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Skin Care Then & Now

By Janet McCormick

Originally published in Skin Deep, September/October 2009. Copyright 2009. Associated Skin Care Professionals. All right reserved.

Knowing how far we've come as a profession, with amazing advances in skin care ingredients, is valuable background for estheticians. There may be opportunities to share your expertise with clients, enhancing your role as the expert. This background can also enhance your pride in your work.

Excavations have revealed writings about skin care in ancient times. For example, the secrets of the incredible beauties of ancient Egypt--Cleopatra and Nefertiti--have been discussed for hundreds of years and are still practiced. These women are renowned for bathing in milk to soften their skin. (We know now that milk contains lactic acid.) In ancient Greece, athletes covered themselves in olive oil mixed with herbs. They used fine sand sprinkled on the oil to provide sun protection. Women used this same concoction (without the sand) to soften their skin.

Newspaper advertisements document skin care in the 1800s and 1900s. These show the development of science and technology, as evidenced in homemade and commercially made soaps, shampoos, and basic hygiene products. The increased availability of magazines in the 1900s meant more attention to skin care and more sophisticated treatments for such conditions as acne. The most noteworthy progress and interest in skin care emerged in the last half of the 1900s with the advent of television, then in the 2000s, with extensive use of the Internet and swift expansion of the global economy.


1950s-The Profession Changes
Before the 1950s, professional skin care focused on deep cleansing and softening. Then, the phenol peel was developed. This was a deep peel that was performed only by physicians because it required sedation of the patient and monitoring of vital signs for potential side effects. The phenol peel can remove deep wrinkles, but, potential complications can be dramatic and serious--pigmentation, depigmentation, scarring, abnormal heart rhythms from fume inhalation, and in extreme cases, death. It is rarely used now, since lasers can perform the same task with more dependable results.

Trichloroacetic acid (TCA) was developed and is typically used as an intermediate-to-deep peeling agent with the depth dependent on the acid's concentration. It is available in concentrations of 10-35 percent. A TCA peel destroys epidermal cells, possibly penetrating to the dermis in the higher percentages, allowing new and smoother skin to heal in its place. This type of peel is useful for eliminating surface wrinkles, superficial blemishes, and pigmentation problems. Skin care professionals use lower percentages (10-25 percent) of the TCA peel and the states tend to regulate it, preventing estheticians from using it or regulating the percentages they can use outside a physician's office. Side effects are pain and peeling.

Next to be developed was the Jessner's peel, which is a medium-depth peel made from lactic (alpha hydroxy) acid and resorcinol. With TCA and Jessner's, clients peel for about a week before nice, smooth skin is revealed. There is reddening for weeks, even months, afterward.


1980s-Sugar Cane Sweetens the Mix
The most pivotal development for antiaging skin care for esthetician use was glycolic acid, an alpha hydroxy acid (AHA) found in sugar cane. Dr. Eugene Van Scott and Ruey Yu developed it for skin care use in the 1970s and it became the premiere antiaging treatment in the 1980s and 1990s. It is used in salons and spas in strengths from 20-50 percent, and in medical offices from 50-80 percent. The higher percentages, coupled with a low pH factor, can cause significant peeling. Glycolic acid was added to home care products in lower percentages for exfoliation and to augment professional care. Glycolic acid has been formulated in a synthetic form because in its natural state it's too irritating and unpredictable, even when diluted.

In the 1990s, lactic acid was added to the esthetician's toolbox. Estheticians realized its molecules, larger than those of glycolic acid, garnered the same results but with more control and fewer reactions. Salicylic acid, a beta hydroxy acid, also came into the professional mix as an exfoliant that works well to treat acne. At last, estheticians had many choices in exfoliation products.

Since 2006, cosmetic chemists have been developing so-called designer peels, which are professional products using these chemicals in new combinations and at lower percentages, often incorporating other ingredients. The effect is to reduce stinging and downtime. Treatments are more gentle now because continual irritation is suspected to advance aging.


1990s-Topical Treatments
Until the 1980s, home care topical agents were used primarily for hygiene and softening. Only recently has the medical community recognized that topicals can actually treat or improve skin. In the late 1990s, new delivery systems and ingredients that could penetrate skin emerged, gradually achieving acceptance as successful esthetic treatments from even the most traditional, naysaying physicians.

The first topicals were our grandmothers' barrier moisturizers--cream products that sat on the surface of the skin to retain the skin's natural moisture, preventing transepidermal water loss. Many were applied as masks, leading to the comedic portrayal of women with their hair in rollers and thick masks on their faces at bedtime. These topicals penetrated very little, but were still better than nothing. Then, glycolic acid was formulated into home care products with noticeable effects. Estheticians were recommending constant and rapid exfoliation as home care. Antiaging clients were peeled and sent home with exfoliants to continue peeling. During this time, the mantra of estheticians became "If it doesn't sting, it's not working." Clients bought into this philosophy and some continue to believe in this approach, even though peeling is no longer necessary for antiaging, because of new delivery systems in more recent products.


Antioxidants Versus Aging
The next great home care ingredients were antioxidants, introduced in the mid-1990s and found to support the skin's resistance to aging and to fight and repair sun damage. Antioxidants actively combat free radicals, the ambient oxygen molecules thought to be the cause of premature aging and wrinkles. Vitamins C and E were recognized as champion antioxidants, although C was very unstable and E accomplished little unless it worked in active formulation with an effective vitamin C. Other antioxidants, such as coenzyme Q10 (ubiquinone) and alpha lipoic acid (ALA) were developed. It seems every day a new antioxidant is announced or an old one is upgraded and re-launched in a new form.

At the same time, skin-changing ingredients such as retinoids and growth factors emerged. Positive results were obvious to clients and treatments evolved from relaxation-only to results. Clients started to see antioxidants as necessities for antiaging and rightfully so.


Versatile Peptides
Peptides were launched in 2003 and they've been used for every possible skin care purpose since then. Along with these are the new DNA-altering ingredients, promoted by some as the next miracle skin care platform.

Since then, advancement in cosmetic peptides has exploded, with products available for every possible purpose in skin care. The new mantra for ingredients is "stimulate, heal, rebuild, and protect." It's no longer "peel, peel, peel."

Skin care has evolved from prehistoric applications to our fountain-of-youth treatments for ourselves and our clients. Skin care has changed from a relaxation to a results business. The profession has become mainstream, thanks to development of new ingredients and the reformulation of old ones. All of these developments result in meaningful progress for skin care professionals--your work is not only mainstream, but profitable.

Janet McCormick is an esthetician, manicurist, and former salon owner and spa director. She holds a master's degree in allied health management, as well as a Comite International D'Esthetique Et De Cosmetologie (CIDESCO) diploma. She has written more than 300 articles and is owner of Spa Techniques Consulting. She can be reached at 863-273-9134 or janetmccormick@aol.com.




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