The cost of cheap skin treatments?

What is the cost of treating our clients safely? High, as most of us in the industry know. We use some impressively dangerous devices and manufacturers that wish to supply us, Canadians with their devices need to go through proper application and licensing with our government, so that the devices in question, when used accordingly deliver results, safely. When you consider R&D, production, safety data, clinical studies, permits… etc. you start getting a glimpse of the true cost of a treatment. So, why then, is there such a huge difference in prices we see on the market? Cheaply imported equipment from countries like China, is one example. There isn’t much that can’t be brought to Canada however it doesn’t mean it’s legal or approved. Sadly, for many new technicians, as well as seasoned ones, the desire to keep their operating costs low can be overwhelming. Time and time again, I get shocked by how many of these technicians don’t do their research before jumping, both feet in, into buying widely available equipment, by training institutions we consider reputable, is astounding.

Some years ago, I worked at a gorgeous day spa, this place was top notch in every way possible. We had back to back I.P.L. hair removal appointments at discounted prices to attract new clients. It worked. Many numerous attempts to talk my boss into raising prices per treatment, fell on deaf ears. You can guess how this ended? Our I.P.L. handpiece eventually, as I tried to explain to my management, ran out of pulses. It was time to replace the handpiece. The cost of the new handpiece couldn’t be worked into the budget. Wonder why? (insert eyeroll) Management figured it would be cheaper to purchase a brand-new platform from some unknown online company. I kid you not, the platform, along with an I.P.L. handpiece to perform hair removal, skin rejuvenation, acne and vascular/pigmentation issues, for under $6000.

For those that know me, know I would fervently advise against this purchase, first, this device wasn’t approved by Health Canada. I asked my employer, in all seriousness if the insurance policy covers liability for the device, in case something should go wrong. Once again, no research was conducted, and I was told, they are good: “We have a Salon Policy” please, for all those, with “Salon Policies” that operate medi-spas, I urge you to read the policy, then immediately set up an appointment with your broker, so you can discuss your needs. A salon policy is an umbrella policy and wouldn’t give you all the necessary coverage.

Shall I get back to the newly acquired equipment then, you see, something did go wrong not long after they received the new machine. A client came in for her scheduled skin rejuvenation appointment and left with 3rd degree burns to her face.

I need to clarify; the new machine was not to blame. It was the technician’s fault. She failed to re-asses the client intake form, she did not perform a new patch test as is required with each new piece of equipment, she failed to adjust the parameters of the treatment from one machine to another and this client ended up scarred for life. Lawsuit was filed, against the spa as well as the technician, by the victim, and she deserved every penny of the millions she was awarded due to negligence. This case never made it to court, as it turned out, the insurance provider wouldn’t cover liability once investigations revealed, the equipment used wasn’t approved by Health Canada. The spa had to pay the awarded monies out of pocket, and they tried selling the business until they had no choice but to shut down in the end.

Yes, you can get insurance. However, there are many limitations and as a provider you need to do your homework to ensure you will get coverage when need arises. Many insurance companies blindly offer coverage in an attempt to get those premiums, nevertheless in an event of negligence or simply, your client not following post protocol could cost you millions if it turns out your equipment is not approved for use in Canada.

As mentioned before, many “reputable” training institutions offer affordable equipment that includes training, but it will always be your responsibility to find out if such equipment is approved. This is very easy to find out. Simple Google search for, MDALL, will take you to government website where you can search in their ACTIVE LISTING or ARCHIVED LISTINGS SEARCH. It either is in there or “NO MATCH FOUND” means the equipment is not approved.

Your next step, if you can’t find the device on the government listings, but still desire to buy anyway, is to set up that appointment with your insurance broker and have an honest conversation about what ifs and would you be provided coverage?

My advice remains same, find a reputable company, that went through application and licensing process to be able to sell you the equipment, yes it will cost more but you do need to price your service menu accordingly. Value yourself, the time and money you invested into your education and business. You do not need every client out there, just the ones willing to pay you your worth in exchange for great results, safely.

To all our amazing clients, you too need to be involved and do your homework. Please remember, skill and expertise along with powerful equipment, shouldn’t come cheap. It’s better for everyone if you wait until you can afford these treatments, because at the end of the day, it’s not a need, it is a want.

Fractional Resurfacing Treatments

Our world is excessively focused on youth and beauty, otherwise there would not be millions upon millions of creams, peels, lotions, potions, serums, advanced technology or injectables! For majority, it is all too confusing, but how could it not be? We have many manufacturers quickly spit out treatments, put a slightly different tweak on it and try to convince you, it is brand new, the best, the greatest! When in fact, they are using already discovered treatments and are attempting to refurbish them to convince the end user, there is nothing else out there like it.

I will focus my attention on Fractional Resurfacing treatments. On tv, on social media, in clinics it’s all the rage, and over the last decade, the variety and tweaks to good old-fashioned fractional treatments has exploded.

What is then a fractional treatment? Think of it like aerating your lawn. The purpose is to cause small areas of damage, to allow the healthy surrounding area an increase in oxygen and nutrients and to jumpstart the healing, which at the end of the healing cycle improves the look of your lawn, or as is the case for your skin using fractional resurfacing. The analogy isn’t perfect but it’s dang near close.

Now that we have established the benefits of using fractionated treatments for the treatment of aging, fine lines, wrinkles, hyperpigmentation, scarring, the list goes on… let’s figure out what equipment is best for the job.

You have more than likely heard about the Fraxel, the Pixel, the Clear Lift, the CO2, the Venus Viva, the Fractora, eMatrix, and many more, yet what no one takes the time to clear up is the fact that all these technologies take a form of energy, supplied by the electromagnetic spectrum, and apply it to the skin in small “dots” in a matrix (or a grid pattern for the purpose of injuring a tiny portion of skin and relying on your own skin’s injury healing mechanism to take care of the rest. (The Wound Healing Cascade) Same concept applies to all forms of microneedling as well!

So, what exactly sets these numerous machines apart? First, the spectrum of energy it uses and what is powering it? The electromagnetic spectrum is simply a range of frequencies of electromagnetic radiation, as well as their respective wavelengths and photon energies. We are surrounded by this spectrum; we live and depend on it for many things. The science has discovered a multitude of applications, when a specific spectrum is selected to produce different effects, in our case, for therapeutic and medical purposes.

Now, getting to the second part, the power supply, the excitation portion. In the case of true light therapy (IPL and Laser) plugging in to the outlet to get electrical power will not make you the type of light that can accomplish the job, this is when we need the help of a medium, this can be gas, liquids or solids. (More on this in my first article, Laser vs I.P.L., you should check it out)

So, you have a C02 Fractional, that means you are getting a laser treatment, or maybe it’s an erbium yag (er:Yag) in which case it is still a laser treatment using a solid medium… and so forth (do you see the pattern?)

Let’s work our way though the electromagnetic spectrum and pick up a radio frequency out of the line up. Still rather a simple concept of using form of energy to “burn” a dot into the skin, or a grid of dots. Therefore, the treatment is still fractionated but is using a different kind of energy to accomplish the job.

Usually, around this part of the lesson, the confusion arises over when to use which energy. Questions of who is a good candidate? What are contraindications for each? When would you use one over the other? Etc…

The short answer: you usually can’t afford more than one technology and those that do, have large clinics with more equipment than capable technicians. In my humble opinion, all these previously mentioned technologies are very lovely, they deliver the promised result but only when used to its potential correctly. Downfall to our industry, are uneducated technicians operating equipment far superior to their limited knowledge. It is not as simple as plugging it in and hitting a few buttons before we blast holes into your skin.

Expert knowledge of skin components and how they work is paramount, as is the understanding of lifestyle and contraindications so we can determine which treatment, how often, how many and what pre and post care protocols will be involved before you can ever bring the technology to the patient’s face. All technology has limitations and that is acceptable in the hands of a technician who isn’t afraid of admitting, the equipment they invested in, may not be the very best option for everyone. In their pursuit to make a sale, there is no winners or benefits to you, the consumer.

St. Ives scrub?

If I had been charging people, every time I got asked my opinion on St. Ives scrub, over the last decade alone, I would have made some serious buck. Clients and students always want my professional opinion when discussing products and my honesty doesn’t always align with what they want to hear, probably because over the counter, cheap product is easily accessible, and their ads are everywhere, eventually convincing you these scrubs are a must have. The truth started surfacing some time ago and there was even a lawsuit, which got dismissed by the judge due to plaintiff’s inability to directly prove cause. Facts still stand, St Ives scrub is without a doubt horrendous to your skin, put aside the fact that the class action lawsuit created their own case studies to exhibit the damage rather than use actual researched cases, which is why the judge tossed it in the first place, there are no proper studies to show the damage it causes. No double-blinded studies, as proper researchers would use anyway. No one has time for that! Instead it’s our job, as service providers to educate, then present you, the consumer with a better choice.

Over the years, I have had the pleasure of using many scrubs, beautiful products that contain potent ingredients and more polished exfoliators. Regardless of which of these products you choose, you should never over-exfoliate. No more than twice a week for thick, textured and oily skins and once a week for drier, more mature types. During exfoliation you should pay close attention to not get overly aggressive in areas of chronic redness, (we all get it, particularly on the cheeks and nose) those with sensitive, easily irritated skin would benefit from using a gentle terrycloth facial towel to simply wipe off their cleanser, the terrycloth texture offers more than enough exfoliation. (just ensure you have a nice, clean towel for each wash)

Signs that you are over-exfoliating? Look for tight, shiny forehead, red and irritated patches of dry skin, acne like breakouts, dehydration and fine lines (think of the land in drought)

What is happening!? You see, on average, most healthy people in the teens, and 20 to 30’s will produce new skin cells at the basal layer and push it through the other four layers of the epidermis, to prepare for natural sloughing, every 28-30 days, approximately, add additional 10 days for each decade after 30 to accommodate for aging and slowdown of cellular turnover. We get great skin by helping speed up this natural process, but we are humans and over-abusers. In our brain, we get this idea that we are glowing, our products absorb better and work better so we figure, if once a week gives me radiance, then every day will be even better! FULL STOP! NO…

Simply put, over-exfoliating puts our skin into a frenzy. Not only is the environmental protection stripped but the sebaceous glands (those pesky white and black heads and oil on the skin) are sending a signal to the brain that there is no oil or stratum corneum left, so brain will respond by telling your glands to produce more, (oily skin needs a moisturizer too to help keep skin happy, but that’s a story for another time) and more oil, more new cells = more clogging, among other issues, such as sensitivities to your environment and other ingredients. (the number of clients that tell me they are allergic to skincare is alarming by the way!)

We need to get back to the purpose of this article, we know the skin is amazing and capable of many feats, protection, sensation, heat/cold regulation, excretion, secretion, absorption and my favourite, wound healing! In fact, many advanced treatments rely on this wound healing cascade, to signal a release of our own growth factors, to help produce new collagen, everyone’s favourite side effect of “hurting” the skin. That said, clinical studies, one after another all signal to same outcome, injury needs to be controlled, even and at a right angle (90°) into the skin in order to produce the best outcome post healing (Dr. L. Setterfield, 2013)

Sadly, for all those fans of St. Ives scrub, even at cosmetic level, it exfoliates your skin unevenly, it does cause uneven abrasions and has a potential to get caught and lodged in to the skin, which can lead to further inflammations, infections and worse breakouts.

I told myself, I would keep this one short, so to make good on my word, if you must use an exfoliant, use one that has biodegradable, spherical beads, no more than once a week. My current favourite is by Vivier, Vitamin C scrub, and as far as St. Ives scrub goes, I wouldn’t even use it on my feet!

Endor Milk Cleanser

Couple of weeks ago, I had written an article about Endor Technologies Skin Care line. My experience, unlike any other products so far, has me convinced that these creators (wicked awesome Endor scientists) are on to something big. While their star products, Anti-Aging facial serum, moisturizers and anti-cellulite body cream are beyond amazing, I feel as if the cleansers do not get nearly enough credit. As I mentioned in my other article, their line is not big, and my scientific side of the brain had a hard time coming to terms that one product can work for any skin type and condition. I need you to bear with me, it will all make sense, eventually.

Yes, the facial serum and the eye contour cream most definitely check all the boxes. Collagen rebuilding. Check. Fine lines gone, yep. Pigmentation improved, oh yeah. Redness calmed, most definitely! You get my point. They do offer two moisturizers, anti-aging cream takes care of younger, normal-combination, oily skins with first signs of aging and the anti-aging nutritive moisturizer tackles aging, mature, dry skins. My fears realized as I knew they would, getting sidetracked by their spectacular, and result oriented products. This blog is about their Milk Cleanser.

Quite a few weeks into using Endor milk cleanser, I kept using my Skinceuticals Age + Blemish toner after cleansing. Once I ran out of the toner, I did the unthinkable and didn’t replace it. (I know, crazy) It turned out much better than I anticipated. Before bed, I use the milk cleanser to remove my make-up and other accumulation of daily debris, mascara was always tough, regardless of the cleanser, so when this cleanser took it off, I was impressed. (Even more, when I woke up the next day without any mascara trace around my eyelids) My worry was that, cleaning without toning would leave my skin’s pH balance whacked out and over time my barrier function would decrease, much like it does with most cleansers on the market, and the reason why so many people struggle with skin issues and sensitivities, among other conditions. It’s imperative that you tone after cleansing, that is, unless you clean your face with Endor Milk cleanser. It was time to break down the ingredient list and figure out why it works so amazingly well. It has quite a few but this company is committed to medical innovation, and when you combine brains, science and highly potent botanicals, you get a winning combination of synergistic relationships between those ingredients. Water and liquid paraffin (this is the good stuff, very small molecule which allows it to be liquid and so safe, you can ingest it) form a beautiful base, where sweet almond oil is the principal of the dance, surrounded by a cornucopia of ballet stars, such as Bisabolol, Yarrow flower extract, Horse chestnut seed extract, Calendula, Chamomilla Recutita flower extract, Witch Hazel, Mallow flower extract and Peppermint Leaf extract. Of course, no serious company will allow all these stars to spoil, so preservation is key, in small amounts. They all need to mix and mingle, and yes, a small number of emulsifiers, surfactants, thickeners and the like are needed, to allow the product to look, feel and act appropriately for as long as possible.

Milk cleanser removes all my stubborn makeup, including my mascara. I will use a q-tip to gently wipe away all mascara traces before I wipe the cleanser off.

So then, let’s get back to our principal, Sweet Almond oil. It contains many skin benefiting components, vitamin E, vitamin A, protein, potassium and zinc. This is essential to our skin’s health by promoting cellular renewal, antioxidant to neutralize free radical damage, prevent trans epidermal water loss, strengthen the cell membranes and promote healing.

Bisabolol is an extract from a part of chamomile with excellent soothing abilities, particularly beneficial for irritated and sensitive skin.

5:30am, hot shower, morning routine. I apply my cleanser before getting under the hot stream of water, keep it on until I am ready to rinse the conditioner out of my hair. My pale white skin is protected, not dried out, not itchy, or red from the hot water (vasodilation is when blood flow is stimulated to expand your vessels, which can cause white skin to have diffuse redness)

Yarrow flower has incredible healing properties, it can help prevent wounds from bleeding and even help calm conditions such as eczema. Moreover, used in a cleanser, it can help maintain skin’s pH balance, acts much like an astringent and shrinks the follicles (pores) as well as helps to control sebum production.

Next, we move onto Horse Chestnut seed extract. This potent ingredient has been used and tested to showcase its abilities to strengthen capillaries (bye bye redness), it is an antioxidant as well as anti-inflammatory. To help boost all these benefits, we can’t not mention Calendula, well known for its ability to treat sun burns, it helps heal redness, acts as an antiseptic, treats wounds and it can help heal acne.

Chamomile has many parts that can be extracted and Chamomilla Recutita flower extract adds to the calming of inflammation and sensitive skin.

Witch Hazel is extremely multitasking. It is proven to relieve inflammation, reduce irritation, fight acne, protect against skin damage, controls spread of infection and, balances the pH of skin. It is usually a main component in any toner and can be found in first aid aisles of any market.

Mallow flower extract is a nice addition in helping heal wounds and Peppermint Leaf extract for soothing and cooling benefits.

You might be thinking, by this point (if you got this far) “Oh, I can just get any of these, anywhere and in lots of other products! What makes Endor Milk cleanser so special?”

Well, you see, Endor is a pharmaceutical company that has access to the cleanest most potent extracts, or synthetically derived ingredients to ensure the batch is consistently the same from one bottle to the next. The process of extraction and manufacturing is important to ensure safety, efficacy and consistent long-term effects. Medical skin care has drug like potency, designed to affect the skin structure and cause biochemical changes. It is the reason why you shouldn’t be allowed to just pick it up off a shelf, but instead see a skin specialist to determine your needs. Probably the reason why most consumers jump from one bottle to the next, continually looking for the next product that promises results, in vain. I can tell you, as a consumer myself, without the education on the histology and physiology of the skin, and basic ingredients chemistry, you are not qualified to diagnose your skin properly. Instead, we get bombarded with media telling us what we need. Do you really think Hollywood stars or social media influencers get results from the products they promote? Do you really think they even use those products? So, why do you continue to support and buy things that aren’t designed to affect the skin to change how it functions? Advertising dollars work well.

Now, I’m not naive to the fact that our industry is lacking expert skin therapists. I apologize on behalf of all those therapists that work hard and get the education to become the best in their field, because there is probably 8 out of 10 that don’t, and those are the ones that disappoint and fail you, by allowing you to walk out of your treatment without educating you. You have one skin, and your skin deserves only the best ingredients. It is your skin that entices me to keep up my own education, and my passion for educating others extends to all my students.

I will compile a list of locations that retail Endor Technologies and other amazing cosmeceuticals and update this blog when I have a complete list.

Endor – How it changed my skin

Sometime in 2018, end of July, I had the pleasure of meeting a rep from Arylide Life Sciences when she came in to my classroom to present a workshop for my class. It only took moments to realize she had a genuine passion for the product that she uses and represents, it was refreshing and welcoming, but more than anything helpful in a room full of students just entering the field of Clinical Esthetics.

Her extensive knowledge on the products, their ingredients and functions within the skin’s structures was what had me wanting to get my hands on the products as soon as possible. The entire line, which isn’t very big (and what makes it attractive, if you are not a fan of multiple items in your routine) focuses on gold thioethylamino hyaluronic acid (a new ingredient, developed with spherical nanoparticles linked to hundreds of low molecular weight hyaluronic acid oligomers).

To help you understand the implications of this, in the terms of skin benefits, I should explain what nanotechnology is. In short terms, science can manipulate matter on an atomic, molecular, and supramolecular scale. Size of matter then becomes between 1 – 100 nanometers. To put this into perspective, the size of human hair strand is about 70 000 nanometers. So, this amazing new ingredient of gold and hyaluronic acid particle technology is between 20-22 nanometers. (Very, very tiny) What that means for our skin is, it will penetrate, and it will reach the depths of our skin more than any product available, let’s say, over the counter. (OTC products are an article for another timeJ)

It can help to deliver ingredients that target specific receptors and thus trigger a specific response within the body. (Think about each individual skin cell, and what that means) It triggers production of your own growth factors to stimulate hyaluronic acid, collagen & elastin, which allows for more balance in the skin. Around 30 years of age, our body stops producing collagen (lame I know), combine that with UV rays, pollution, lifestyle, and other free radical causing yuckies, and the end result is glycation (fancy term to describe aging). What we are left with is the 3 D’s of aging. Our skin will Deteriorate, causing the volume to Deflate and gravity will cause it to Descend.

In their very impressive clinical studies, they have demonstrated the efficacy of their product, with no side effects, unless plump skin is a side effect? In which case, take my money! All joking aside though, I started my journey using their Anti-Aging Facial Serum. I already knew that the key to hydration is hyaluronic acid (capable of holding 1000 times its weight in moisture) so, I had that covered. Next step is to see how it changes the structure of my skin to help me build my own collagen, and improve elastin for elasticity. (This is the part where I vibrate with excitement, you would need to be in the room to know what I’m talking about)

In order to reverse the signs of aging, we must activate those three components, hyaluronic acid, collagen and elastin.  To do that, our product needs to be capable of reaching deep dermal layers and activating the cell (CD44 receptors) in order to activate the multiple CD44 receptors our ingredient has to reach the target all at the same time. Therefore, tiny particles of our powerful ingredient will get deep enough where they will, like a swarm of bees activate those receptors into stimulating the growth of our own collagen and elastin. Long gone are the days of bulky molecules sitting on the surface of our skin doing absolutely nothing! (I’m looking at you OTC products)

After some two weeks of using the facial serum, I couldn’t get over the hydration levels, and how comfortable I was in my skin. I needed to expand my range, next I introduced their Milk Cleanser. The sweet almond in it is dreamy, the consistency and texture is like putting silk on your skin. It doesn’t dry out my own barrier, yet it efficiently removed my stubborn make up. I like the option of not needing to rinse it off, particularly before bedtime when I am prone to be startled out of my after dinner slumber by water splashing. The gentle blends of surfactants (cleansing agents that help dissolve yuckies) along with witch hazel proves that maybe toner isn’t needed. I am pro toner, let’s just put that out there. It’s meant to adjust the pH balance on your skin after cleansing to keep your barrier intact (trust me, you need a healthy barrier for protection against the environment) but after a few weeks, I let go of the toner, as it turned out, I just needed to trust the science behind their cleanser. At this point, my skin was hooked, I needed to introduce more of their products. I got my hands on the Eye Contour cream (It won Editor’s Choice 2019 btw) and lastly, the Anti-Aging Nutritive Cream. All their power house products are based on the same science and same main ingredient composition.

As a skin expert, and years of practice in the field, I am well versed in all things ingredients and chemical composition, and how they influence the skin. I readily promote high potency ingredients to target skin conditions, unrelated to a specific brand because most all professional grade, cosmeceutical companies have amazing line up of products and I don’t care which brand it is, because I can trust their ingredients will have drug like effect, that can affect the structures of the skin, and not just alter the appearance until it is washed off. I have been testing hundreds of products over the years, and I will continue to do so, every time something new and exciting catches my attention. That said, if I can’t test the said product within the Endor line, then that’s just it. I will never replace what I have currently. And the accompanying pictures tell why.

Here we have my hormonal acne, that ravaged my poor face, post hysterectomy almost two years ago. I have tried everything, please keep in mind, I have access to an overabundance of great products to choose from, as well as almost any professional treatment I could want. I have tried many. They helped slightly, but the acne just kept coming back. Endor Technologies skin care line wasn’t created to target acne, and I am not recommending it for acne, but I am simply sharing my experience. I have a theory as to why, the gold particles in the product shed from the skin, allowing my skin to continually regenerate, thus push the dead keratin out of my follicles, (which is one of the reasons why P. Acne bacteria would multiply, this bacteria is anaerobic, meaning it cannot live in the presence of oxygen, so if the skin can “push” it all out, it makes sense that oxygen too would be able to now get inside the follicle) It’s just something my brain is putting into a theory.There’s a lot more that I could go into, but seriously, that is not my area of expertise to figure out. It works, and that is all I care about.

Here is a picture of my acne healing (I am not kidding, it resolved my acne within weeks) I was left with post inflammatory hyperpigmentation, as is often the case after acne breakout dries up and the scab flakes off. Make-up did a good job covering up the discolorations, but I didn’t notice the amount of collagen and elasticity my skin had formed until I put these side by side. I was so focused on the discoloration, I wasn’t paying attention. The picture on the right has NO makeup, NO filters. (I never use my selfie side of the camera because they give the pictures a more polished look, even when you turn off the “perfector”, and there is more than enough lies on the internet, I don’t need to be contributing to it) The deeper lines in my nasolabial folds and even my early marionette lines softened up and filled out drastically. My crow’s feet are much softer and even the tiny scar in the center of my neck has almost disappeared! Yes, my own collagen and elastin has grown just like the rep promised it would.

Lastly, this is where I see the kind of damage it has fixed. The texture, the discoloration from sun damage and the plumping. There is nothing temporary about these results. I haven’t had a single acne breakout in months!

I am 38, I haven’t had botox (since I was 27) or any fillers for that matter. I can’t have injectables or aggressive/advanced treatments because of trigeminal neuralgia diagnosis.

p.s. This is not a paid endorsement