally throughout one's lifetime. Extrinsic or "external" aging is environmental and occurs as a result of exposure to the sun, air pollution, smoking, lifestyle, cosmetics, allergens and, all to frequently, a personal negligence in caring for the skin. The most damaging of all of extrinsic influences is, of course, unprotected exposure to sunlight. In fact, it has been argued that 90 percent of the skin's overt signs of aging such as wrinkles, sagging, and hyperpigmentation (age-spots) are due to sun damage. If this is true, aestheticians have a profound opportunity to literally slow and, in many cases, reverse the skin's aging process.

Why is it that as we grow older, our skin's ability to repair and recover from skin damage decreases? The answer is FREE RADICALS!
Free radicals attack and damage cells which results in inflammation. Therefore hindering the vital reproductive process of new cells. This creates a "crippling cycle" resulting in more unstable free radicals, more damaged cells and less and less healthy ones.
It is important to note that the internal activity of free radicals is a natural process and the body will normally adjust to it. However, environmental or extrinsic factors can actually increase or "accelerate" the activity of free radicals, thus making the body susceptible to free radical "damage" and the "crippling cycle" to follow. The biggest environmental factor being, once again, unprotected exposure to the sunlight but also includes air pollution, smoking and certain foods and chemicals in everyday products.

How does "free radical damage" age our skin?
Collagen gives our skin a youthful, healthy glow. Unfortunately, collagen is the "primary target" for free radicals. A "grid-forming protein" which maintains the skin's structure, collagen keeps skin smooth and resilient when healthy, but becomes stiff and brittle when damaged. Any internal free radical damage to the skin's collagen fiber will eventually surface resulting in wrinkles, sagging and an overall "tired-looking" appearance to the skin!
It is at this point that the search to reverse the effects of "aging" and recapture a more youthful-looking skin begins!

How do Skin Peels keep Skin Youthful & Healthy-looking?
In order to visualize the effectiveness of skin peeling to reverse the signs of aging and restore a more youthful-looking skin, let's consider a man who shaves daily. Without exception, the lower half of his face will appear healthier, more toned and smoother with less fine lines and wrinkles. Similarly, skin peels involve the "removal" of dead skin cells through a variety of skin peel solutions followed by a natural "stimulation" of the skin that encourages new cell production and softens the stratum corneum.

Here's how it works...
When applying any solution that breaks down and lifts away dead skin cells, a mild injury occurs to the skin. This "controlled" injury then triggers the inner "healing" dynamics of the body and an "army" of restorative support rushes to the site of the "wound". This natural "healing" process results in the production of new collagen and restoration of damaged skin cells. Surface benefits show up immediately following light peels and include the following:

• Smoother skin
• Brightened skin tone
• Fine lines are softened
• Enlarged pores are diminished
• Blemishes lessen
• Skin has a healthier, overall appearance

Throughout its more than 50 years as a safe, effective service in the skin care industry, skin peels have improved both in quality and in the variety of acids formulas available to the aesthetician. In addition, new treatment recipes and application techniques are constantly being developed as a result of new discoveries in the scientific study of skin health. Today, the aesthetician has a wide variety of superficial, non-invasive peeling treatments to offer clients of:

ALL skin-types providing, in many cases, amazing results in age prevention as well as age reversal. As an aesthetician, therefore, education is your key to maintaining this viable, ever-expanding treatment room service and absolutely critical in your effort to EXCEL!
Some of the most common skin peel ingredients and formulas used are listed here–
Enzymes – Digestive enzymes have long been used in the aesthetic treatment room. The strength of these enzymes offer a light surface polish to skin and gentle dissolving of surface cells. Some enzymes have been enhanced and intensified to offer greater peeling benefit to the skin. Enzymes are proteins generally derived from fruit, vegetable, dairy, or animal origin that acts as a biological catalyst to accelerate or produce a chemical change. Common choices are Papain, Bromelain, Pumpkin, and Pepsin.
Alpha Hydroxy Acids – Glycolic, Lactic, Malic, Tartaric, and Citric - AHAs increase cell turnover and influence the structure of new skin cells. This results in smoother more refined skin tone, improved hydration and a minimization of fine lines and wrinkles. The dermal effects are higher amounts of mucopolysaccharides and collagen and increased skin thickness.
Beta Hydroxy Acid – Salicylic Acid – When applied to skin a portion of salicylic acid is converted into copper salicylate, a potent anti-inflammatory. Salicylate has ultraviolet absorbing properties, which protect the skin from the effects of sun damage. Salicylic Acid smoothes, softens, and minimizes fine lines and wrinkles.
Retinol Acid (vitamin A Derivative) – Retinol is unquestionably effective in treating sun induced wrinkles and pigmentation associated with aging skin. The rapid cell turnover that occurs with retinol results in a smoother, silkier skin. Other benefits of retinol are the overall improvement of circulation that increases oxygen supply to the skin. This aids in strengthening blood vessels not to mention the healthy glow clients report. Skin cells have specialized enzymes that convert retinol into retinoic acid.
Jessner Peel – This is a formula created by Dr. Max Jessner who felt the strength of acids could be reduced, still maintaining efficacy and blended together creating a synergy that enhances the performance of all the acids. His theory worked because this formula is considered a classic and is used by professionals all over the country.
Jessner Formula: Salicylic Acid – softens keratinized barrier cells, reduces structural stress, antiseptic and exfoliant; Resorcinol – exfoliant, antiseptic, anti-itching, astringent, and preservative; L-Lactic Acid – promotes cell turnover, regenerating, anti-microbial, hydrating; Ethanol Alcohol– antibacterial, antiseptic
The benefits of a Jessner Peel are diminished fine lines, reduced pore size, even skin tone, smoother texture, and a vibrant, healthy glow.
Azelaic Acid -This is created by oxygenating oleic acid, which is an unsaturated fatty acid found in milk fats. It is a relatively safe acid to use in conjunction with other acids and has exfoliating properties as well as lightening and antibacterial support.
Trichloracetic Acid (TCA) - TCA is a chemical that is manufactured by the chlorination of acetic acid. It is a safe substance in that it is non-toxic, self-neutralizing, and very stable. TCA has long been used medically but as with other acids used in aesthetics, when reducing strengths and adjusting application, it becomes another tool for skin rejuvenation.
Mandelic Acid AKA alpha-hydroxy-benzeneacetic acid- is found in almonds (mandels in German). It has long been used as an antiseptic because of its antibacterial activity, but studies show that it can be beneficial in the treatment of skin problems such as photo-aging, irregular pigmentation, and acne.
Ursolic Acid - Has anti-inflammatory, anti-tumor (skin cancer) and anti-microbial properties. Ursolic acid is present in many plants but the extracts of rosemary, Greek sage, oleander, periwinkle, and spike lavender have particularly high concentrates of this chemical.
Betulinic Acid - Has anti-cancer benefits due to the reduction of ultraviolet-C-induced DNA breakage. It also inhibits tumor development by carcinogenic chemicals. Betulinic Acid has anti-inflammatory, anti-viral, and anti-aging benefits. It increases ceramide and collagen and preserves the structure of collagen fibers. Betulinic Acid is present in a number of plant species, the root of goa bean, the bark of American dogwood, and white mulberry.

The aesthetician has many choices available that will complement medical procedures such as fillers, injectibles, and laser – either by doing in conjunction or pre/post a treatment. One of the keys to success is doing what you do with total confidence. Learn your craft well and be educated on everything you do. Remember – A treatment is only as good as the therapist giving it – no matter what your credentials. Skin rejuvenation does not end in the treatment room. You must send your clients home with good skin products and educate them on how to properly use, maintain results, and prevent further external aging.
The pictures shown were performed by aestheticians around the country using different peeling ingredients and cosmeceutical home care products.
Aesthetician Carrie Broheimer ~ Aesthetician Renee Seibenlist ~ Aesthetician Shari Cardinale

Cosmeceutical Home Care
The definition of the word cosmeceutical taken directly from Webster’s medical dictionary is “a combination cosmetic and pharmaceutical product, such as anti-wrinkle cream and sunscreen.”
This approach to skin preparations has elevated the potential for effective daily use product and has gained the trust of clients when they see serious skin improvements.
A critical step in the skin rejuvenation process is “post care”. One very prominent ingredient to ensure topical healing and cell renewal is Epidermal Growth Factor.
Epidermal Growth Factor - Many experiments have revealed that pharmacologic dosages of exogenous EGF have markedly positive effects on both epidermal and dermal components of wound repair. In fact, it has been demonstrated that EGF can stimulate dermal repair in other clinical situations such as donor sites, partial thickness burns, or chronic skin ulcers. EGF applied to the skin not only increases mitosis, but also synthesis of proteins, an increase in the number of fibroblasts, increased circulation, increased accumulation of collagen, and increased angiogenesis (blood vessel formation).
There are many superior ingredients found in skin care products. What has to be considered is the function of these ingredients in a formula and the base they are in. An inferior base will reduce the quality of an active ingredient as well as efficacy. These are just a few of the active ingredients being used with success for skin rejuvenation - L-Ascorbic Acid (Vitamin C), Retinol (Vitamin A), AHAs & BHAs, Enzymes, Peptides, Mandelic Acid, Epidermal Growth Factors, Kojic Acid, Hydroquinone, L-Arbutin, Hyaluronic Acid, Antioxidants (there are too many to list), Zinc Oxide, Titanium Dioxide, and many other vitamin and mineral complexes.
Interest in Skin Peels and the search for younger-looking skin is here to stay.
Regardless of new discoveries and technological advances, peeling techniques for skin rejuvenation will remain one of the aesthetician’s most effective tools in the treatment room. What must remain constant is YOU and your dedication to the profession of aesthetics!

Rhonda Allison began her aesthetic career as owner and operator of an innovative, specialized and award-winning skin care facility in Dallas, Texas during the late 70s. Over the years, Allison's ability to artfully combine emerging technologies with a deepening understanding of health and chemistry have led to the development of her superior line of skin care products and treatments that promote the healing and rejuvenation of the skin. Today, Allison speaks throughout the world as a leading educator in advanced aesthetics. For more information, please contact her at www.rhondaallison.com.