What is a chemical peel?
What is a facial? Why do I need one?
What is microdermabrasion, and how will I benefit from it?
What causes acne? How can skin care treatments help?
What is rosacea, and how is it treated?
What are antiaging treatments?

What is a chemical peel?
A chemical peel is an acid solution that is applied to the skin. It dissolves the outermost layer of skin cells, which then peels off over the following days to reveal the fresher, younger layer below. Peels are very effective in treating a large range of skin concerns such as aging, sun damage, acne, mild scarring, improving skin brightness, and evening skin tone.

Peels can be light, moderate or deep. Light peels require no down time from work and your normal activities. Moderate peels may require a day or two, and deep peels can require a week or more of down time to allow the skin to fully heal. Estheticians who are not working in a medical setting perform light to moderate peels only. Deep peels can only be performed by a physician, or under a physician’s supervision, for your safety.

Preparing for treatment
Most skin colors and types can benefit from chemical peels, though it is best to check with your esthetician about which peel might be right for you. If you’re taking acne medication, Retin-A or Accutane, talk to your esthetician and/or doctor about stopping the medication before and during treatment to avoid complications. Your esthetician can review any other contraindications with you prior to your treatment to determine if a chemical peel is right for you. Be sure to answer all questions honestly and completely on your consultation form prior to your peel.

What to expect during a chemical peel
The skin is cleansed and a prep solution will be applied to remove surface oils and allow the peel to penetrate the skin evenly. Any sensitive areas that cannot be treated will be protected with a thin film of petroleum jelly. Your eyes will be covered to protect them. One or more chemical mixtures will be applied, such as glycolic acid (from sugar cane), trichloroacetic acid (similar to bleach), salicylic acid (wintergreen—good for acne), lactic acid (from milk), or a combination peel called a Jessners peel. The peel will be applied in 1–3 layers, depending on the depth of penetration intended. The acids react with the skin to produce a “controlled wound,” allowing fresh skin to regenerate and emerge. A tingling, burning or hot sensation is normal. Most peels remain on the skin only a few minutes, and are closely watched by the esthetician. A fan may help you stay more comfortable. After some peels, a neutralizing solution is applied to stop the peel. Other peels are self-timed and stop on their own.

After the peel
After most peels, the skin will be pink to red, and look shiny and tight. It is vital to apply sunscreen of SFP 30 or greater to the skin for the next 48 hours, minimum. You must also stay out of the sun, as your skin will be very sensitive to UV rays and could be damaged by sun exposure. The skin will begin to flake or peel within 2–3 days after the treatment, unless you had a lactic acid peel—these encourage moisture retention and may not produce any actual peeling. Sun-damaged areas of your skin will appear darker at first, then will lighten. This is normal. Deeper peels can produce peeling for a week or more. To assist in removing the flaking skin, an enzyme peel or light microdermabrasion treatment is sometimes scheduled a week or so after the initial peel. For maximum results, a series of peels is usually recommended, and may be necessary for treating challenging issues such as hyperpigmentation.

Home care after a chemical peel
Your esthetician will recommend healing products to use for the week or two following your peel. These will soothe and nourish your skin, and aid in its recovery. Usually it is best to avoid makeup during this time, to allow the skin to heal and function without interference. However, if you must wear makeup, mineral makeup will not adversely affect the skin.

Your esthetician
Your skin care treatments should be provided by a properly trained professional. Don’t hesitate to ask your skin care therapist about her background, training, and experience—especially as it relates to the treatment you are considering. Your therapist is a professional member of Associated Skin Care Professionals. Our members have been validated as meeting their state’s licensing credentials and/or core training requirements, and agree to follow a code of ethics which ensures you’ll be treated responsibly and with the utmost respect. ASCP also provides its members with comprehensive resources that allow them to keep up with changing trends, making certain you’ll receive the most up-to-date therapies available.

What is a facial? Why do I need one?
A facial is a professional cleansing, purifying, and beautifying treatment of the skin on the face and neck. Facials are the number one treatment performed by estheticians, and a good way for your therapist to get a good understanding of your skin prior to suggesting more aggressive treatments.

For most people, facials can be scheduled every four weeks, although your therapist may recommend a different schedule. There are many variations of facials based on different needs, as well as different lengths of time. A mini facial may be only 20–30 minutes in length, while a more luxurious version may be 75–90 minutes in length. Tell your esthetician exactly what you want to get out of your facial, and she/he will be able to recommend a facial to meet your needs.

Preparing for a facial
Be sure to allow enough time to fill out a comprehensive intake prior to your treatment. Plan to arrive a little early so you will not feel rushed and can enjoy the entire length of your treatment. Remember that your hair may become damp during the facial, and will usually be held back from your face with a soft wrap or headband, so you may not want to schedule a public appearance right after your facial! There is no need to remove your makeup prior to the appointment, as it will be cleansed off during the facial.

What to expect
Facials are generally very relaxing and soothing. Your esthetician will explain to you what the treatment steps will be. Be sure to communicate with your esthetician during the facial if any product burns, itches, or if you need anything or have any questions. Otherwise, just lie back and enjoy the experience. A basic facial generally includes the following steps:

• Makeup removal and cleansing of the skin.
• Skin analysis.
• Exfoliation by mechanical, enzymatic or chemical means.
• Massage of the face and neck, to aid in relaxation and stimulate blood and oxygen flow to the skin.
• Extraction of blackheads and other impurities, either manually (using gloved hands and cotton or tissue around the fingers with gentle pressure to remove the impacted pore) or using a metal extraction implement designed to clear blocked pores. This can also include the use of a lancet (a small, sharp blade to lift the dead cells of the skin prior to extraction).
• Application of products targeted to your skin type (dry, oily, mixed, sensitive, or mature).

After the facial
After a facial, your skin will probably be soft, smooth and well hydrated. However, if multiple extractions were needed or if you required a fair amount of exfoliation, your face may be somewhat rosy for one to two hours or more, depending on how sensitive your skin is. This is quite normal. You can apply mineral makeup after your facial if there is some redness you want to conceal.

What about home care?
Your esthetician will go over which professional home care products for you to continue the improvement in your skin following your professional treatment. This way, you will be using products that maximize benefits and prolong the effects of your treatment. Your therapist can explain how, when and how much of the products to use. Feel free to call the therapist later, if you have any questions.

What is microdermabrasion, and how will I benefit from it?
Microdermabrasion is a method of exfoliation that uses a machine to remove dead surface skin cells and initiate cellular turnover. It was first adopted in Europe in the 1980s and was introduced to the United States in the late 1990s. Its introduction led the revolution of device-driven, noninvasive cosmetic procedures. Today, microdermabrasion remains one of the most popular services employed in both medical and day spas.

The two most common methods are crystal and diamond. The crystal method uses a wand which sprays fine crystals onto the skin, loosening and removing dead skin cells, while simultaneously using vacuum suction to remove the used crystals and dead skin. It has been compared to a mild “sandblasting” of the skin. The diamond method uses a diamond-tipped wand to sand and resurface the skin, combined with suction to remove the dead skin cells. Both methods stimulate blood circulation and revitalize collagen production, which promotes younger-looking skin. The degree of exfoliation depends on the number of passes, level of crystal spray or coarseness of the diamond wand, the pressure and suction used, and the frequency of treatment.

Microdermabrasion can be helpful to treat aging and sun-damaged skin, altered pigmentation, fine lines and wrinkles, stretch marks, and some types of acne and acne scarring. It is especially effective in treating the under-eye area and crow’s feet. Results may include improved skin tone, reduced visual appearance of aging, fewer breakouts, diminished appearance of scars, refined skin pores, renewed elasticity, and a healthy glow. Microdermabrasion may be recommended for those with chemical sensitivities and can be used on most skin colors and types, although there are some contraindications. Ask your skin care professional if microdermabrasion is right for you.

Preparing for treatment
The procedure is noninvasive and requires little preparation. You may remove your makeup and come to the treatment room with a clean face, or allow your skin care professional to remove your makeup for you.

What to expect
Most clients do not find the procedure to be painful, and it requires no anesthetic. The esthetician will instruct you to relax as she applies the wand to your face in a slow, methodical way. One microdermabrasion treatment should take 30 minutes to an hour. There are no side effects, and your skin will look glowing and fresh almost immediately after the treatment. Some more aggressive treatments may cause the skin to look slightly pink and tender for a few hours afterward. You can resume normal activities and apply makeup and moisturizer directly after your microdermabrasion session.

Home care after microdermabrasion
Because fresh skin has been newly exposed, it is important to apply sunscreen and to avoid direct sunlight and tanning booths following your session. Also, avoid products containing harsh chemicals, dyes, or perfumes until the skin has fully healed. Your skin care professional will explain the home care regimen that is right for you, and send you home with written instructions.

What causes acne? How can skin care treatments help?
Acne is the most common skin disorder, and 85 percent of all Americans will experience it some time in their lifetime. While commonly thought to be an adolescent problem, it can appear at any age, most often on the face, back, and chest.

The causes of acne are complex, but usually involve the overproduction of oil, the blockage of follicles that release the oil, and the growth of bacteria in those follicles. This can be triggered by many things, including a change in medications or a change in hormone levels caused by stress or other factors. It’s important to treat acne early to avoid scarring.

There are 4 grades of acne. Grade 1 is the mildest form, with open and closed comedones (whiteheads and blackheads). Grades 2 and 3 include papules and pustules as well. Grade 4 is the most advanced form, with all the above plus the appearance of cysts or nodules beneath the skin surface, that can be dime size or larger and often require medical attention to treat. Acne is not only painful but can be very emotionally and psychologically challenging as well.

Who can benefit from acne treatment?
Anyone who has acne can benefit from treatment. Acne sufferers often state their quality of life and self-esteem improves dramatically once their acne is alleviated. If you are seeking a licensed esthetician’s care, chances are you’ve already tried over-the-counter preparations with disappointing results.

Depending on the grade of your acne, your esthetician will go over the treatment options that would be the most successful for you. If you have Grade 4 acne, your esthetician will refer you to a dermatologist who can treat it medically. Once your acne is under control and improving, your esthetician can suggest treatments that will assist you in accelerating the healing process, relieving pigmentation which often accompanies acne.

Visiting your esthetician for acne treatment
Be ready to fill out a medical questionnaire and describe what medications and skin care products you are using. Your therapist will do an analysis of your skin, look for any interactions between products and medications, and devise a treatment plan that’s suitable for your unique needs. Keep in mind that results require a commitment on your behalf to follow a prescribed home care and professional treatment program. This often involves a series of professional treatments. It takes time to balance the skin and treat acne. Though results may not happen overnight, you are on the path to reclaiming your beautiful, clear skin!

What should I expect from my acne treatment?
You should expect regularly scheduled treatments. Your treatment program may begin with an acne facial. This may include deep cleansing and extractions (clearing blocked pores), special exfoliation that will not increase inflammation or spread bacteria, a balancing/calming mask, anti-bacterial and balancing products, or some combination of these. The goal is to deeply cleanse follicles and disinfect them, clearing away oil, bacteria, and dead skin cells.

Your esthetician may also recommend a series of chemical peels. Once the active acne is cleared, microdermabrasion will assist in minimizing the appearance of scarring and diminishing residual darkening of the skin (hyperpigmentation).

What about home care?
Your esthetician can provide the best guidance on caring for your skin between treatments. Generally, this will involve keeping your skin clean and avoiding picking at your blemishes—the single biggest cause of scarring. It’s very important you follow instructions given to you by your esthetician. Untreated or undertreated acne can lead to continuing, worsening outbreaks and scarring. Your esthetician will be in close contact with you to be sure your products are working effectively for you. As your treatment progresses, your esthetician may change your home care routine to fit your changing skin’s needs.

What is rosacea, and how is it treated?
Rosacea (rose-AY-sha) is a chronic skin disease that causes varying degrees of redness and swelling, primarily on the face, but also at times on the scalp, neck, ears, chest, and back. It is considered a vascular disorder (a disorder of the blood vessels).

The condition can develop over a long period of time and is more common in adults, particularly those with fair skin. More women get it than men, though in men the condition is often more pronounced. Severe, untreated rosacea can lead to a disfigurement of the nose called rhinophyma.

There are four grades of rosacea:

• Grade 1: Mostly redness.
• Grade 2: Pimples and other blemishes.
• Grade 3: Edemas (swelling due to fluid retention) and inflammatory bumps on the nose.
• Grade 4: Symptoms affecting the eyes.

No one knows the cause of rosacea, but it is thought to run in families and can be aggravated by environmental factors and diet. Although rosacea can be accompanied by pustules, it is not acne. Researchers believe rosacea might be caused by several things: abnormal function of the blood vessels, sun damage, and an abnormal inflammatory reaction.

People with rosacea often learn that certain things trigger their flare-ups. It is believed that fluctuations in temperature (especially extreme heat or cold) is a common trigger. Spicy foods and alcohol consumption can also cause flare-ups.

How is rosacea treated?
The key to rosacea treatment is to catch it early. It may start with skin that merely flushes red. Reducing skin temperature and calming the skin is usually the first objective. Once inflammation is under control, other treatments follow. There are many treatments, including topical agents containing azelaic acid or the antibiotic metronidazole. Both have proven helpful in relieving the symptoms of rosacea. Your physician may also prescribe internal antibiotics in the tetracycline family. Esthetically, rosacea is treated with chemical exfoliation, ultrasonic treatments, and calming, soothing, hydrating treatments.

While not a cure, any of these treatments can help control symptoms, sometimes for several years. Self-treatment is not advised, beyond a simple and gentle cleansing routine. Some over-the-counter remedies may actually worsen symptoms, as will aggressive scrubbing and rubbing.  Your licensed esthetician may refer you to a dermatologist for evaluation and medical support.

What to expect from a rosacea treatment
Be ready to fill out a medical questionnaire and describe what medications and skin care
products you are using. Your therapist will do an analysis of your skin, look for any interactions between products and medications, and devise a treatment plan that’s suitable for your unique needs. Be prepared to commit to a series of treatments and a home care regimen.

After your professional treatment, your skin care therapist can recommend a home treatment plan, as well as follow-up professional treatments. Your skin may be more sensitive after treatment. Many professional skin care lines provide specialized products that sooth the inflammation of rosacea. Your esthetician will carefully choose products for you that are least likely to irritate your skin.

What about home care?
Your esthetician can provide the best guidance on caring for your skin after a treatment. In general, people with rosacea should keep a diary of things that trigger their condition: environmental factors such as sun, wind, stress, exposure to heat or severe cold, alcohol or spicy food consumption, and irritating face products. Responses to treatments vary widely; trial and error is unfortunately part of the process when working with rosacea.

What are antiaging treatments?
Thanks to the wonders of science, and innovation by skin care professionals, you can choose from a wide range of antiaging treatments. You need not have wrinkles or discoloration to actively participate in an antiaging regime—many smart consumers begin caring for and protecting their skin at a young age.

Consumers today are opting for minimally invasive procedures to avoid downtime and the unmistakable appearance of having had surgery. People may notice after treatments with your skin care professional you simply seem healthier, happier, less tired, and more confident.

Some antiaging treatments your skin care professional may be able to provide are a wide variety of facials, microdermabrasion, chemical exfoliation, galvanic treatment, and phototherapy (exposure to light-emitting diodes or intense pulsed light). He or she may be trained in a host of other treatments that, while not strictly antiaging, go a long way toward making you feel more attractive, such as hair removal, makeup application, and sunless tanning.

Who can benefit from antiaging treatments?
Anyone who is smart enough to use sunscreen is already participating in an antiaging regimen, and there is so much more you can do. Treatment recommendations will vary according to skin type and condition, chronological age and skin maturity, level of sun damage (everyone has some), and the goals you have for your skin. Your esthetician can outline your options and make recommendations.

How should I prepare for the treatment?
Be ready to fill out a medical questionnaire and describe what medications and skin care products you are using. Your therapist will do an analysis of your skin, look for any interactions between products and medications, and devise a treatment plan that’s suitable for your skin type and condition. If possible, come to your appointment without anything on your skin; otherwise your skin care professional will cleanse your skin. Start your care when you are ready to commit to a series of treatments and a home care regimen.

What to expect
The results of your treatment may be obvious right away or may take some time to achieve. This depends entirely on your program and the methods used. Your skin care professional should be able to outline realistic goals for you. In some cases, skin is in poor condition and needs to be strengthened and conditioned before antiaging treatments can be performed. If you are suffering from acne, dermatitis, or rosacea, you may have to set your antiaging goals aside until you’ve cleared those symptoms. The good news is you may gain younger-looking skin as a side benefit of clearing and treating these conditions.

What about home care?
Your esthetician can provide the best guidance on caring for your skin after a treatment. He or she may have products available for your use. It’s key to commit to a home care regimen in order to maximize your investment in the treatments your esthetician provides.