Ocspa

LNE & Spathe magazine for skin care and spa professionals

October 2011

$7.50

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G AN IC

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Say you saw it in LNE & Spa and circle #157 on reader service card

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CONTENTSSpots Be Gone!winning the war against hyperpigmentation page 46

&OCTOBER 2011 V OL U ME 26

spa

N U M B ER 1 0

Autumn Body Essentialsscrubs, blends and moisturizers page 66

skin

No Longer Stuck in the Mud A Balancing Act Fall Into Brightening Electrotherapy Melasma Spots Be Gone! Frosting Versus Blanching Understanding and Correcting Sun Damage Skin News

31 32 35 38 43 46 51 54 59

spaMeridian Magic Spa News

Create a Luxurious, Impeccable Lavatory Autumn Body Essentials

65 66 72 77

Heat Up Your Fall Menuwithout burning a hole in your budget page 90

green spaPure, Clean Water Sabai Wellness Center Autumn Delights Green Spa News

103 104 107 109

business

Autumn Delightstop 10 beauty foods of fall page 107

Quality Customer Service: The Key To Online Success 81 Q&A With Joanna Vargas 82 Turn Over A New Leaf 86 Heat Up Your Fall Menu 90 Avoiding Employee Termination Layering Technology Biz News

93 96 99

extras

Face It!page 117

image

Eyelash Hygiene Safety Fall Makeup Trends Face It! Age Is Just A Number Image News

113 115 117 119 121

From the Editor 6 Spa of the Month: Studio 55 Day Spa & Salon, Laredo, TX 10 Preview: The International Congress of Esthetics and Spa, Philadelphia, PA 23 Calendar of Events 124 Advertisers Index 130

Cover

courtesy of Franck Provost

Les Nouvelles Esthtiques & Spa, American Edition, (USPS 003-687) (ISSN 1043-9641) is published monthly, 12 times per year and is sold exclusively by subscription. Publishers Name: Jean Jacques Legrand, M.D., 3929 Ponce De Leon Blvd., Coral Gables, FL, 33134. Periodical postage paid at Miami, Florida, with additional mailing offices. Postmaster: Send address changes to: Les Nouvelles Esthtiques & Spa, American Edition, 3929 Ponce De Leon Blvd., Coral Gables, Florida 33134, United States Subscription: Annual Rate $45.00 Canada Subscription: $55.00 (American) 1st Class Postage Overseas Subscription: Two years for $140.00 (U.S.) Air Mail Postage

Page 4 www.LNEONLINE.com

Les Nouvelles Esthtiques & Spa October 2011


Natural antioxidants and pore refinement.pumpkin extracts carrot extracts glycolic acid

Beautiful Results with Pumpkin

from the

editorIT IS ALWAYS IMPORTANT TO KEEP UP WITH the latest research and information that affects your business. LNE & Spa brings you closer to everything thats happening right now in the spa and skin care industry. Strategies, techniques and treatments that target hyperpigmentation and antiaging services are the focus of Octobers issue. By offering results-oriented treatments, your practice will grow and business will thrive! Veteran and industry expert Mario Montalvo recently had the opportunity to meet and interview the powerhouse couple behind the unique Studio 55 in Laredo, TX. A key component of the establishments longevity and success is the owners attention to the smallest detailsand making sure they exceed client expectations! Learn more about our October Spa of the Month starting on page 10. With the seasonal weather changes of the fall, you may want to offer signature and custom body treatments. Marcia Fialdini shares some great recipe ideas in her article Autumn Body Essentials, starting on page 66. Keith West-Harrison tells you how you can Heat Up Your Fall Menu (without burning a hole in your budget) on page 90. On a closing note, make sure you take the time to invest in yourself this fall by attending The International Congress of Esthetics and Spa in the beautiful and historic Philadelphia, PA on October 23 and 24. The expertise to be shared by the keynote speakers at the General Session and specialized seminars is not to be missed! There will be opportunities to network with other professionals and exciting new vendorsand check out the latest products and equipment to update your business and services. The final International Congress of Esthetics and Spa conference of 2011 is a great place to re-ignite your passion for our industry! Have a fantastic month and enjoy the changes and colors of fall! n

advanced Rejuvenating concepts

Warm the senses and relax the mind with AdvAnCed RejuvenAting ConCepts pumpkin fACiAl treatment. A must-have service for the fall season. the renowned pumpkin peel ContAins A 30% glyColiC ACid With RejuvenAting pumpkin Wine And fRuit enzymes for a naturally oxygenating peel treatment. this acid-enzyme blend promotes improved skin tone and texture for most all skin types, including sensitive skin. Anti-inflAmmAtoRy And AntioxidAnt benefits from pumpkins can be achieved at home with the natural fRuitzyme pumpkin system. pumpkin and carrot extracts are complimented with centella, willowherb, chamomile and moRe foR A Result-oRiented Regimen. discover the science of skin rejuvenation! arcskincare.com | toll Free: 800 689-0499

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Denise R. Fuller, [email protected]




Say you saw it in LNE & Spa and circle #206

3929 PONCE DE LEON BLVD. CORAL GABLES, FLORIDA 33134 800.471.0229 (USA) 305.443.2322 Worldwide fax 305.443.1664 www.lneonline.com e-mail: [email protected] [email protected] Publisher Dr. Jean Jacques Legrand Chief Executive Officer Rodolphe Legrand [email protected] Editor in Chief Denise R. Fuller [email protected] Art Director Sacha Smith [email protected] Assistant Editor Amanda Clinton Winter [email protected] Director of Sales Danni Boucher [email protected] Marketing Director Christle de La Haye [email protected] Conference Coordinator Laura G. Bazo [email protected] Exhibitor Operations Assistant Mayli Bueno [email protected] International Editor Michele de Lattre-Pierantoni 7 Avenue Stephane-Mallarme, 75017 Paris, France - 43 80 06 47 ADVISORY BOARD Mark Lees, Ph.D. Lydia Sarfati Rob Trow Lake Louise Nina Curtis Diane Buccola

work smarternot harder.

ContributorsSamuella Becker Linda Bertaut Ann Brown Michelle DAllaird Marcia Fialdini Tammy Finch Gena Flores Karla Hirkaler Hannelore Leavy Brenda Linday Dan Lok Lake Louise Janel Luu Ellie Malmin Danae Markland Mario Montalvo Flynn Marie Pyykkonen Linda Rae Lydia Sarfati Barbara Schumann Judith Stanton Pam Stellema David Suzuki Sherry Taylor Keith West-Harrison Jennifer Wild, D.O. Noreen Young

Advance Hand Held Toolsbio-therapeutic.com 800.971.6259Say you saw it in LNE & Spa and circle #139 on reader service card

Printed with 100% soy-based ink. This magazine is recyclable. Please recycle where facilities exist.



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dermaquestinc.com or contact us at 800.213.8100 or [email protected] you saw it in LNE & Spa and circle #261 on reader service card

SPA

OF THE BORDER TOWN BEAUTY MONTH STUDIO 55 DAY SPA & SALON, LAREDO, TXby Mario Montalvo

T

HE WORD PIONEER HAS BECOME somewhat hackneyed, but in the case of Marisela and Robert Higgins, it is true to its meaning and eminently suitableespecially since they decided to open Studio 55 Day Spa & Salon in Laredo, TX. Laredo is a border town on the southernmost tip of the Lone Star State, across from Nuevo Laredo, Tamaulipas, Mexico. According to the 2010 census, the city population was 236,091, making it the second largest city on the TexasMexico border, and the third largest on the United States-Mexico border after San Diego, CA, and El Paso, TX.

SerendipityLaredo is a city that is perhaps more social than contemplative, so the opening of a day spa by the Higgins was serendipity at its best. In 1985, on a flight from Acapulco to Los Angeles, Marisela and Robert Higgins met each other for the first time. Since then, the pair has been inseparable. As a couple for more than 25 years, business partners, and parents to their daughter Alexa, they compliment each other. Marisela is the creative one, with bilingual skills and extensive knowledge of public relations in the banking industry, while Robert provides his vast business expericontinuesLes Nouvelles Esthtiques & Spa October 2011


spa of the month|studio 55 day spa & salon

ence garnered as the international vice president of Dennys for 26 years. They are the perfect yin and yang team. Their arrival in Laredo, which is not their original hometown, was the result of a business deal that Robert was working on that would take a year to finish. In the interim, Marisela wanted something to do, so her initial thought was to open a nail salon. Her vision expanded when she realized that Laredo had no day spa, though it would be a perfect location for one. She was looking for something innovative and unique to Laredo, so Marisela began researching the ins and outs of managing a day spa and salon. Initially, she spent an entire year completing courses in esthetics, massage therapy, hand and foot treatments and spa management, as well as visiting various spas throughout the country. In October 1998, Laredos first day spa opened its doors.

TransformationMeticulous attention had gone into the building and furnishing of Studio 55 Day Spa & Salon. It has also undergone three transformations. The initial 1,500 square feet has now grown to 4,500 square feet, all within a period of three years. Upon entering two double doors, clients immediately begin an intriguing journey of the senses. The reception area/boutique spans the length of the spa, and is carefully sectioned off with areas dedicated to skin, hair and body products, as well as candles, sachets, accessories, etc., all with price points to suit every taste and pocketbook. There is even an area dedicated to costume jewelry. This all provides the customer with a desire to linger, book another service or purchase whatever is recommended for continuing the spa experience at home. The area is inviting, not intimidating. continuesPage 12 www.LNEONLINE.com Les Nouvelles Esthtiques & Spa October 2011




Even though the salon offers nail and hair services, they are at opposite ends of the spa. Moreover, no services with offending odors are allowed. The entire atmosphere is geared to achieve perfect nirvana. Treatment rooms are aligned on the right and left sides of a corridor hallway brightened by soft lighting, with strategically situated scented candles and fresh flowers placed along the way. The changing rooms are also spacious, each with their own steam room, and well-appointed. Instead of the traditional lock and key, guests select their own password for their assigned locker.

There are also 11 types of body care services, including body wraps and peels, island hot stone wraps and an assortment of body scrubs.

The meticulous attention paid to hygiene and sanitation is immediately noticeable; it is well above the standards of a hospitals surgical room. Marisela ensures that the standard is met in each and every area of the spa, enforced by a three-person maintenance team. Facial rooms are spartan, with cutting-edge equipment and formulations and comfortable, hydraulic-controlled tables. There is no clutter or intrusive lighting.

Ample optionsThe menu of services is varied and extensive, addressing every area from head to toe. It reads like a provocative smorgasbord, which entices clients to experience the many others available after they try one service. The menu, which is updated on a regular basis, covers 10 styles of body massage, from reflexology to aromatherapy, to 20-minute neck and shoulder massages for time-pressed clients. In the near future, the spa will introduce a new massage service named A-Shiatsu, which entails the operator holding onto an overhead pole while rendering the treatment with their feet. There are also 11 types of body care services, including body wraps and peels, island hot continuesPage 16 www.LNEONLINE.com Les Nouvelles Esthtiques & Spa October 2011

Feel, Smell, and See the Difference!

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stone wraps and an assortment of body scrubs. The spa also offers laser cellulite reduction and Endermologie treatments for the entire body, or specially targeted for problem areas. In the area of facial care, the menu lists 14 different services ranging from dermabrasion, chemical and enzyme peels, aromatherapy and anti-aging. Two forms of oxygen therapy can also be included with any of the services, such as a Hyperbaric Oxygen Facial, which complements an enzyme treatment or microdermabrasion. Another unique feature is the spas Thermal M machine, a cocoon-like structure that provides all the benefits of a self-contained Vichy shower, steam, water massage, and helps to prep the client for a following treatment, or remove any residue of body wraps or scrubs. It provides hot and cool temperatures, which makes it ideal for a slimming or detoxifying treatment, or for use prior to any body treatment. In short, nothing is left to chance in Studio 55 Day Spa & Salon. There is also a downtime area for relaxation between treatments where clients can also enjoy their spa lunch. Quality control is maintained throughout all the services and targeted to ensure maximum client protection, at all times. The Hand and continues

BUSINESS BUZZSO HOW DO SPA OWNERS MARISELA AND ROBERT make their day spa successful in todays economic atmosphere? Check out their business secrets and theories: The spa industry is surviving the recession relatively well, with average declines of less than 10 percent below 2007 revenues. What the future holds for the spa industry depends on two factors: (1) economic recovery, especially in unemployment, and (2) the ability of spa owners to be creative in the management of the changing conditions in their own market areas. Due to the massive growth of the industry, we must use our ingenuity to develop ways to maintain and grow our share of the market. It is no longer a matter of appealing to elite women between the ages of 25 and 55. Our menus and marketing must be structured to attract men, teenagers, working women and ethnic groups, as well as those who make up our core business. Spa owners who want to get out of the doldrums need to start implementing programs to broaden their client base.

Given the slowness of the economic recovery, the short-term future of the spa business is more dependent on owner creativity than on general economic conditions. Even if you own an upscale spa, you must not consider your services as special treats. The days of pampering are long gone. Clients want visible results related to their health and wellbeing, and they want it at a reasonable price. Spa owners need to educate their clients on the therapeutic benefits of treatments and the value of managing and preventing stress. Spa services should be considered as a lifestyle habit rather than a special treat or something to be used only because you received a gift certificate. The future of the spa industry depends on people of all ages placing a value on maintaining good health. Fortunately this is a positive trend that we see improving with each generation. It is up to the spa owner to take advantage of this trend by providing the best possible service on a high professional level that is perceived by the client to be an equitable value and investment in their well-being.



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Foot care area is also removed from the treatment rooms and it offers 13 different services. The pedicure chairs are ample and comfortable, but again sanitation has been the focus, as each chair offers its own twist. The foot baths are each self-contained and are outfitted with individual filling and drainage; each with its own set of pipes underneath the chair.

Down to businessIt may appear that every stage of the spas development has evolved effortlessly, but to the contrary, Robert and Marisela faced formidable challenges, particularly in the area of staffing. However, they turned every challenge into an opportunity. Every new employee is tested for their level of expertise, gets acquainted with all the spa procedures, andwhen deemed necessaryis trained further locally or sent to specific classes in other cities. The owners goal has always been to maintain the highest standard of excellence in their area of expertise. This concept has paid off. The spa now does 1,900 services per month. At Studio 55 Day Spa & Salon, no particular service dominates the others. Also the quest to add new services that would suit the spas clientele never ends. Services are not chosen randomly or because something is popular. Careful deliberation is used before introducing a new procedure or phasing one out.

Making itIndependently and then eventually together, Marisela and Robert have navigated their way through becoming parents, professionals and successful entrepreneurs. This year, Marisela and Robert Higgins received the Junior Achievements 2011 Business Hall of Fame Laureates. They are living proof that anything is possible through hard work and perseverance. n Photography by Jacob Walters

Mario Montalvo is a consultant to the health and wellness industry. A licensed esthetics instructor, he has been active in beauty therapy for more than 35 years. He is a pioneer in esthetics and a CIDESCO Diplomate Dhonneur and International Examiner. He can be reached via email at [email protected] 20 www.LNEONLINE.com Les Nouvelles Esthtiques & Spa October 2011


Foot care area is also removed from the treatment rooms and it offers 13 different services. The pedicure chairs are ample and comfortable, but again sanitation has been the focus, as each chair offers its own twist. The foot baths are each self-contained and are outfitted with individual filling and drainage; each with its own set of pipes underneath the chair.

Down to businessIt may appear that every stage of the spas development has evolved effortlessly, but to the contrary, Robert and Marisela faced formidable challenges, particularly in the area of staffing. However, they turned every challenge into an opportunity. Every new employee is tested for their level of expertise, gets acquainted with all the spa procedures, andwhen deemed necessaryis trained further locally or sent to specific classes in other cities. The owners goal has always been to maintain the highest standard of excellence in their area of expertise. This concept has paid off. The spa now does 500 services per month. At Studio 55 Day Spa & Salon, no particular service dominates the others. Also the quest to add new services that would suit the spas clientele never ends. Services are not chosen randomly or because something is popular. Careful deliberation is used before introducing a new procedure or phasing one out.

Making itIndependently and then eventually together, Marisela and Robert have navigated their way through becoming parents, professionals and successful entrepreneurs. This year, Marisela and Robert Higgins received the Junior Achievements 2011 Business Hall of Fame Laureates. They are living proof that anything is possible through hard work and perseverance. n Photography by Jacob Walters

Mario Montalvo is a consultant to the health and wellness industry. A licensed esthetics instructor, he has been active in beauty therapy for more than 35 years. He is a pioneer in esthetics and a CIDESCO Diplomate Dhonneur and International Examiner. He can be reached via email at [email protected] 20 www.LNEONLINE.com Les Nouvelles Esthtiques & Spa October 2011


Say you saw it in LNE & Spa and circle #124

the international congress of esthetics and spa

R E G I S T R AT I ONALL-INCLUSIVE

2 - DAY ADMISSION

1 - DAY ADMISSIONSAVE WHEN YOU REGISTER by 09/30/11 2 - day admission is $75 after 09/30/11 1 - day admission is $50 after 09/30/11

60 $40$

Presented by:

Exhibit Hall (including the Wellness & Organic Pavilion) All General Session Lectures and Demos Green/Wellness Summit In-Depth Makeup Class Advanced Salon/Spa Business Seminar Salon/Spa Management Seminar Medical Esthetic Seminar National Aesthetics Spa Network-NASN NEW Aesthetic International Association-AIA All Manufacturers Workshops All Demonstration Stages Green Spa Network Village NEW Spa Buzz Networking Event NEW

PHILADELPHIA N S Y L VA N I AP E N N S Y L VA N I A C O N V E N T I O N C E N T E R

5

WAYS TO REGISTER:

INCLUSIVE! SEPARATE FEES

ALL NO

PHONE: 1.800.471.0229 / 1.305.443.2322 ONLINE: www.LNEONLINE.com E-MAIL: [email protected] FAX: 1.305.443.1664 MAIL: Aesthetic Expo 3929 Ponce De Leon Blvd. Coral Gables, FL 33134

PEN

October 23 & 24,2011

prograM preVieWSponsored by:

CONTACT US TODAY FOR YOUR FREE SHOW PROGRAM: WWW.LNEONLINE.COM 1.800.471.0229 / 1.305.443.2322Endorsed by:

Show hours: Sunday, October 23 from 9:00 a.m. to 6:00 p.m. Monday, October 24 from 9:00 a.m. to 5:00 p.m. Pennsylvania Convention Center 1101 Arch St. Philadelphia, PA 19107

hotel & traVel inforMationHOTEL RATES PER NIGHT

$128HAMPTON INNSuperior - Tourist Class

Single

Located across the street from the Convention Center

Rate includes deluxe continental breakfast

$128

Double

$138

Triple

$138

Quad

Standard Room

HILTON GARDEN INNFirst Class

$149 $169

Junior Suite

$149 $169

$159 $179

$169 $189

Located across the street from the Convention Center

NON-SMOKING HOTELDouble Triple

$169Superior First Class National Register of Historic Places

Single

COURTYARD by MARRIOTT

Located 1 block from the Convention Center

$169

$169

$169

Quad

NON-SMOKING HOTEL

PHILADELPHIA MARRIOTTDeluxe

$199

Single

Adjacent to the Convention Center

$199

Double

$219

Triple

$239

Quad

NON-SMOKING HOTEL

RESERVE YOUR HOTEL

Visit our website: www.LNEONLINE.com E-mail: [email protected] Tel: 305.443.2322 US: 1.800.471.0229 Fax: 1.305.443.1664

All rates are PER NIGHT Plus 14% room tax. Congress rates are subject to availability. CANCELLATION PENALTIES: $50 cancellation fee if reservations are cancelled after 10/7/2011. Full one night deposit if cancelled after 10/14/2011. Cancellation penalties are STRICTLY ENFORCED

AIRLINE RESERVATIONS & CAR RENTAL

To make your airline reservations at the best possible airfare or to rent a car you may contact Lissette Martin toll-free at 1.800.544.1222 ext. 258 or e-mail your request to [email protected].

GETTING TO PHILADELPHIA BY TRAIN

Taking a train is a fast, inexpensive and easy way to travel. Save on gas and parking fees for Convention Center and hotels. Amtrak Rail Service, for information call: 1.800.872.7245 or visit www.amtrak.com and refer to convention fare code X21H-930. Patco, for information call: 1.856.772.6900 or 1.215.922.4600 or visit www.ridepatco.org. Septa, for information call: 1.215.580.7800 or 1.215.580.4000 or visit www.septa.com.

AIRPORT SHUTTLE AND TAXICAB SERVICES

The shuttle fare from the airport to the city center is approx. $10 - Taxicab service is approx. $28. For more information please call 1.215.937.6958, or visit the Philadelphia airports website at www.phl.org.

The International Congress of Esthetics and Spa / Philadelphia 2011

GENERAL SESSION & SEMINARSSUNDAY, OCTOBER 23GENERAL SESSION Located inside the Exhibit Hall9:30 a.m. 9:45 a.m. 10:30 a.m. 11:00 a.m. 11:45 a.m. 12:15 p.m. Opening Ceremony by William Strunk Clinical Acne Treatment by Mark Lees, Ph.D., M.S. DEMO How Customers Think: A Window Into the Consumers Mind by Leon Alexander, Ph.D. LECTURE Sound Therapy Body Treatment With Tuning Forks by Ann Latocha DEMO The ABCs of A, C and E by Michael Q. Pugliese LECTURE Spiritual Makeup by Leslie Christin DEMODED INCLU WITH SION ADMIS

GREEN/WELLNESS SUMMIT Located in room 119A2:00 p.m. to 3:00 p.m. What Does it Mean to be a Sustainable Spa? (Panel discussion) Moderator: Peter Plishka- Natural Body Spa Panelists: Robert Sachs - Author of Health Secrets From the Roof of the World Dawn Tardif - BodiScience Holistic Spa Penny Ordway - Eviama Life Spa Building a Green Team: The First Step to Sustainability (Panel discussion) Moderator: Melanie Sachs - Certified Ayurvedic Life Counselor Panelists: Peter Plishka - The Natural Body Spa Dawn Tardif - BodiScience Holistic Spa Penny Ordway - Eviama Life Spa Make Your Message Resonate With Green Consumers (Lecture) By Peter PlishkaThe COA hasapproved these classes for 1 CE each

3:00 p.m. to 4:00 p.m.

4:00 p.m. to 4:45 p.m.

MEDICAL ESThETIC SEMINAR Located in room 119B2:00 p.m. to 3:00 p.m. 3:00 p.m. to 4:00 p.m. Medical Esthetics: What it Takes by Susanne Warfield Esthetic Equipment: Can I use it? by Susanne Warfield

SALON/SpA MANAGEMENT BUSINESS SEMINAR Located in room 119B4:00 p.m. to 5:00 p.m. Are You Wowing Your Clients? by Laura M. Cummins

NATIONAL AESThETIC SpA NETWORk (NASN) Round Tables located in room 121C3:30 p.m. to 5:00 p.m. Moderator: Denise R. Fuller IncreasingYourProfitsbyMaryTurner Cost-effectiveMarketingbyGenaFlores BecomeaHolisticPractitionerbyJulieStarr

AESThETIC INTERNATIONAL ASSOCIATION (AIA) Located in room 126A2:00 p.m. to 3:30 p.m. 4:00 p.m. to 5:30 p.m. Cellulite - Facts, Fiction and Results by Michelle DAllaird-Brenner Essential Oils and Common Skin Conditions by Rose Linkens

MONDAY, OCTOBER 24GENERAL SESSION Located inside the Exhibit Hall9:20 a.m. 9:30 a.m. 10:15a.m. 10:45 a.m. 11:30 a.m. 12:00 p.m. Opening Ceremony by William Strunk Netra Basti: Bathing the Eyes in Ghee by Melanie and Robert Sachs DEMO TheFengShuiofProfitableSpas:ApplyingAncientKnowledgeinthe21stCenturybyJudithWendellLECTURE Scrub Away Cellulite by Gena Flores DEMO Hyperpigmentation Causes and Remedies by Carl Thornfeldt, M.D. LECTURE Brow Sculpting for Men and Women by Deanna Netti-Cahill DEMO

DED INCLU WITH SION ADMIS

ADvANCED SALON/SpA BUSINESS SEMINAR Located in room 119A2:00 p.m. to 2:40 p.m. 2:40 p.m. to 3:20 p.m. 3:30 p.m. to 4:15 p.m.

Growing Your Business Using Social Media: The Next Level by Lake Louise Apps are Where its at! by Lake Louise Small Business Marketing Strategies That Attract Big Business Customers by Alexis Ufland

IN-DEpTh MAkEUp CLASS Located in room 119B4:00 p.m. to 5:00 p.m. 1:30 p.m. to 2:30 p.m. 2:30 p.m. to 3:30 p.m. 3:30 p.m. to 4:30 p.m.

Keys to a Successful Photo Shoot by Buntricia Bastian

ThE SpA BUzz Round Tables By Kristi Konieczny Located at the Spa Buzz Lounge inside the Exhibit HallSocial Currency | Successful Practices Best Practices | Lessons Learned Wellness | Implementing all Components Into Your Business and Life

AESThETIC INTERNATIONAL ASSOCIATION (AIA) Located in room 126B1:30 p.m. to 2:30 p.m. 3:00 p.m. to 4:30 p.m. The New Age of Networking by Mike Lewis, Internet Strategist Meet the Needs of Your Menopausal Clients by Trish Green


Workshops2:00 p.m. to 3:00 p.m.ROOM 115 A ROOM 115 B ROOM 115 C ROOM 116 ROOM 117 ROOM 118 A ROOM 118 B ROOM 118 C ROOM 121 A ROOM 121 B ROOM 121 C ROOM 122 A ROOM 122 B ROOM 123 ROOM 124 ROOM 125

s u n d a yoctoBer 23


MINENCE ORGANIC SkIN CARE Master the Hungarian Massage Techniques for the Instant Facelift (Hands on demonstration) By Boldijarre Koronczay MARk LEES SkIN CARE, INC. Redness & Wrinkles: What Every Esthetician Should Know By Mark Lees, Ph.D., M.S., CIDESCO Diplomat SAIAN NATURAL CLINICAL SkIN CARE Non-Surgical Face Lift, Neck Lift and Collagen Infusion Therapy Achieved Through Galvanic/ Microcurrent/Infrared Technology and Natural Clinical Peptide Products By Margarita Saian HYDROPEPTIDE Peptides, Stem Cells, Growth FactorsDont be Left Behind! By Diane Forsyth RHONDA ALLISON Learn the Secrets to a Perfect Body Peel By Rhonda Allison EvAS ESTHETICS Advanced Speed Wax Techniques With the Wax Queen Using Berodin Depilatory Wax By Lori Nestore BIO JOUvANCE, INC. Bio RollerMicro-needle Facial Therapy: How it Works and How Your Clients Benefit By Sonia Boghosian PCA SkIN A Deeper Look at Chemical Peeling By Erin Holder, LE SkIN FITNESS THERAPY Introducing the Newest Trends and Seasonal Changes ByJeannetteCosteiu OSMOSIS SkINCARE HumanStemCellsinSkinCareByBenJohnson,M.D. MLIS Holistic Slimming By Wallace Nelson BON vITAL, INC. Increase Profits by Incorporating Add-on Products By Bruce Baltz EDGE SYSTEMS CORPORATION Skin Health For Life - Revitalizing Your Esthetic Practice WithProven, Hands-on Marketing Tactics By Alan Reich NATURE PURE LABS SW, INC. Non-Surgical Instant Face and Neck Lift Procedure With Advanced Organic Bioactive Stem Cells and Micro-needling By Victoria Markman DERMAWARE BIO-TARGETED SkIN CARE CorrectivePeeling:FaceLiftJessnerPeel&ScienceByRobertM.Zone,Ph.D.andGl.Zone A NATURAL DIFFERENCE Like Nothing Else By Irene Stuckey

3:30 p.m. to 4:30 p.m.ROOM 115 A ROOM 115 B ROOM 115 C ROOM 116 ROOM 117 ROOM 118 A ROOM 118 B ROOM 118 C ROOM 121 A ROOM 121 B ROOM 122 A ROOM 122 B MINENCE ORGANIC SkIN CARE Newest Trends and Techniques in Natural Skin Care! (Hands on demonstration) By Boldijarre Koronczay MARk LEES SkIN CARE, INC. Making Extractions Easier: Causes and Treatment of Clogged Pores By Mark Lees, Ph.D., M.S., CIDESCO Diplomat SPAWARE SOFTWARE Using Social Media With Automated Marketing and the Easy Five-Step Selling Process By Blake Rector ROSE SkIN CARE PRODUCTS How to Treat Skin Tags, Cholesterol Deposits and Unwanted Growths (Demonstration) ByJohanneClement RHONDA ALLISON New Peel Innovations By Rhonda Allison EvAS ESTHETICS Color Blind Skin Analysis With an Overview of Evas Esthetics and Hydrophilic Cleansing Oils By Lori Nestore SESHA SkIN THERAPY Hyperpigmentation:Causes,EffectsandSolutionsByPhyllisHsieh vIvANT SkIN CARE Acne: Myths, Causes and Treatments By Mariamar Masso MARTINNI BEAUTY, INC. Learn How to Earn Big $$$ Removing All Types of Skin Growths By Lana Yu REMY LAURE - EUROPEAN BEAUTE Face and Body Mapping By Patty Leung BON vITAL, INC. Product Education and Body Mechanics By Bruce Baltz DELUxE FOR BUSINESS Get More Clients With Your Online Marketing By Ryan Christopher

deMonstration stages2:00 p.m. to 3:00 p.m.STAGE-A STAGE-B STAGE-C STAGE-D STAGE-D

s u n d a yoctoBer 23


PHYSIODERMIE (METHODE)/DERME.CA The Latest Knowledge on Sensitive Skin, Rosacea and Acne Rosacea By Michael Ibbott TOUCH BEAUTY, LLC Melanin Management: Facts, Myths and Techniques By Barbara Schumann NELLY DE vUYST/DERME.CA RejuvenatingAnti-AgingSolutionsCombinedWithRadiofrequencyTechnologiesByKarinaGeoffroy CIRCADIA BY DR. PUGLIESE Demystifying Stem Cell Ingredients By Peter T. Pugliese, M.D. EvE TAYLOR Skin Care for Men By Trish Green, CIDESCO Diplomat

3:30 p.m. to 4:30 p.m.STAGE-A STAGE-B STAGE-C STAGE D STAGE-E

PHYSIODERMIE (METHODE)/DERME.CA EffectiveSkinRejuvenationServiceforDamagedSkin(WithoutIPLorLasers)ByMichaelIbbott TOUCH BEAUTY, LLC Massage With Intention By Barbara Schumann NELLY DE vUYST/DERME.CA Rosacea,AcneRosacea,RednessandAgingByKarinaGeoffroy CIRCADIA BY DR. PUGLIESE The Truth About Oxygen and the Skin By Peter T. Pugliese, M.D. and Michael Q. Pugliese EvE TAYLOR Reflexology: Treatment of the Skin From the Inside Out (Live demonstration) By Trish Green, CIDESCO Diplomat


Workshops2:00 p.m. to 3:00 p.m.ROOM 115 A ROOM 115 B ROOM 115 C ROOM 116 ROOM 117 ROOM 118 A ROOM 118 B ROOM 118 C ROOM 121 A ROOM 121 B ROOM 121 C

M o n d a yoctoBer 24


MINENCE ORGANIC SkIN CARE Hungarian Secrets for Anti-Aging Massage Techniques (Advanced hands on demonstration) By Boldijarre Koronczay BON vITAL, INC. Increase Profits by Incorporating Add-on Products By Bruce Baltz SAIAN NATURAL CLINICAL SkIN CARE Non-Surgical Face Lift, Neck Lift, and Collagen Infusion Therapy Achieved Through Galvanic/ Microcurrent/Infrared Technology and Natural Clinical Peptide Products By Margarita Saian HYDROPEPTIDE MaximizeandGrowYourRetailSalesByAprilZangl

RAW MENS SkIN CARE RAW: How to Capture the Male Market By Rhonda Allison EvAS ESTHETICS Brazilian Bikini Waxing With the Wax Queen Using Berodin Depilatory Wax By Lori Nestore BIO JOUvANCE, INC. Pre-peel Skin Diagnosis Techniques and Proper Peel Selection By Sonia Boghosian PCA SkIN Treating Ethnic Skin With Confidence By Erin Holder MARTINNI BEAUTY, INC. Learn How to Earn Big $$$ Removing All Types of Skin Growths By Lana Yu OSMOSIS SkINCARE Melasma,Rosacea,Acne,AgingandDNARepairByBenJohnson,M.D. MLIS Candida Solutions By Linda T. Nelson, Ph.D.

3:30 p.m. to 4:30 p.m.ROOM 115 A ROOM 115 B ROOM 118 A MINENCE ORGANIC SkIN CARE The Organic Way: Treating Acne, Rosacea and Eczema With Natural Ingredients (Hands on demonstration) By Boldijarre Koronczay BON vITAL, INC. Designing a Signature Treatment By Bruce Baltz EvAS ESTHETICS Do it My Way and Make Lots of Money! (Unless you Enjoy Being Poor) By Lori Nestore

Visit WWW.lneonline.coM for all details.

deMonstration stages2:00 p.m. to 3:00 p.m.STAGE A STAGE B STAGE C STAGE-D STAGE-E TOUCH BEAUTY, LLC TheBoomerangEffectByBarbaraSchumann

M o n d a yoctoBer 24

DED INCLU ITH W SION ADMIS

PHYSIODERMIE (METHODE)/DERME. CA Morpho-Lympho-Drainage of the Face (Live demonstration) By Michael Ibbott NELLY DE vUYST/DERME. CA IncreaseYourSpa/MedicalSpasSalesWithCutting-EdgeEquipmentandServices!ByKarinaGeoffroy CIRCADIA BY DR. PUGLIESE Peptide Technology By Michael Q. Pugliese EvE TAYLOR A New Approach to the Aromatherapy Spa Experience (Live demonstration) By Trish Green, CIDESCO Diplomat

3:30 p.m. to 4:30 p.m.STAGE A STAGE B STAGE C STAGE D STAGE E PHYSIODERMIE (METHODE)/DERME. CA Acne and Lesions: Scientific Causes and Current Solutions By Michael Ibbott TOUCH BEAUTY, LLC Melanin Management: Facts, Myths and Techniques By Barbara Schumann NELLY DE vUYST / DERME. CA ProvenMethodsforBoostingRetailSales!ByKarinaGeoffroy CIRCADIA BY DR. PUGLIESE Pigmentation Disorders: Causes and Treatments By Michelle DAllaird EvE TAYLOR Lymphatic Drainage for the Face (Live demonstration) By Trish Green, CIDESCO Diplomat


eXhiBitor list5 Star Formulators A Natural Difference Aesthetics Complete Aesthetics Unique A1A Facial + Salon Equipment AIA-Aesthetics International Association Alex Cosmetic Herbal A-Peel AromaSalts Associated Skin Care Professionals Athena Beauty B&S Beauty Supply Beauties City Supplies, Inc. Beauty Attica, Inc. Bio Jouvance, Inc. Blinc BodeWell BodySense Midwest Bon Vital, Inc. Bronze Biologic Spray On Tanning Brow Diva Chado En Chromogenex US, Inc. Circadia by Dr. Pugliese Clarisonic ClearFX Skin Cosmtiques France Laure Crown Brush Co. / Div. of Crown Industries, Inc. Deluxe for Business Dermascope Magazine Dermatic Essentials DermAware Bio-Targeted Skin Care Diamond Way Ayurveda DMK-Dann Montague-King DPC Dr. Jeff Skin Care Dr. Jules Nabet Skin Care Dynamis Skin Science / MEG 21 Edge Systems Corporation minence Organic Skin Care Equipro Evas Esthetics

as of september 1, 2011

Eve Taylor North America Extend Your Lashes Eye Kandy Cosmetics Fake Bake Tanning Products Falcon International Group, Inc. Fallene Ltd. Fiafini, Inc. Five Star Formulators Germaine de Capuccini Gold Cosmetics & Skin Care Grande Lash-MD Health Mate Sauna HydroPeptide i-lipo Intelligent Skin Sense LLC Jaco Wholesale Day Spa Supplies JMT Group Jojoba Company Klapp USA, Inc. Lady Burd Exclusive Private Label Cosmetics Lavie - Organique Lavinia Borcau Skin Care Les Nouvelles Esthtiques & Spa LightStim Liquid Ice of Switzerland Lizette Cosmetics, Inc. Lotus Moon Luminosity Mlis M.A.D. Skincare Magazine Service Outlet (CMS of Holland) Mark Lees Skin Care, Inc. Martinni Beauty, Inc. michael marcus cosmetics Minkys Monique Mathieu Nature Pure Labs SW, Inc. Nelly de Vuyst / Derme.CA Olie Biologique Osmosis Pr Medical Skincare PCA Skin

PFB Vanish, Inc. Pibbs

Physiodermie (Methode) / Derme.CA Pinnacle Cosmetics Rapid Lash Raw Mens Skin Care Rena Levi Skin Care Revitalash Reviva Labs

Rmy Laure - European Beaute

Rhonda Allison Saian

Rose Skin Care Products Salonwear

Satin Smooth

Sesha Skin Therapy Shellac

Shea Terra Organics Shira Esthetics SkinAct

Skin Fitness Therapy Smockers By Bexar Mfg. Co. Sottos International

Solise - A Daily SunCare Company South Seas Skin Care Sparenity

Spa Manufacturer Direct Spaware Software Tea Docents

Sun Laboratories, Inc. Tei Spa By Tip Essentials, Inc. Teka Fine Line Brushes, Inc. The Dead Sea Pavilion The Unique Edge Touch Beauty, LLC Violet Skin Boutique Vivant Skin Care

Zion Cleanse Detox Foot Baths


Satin SmoothProfessional warmers are exclusive designs created to efciently maximize your space and add customized waxing services for optimal client comfort and wellness. Thermostatically designed to create an even temperature through-out the day, these state of the art appliances can be used to expand your service menu by adding the selections of different waxes, to your business.

Feel good all over!

Please visit us at The International Congress of Esthetics & Spa in Philadelphia at booths 305 and 307Say you saw it in LNE & Spa and circle #304 on reader service card2011 Satin Smooth For more information on Satin Smooth products, visit our website: www.satinsmooth.com or call our customer service line: 1-800-726-4204 11SS125649


skinby Janel Luu

no longer stuck in the mud

CENTURIES AGO, WOMEN APPLIED mud and clay-based facial masks for beauty benefits. During this time it was also popular to mix natural earth elements such as pearls or jade into masks. These exotic and rare ingredients were ground up and combined with water to create a paste, which was applied to the face for anti-aging effects ... thus the first beauty masks were born.

are more readily and evenly absorbed. Generally, there is no rinsing of the skin required after its removal.

In conjunction with technologyOne of the most exciting attributes of these lift-off gel masks is that they are liquid based and can be used with ultrasound and galvanic machines. The effectiveness of these masks depends on the quality of the serum and actives impregnated in the freeze-dried marine collagen, but overall it is an impressive technology. In addition to the freeze-dried collagen masks, which provide exceptional benefits due to the inherently hydrating and vitamin-rich makeup of the collagen, the second type of lift-off masks are custom-blended and can have antioxidant, brightening, oxygenating and/ or anti-aging benefits. These customcreated spot treatment masks please our instant gratification clients. This is an ideal way to immediately increase the penetration of the active ingredients and give your treatment a unique point of difference for the most results-driven consumer. These effective custom masks are sometimes saturated with a stabilized form of multi-peptides that strengthen skin elasticity and smooth the appearance of fine lines.

Latest evolutionNew technologies continue to arrive, but the key is to find a mask that awes the consumer and esthetician, with results lasting well beyond the treatment itself. The latest evolution in masks adds beneficial ingredients to the skin with unique carrier systems, in combination with machine treatments, and does not have to be rinsed off. The most impressive and innovative technology to date is the introduction of lift-off masking preparations. There are two types that deliver excellent results. The first type is a saturated, removable freeze-dried marine collagen mask infused with actives, and the second is a lift-off mask custom-blended with targeted, concentrated actives. The first type of freeze-dried marine collagen gel masks works when released from the non-woven paper and infuses skin with non-water based serums. As a onetime use mask, it creates an occlusive barrier, effectively penetrating the actives directly into the skin. This mask creates direct contact with skin for ultimate penetration in a controlled environment, allowing the ingredients to work most effectively. While the mask is on the skin, this barrier helps to oxygenate and increase circulation so the actives in the masksOctober 2011 Les Nouvelles Esthtiques & Spa

rinse, the ingredients remain on the skin, causing results to last much longer than traditional cream or paste masks. For the most accelerated results, look for masks with a complex marine collagen peptide. To brighten your clients look, find the most stable vitamin C (MAP) actives, which also provide a unique cooling sensation. A mask combining this vitamin C with green and white tea extracts should brighten skin and minimize the appearance of hyperpigmentation. If clients prefer exotic ingredients, look for a combination of ceramide III, caviar and algae-based extracts to keep the skin hydrated and protected for supple, healthier-looking skin. Remember, gel-texture masks are wet to the touch and have active ingredients, while the custom-created masks need to be blended with an activating fluid to release the ingredients into the skin. Either way, the clients face is invariably left with a dewy softness, and both masks provide more long-term benefits than traditional masking techniques. At last, masks are no longer stuck in the mud! n Janel Luu, founder and CEO of Le Mieux Cosmetics, has been a leading product developer for skin care and cosmetics companies for more than 25 years. She specializes in anti-aging cellular technology, focusing on research and development, and provides guidance to cosmetic chemists on innovative formulations.www.LNEONLINE.com Page 31

Fast resultsLift-off masks are exciting and innovative in many ways: they work more quickly and effectively than traditional masks, and provide long-term benefits by delivering active ingredients deep into skin without the interference of the surrounding air. Since we do not

photo: auremar/Shutterstock.com

by Barbara Schumann

skin| a balancing actWHILE THERE HAS BEEN A PROLIFeration of hormone-based products on the topical skin care market, there is the problem of a huge misunderstanding of what topical hormones can actually do to improve the condition of the skin. It is important to ignore the marketing buzz and hype. Estheticians and consumers need to have a better understanding of the biology and function of hormones as they relate to the skin, so that when they are presented with an over-the-counter topical skin care treatment, they can apply their own logic and make a decision from a stance of knowledgeand not just because it sounds good. We all know how adept marketing professionals are at making things sound good. metabolism and tissue function, to name a few of the more obvious things. The endocrine system works by producing and releasing different types of hormones to maintain and control a number of important functions throughout the body, including the lymphatic system, which works in close cooperation with other body systems to help the immune system destroy pathogens, and filtering waste so that the lymph can be safely returned to the circulatory system; removing excess fluid, waste, debris, dead blood cells, pathogens, cancer cells and toxins from these cells and the tissue spaces between them; and also working with the circulatory system to deliver nutrients, oxygen, and hormones from the blood to the cells that make up the tissues of the body. An imbalance of our hormonal function in the body (either too much or too little hormone volume) can have a ranging effect on the bodys overall function, from the most subtle of deviations or fluctuations in function to dramatic malfunctions, or even a shutdown of certain organs or their systems in the body. Being the largest organ, the skin is not only affected by the hormones, but also by any malfunctioning organs triggered by hormonal imbalances. body health. Everything good and bad is reflected by our skin and its condition. That is why the first step to great skin is improving our general lifestyle choices: eating healthier, drinking the right amount of fluids and eliminating any of the bad habits that we indulge in at the expense of our health. It is then that we can try to repair or intervene with topical applications.

Moment for logicIt is here that we need to apply some logic. Just because a hormone regulates or affects certain functionalities in the body does not mean that it will work in the same manner in a topical application. The key functioning ingredients for any formulation is dependent on its entire balance, as well as the type of suspension used. Some need to be presented in an occlusive formulation and others are better served with a water-soluble, non-occlusive formula to allow for better penetration. There are several theories when it comes to topical treatments. Penetration is the ability for the product to enter the skin via tissue, pores, sweat glands and hair shaft. Stimulation is the ability of a product to stimulate natural production. Occlusion is the ability of a product to set up a protective barrier. Evaporation is the ability of a product to stay and interact with the skin, as opposed to evaporating from its surface. Decoy is the ability of a product to mimic the tissues own structures and therefore stimulate the bodys production of a balancing or complimentary hormone. Bio-availability is defined as the ability,Les Nouvelles Esthtiques & Spa October 2011

Basic biologyOur endocrine system helps regulate our hormones. Hormones in turn help regulate the function of organs and the lymphatic system. With a better understanding of these relationships and how they affect the skin, we can then begin to understand how, as estheticians, we can help manage our clients skin care regimen. The endocrine system is a complex network of integrated hormone-producing glands and organs. It functions in much the same way as the nervous system, acting as the communication between the body and the brain. These specialized glands are what control our hormone production, otherwise referred to as our body chemistry, which in turn controls the function of the organs. The endocrine system is credited with controlling growth, mental development,Page 32 www.LNEONLINE.com

Skins functionOur skin serves several functions. It is our bodys protective barrier, maintaining and controlling the bodys fluid levels and temperature. It assists with the evacuation of toxins and the photoproduction of nutrients. Whereas the eyes may be the window to the soul, the skin is the window to our overall

photo: Stockbyte/Getty Images

skin

rate and extent by which an ingredient or drug reaches the intended treatment area or intensity, and is applicable to oral and topical applications.

Typical topical hormonesThere are literally hundreds of hormones in our bodies. However, this article focuses on those that directly affect the skin or have achieved widespread popularity in the topical skin care industry. Steroids like cortisol and aldosterone are produced by the adrenal cortex, and although they have no direct impact on the skin, when produced in the body they do affect the systems and organs that can have a dramatic effect on the skin and its appearance. They have been used in topical applications because of their ability to mobilize amino acids, increase blood volume and act as a strong anti-inflammatory. It is now understood that steroid topical applications do enter the bloodstream, and that their negative impact on the body in general outweighs any benefit to the topical application. Therefore they are strongly controlled by the Food and Drug Administration, no longer available over the counter and can only be dispensed with a doctors prescription. There are several peptides that have a direct effect on body tissue and the skin; the challenge is the fragility of the structures make them difficult to harvest therefore most that are used in topical applications are synthetic reproductions. On the other hand, hormones are much sturdier in structure and can be harvested for effective topical application. Progesterone assists the skins healing process by regulating collagen. Growth hormone stimulates growth and cell reproduction. Lipotropin stimulates melanocytes to produce melanin. Melanocyte stimulating hormone (MSH) triggers melanogenesis through melanocytes in skin and hair. Estradiol helps regulate the maintenance of blood vessels and skin. There are several topical hormones that have become popular in the skin care industry. Organizing it in categories allows us to have a better understandOctober 2011 Les Nouvelles Esthtiques & Spa

ing of the therapists role in managing the skin concerns of those who have hormonal variations. Acne is the term used for inflamed skin that presents plugged pores (blackheads and whiteheads), pimples and even deeper lumps (cysts or nodules), which occur on the face, neck, chest, back, shoulders and even the upper arms. It affects most teenagers and adults in their 20s and beyond. Adult female acne can be triggered by changes in hormones, ovarian cysts or pregnancy. Treatment includes oral contraceptives, either alone or in conjunction with other therapies, oral medications or topical creams, gels or lotions with vitamin A derivatives, benzoyl peroxide or antibiotics to help unblock the pores and reduce the amount of bacteria. Hirsutism is characterized by excessive hair growth on the female face and body; 1 in 20 American women are affected. It might be caused by genetics or abnormally high levels of the male hormone androgen in the blood. Treatment includes oral anti-androgens or topical creams to slow the hair growth, particularly on the face. Polycystic ovary syndrome can also trigger the condition. Melasma is also known as the mask of pregnancy. It is caused by an overproduction of melanin, a natural substance in the body that gives color to the hair, skin and eyes, leading to dark patches on the face. It is recommended to wear a broad-spectrum sunscreen with a sun protection factor (SPF) of 20 or higher to prevent further darkening of the skin. Treatment can include topical prescriptions or over-the-counter products containing hydroquinone, or prescription products containing retinoids, azelaic acid or hydroxy acids. Menopause presents several characteristic changes to the texture, turgor and suppleness of the skin. In general, there is thinning of the skin, loss of elasticity and increased sensitivity due to lower levels of estrogen. Treatment options include prescription retinoids or over-the-counter products such as

retinol, alpha-hydroxy acids, antioxidants or peptides. Androgenetic alopecia is hair loss in which hair thins on the top of the head and becomes finer in texture. This is primarily a genetic condition. Treatment options include topical minoxidil and other therapies, including oral medications that can block the effect of androgens, such as hormone replacement therapy and spironolactone.

Ingredients that seem to helpSeveral studies have established that topical estrogens produce significant skin improvements in women during or after menopauseessentially, in women whose estrogen levels are low. While systemic effects of small amounts of topical estrogens appear to be rather small, some concerns remain. Oral estrogen replacement has been shown to increase the risk of breast cancer in some studies. There are understandable concerns that possible systemic effects of topical estrogens, however small, might contribute to breast cancer risk. Progesterone has a role similar to estrogens in skin health and could be used topically to prevent or partially reverse menopausal skin deterioration. A 16-week study published in The British Journal of Dermatology in September 2005 involved 40 women and evaluated the effects of 2-percent progesterone cream on the function and texture of the skin in women during or after menopause. The study design was robust: double-blind, placebo-controlled and randomized. On average, the women studied experienced a 23 percent increase in skin firmness, a 29 percent reduction in wrinkle count near the eye and an almost 10 percent reduction in the depth of laugh lines. The studys conductor, Dr. Gregor Holzer and his colleagues reported that no serious side effects were observed. Copper peptide is the resulting compound, consisting of a peptide and a copper atom. Certain kinds of peptides continueswww.LNEONLINE.com Page 33

skin|a balancing acthave an avid affinity for copper, to which they bind very tightly, therefore stabilizing them in topical applications. Peptides are small fragments of proteins; which are the key building blocks of most living tissues. Loren Pickart, Ph.D., discovered the benefits of copper peptides for tissue regeneration in the 1970s. He found and patented the number of specific copper peptides (in particular, GHK copper peptides or GHK-Cu) that were particularly effective in healing wounds and skin lesions, as well as some gastrointestinal conditions. One of the end results of this research was Iamin gel, which is FDA-approved for the treatment of acute and chronic wounds and ulcers. Many substances can have a positive effect on wound healing. A distinctive feature of GHK copper peptides is that they reduce scar tissue formation while stimulating normal skin remodeling. In other words, they help improve restoration of the damaged area to its original look. Matrixyl 3000 is a combination of the two peptides: palmitoyl oligopeptide (a.k.a. GHK peptide) and palmitoyl tetrapeptide-7. Palmitoyl oligopeptide is a fragment of a type I collagen molecule, and it is believed to serve as a biological indicator of increased degradation of the skin matrix. When the key skin matrix-producing cells (fibroblasts) detect increased levels of GHK, they assume that the skin matrix is being lost at a higher rate and begin synthesizing it more vigorously. Thus, Pal-GHK (a version of GHK designed for better skin penetration) is intended to stimulate skin matrix replenishment via topical application, leading, presumably, to wrinkle reduction, skin firming and other benefits. Palmitoyl tetrapeptide-7 consists of a short chain of four amino acids (i.e., GQPR peptide or glycineglutamine-proline-arginine) connected to palmitic acid. Palmitic acid is a fatty acid added to improve the peptides oil solubility and thus skin penetration. It is believed to work by reducing the production of interleukin-6 (IL-6) by the key skin cells, keratinocytes and fibroblasts. IL-6 is a molecule that promotes inflammation, which, in turn, leads toPage 34 www.LNEONLINE.com

faster degradation of the skin matrix. Thus, it contributes to the development of wrinkles and the loss of skin firmness and elasticity. By reducing the levels of IL-6 and possibly other inflammation mediators, palmitoyl tetrapeptide-7 is thought to slow down the degradation of the skin matrix and may also stimulate its replenishment.

Treatments to considerOther forms of therapy to consider include interventional treatments like exfoliation, resurfacing, injectables and lasers. Although these cannot be used in prevention, they can be quick and dramatic in curtailing the effects of hormone fluctuations. Exfoliation/resurfacing is the utilization of mechanical scrubs, acid peels, chemical peels or even laser resurfacing. The theory here is that when you help shed the outer dead layer of the skin, you trigger the production of collagen, because this attack on the protective layer sends a signal to the deeper layers of the skin to become more active. This too has produced smoother and firmer skin. One of the softer, noninvasive treatments is microdermabrasion, a mechanical exfoliation or micro-resurfacing. It is a cosmetic technique that uses a mechanical medium for exfoliation, along with adjustable suction to remove the outermost layer of dead skin cells from the epidermis. It is a noninvasive procedure, performed in-office by a trained skin care professional. The theory is that the skins surface is disrupted, cell division occurs, and this stimulates fibroblast activity leading to collagen production. Human skin sloughs off at a slower rate with age, so proponents of the technique claim the exfoliation of several layers of the stratum corneum can lead to generally more youthful appearing skin. It has also been accepted that certain injectables can also help build collagen. It seems that there is an injectable on the market today that has a credible claim to build collagen. It is an altered form of lactic acid, which our muscles naturally produce. When it is

injected, it triggers the signal to the collagen-producing cells to make more. There is an extensive amount of research that showcases the ability of lasers to help the dermis build collagen. The different forms are long-wave lasers, which are known to build collagen; and photo-rejuvenation with intense pulse light devices and IPLs, which also send signals to the skin to make more collagen. Then there are light resurfacing lasers such as the light erbium lasers and fractional resurfacing. Both seem to have a dramatic effect in some patients, while in others, not much.

The art of treatmentThe treatment of the skin has developed into a holistic scientific art. Today we have a much better understanding of the chemical and hormonal balance of the body and how it affects the skin. Research is still aggressively looking for the lightning rod that will help the body achieve a more controlled hormonal balance, especially in the aging process. It is by having a better understanding and awareness of the endocrine system and its impact on the health and aging process of the body that we can look into treating and eventually eliminating illnesses that are triggered by a decline in chemistry. The great news there is that the skin care industry will directly benefits from this medical research. n Barbara Schumann is the founder of Touch Beauty and the Schumann Legacy Foundation. As a licensed skin therapist and skin care line developer since 1991, Schumann has made it her business and calling to bring out the best in people. The German-raised daughter of a skin care legend, Schumann uses all of the bedrock knowledge she has learned over the years and takes it to another level.Les Nouvelles Esthtiques & Spa October 2011

by Lydia Sarfati

skin|

fall into brightening

groundbreaking brightening technology reveals a radiant, more luminous youRECENTLY, THERE HAVE BEEN SOME very exciting advances in skin care science, particularly targeting hyperpigmentation. Fall is the perfect season to introduce these types of products and treatments to your clients to help treat any hyperpigmentation that may have developed during the sun-filled summer months. As an esthetician, it is important for you to understand how hyperpigmentation occurs, what ingredients to avoid, and what is available to successfully treat clients afflicted with this condition. While most brightening products work through tyrosinase inhibition, the enzyme that accelerates the oxidation of tyrosine, it is possible to influence the process at multiple points. Hyperpigmentation occurs when ultraviolet rays from the sun attack the keratinocyte of the skin; the keratinocyte then signals the melanocyte, which initiates the production of melanin. Once the melanocyte receptors are attacked, it triggers tyrosinase, endothelium (ET1) and alpha melanin stimulating hormone (alpha-MSH) to produce melanin. Melanocytes travel through their dendritic cells containing melanosomes that carry the melanin pigment. Once they travel to the above keratinocyte where it is aggregated and deposited, they produce the melanin pigment. This process is called melanogenesis, which creates hyperpigmentation.

highly purified watermelon extract protects DNA in skin cells from damage caused by ultraviolet-light induced free radicals

marine biotechnology and revolutionary peptide research can now help rapidly reduce the appearance of uneven skin tone while battling hyperpigmentation to reveal a more luminous complexion.

Bellis daisyIn my opinion, this is the most revolutionary brightening ingredient to date. In vivo and in vitro studies show that bellis daisy has a rapid skin-brightening effect. It provides even toning and helps reduce the appearance of age spots. Bellis daisy also reduces the ultraviolet-stimulated induction of melanin biosynthesis. The powerful flower is actually able to decrease tyrosinase activity and the binding likeness of melanocyte-stimulating hormone (alphaMSH) to its receptor. Bellis daisy not only decreases tyrosinase activity, it has been shown to work on multiple pathways. Bellis daisy acts by controlling the messenger. It reduces the ET-1 (endothelin) expression by about two thirds, and it decreases alpha-MSH binding. Without ultraviolet exposure, bellis daisy shows an in vivo color decrease of up to 20 percent in just 14 days.

Basic backgroundAlso called pigment, melanin is a substance that gives skin and hair its natural color. Those with darker skin have higher amounts of melanin. By contrast, those with less pigment have more fair skin. Melanin pigments are formed as part of the process of metabolizing an amino acid called tyrosine. Tyrosine channels the production of melanin and other pigments by oxidation. In humans, melanogenesis is a darkening of the skin, or an increased production of melanin, also called hyperpigmentation. This is a common, usually harmless condition in which patches of skin become darker in color than the normal surrounding skin. This darkening occurs when an excess of melanin, the brown pigment that produces normal skin color, forms deposits in the skin.October 2011 Les Nouvelles Esthtiques & Spa

From past to presentIn the past, ingredients such as hydroquinone and mercury chloride have been used to treat melanogenesis. These ingredients, however, have been linked to a variety of health issues, even when used in small percentages. Today, we have groundbreaking natural ingredients that can help reverse hyperpigmentation from the sun, acne scars, hormonal changes and certain prescription medication without taking the risk of causing your client future health complications. Innovative

photo: Juice Team/Shutterstock.com

Licorice extractThis ingredient, known for its skin-brightening benefits, is glabridin. Featuring strong anti-inflammatory properties, glabridin inhibits pigmentation by precontinueswww.LNEONLINE.com Page 35

skin|fall into brighteningventing tyrosinase activity without being toxic to the cells. binding to its receptors, thereby decreasing melanin synthesis. This peptide is actually able to decrease melanin production, thereby targeting hyperpigmentation before it starts. lata is known to decrease tyrosinase activity by as much as 52 percent.

Willow bark extractWillow bark extract provides natural beta hydroxy acid without skin irritation. It enhances cell renewal and encourages the shedding of dead skin, revealing brighter looking skin.

Watermelon fruit extractThis highly purified watermelon extract protects DNA in skin cells from damage caused by ultraviolet-light induced free radicals. This helps decrease skin redness after ultraviolet irradiation by as much as 68 percent. Watermelon extract also contains naturally occurring vitamins, carbohydrates and amino acids.

Pelvetia canaliculata extractThis beautiful, lettuce-like seaweed has anti-inflammatory properties that help protect against DNA deterioration. Most notably, it targets existing pigmented spots for a more even-toned complexion. In fact, Pelvetia canalicu-

Hexapeptide-2This fast-acting skin-lightening peptide acts as an antagonist to alpha-MSH,

Kojic acidKojic acid is derived from a variety of fungi. It inhibits melanogenesis by chelating the copper bound to tyrosinase. It decreases the number of melanosomes and dendrites, which makes it useful in treating hyperpigmentation.

Natural, yet effectiveToday it is possible to help your clients reverse hyperpigmentation. These revolutionary brightening ingredients are a natural and effective method in your quest to achieve outstanding results without damaging the delicate structure of the skin. As always, I believe in a natural approach to skin care to keep your clients healthy, and looking and feeling beautiful. So go ahead, help your clients fall into brightening this season, the natural way! n Lydia Sarfati is the president and founder of Repchage. She is an internationally recognized skin care expert with more than 30 years of experience in the industry, and has been quoted in multiple highly respected publications and appeared on television for her expertise. Sarfati is the honorary chair of EstheticsAmerica, CIDESCO USA and the Skin Care & Spa Council Director of Intercoiffure North America. She is the recipient of numerous prestigious industry awards, including LNE & Spas Crystal Award. Email her at [email protected] you saw it in LNE & Spa and circle #183 on reader service card




AS A PRACTITIONER AND EDUCATOR, IT ALWAYS amazes me that there are so many estheticians who are full of inquiries and ideas regarding the simplest, most essential and first forms of electricity ever used in facial therapy: galvanic current, high frequency, vacuum/suction and the Lucas spray. The use of electricity in facial therapy, known as electrotherapy, is nothing new. It has been used in facial therapy since the early 1900s in European skin care and the United States since the late 1960s. The problem for many U.S. skin care professionals is the lack of training in basic licensing courses in this country. Many professionals were simply showed a demonstration, allowed to use the device once or twice, and learned enough theory to answer a question on a test. Few actually used electrical equipment as a component of a basic facial procedure. Regardless of what you currently know, keep reading. I promise to take you from a beginner to a novice, a novice to an advanced level, or to give my electrically advanced colleagues one or two more tricks to add to your current skin care treatment protocols.

Galvanic currentGalvanic current can be used for multiple purposes, on all skin types, and in almost any facial treatment, basic or advanced (minus contraindications). The concept of using galvanic current to transport electrically charged chemicals through the skin is more than 100 years old. Galvanic current is a one-directional current, flowing from point A to point B. It functions by the use of polarity between an anode and a cathode to force a water-soluble solution into the skin (a process called phoresis). Polarity refers to having opposite poles in an electrical current, similar to opposite sides of magnets that are attracted to one anoth-

Galvanic current uses Basics (before and after facial mask): Apply a watersoluble product rich in vitamins, minerals, peptides and other nutrient-rich ingredients that can be forced deep into the epidermis and optimize the health of the skin.

electrotherapyENERGIZE YOUR TREATMENTSPage 38 www.LNEONLINE.com Les Nouvelles Esthtiques & Spa October 2011

background: Alegria/Shutterstock.com

er. One of the unique benefits of galvanic current is that it is able to create both a mechanical and chemical effect on the skin. By altering the pH of the skin, galvanic current has the unique ability to force nutrientrich ingredients deep down through the epidermis. Milady, a part of Cengage LearnDepending upon the poing. Photography by Paul Castle. larity of the active electrodes current, either positive or negative, two different, yet beneficial processes influence change on the skin. 1. Iontophoresis is the result of using a positive current and applying a positively charged (acidic) product to the skin. It is antibacterial and used to nourish and feed the skin, as well as minimize skin sensitivity. Iontophoresis can provide fabulous benefits to mature, dehydrated, pigmented skin; rosacea; and skin in need of extra nourishment. 2. Desincrustation is the result of using a negative current and applying a negatively charged product (alkaline) to the skin. It increases circulation and skin sensitivity, creates a bacteria-friendly environment, but most importantly saponifies sebum, enabling a deep cleaning and an ease in the removal of clogged pores and comedones. Desincrustation provides fabulous benefits when improving oily, clogged and acneic skin types.

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Do not worry about removing the product when you remove the maskit has been locked down beneath the acid mantle, where it will stay. It will not be washed off. Specialty (to boost facial treatments designed for a specific purpose or to deliver specific results): Todays clients are all seeking results-oriented facial treatments to target specific concerns such as pigmentation, fine lines and wrinkles, loss of elasticity, firmness, skin texture and tone, acne and rosacea. With any of these facial services, a concentrated treatment product is applied to the skin, then followed with the appropriately charged electrode. These water-based products are forced beyond the acid mantle, where they can act on cellular components deep within the epidermis and further boost the efficacy of the other treatment products.

Advanced: To really take galvanic current to its maximum potential, create special services that revolve around the use of galvanic and the products designed to work in conjunction with it. Here are a few examples: Skin lightening treatment: Following exfoliation, apply an acidic (low pH) product packed with tyrosinase inhibitors. Perform iontophoresis. Apply another layer of product, followed by a modeling mask that contains bearberry, arbutin and vitamin C. After removing the mask, apply a vitamin C serum and finish with sunscreen. Follow a microdermabrasion with iontophoresis and instantly double the services benefits. Rapid acne Rx: Follow cleansing with desincrustation solution, then apply galvanic current. Immediately perform extractions. Reverse the charge of the active electrode to rebalance the pH of the skin. Apply an anti-inflammatory serum (perhaps one with linoleic esters), followed by a cool modeling mask. Maximum hydration: After massage, apply a nutrientrich, humectant serum using iontophoresis. Follow with a paraffin mask and saturate dehydrated skin. The list of possibilities goes on. The point is this: there is no one way to incorporate galvanic current into a facial treatment. Whether it is a basic facial, a boost or something more advanced, galvanic current can be a part of every facial treatment.

High frequencyAlso referred to as the Tesla current, high-frequency was developed and introduced in 1892 by French biochemist Nikola Tesla for the treatment of skin diseases, and incorporated into European skin care therapies in the 1930s. continues

Milady, a part of Cengage Learning.

BY MICHELLE DALLAIRD

October 2011 Les Nouvelles Esthtiques & Spa

www.LNEONLINE.com Page 39

skin|electrotherapy

High frequency current is a rapid oscillating current that works in conjunction with glass electrodes, which contain either neon or argon gas to produce physiological effects on the skin. When applied to the surface of the skin, a mild electrical current passes through the neon or argon gasfilled glass electrode, causing it to ignite Milady, a part of Cengage Learning. and affect the skin. High frequency current Photography by Rob Werfel. increases circulation, produces a warming effect and is a powerful antibacterial. When the gas inside the electrode ignites, it energizes the oxygen around the electrode just above the surface of the skin. This energized oxygen, referred to as O3 or ozone, creates a powerful antibacterial effect.

Vacuum/suctionThe vacuum is the least-used part of every multifunction machine, but it certainly has its place in facial therapy. Also referred to by many as the ventouse attachment, the vacuum/suction is a glass attachment that comes in a variety of shapes and sizes. It has a small hole on one side. When this hole is placed flush on the skin and covered with a finger, it creates a mild suction effect across the face.

Vacuum/suction uses Basics: It can be carefully used prior to or following extractions to loosen debris from within clogged pores. For mature, tired or dull skin, the vacuum can be used gently and lightly across the entire face, below the zygomatic arch to increase circulation, giving the skin a flushed, glowing appearance. Specialty: Create a regenerating facial treatment designed to increase circulation and revive the skin. Following the facial massage, remove all massage product, beginning at the center of the forehead. Work from the center of the face, moving outward in long gentle strokes with a small, flat attachment. Advanced: Prior to moving to an advanced level with any vacuum/suction, it is imperative to have a thorough understanding of the lymphatic system, especially of the face and neck. It is imperative that you become well-versed in the placement of lymph courtesy of quipro. nodes, the direction of lymphatic flow and proper drainage of lymph. With this knowledge you can create targeted treatments to reduce swelling and fluid retention and promote healing. Mild suction delivers amazing lymphatic drainage results and benefits, delivering instant improvement to the skin.

The Lucas spray is an age-old spray machine used to pulverize toners, infused waters and lotions.

Highly beneficial for use on mature and dehydrated skin, the warming effect of high frequency and its ability to increase circulation is a quick, easy solution to saturate the stratum corneum with humectants and leave the skin with a youthful, rosy glow.

High frequency uses Basics: Cover the face with an unfolded piece of gauze. Run the glass electrode across the gauze over acne breakouts or areas of face where extractions have just been done to kill and prevent the spread of bacteria. High frequency can also be used at the very end of any facial to prevent possible breakouts. Specialty: Perform high frequency after waxing services on areas such as the face, bikini area and underarm to prevent breakouts. For specialized acne treatments, cleanse, apply an enzyme product, extract, perform high frequency and apply an anti-inflammatory serum. Voila! Just 30 minutes to achieve perfectly cleansed, bacteria-free skin. Advanced: Indirect high frequency is the ultimate in treatments, yet it is used. Often referred to as a Vienesse massage, this technique is an excellent choice for mature, dehydrated skin types. The technician becomes the conductor of the current as the client holds the indirect electrode and handpiece. Place one hand on your clients face, turn up the current very slightly, place your other hand on the clients skin and perform a full facial massage. The mild current will flow through your hands and create a soothing, warming and completely relaxing massage that also creates heat, aiding in mild product penetration.Page 40 www.LNEONLINE.com

Lucas sprayAlso referred to as the Dr. Lucas Pulverizer, the Lucas spray, created by Dr. Lucas Championniere, is an age-old spray machine used to pulverize toners, infused waters and lotions. The cool pulverized mist penetrates deep into the upper layers of the epidermis, promoting circulation, micro-massage and a deeper, more thorough cleansing of the pores.

Lucas spray uses Basic: Use the Lucas spray following cleansing and extraction as a toner to refine the pores and prevent bacteria. It can also be used with a mild herbal blend following the removal of a mask to refresh and energize the skin. continuesLes Nouvelles Esthtiques & Spa October 2011


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Specialty: Create skin-specific or treatment-specific blends to be used in targeted facial treatments. Chamomile and lavender are excellent for dehydrated and sensitive skin treatments. White lily, bearberry and licorice can be blended and incorporated into skin-whitening treatments.

Do not hold back and have no fear ... simple electricity has always been here!

used properly it does neither. Electricity does offer the ability to alter the acid mantle, increase heat in the dermal layer of the skin and target specific skin concerns, such as excess sebum and bacteria, all of which the human hand cannot. Keep in mind that although they are relatively basic treatments, all of the above require a thorough understanding of not only the electrical apparatus, but also its application to each individual client. Do not hold back and have no fear ... simple electricity has always been here! n

Advanced: Create a mild blend of herbs and/or mints. Perform a full-body brushing or other exfoliation. After removing product from the body, apply a mist of the refreshing blend from head to toe, leaving the body soft, smooth and exhilarated. Go one step further and create a blend with cinnamon and coffee. Apply it to the torso, buttocks and legs following a cellulite wrap. Your client will be tingly and toned for hours.

Feeling sparksMany believe that electricity is not necessary in skin care services, and argue that it diminishes the personalization of what we do and the gift of the human hands. However, when

Michelle DAllaird is a successful entrepreneur. She owns and operates the two Aesthetic Science Institutes in New York. She is a licensed esthetician and cosmetologist as well as a CIDESCO Diplomat. DAllaird is a contributing writer for Les Nouvelles Esthtiques & Spa and Dermascope magazines, and has co-authored the Salon Fundamentals Aesthetics textbook. She speaks at conferences across the United States and acts as a consultant for an international cosmetics company, providing educational services across Europe and Asia. DAllaird is also vice president of education for the Aesthetics International Association.




by Brenda Linday

skin|melasmaunderstanding and treating it with confidenceMORE THAN SIX MILLION AMERICANS suffer from melasma (from the Greek word melas, which means black), and half of these patients do not know what causes it or how it is treated. Great strides have been made toward understanding melasma. However, it is still one of the most frustrating and misunderstood conditions faced by both the clinician and the patient in the skin health industry today. Not only is melasma a women, it can also occur in women who are using birth control pills, undergoing hormone replacement therapy (HRT) or experiencing any hormonal fluctuation. Melasma also appears on the cheeks (21 percent of cases) and the jawline (16 percent of cases). Other areas of the body, such as the forearms, are also susceptible. Although it is most commonly seen in women, 10 percent of all melasma cases affect men.

Determining melasma depthDetermining the depth and severity of melasma is an important factor in setting realistic patient expectations. Because melasma can lie significantly deeper within the skin than ultravioletinduced or post-inflammatory hyperpigmentation (PIH), it may take up to six months for some patients to see any improvement in their skin. Unfortunately, patients suffering from dermal melasma may see little or no improvement, regardless of treatment. The Woods Lamp is a useful tool in determining melasma depth. There are many types available to the clinician, ranging from handheld models to more advanced machines. The Woods Lamp should be used in a dark room, approximately five inches away from clean, dry skin. The depth of melasma can be determined based upon how it illuminates: Epidermalmelasma,themostcommon type, will illuminate under the Woods Lamp. It is characterized by an increased amount of pigment in all layers of the epidermis. Dermalmelasmaischaracterized by increased amounts of pigment throughout the dermis. Because it is too deep for the light to reflect, this type of melasma will not illuminate under the Woods Lamp. Mixedmelasmaischaracterized by an increase of pigment in both the dermis and epidermis, and will continueswww.LNEONLINE.com Page 43

Current treatment recommendations for melasma consist of gentle, blended chemical peels combined with daily care products formulated with mild melanogenesis-inhibiting ingredients.

complex condition to understand and treat, it is even more difficult to explain to our patients. In order to successfully treat melasmaor any other type of hyperpigmentationpresentation, depth, classification, disease pathway, potential causes and ingredient mechanism of action must be understood.

DefinitionMelasma is most commonly seen on the central portion of the face (63 percent of cases), and is presented in large, dense patches with distinct borders. It is because of this presentation that melasma is also called the mask of pregnancy. While this condition does indeed affect pregnant and lactatingOctober 2011 Les Nouvelles Esthtiques & Spa

photo: puhhha/Shutterstock.com

Melasma lesions exhibit physiological differences from other types of hyperpigmentation. They have been shown to contain a higher amount of pigmentproducing melanocytes, which are larger and darker than normal, healthy melanocytes. In addition, the number of these melanocytes arms, or dendrites, that are responsible for transporting the bodies of pigment (melanosomes) is also higher. Melasma lesions have also been found to display an increase in vascularity and redness. The reason behind this is not known, and it is not always visible to the naked eye. However, the use of topical, anti-inflammatory products may also assist in reducing the visibility of melasma lesions.

skin|melasmafluoresce under the Woods Lamp in some areas. Indeterminatemelasmaisvery rare, and a Woods Lamp is not useful in this case. The Melasma Area and Severity Index (MASI) is used to determine the severity of melasma. Each area of the face is categorized, and an overall score ranging from 0 to 4 is given based upon the percentage of the skin affected, and the darkness and uniformity of the patches: 0=noabnormal hyperpigmentation is present 1=lessthan10percentofarea is covered by faint, barely visible hyperpigmentation 2=10to29percentof area is covered by mild hyperpigmentation 3=30to49percentofarea is covered by moderate hyperpigmentation 4=50to69percentof area is covered by severe hyperpigmentation levels can also stimulate the development of melasma. Medications such as contraceptives and hormone replacement therapy (HRT) also cause changes in hormone levels and can contribute to the onset of melasma. Other types of hormonal changes such as perimenopause and menopause can result in androgen (male hormone) dominance due to the decrease in estrogen and progesterone. Some studies have shown an increase in tyrosinase activity due to this higher androgen level. Thyroid or other hormonal disorders, such as p

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