Microdermabrasion (MDA) Manual

Pixi Peel Training Manual Page 1

Aims:

For you to become an educated, safe and effective Diamond Peel skin

rejuvenation therapist.

Objectives:

To understand the underpinning knowledge required for you to safely

and effectively operate the equipment, to understand the

contraindications and the contra-actions to treatment, how to effectively

meet your various client skin care needs, to appreciate the health &

safety issues of treatment & equipment maintenance and how to consult

effectively with potential clients.


Contents

Section 1 Introduction

1.1 Benefits & Clinical Application of Diamond Peel

1.2 Explanation of Benefits

1.3 DP performs three Actions

1.4 Frequently Asked Questions

Section 2 Pre Treatment

2.1 Vital Operational Procedures

Section 3 Background Theory

3.1 Skin Anatomy and Functions

3.2 Lymphatic System

3.3 Importance of the Skin

3.4 Epidermal renewal

3.5 Maturing Skin

3.6 Environmental Factors (Over-Exposure to the Sun)

3.7 When to use a Sunscreen

3.8 The Melanin Unit

3.9 Hyper-pigmentation and the Cause

3.10 Skin Disorders

3.11 Diamond Peel Dermabrasion: Pre-surgery and post surgery

3.12 DP and Micro-pigmentation

3.13 DP and Collagen replacement Therapy

3.14 DP and Topical Actives

Section 4 Products After Treatment

4.1 Products After Treatment

4.2 Home Care


Section 5 Consultation

5.1 Client Consultation

5.2 Client Commitment

5.3 Contra Indications

5.4 Complete Client Medical Record Card

5.5 Sensitivity Skin Test

5.6 After Care Rules & Product Explanation

Section 6 Treatment

6.1 Treatment Protocol

6.2 Treatment Levels

6.3 Treatment Applications and Correct Pressure Levels

6.4 Facial Diagram Demonstrating Stroking Directions

6.5 To Commence Treatment

6.6 Face Treatment

6.7 Jaw Line Lift

6.8 Cheek Muscles Lift

6.9 Brow and Forehead Lift

6.10 Treatment for Acne-Prone Skin

6.11 Treatment for Acne and Post-Operative Scarring

6.12 Body Treatment

6.13 Indications for Body Exfoliation in Preparation Tanning Treatment

6.14 Body Exfoliation: Application

6.15 Cellulite


Pixi Peel System

The Pixi Peel skin treatment performs a progressive rather than an aggressive treatment over a

course of 10 to 20 sessions. Pixi Peel Diamond Peel offers a safe, controlled method of skin

exfoliation.

DP allows you to perform superficial peeling of the Stratum Corneum reducing its thickness through

mechanical abrasion of the dead skin cells. By placing the hand piece with the diamond head onto the

skin the head will resurface the skin surface. The diamond head can gently remove the epidermal

cells layer by layer. Dead skin cells are drawn away through the vacuum action and rest on the filter

inside the hand piece.

1.1 Benefits & Clinical Application of Pixi Peel DP

• Total control in exfoliation, eliminating any guesswork that can often be associated with AHA or

chemical peels.

• Allows the entire face and neck to be treated in a single session, with particular attention paid to the

client‟s areas of concern.

• The client can return to a normal lifestyle immediately with no down time or interruption to daily

routine.

• Eliminates possible adverse reactions often associated with chemical solutions.

• Immediate visible results, even after the first treatment, helps keep the client motivated.

• Can safely treat all skin colours or types.

• Offers reduction of moderate early ageing signs such as lines and wrinkles offering an overall

rejuvenation for aged skin.

• Stimulation of Fibroblasts for collagen reproduction.

• Rejuvenation of the overall skin with improved tone, elasticity and muscle tone.

• Enhances penetration of approved topical actives after treatment.

• Successfully treats a wide range of skin problems associated with both the face and body.

• Performs a controlled and adaptable progressive skin exfoliation.

• Perfect for congested skin with open pores and comedones and acne prone skin.

• Deeper exfoliation for thickened blemished skin and acne scarring.

• Reduces the thickness of the Stratum Corneum.

• Successfully helps lift and eradicate Pigmentation marks. Perfect for sun-damaged skin.

• Total Body Exfoliation Diamond Peel offers a successful Cellulite treatment as the vacuum action

helps with lymphatic drainage, whilst exfoliation helps to smooth appearance of uneven skin.

• Can be used to treat the very delicate skin under the eyes by creating a lymphatic drainage effect

through reducing the vacuum suction on your machine


1.2 Explanation of Benefits

The Vacuum Action

Boosts circulation, hyperaemia can be observed as the superficial skin is stimulated. Hyperaemia can

be observed as the superficial skin is cleaned. By encouraging hyperaemia we are improving the

micro-circulation; (increasing the blood supply) thus providing nutrients necessary for the stimulations

of fibroblasts for collagen regeneration i.e. increasing blood supply in the epidermal layers producing

skin regeneration. The degree of epidermal abrasion can be varied by changing the diamond heads

used on the skin and increasing the vacuum suction on the machine. The result is skin that is instantly

smooth and fresh, whilst promoting new skin and collagen growth resulting in a tauter, more

rejuvenated skin after a course of treatments.

Face and Body

Pixipeel can treat both the face and body allowing a wide range of skin problems to be treated safely

and effectively with predictability of results. Exfoliation is derived from the Latin „Exfoliatus‟. Definition

„to strip leaves‟ Cosmetic exfoliation encourages normal shedding of the Stratum Corneum; it is

considered non-invasive as no viable tissue is involved.

Peel and Lift

Pixipeel provides an excellent method for skin resurfacing and correcting skin irregularities but also

provides an exercise programme for tired muscles, achieving an instant lift within minutes. This is

achieved by utilising the vacuum function with skin exfoliation. The muscles of the face are

manipulated as the vacuum action compresses the muscle tissue intermittently, thus performing an

isometric exercise i.e., one that does not involve shortening or lengthening the muscle instead, simply

firming the muscle through manipulation by intermittently compressing the muscle tissue. This action

gives an instant lift to the cheek bone, jaw line and the upper eyebrow areas. Combined with

exfoliation, this procedure now offers you the opportunity to provide your client with both an exfoliation

and lifting treatment all within a 30 minute treatment. By performing both actions together in one

session the Pixi Peel treatment is even more appealing to your clients whilst earning your salon more

profit as the combined treatment cost to your client is higher yet takes no more time.

Lymphatic Drainage

Pixi Peel treatment also has a direct effect on the lymphatic system. The lymph flow is increased,

thereby removing waste products and skin tone is greatly improved by stimulating exhausted skins.

Perfect for clients suffering from puffiness below the eye.

1.3 DP performs three Actions


1. Correction

By placing the hand piece on to the skin with the diamond head this will impinge directly on to the skin

surface. The diamond heads can gently remove the epidermal calls layer by layer. This action allows

for the controlled exfoliation of the Stratum Corneum allowing a smoother fresher skin to emerge thus

correcting surface irregularities. (Dead skin cells are drawn away through the vacuum action and rest

on the filter within the hand piece.)

2. Stimulation

The combined abrasion and vacuum action stimulates micro-circulation. Hyperaemia can be observed

as the superficial skin is cleaned. By encouraging hyperaemia we are improving micro-circulation

(increasing the blood supply) thus providing nutrients necessary for the stimulation of the Fibroblasts

for collagen regeneration.

3. Isometric exercise

The vacuum function can be utilized to manipulate the facial muscles as it compresses tissue

intermittently. Resulting in an immediate lifting effect to the upper brow, cheekbone, jaw line and

improves overall skin tone. The vacuum action has a direct effect on the lymphatic system. The lymph

flow is increased removing waste products.

1.4 Frequently Asked Questions

Question 1: What is the difference between AHA and epidermal skin abrasion?

Answer 1: Used in the incorrect strength, or in inexperienced hands, use of the AHA may cause

irritation, which can lead to Post Inflammatory Hyper-Pigmentation. Use of AHA products cannot be

controlled as epidermal skin abrasion in treatment of lines, wrinkles, scars etc. however when used in

acceptable concentrations they can play an important role in the home-care maintenance programme.

Question 2: Will epidermal skin abrasion reduce or prevent lines and wrinkles?

Answer 2: Regular exfoliation will remove dead skin cells allowing more radiant youthful skin. Just

like physical fitness our skin needs an exercise programme to keep it young and healthy. Through

regular stimulation to the micro-circulation regular treatment aids in the production of new collagen

and elastin formation. The deep lines that tend to appear above the top lip (known as lipstick lines)

respond very well with regular treatment. If any adequate exfoliation and stimulation programme is

followed at an early age, the skin can retain its youthful appearance longer.

Question 3: Does epidermal skin abrasion make the skin more sensitive?


Answer 3: No. Epidermal skin abrasion does not cause skin sensitivity. However, whilst undergoing a

course of treatments, we would advise using a high protection sunscreen as the skin will be more

susceptible and receptive to sun exposure and products used.

Question 4: Will facial scrub provide the same results?

Answer 4: No. Because some products may scratch the skin, causing irritation, they are merely

loosening the corneocytes and not removing the dead skin cells in a controlled manner. They have no

stimulation effects on the micro-circulation, and cannot erase or blend scar tissue or help the

smoothing of lines and wrinkles.

Question 5: Is Micro-Epidermal Skin Abrasion suitable for everyone?

Answer 5: Occasionally clients with very sensitive skin may show a reaction to the diamond heads

employed, which, in extreme conditions may result in inflammation and an unnatural redness with

irritation. It is extremely rare, however. To prevent any such incident it is advisable to perform a skin

test immediately before commencing treatment. Treatment should not be commenced if the skin is

exhibiting extreme sensitivity, open sores, cuts, abrasions etc... if the client is receiving tropical or oral

medication treatment should not proceed without the physician‟s approval.

Question 6: Is there a danger of over exfoliation on the skin?

Answer 6: A normally functioning epidermis naturally renews itself monthly on average. However this

can vary depending on the age of other aggravating factors. This process of cell renewal is a

continuous process and removal of an overly thickened Stratum Corneum (Hyperkeratotic skin) would

not deplete the epidermis of its natural ability to replace the renew skin cells.

Question 7: I have heard that speeding up the mitosis of the cells can lead to a cancer cell being produced?

Answer 7: Epidermal skin abrasion will not increase cellular activity to an unacceptable level.

Abnormally high cell turnover, as seen in certain cancer causing agents such as UV radiation can

produce defective cells, which in turn may produce the cancer-causing cell. However, micro epidermal

skin abrasion will not increase mitosis of the cells to an abnormally high rate. Regular exfoliation -

(helping to remove the dead skin cells) will actually promote the production of a greater amount of

healthy cells.

Question 8: How does epidermal skin abrasion help with age spots, (Keratosis)?

Answer 8: Many age spots that appear on the face are benign. Simple Keratosis, Actinic Keratosis

and Seborrhoeac Keratosis all have a thickened Stratum Corneum in common. Regular exfoliation will

help smooth and reduce the thickened Stratum Corneum.

2.1 Vital Operational Procedures


Hygiene in the Workplace

Sterilising the diamond heads between clients is essential to destroy any harmful bacteria which could

cause infection. Good hygiene in the workplace will prevent cross infection and secondary infection.

Personal Hygiene

We would recommend gloves to be worn, washing hands regularly before and after each client. Hair

should be tied back, and avoid touching your face. Cuts and abrasions on the hands should be

covered with clean dressings.

Ensure that the vacuum suction is started on a low setting; test on skin before performing a treatment.

The skin should be cleansed with a gel or water based formula and be completely dry before

commencing treatment. Change the disposable filter after each client.

Always check over you heads; high usage will need replaced.

Section 3 - Background Theory

3.1 Skin Anatomy and Function

The saying “beauty is skin deep” is a truthful assessment in determining the health and appearance of

our skin. Our skin is the part we display to the world. Its diversity can show our age origins and health.

The skin functions as a protective barrier against environmental stress and impedes the preparations

of water and toxins. As a sensory organ our skin regulates body temperature and transmits

sensations such as pain and pressures every minute of the day. The skin is the body‟s largest organ

comprising 15% of our body weight. Multi-purposed, it varies in thickness throughout the body.

However, this paper thin protective mantle supplies a tough suit of armour. Our skin is composed of

three primary layers: epidermis; dermis; and the subcutaneous tissue. The epidermis is a self-

renewing barrier to water loss and is resistant to chemical, physical and micro-biological insult. It is

approximately 0.1mm thick (or only half as thick as paper). The epidermis is not uniform and can be

divided into two basic layers; the outermost Stratum Corneum (dead skin cells), and the viable

Stratum Malphigihi (cellular acrive part of the epidermis). The stratum Malphighi can be divided into

highly differentiated subleases:


The Epidermis

Stratum Granulosum

Outer most living layer it is in this layer that the cells begin to die and are being shed. The cells have

lost most of their moisture and lipids. This layer also contains the substance keratinohyalin, which is

the basis of keratin. Keratin is the fibrous material that makes the skin virtually impregnable to micro-

organism insult and internal water loss.

Stratum Lucidum

Two-to-three rows of dead translucent cells which have an indistinct outline but no nuclei; this layer is

only seen in the thick skin of the palms and soles.

Stratum Spinosum

Eight-to-ten rows of round cells, which fit together by short prickles projecting from each cell, hence

the name they are know by: Prickle Cells. Each cell is compactly arranged with its neighbours, they

are capable of motosis, although the mitotic rate is slowing down.

Stratum Basal

A single row of cells resting on a membrane which separates the epidermis from the dermis these

cells receive their own oxygen and nutrients from the dermis. The cells divide continuously to produce

new cells and are stimulated into increase movement by stimulating the skin. Situated at the base of

the epidermis 95% of the Stratum Basal is composed of Keratinocytes. The major cell type of the

epidermis is the Keratinocyte, which produces the highly resistant insoluble protein called Keratin.

Keratin provides the protective barrier of the epidermis. Basale Keratinocytes constantly divides

through mitosis to form identical replacements every few days.

Replaced Basal Keratinocytes migrate upwards and outwards to form layers of cells interconnected

by desmosomes, (prickles or spines) comprising the Stratum Spinosum. Hence the name Prickle cell

layer. Keratinocytes continually become transformed and their nuclei in the Stratum Granulosum or

Granular layer. Keratin becomes more evident in the Granular layer hence the name Granular cells.

As Keratinocytes mature in different layers of the epidermis and transfer from the Stratum Basal to the

Stratratum corneum they change their structure and chemistry. The entire physiochemical process of

the cellular proliferation represents the maturing of Keratinisation. As a result the Stratum Corneum is

constantly regenerated.

Various changes in the Stratum Corneum can send messages to the basal layer to reproduce cells at

different rates. Removing the upper layers of the Stratum Corneum by exfoliation will prompt the basal

layer to reproduce cells quicker. Melanocytes comprise the other 5% of the Stratum Basale. These

cells synthesise melanin, which is transferred via melanosomes e.g. arm-like extensions, surrounding

Keratinocytes. There is approximately one melanocyte to every 36 keratinocytes. Keratinocytes are

responsible for the distribution of melanin throughout the skin for sun protection. The combination of


melanocytes with the neighbouring Ketratinocytes with which it supplies melanin is termed „the

epidermal melanin unit‟. Variations in genetically determined skin pigment are related to the

difference in the Melanosome structure produced by the melanocytes and not to larger melanocytes

in darker skinned races. Melanin offers minimal photo-protection. Melanocytes reduce in number and

function in old age.

The Dermis

The dermis consists of two layers: the upper Papillary and the reticular layer. The dermis is comprised

on connective tissue fibres, elastin fibres and reticular fibres. It also contains many dermal structures,

hair follicles and appendages, nerve fibres and endings, blood capillaries, fibroblasts, mast cells and

lymphocytes. The Papillary dermis is the thinner upper layer of the dermis situated beneath the

stratum Basale of the epidermis. It is composed of interwoven collagen and elastic fibres.

The Reticular Dermis

The deepest layer is composed of coarse collagen bundles and lies beneath the bulk of the dermis. It

contains most of the dermal protein fibres, structures and cells. The dermal; protein fibre gives skin its

strength and flexibility, forming a support for the epidermis. Collagen fibres amount to 70% of the dry

weight of the dermis.

Subcutaneous Layer

The layer of tissue beneath the Reticular Dermis is known as the subcutaneous tissue, composed

mainly of adipose, or fatty tissue. It functions as a heat insulator, shock absorber and as a source of

fuel that is mobilised during starvation and exercise. Subcutaneous tissue varies in thickness.


3.2 The Lymphatic System

This is the system that carries lymph; a watery fluid derived from blood plasma, around the body. It

deals with waste products and works in conjunction with the blood, in particular with the white blood

cells, or lymphocytes, that are important to the body in its defence against disease. There is an

efficient network of Lymphatic vessels in the dermis, which become lymph capillaries in the

subcutaneous layer, helping to remove waste products from the skin. The lymphatic vessels and

capillaries generally flow parallel to arteries and veins and empty into the main lymph ducts, the

thoracic and right lymphatic duct. The lymphatic vessels have valves to help prevent back flow;

massage movements or vacuum application in the wrong direction can move lymph backwards,

possibly spreading infection. For this reason massage and vacuum treatments on a client that has no

infection the suction created by the vacuum will have a mild lymphatic drainage effect enhancing the

results of treatment.

3.3 Importance of the skin

The blood that circulates in the skin delivers nutrients to the tissues and dissipates or conserves body

heat. Other primary functions are to protect the body from harmful outside elements and to balance

the body fluids by releasing perspiration. Skin is a vital sensory perception. For example, if a pan is

hot, the skin is the first to know and send warning signals. The skin is the mirror to ones health. Tell

tale signs of eating disorders such as anorexia or bulimia often include thinning of the skin, fine lines

and drying and dehydration due to lack of nutrients. Vitamin C deficiency may result in broken blood

vessels; lack of vitamin D can inhibit wound healing and reduce skin elasticity.

3.4 Epidermal renewal

One of the unique features of the epidermis is its ability to regenerate itself. The process of

continuously regenerating and shedding epidermal keratinocyte is known as cellular turnover and

desquamation. On average in normal skins we develop a new coat of skin every four to six weeks.

However with age and poor general health, the rate is considerably slower. It can take up to 19 days

for Basal Keratinocytes to reproduce in the Stratum Basale. The time required for replicated

Keratinocytes to travel from the Basale to the Granulosum is between 26 to 42 days, with an

additional 15 days until corneocytes are shed from the Stratum Corneum. Therefore from Basale

Keratinocytes replication to complete cell turnover would represent a total epidermal renewal time of

60 to 76 days.

3.5 Maturing Skin


One aspect of ageing is its effect on our skin. We can break down the components of ageing into two

categories: Intrinsic and Extrinsic.

Extrinsic or Environmental

In order to understand the changes involved in ageing skin, we must first understand the skin‟s

normal anatomy. The skin has three layers. The lowest layer is composed of subcutaneous fat, next,

the dermis, which is composed mainly of the ground substance (Fibroblasts, collagen, elastin, nerves

and vessels). The epidermis is the most superficial layer and is composed of a living portion made up

of Basale cells, Keratinocytes, Melanocytes, Langerhans cells, (cells vital to the skin‟s immune

function) and finally the Corneocyte or dead layer on the top.

The anatomy of ageing would be as follows:

Grossly the skin becomes dryer, rougher thinner with the appearance of pigmentation marks in sun

exposed areas. Microscopically there is no decrease in the number of Corneocytes; however, the

individual cells begin to look large and irregular. The Keratinocytes show a decrease in the number of

layers of these cells, and each cell tends to be shorter and broader.

The Melanocytes decrease in their density from 10% to 20% per decade. During exposure to sunlight

they produce melanin, although in a blotchy pattern. This answers the question why old skin tans

unevenly. The Fibroblasts, which are responsible for the production of collagen and elastin, increase

in size as we age while their functional activity decreases. The content of dermal collagen, the most

important component, decreases by 1% per year after the age of 20. The collagen fibres also become

thicker and more brittle with age due to an increase in the cross linkage.

Elastin fibres decrease and fragment with age. There is a definite decrease in the blood vessels and

blood supply. The number of pressure and touch sensors decrease, making older skins more

susceptible to thermal and mechanical injury. The amount of fat decreases and overall the skin is

thinner and more susceptible to various conditions such as dryness, infection, and skin cancer.

In addition to the intrinsic or natural ageing process, the effects of the extrinsic factors such as

sunlight are responsible for many of the cosmetic problems associated with ageing such as age

spots, pigmentation and wrinkles. Many factors influence cellular regeneration and desquamation.

Dermal growth factors, hormones and vitamins A and D, can influence epidermal cellular turnover. In

addition age general health, and genetics influence cellular proliferation i.e. (repeated and rapid

reproduction of new cell division). Generally, young skin regenerates more rapidly.


3.6 Environmental Factors (Over-exposure to the sun)

When skin exposed to excessive sunlight, a natural response of the Stratum Corneum is to become

thicker to protect the sub layers of the skin. This may result in slower shedding producing thickened,

dry, and rough skin. Abnormal cell division is also seen in hyper-keratotic disorders, e.g. overgrowth

of the Stratum Corneum. Excessively dry rough skin is a condition that affects many people and

appears to be the result of abnormal desquamation. Over exposure to ultra violet rays can seriously

damage our skin. It has been fashionable over the last 50 years to acquire a tan. In addition there

appears to have been vast changes in the ozone layer which has added to the problems caused by

sun to the younger generation.

It is easy to recognise the additional signs of sun damage added to the normal process of ageing.

Darker skin races manage to look younger at the age of 50 that their paler skinned equivalents due to

the increased amount of melanin produced offering more protection. UV light affects the epidermal

cells, which are constantly dividing and replacing themselves. Eventually this process breaks down

and rough areas develop (Keratoses) which can develop into skin cancer. The same UV light causes

changes in the melanocytes, which produce the pigment and irregular brown patches like large

freckles appear. They are sometimes called liver spots but have nothing to do with liver disease.

These brown marks may develop in relatively dark skins that are not particularly prone to the

development of skin cancer. The UV light can penetrate into the dermis where the collagen and

elastic tissue give the skin its strength and flexibility.

Damage to these structures causes increased wrinkling and the thickened yellow appearance known

as elastosis, often seen in people who work outdoors, on the nape of the neck. Often small blood

vessels become conspicuous, especially on the cheeks, a problem known as telangiectasia. The loss

of elasticity also exaggerates the bruising effect that may occur after prolonged sun exposure.

This condition used to be called senile purpura but may be seen in sun-damaged skin at the age of

40. In severely damaged skin with marked elastosis, senile comedones (blackheads) may develop.

They have no connection whatsoever with acne but are extremely unattractive. UVB can also

penetrate the underlying dermis causing considerable deterioration to the collagen and elastin. This

causes wrinkling and a leathery appearance of the skin.

3.7 When to use a sunscreen


It is impossible to anticipate when one will be exposed to the sun; therefore sunscreen should be

applied daily. Furthermore, just because it is cloudy in the morning, there is no guarantee that the

sun will not be strong by mid-day. On holiday, or when playing sport, sunscreens are most effective

when applied to cool, dry skin. It is therefore sensible to apply 20 to 30 minutes before going into the

sun.

3.8 The Melanin Unit

Melanin helps protect the skin from ultra violet light. From the medical point of view we all produce the

same number of pigment producing cells (melanocytes) per square centimetres of skin. However,

those with darker skin produce a different or increased amount of melanin (pigment) that those with

light skin hence the reason darker skin will survive sun-damage much better than fair skin with less

risk of developing skin cancer.

The colour of the skin depends not on the amount of pigment cells but the type of pigment that we

individually produce. Our parents genetically determine the type of melanin produced. Melanin is

produced in the deepest part of the epidermis. Melanocytes make pigment, which remains in the

epidermis and is gradually shed, being replaced by new pigment from deeper in the epidermis. Injury

to the skin can disrupt the normal pattern - e.g. dark marks that remain on the skin after acne has

cleared. The resulting dark marks are known as post inflammatory hyper pigmentation. Some rashes

such as eczema will have the opposite effect causing paler skin (hypo-pigmentation). Any rash or

trauma to the skin allows the melanin to drop to the dermis, the natural clearing mechanism is

disturbed in the affected area, and the skins own natural scavengers will slowly remove the unwanted

pigment.

3.9 Hyper-Pigmentation and the Cause

There are many reasons why hyper-pigmentation (Melasma) can occur. Most obvious causes are the

oral use of birth control pills or hormone replacement therapy, pregnancy, or interaction with certain

medications. Repeated sun exposure or over exposure also plays a part as does inflammation or

trauma caused to the skin. Certain chemicals found in perfumes etc. can also result in pigmentation

marks occurring. Regular Diamond Peel Dermabrasion treatment will show significant benefits to

sun-damaged skin and help remove unwanted pigmentation marks.

A course of Skin Smoothie treatments can achieve beneficial results in the treatment of pigmentation

marks. The treatment is an ideal choice as it allows a gentle approach in treating all skin colours.

Regular treatment can help the ill functioning epidermis to become better organised and thicker with

the horny layer on the surface to be produced in a more regular way. Regular treatment using low


vacuum suction will help the pigment move through the epidermis and be shed normally. Clients

should be advised that a course of between 10 and 15 treatments might be needed. It is also

imperative that the client be advised to wear a sun-block at all times.

3.10 Skin Disorders

This is a specific disease involving the melanocytes which simply stop producing pigment in certain

areas. It can remain localised or spread relentlessly. It affects about 1% of the population irrespective

of skin colour. It presents itself as pure white patches; the melanocytes in the affected area stop

producing any pigment. (Treatment with Pixi Peel can not help this condition). Melasma, Chloasma

This is a darkening of the skin, which is usually symmetrical, and like a mask. Often occurring in

woman who are pregnant or as a result of the contraceptive pill, this can be referred as „Pregnancy

Mask‟. The condition is made worse by sun exposure and will normally remain on the skin for many

months after delivery or stopping the pill. The melanin has dropped to the dermal layer.

Treatment with Pixi Peel Diamond Peel Dermabrasion will help the trapped pigment move through the

epidermal layers to be shed in its normal organised way. However, many treatments may be needed

to improve the area affected. Pityriasis Versicolour (Tinea Versicolour) This is a condition common in hot

countries, and is characterised by areas of increased or decreased discoloration. The most common

areas affected are the front and back of the upper trunk, though this may spread to the back and

upper arms in some cases.

The condition is caused by a small yeast infection, which grows on every body‟s skin, often more

common in hotter climates. It presents itself as small, slightly scaly patches; their colour is variable,

ranging from white to pink to an orange colour. When conditions are favourable it changes its form of

growth and the rash appears. A prime condition for this is sweating and most common cases occur in

people who live in a sunny climate. The condition is often noticed after a holiday in a sunny climate

partly because the infected areas are exposed and do not produce a suntan. The infection can be

successfully treated by a dermatologist. The yeast clears quickly after the application of selenium

shampoo, although normal pigmentation does not return for many months. Due to the problem being

caused by a yeast infection, treatment with Pixi Peel micro-epidermal skin abrasion would not be of

any benefit.

Inflammatory Disorders


Chronic Eczema is often confused with psoriasis as it shows a thickening of epidermis. Acute forms

exhibit tiny clusters of blisters that ooze fluid and then form crusts. It is a contra-indication to DP.

Psoriasis lesions do not itch like eczema and they are scaly silver plaques that cover reddened areas.

DP is a contra-indication.

Degrees of Acne

Acne Grade 1:

Consists of open pores, comedones, white heads and black heads.

Acne Grade 2:

Normally no inflamed. Both grades of acne are perfect for treatment with DP as regular treatment will

help remove the bond holding together and excessive build-up of dead cells, removing blockages and

cleansing pores, thus allowing the skin to rid itself of excessive oils naturally. Regular exfoliation with

DP will show significant results by reducing the cornocytes that are a contributing factor to the

development of comedones, blackheads and white heads. The reduction of excess cornecytes also

refines the thick, rough texture associated with oily skin. Regular exfoliation can substantially reduce

surface sebum.

Acne Grade 3:

(Active acne) exhibits a mixture of closed and open comedones, with papules and pustules. This type

of acne also responds well to DP but the client should be advised to use topical treatments or tropical

prescriptions products to help clear the inflammation and pustules.

Acne Grade 4:

This stage the acne is at its most disfigured. The extent of the active inflammation and pustules

normally result in the development of acne scarring. The skin becomes tender to touch. This type of

acne needs careful attention and a more intensive treatment programme incorporating topical

medication, peeling solutions and bleaching agents to stop pigmentation problems occurring. DP

should only be used over the areas that do not display active pustules in order to prevent spreading

the infection to non-infected areas.

Hypertrophic Scars

Hypertrophic scars are visible as a raised lumpy area over the site of injury. They form when there is

an excess of repaired dermis which causes a protrusion in the epidermis. Micro-epidermal skin

abrasion gradually erases the lumpy appearance and files the area down whilst blending surrounding

skin to make the scar less noticeable and unsightly.

How Stretch Marks are caused:


The skin layers involved with stretch marks are the epidermis superficial layer, which is continually

regenerating, and the dermis, the under lying layer, which amongst others, has the function of

nourishing the thin basal layer at its highest borderline where the skin cells are continually produced.

The dermal has a wavy surface. After rapid weight gain or pregnancy these waves are ironed out- in

some places they are flattened, consequently the epidermis above it drops and becomes thinner as it

has to cover a larger area. This produces variations in the region of a fraction of a millimetre but

sufficient for the stretch mark to appear. The stretch marks appear when the dermis is lacerated and

therefore becomes thin. DP will not remove the stretch mark. However, regular treatment will show an

improvement to the treated area making the marks less obvious. Scar tissue should not be treated

until inflammation has disappeared from the area. Regular treatment with DP will help improve the

appearance of the stretch mark by creating a blending effect to the surrounding scar tissue, also

reducing any pigmentation problems that often making the stretch mark more noticeable.

3.11 Diamond Peel Dermabrasion: Pre-surgery and post surgery

DP offers an excellent tool for management of pre and post surgical treatments such as face-lifts and

laser treatments. It is recommended the client undergoing such treatments has a series of DP

treatments prior to surgery as treatment will prepare the skin helping stimulate fibroblasts needed for

new collagen regeneration. Using pre post surgery, or laser, resurfacing will enhance the results and

help manage the possible pigment changes normally observed after such treatments.

The ideal plan would be 4 treatments prior to surgery or laser and 6 treatments post surgery. DP used

as a once monthly maintenance treatment will also help prolong the results of such treatments and

keep the skin in tip top condition.

3.12 Diamond Peel and Micro-pigmentation

One treatment prior to the topical application of anaesthetic will remove the dead skin cells enabling

the anaesthetic to penetrate better but also allowing the therapist to see a more precise final

placement of the pigment and saturation often limiting the need for additional visits. Once the healing

time is complete DP can be used over the treated areas without worry of removing pigment. Provided,

of course, that the pigment has been placed properly and is sited in the upper dermis.


3.13 Diamond Peel and Collagen replacement therapy

Diamond Peel Dermabrasion is perfect used prior to collagen replacement therapy injections as it

helps prepare the area for treatment. First, by removing the dead skin cells you enable for topical

anaesthetic to penetrate deeper thus having a better numbing effect, secondly, DP prepares the area

for implantation. DP should not be used post collagen injection for at least one month after injection.

The reason being that collagen can be manipulated for up to 48 hours after injection. However, if the

client experiences lumpiness at the site of injections 2 weeks after treatment a very gentle treatment

with Diamond Peel Dermabrasion will help to smooth the area.

3.14 Diamond Peel and Topical Actives

Quite often there is a lack of understanding the products that can be applied to the skin immediately

after treatment. Also, a lack of understanding on how important it is to prescribe the correct skin care

products for the client to use at home. This understanding is imperative if the client is to protect and

enhance the results of treatment.

4.1 Products After Treatment

The skin is receptive after treatment. No AHA's, No Glycolic, No UVA Treatments. The skin is exceptionally

receptive to any products applied directly after treatment. Therapists should check the pH of any

product they are going to use; a low acidic pH will cause irritation and stinging as would a product with

high alkaline content, where as a product with a pH level of between 4.5 and 7 are suitable. Skin care

products that contain a high percentage of botanicals are essential oils are unsuitable for use after DP

as some of the ingredients contained may cause an allergy. Should this occur, there is a real danger

of both the therapist and client thinking that it is treatment they are allergic to, where as it is actually

the ingredients within the skin care preparations. It is important that products are used that replace or

add moisture back to the skin so as to stop the skin becoming dry and peeling. Tropical nutrients,

anti-oxidants and hydrating moisturisers and skin brightening products not only contains skin

brightening actives but also Titanuim Dioxide and Zinc, which offer excellent SPF Factor and is

suitable for a sensitive skin.


4.2 Home Care

Ensure you retail a range of products that enhance and compliment the benefits of your professional

treatment whilst ensuring your clients‟ skin is cared for 365 days of the year.

5.1 Client Consultation

A full and detailed explanation and evaluation of; what the treatment is and what results the client can

expect to achieve over a course of treatment. It is also important to explain to the client how the skin

will react during the course of treatment and to explain what settings you will be incorporating.

For example; if a client needs a more aggressive treatment plan treat sun-damaged skin or acne

scarring it is important that the first treatment be performed using a low pressure setting and

performing a very light exfoliation.

The therapist should try to understand the client‟s skin and how it reacts before becoming too

adventurous. Quite often therapists want to impress the client so much on their first treatment that

they apply too much pressure and work too aggressively. This results in the client‟s skin actually

becoming sensitive and, if the skin has been dragged and too much pressure applied, red stripes can

be evident. This is due to the therapist being too ambitious and not understanding the client‟s skin.

It is always advisable to keep the treatment light during the first treatment and then slowly progress to

a more aggressive treatment as the course progresses, this ensures the client‟s skin becomes used

to the treatment and the client will also understand what is happening. A client that goes home with

red stripes or red, sensitive skin will be a very unhappy client and will probably cancel the course of

treatment because the therapist has failed to explain or perform the treatment properly.

5.2 Client Commitment

The therapist should ask the client how committed they are to achieving results. For example; are

they committed enough to follow the rules provided by the therapist in respect of protecting their skin

and using the correct skin care products in between salon visits. The therapist must ensure the client

thoroughly understands the importance of using the correct skin care products in her home regime in

between treatments.


5.3 Contra Indications

Diamond Peel Dermabrasion is normally not advisable where any of the following conditions exist:

Active or uncontrolled Diabetes

Raised Moles, Warts, Skin Tags

Skin Cancer & Auto immune diseases

Eczema & Seborreic Dermatitis

Telangiectasia

Rosecea & Active Acne

Herpes Simplex

Asthma, Keloid Scars

Herpes Simplex

Clients with a tendency to outbreaks of herpes simplex should obtain a prescription for Zovirax.

The medication should be used 2 days prior to treatment and 3 days post treatment.

Diabetes

The healing response is impaired if the condition is not under control; therefore, DP is not suitable

for clients who have this condition. If the diabetes is under control a doctor‟s note should be

received before you commence treatment.

Accutane for the Treatment of Severe Active Acne

Treatment should not commence for 6 months after discontinuing medication. A doctor‟s letter

allowing treatment to commence should always be sought prior to a treatment course even after 6

months of discontinuation of the drug. AHA and Retin A should be discontinued 7 days prior to

treatment and not resumed until the treatment programme is complete.

5.4 Complete Client Medical Record Card

Include client details on the record card and record areas of concern. This will ensure special

attention is drawn to their specific needs. Their progress made should be visible at each treatment

and results evaluated and documented on the client record card. Explain Contra-indications of

treatment and ask the client to sign the record card after each treatment.

5.5 Sensitivity Skin Test

It is most unusual for a client to be sensitive to the diamond heads employed; however, a skin test

should be performed on the back of the forearm. If the area becomes irritable or swollen do not

proceed with treatment. If the client develops red marks on the skin after treatment it is normally due

to the therapist applying too much pressure.


5.6 After Care Rules & Product Explanation

Clients should be advised as to the adverse effects of ultra violet radiation; extremes of temperature,

the wind, effects of central heating and skin care abuse. Encourage the client to adopt a regular skin

care routine incorporating cleansing, toning, moisturising and applying sun protection products.

Advise on the use of SPF factor 30 to be used daily. Treatment can be repeated at intervals of seven

to ten days. A course of 15 to 20 treatments should be recommended for more problematic skin such

as scar tissue, lines, wrinkles and stretch marks.

Treatment

The Treatment

The client should be explained the treatment in full detail. For example; Pixi Peel Diamond Peel

Dermabrasion offers the prospect of superficial peeling by exfoliating the uppermost layers of the

Stratum Corneum. The controlled diamond head allows the operator to address various defects in the

surface of the client‟s skin including uneven texture, hyper-pigmentation, fine lines and wrinkles, sun

damaged skin, and the blending of scar tissue. The client will experience an instantly revived, more

glowing complexion, even after the very first treatment.

The vacuum action aids lymphatic drainage and allows a lifting effect caused by massaging the

muscles in the face. The most common complaint from a client would be a lack of explanation

regarding what result they can expect. Some clients are told that treatment will totally eradicate deep

lines and wrinkles.

As we all know this is not possible as we are working only in the superficial epidermis. However,

regular treatment will make the lines softer and the general improvement in skin texture will provide

an overall rejuvenated skin. It is therefore important to establish what the client hopes to achieve from

the treatment programme.

See a Difference after the First Treatment

Most clients will see and feel a difference after the first treatment. However, for optimum results, a

course of at least 5 to 10 treatments should be recommended. Explain the benefits of monthly

maintenance treatments to keep the skin in tip top condition.


6.1 Treatment Protocol

• Ask the client to remove contact lenses.

• Cleanse the skin with cleansing gel.

• Ensure the client‟s hair is away from the face.

• The skin must be completely dry before commencing treatment. The therapist should wear gloves.

• Insert a clean filter for your client.

• Attach a sterilised diamond head to your hand piece.

• Select the correct treatment level on your machine.

6.2 Treatment Levels

We advise newly trained therapists to use low vacuum suction until they are fully confident in the

lightness of the strokes. Once the therapist is confident in the use of the Pixi Peel skin system, a

higher vacuum can be utilised. During treatment the skin should be held taught. The hand-piece

should be gently and quickly glided across the skin without using unnecessary pressure.

6.3 Treatment application and Correct Pressure Level

Treatment Level 1 allows a skin smoothie exfoliation revealing fresher, smoother, and healthier

looking skin. Regular treatment provides substantial cosmetic benefits reducing fine lines and

wrinkles, allowing skin re-texturisation, improved skin tone and clarity, lightening of skin

discoloration‟s, reducing pigmentation marks and improving the radiance and overall tonicity of the

skin. Perfect for the management of acne prone skin. Level 2 & 3 can be selected when working on

acne scars or more thickened skin. Level 1 should be used for treating Asian and darker skin tones


6.4 Facial Diagram Demonstrating Stroking Directions


6.5 To Commence Treatment

• Position the client semi-reclining.

• Stretch the skin with the thumb and middle finger holding the hand piece with the diamond head

attached. Place the head into position on the skin. Starting on the forehead at the centre, place the

head into position on the skin.

• Hold the hand -piece as if it were a pen; gently move in a sweeping action across the forehead

towards the temple area covering the entire facial area.

• On treating the cheekbone use very light quick strokes as this area is rather sensitive.

• Perform a gentle exfoliation to the entire facial area and neck area. On completion of a gentle

exfoliation you can return to the areas that need further attention such as thickened skin, pigmentation

marks, acne scarring etc. The secret of a treatments success lies in the pressure of the strokes used.

Light quick strokes should be used for a skin smoothie treatment, slower strokes to concentrate on

problem areas.

6.6 Face Treatments

Treatment of the delicate area of the neck

Level 1. Make contact with the skin; run the head gently and quickly from under the chin to the

collarbone using overlapping strokes to ensure even abrasion.

Treatment of the delicate skin directly under the eye

Level 1. Holding the skin taught place the head into the corner area, pass over the area once using a

light, quick stroke outwards.

Diamond Heads

B- 100 Ideal for Face



E- 200 Ideal for Face

F- 200 Ideal for Eyes, Chin

D- 180 Ideal for Body

D- 200 Ideal for Body

T- 100 Ideal for Body

T- 180 Ideal for Body

Indications for Treatment Level 2 & 3 are suitable for Acne scarring, Lines and wrinkles, Stretch

marks, Scar tissue, Sun-damaged skin, Cellulite treatments and body exfoliation.


Perform a level 1 or level 2 treatment dependent on your client‟s skin sensitivity or if the client needs a

more aggressive treatment. Perform a light exfoliation over the entire area to ensure an even

exfoliation.

Return to areas of concern utilising slightly more pressure and using a slower hand movement.

For Treatment of Lines, Wrinkles, Acne Scarring Stretch Marks, Scar Tissue, Frown Lines etc:

Level 2 or 3. Stretch the skin with the thumb and middle finger. Place the facial head into position.

The head should be run quickly and without stopping length ways along the mark until initial

hyperaemia can be seen. Change direction, working across the path originally traced to stimulate the

surrounding skin. Finish with a circular movement to even the total abrasion. To create deeper

exfoliation on a problem area, allow the diamond head to pass slowly over the skin without exerting

too much pressure.

Telangiectasia

Level 1. Areas exhibiting minor telangectasias should be treated gently performing light quick strokes

over the area.

Completion of treatment, use the calming lotion with the masks.


6.7 Jaw Line Lift to go in here put down picture 6.7

- Position diamond head onto Jaw Line and hold the skin taut with index finger as shown. - Hold for 2 seconds.* - The index finger should be lifting the skin upwards while the diamond head is pushing into the Jaw Line area.


6.8 Cheek Muscles Lift

- Position the diamond head so that it is pushing upwards and under the cheek muscles. - Position the index finger so that it is supporting the top part of the muscle and hold for 2 seconds.* - Work along the cheek muscles in an up and out pattern. - NOTE: * Depending on the sensitivity of the clients‟ skin, this process may be repeated 3 or 4 times.


6.9 Brow and Forehead Lift

- Position the diamond head into position under eyebrow muscle. - Push up and secure skin with the index finger approx. 1 inch (2 cms) above the diamond head. -Pushing upwards at all times continue motion to a count of 2 seconds.* - Work up the forehead following the same pattern. - NOTE:* Depending on them sensitivity of the client‟s skin this process may be repeated 3 or 4 times.


6.10 Treatment for Acne-Prone Skin

Acne is an inflammatory eruption that occurs in and around the sebaceous glands of the face, neck

and back, caused by overactive sebaceous glands, hormonal activity and pore blockage. With acne

prone skin, dead cells build up around the hair follicles and interfere with natural drainage of oil,

causing the hair follicle to clog and fill. The resulting blockage can lead to several problems including

Comedones and congestion.

Even women in their thirties are being affected by different forms of acne often caused by stress

related problems or poor nutrition. It is important that the therapist educates the client in controlling

these outbreaks and advises on the correct skin care products or prescription medicines. It is

important before treating with DP that active acne is brought under control.

6.11 Treatment for Acne and Post-Operative Scarring

Depressed acne scarring, with acne scarring, a small portion in the deep germinative layer is

damaged, leaving it full of fibrous scar tissue. The scar is depressed, as healthy tissue destruction is

more in-depth. Using controlled micro-epidermal skin abrasion creates a precise action to be

performed only on the scar without affecting the healthy skin; it is possible over a period of time to

perform a blending effect of the surrounding scar tissue.

Ice pick type acne scars will not be improved by the use of DP. However, regular treatment will result

in an overall improvement in the quality of the skin.

The Method allows Two Actions:

First, abrasion of the superficial thickened scar tissue to the required depth greatly improves the

general appearance. Secondly, the vacuum action stimulates increased blood flow to the dermis,

aiding in tissue repair and correct cell renewal regeneration.


6.12 Body Treatment


6.13 Indications for Body Exfoliation in Preparation for SprayTanning Treatment

• To encourage the micro-circulation

• Improvement of skin tone

• Removal of hard skin

Note: As most spray tans contain alcohol you may find it is best to offer the body exfoliation 24 hours

prior to your spray tan.

6.14 Body Exfoliation: Application

• Cleanse the areas to be treated

• Allow high vacuum suction

• Follow the diagram illustration

• Attach the body diamond head

Lay the client on her back and starting at the feet, run the nozzle in a controlled and rhythmical

movement using long strokes working towards the heart. Move your hand slower and with more

pressure over the entire area. Continue up to the arms and then onto the abdomen and décolleté.

On completion wipe over with damp mitts and apply moisturiser to hydrate the skin.

Ask the client to lie on her front and repeat the process.

Body exfoliation can also be used for certain problem areas on the body; for example the backs of

arms or the shoulders etc.

6.15 Cellulite

Cellulite is a fatty tissue that accumulates in certain areas. It is often very difficult to remove and tends

to be resilient to diet and exercise. The whole area is characterised by inactivity, sluggishness and

stagnation. Lymphatic drainage is poor and blood circulation is limited. Toxic waste products and

water surround the tissues decreasing oxygen and nutrients to the cells thus slowing down the rate of

cellular regeneration. The skin tone is poor and the skin looks dull and sluggish.

Diamond Peel Dermabrasion makes the perfect choice for cellulite problems as the vacuum action

created during treatment will create a detoxifying draining effect reducing puffy swollen tissues and

improve the micro-circulation. A deep exfoliation treatment will refine the texture of the skin. The

vacuum action will also help create a lifting effect to the skin. Body exfoliation is perfect prior to other

body treatments as it allow the skin to be more receptive to the active ingredients utilised these

treatments

Documents

Microdermabrasion (MDA) Manual