Milia - what is it?

• Milia is the most commonly used term, it’s the plural form of milium, since many are usually found together.

• Milia occur when keratin becomes trapped beneath the epidermis.

• Milia can occur in people of all ages, but they’re most common in newborns, affecting up to 50% of them. They’re typically found on the face, eyelids, and cheeks.

• Newborn milia are often confused with a condition called Epstein pearls, which involves the appearance of harmless white-yellow cysts on a newborn’s gums and mouth.

• Milia are also often inaccurately referred to as “baby acne.”

• Milia tend to go away within 1 month of appearing on a
baby's skin

• In adults, the use of steroid creams can lead to milia on the skin where the cream is applied. However, such side effects from topical medications are rare.

• The most common reason milia form is from using heavy skin care products or hair care items. Comedogenic creams and lotions may prevent the sloughing of dead epidermal skin cells.

• A common method that a dermatologist will use to remove a milium is to nick the skin with a #11 surgical blade and then use a comedone extractor to press the cyst out.

• Milia can also be associated with certain skin diseases, particularly blistering disorders such as Porphyria Cutanea Tarda. It manifests along with blisters on the backs of hands and knuckles.

Professional Modalities For Acne

As we know, treating acne requires a proper at-home skincare regimen, an understanding of our allergies and intolerances, and regular visits to an esthetician. A knowledgeable skin care professional will use a variety of professional products and modalities to deeply cleanse, exfoliate, de-congest, and disinfect the skin, as well as soothe and heal the inflammation associated with acne. There is a myriad of different devices and modalities available to perform a service for acneic skin, but I will focus on a few of the most commonly used among skincare professionals. You may check with your state’s Board of Cosmetology to see if a device is allowed to be used in your state by licensed estheticians, or just by medical personnel.

One of the first modalities we use in school is galvanic. Galvanic current is a constant and direct current (DC) that uses a positive and negative pole to produce the chemical reactions when it passes through tissues and fluids in the body. For acne clients, we use desincrustation. Desincrustation is a deep cleansing treatment that softens and emulsifies sebum, and is the ideal treatment for oily or congested skins preparing the skin for extractions. It should be done after cleansing the skin, using desincrustation fluid - a type of alkaline solution made from sodium chloride (table salt). Although this is a very commonly used machine in our scope of practice, don’t forget to make sure the client fills out the consultation form, and is not contraindicated to receive a galvanic treatment. Contraindications for using a galvanic device are: pregnancy, metal implants/pins in the face or body, epilepsy, pacemaker, and high blood pressure. 

Another great way to cleanse the skin is by mode of ultrasonic exfoliation. An ultrasonic skin spatula or ultrasonic skin scrubber is a small hand-held device that features a thin plate that vibrates 28,000-30,000 Hz per second, and removes dead skin cells, dirt, and debris. The spatula works by creating high speed oscillations that extract pores without pain. For those clients with sensitive skin, ultrasonic exfoliation is a wonderful alternative to skin-cleansing brushes and microdermabrasion (both of which spread bacteria and aggravate redness and discomfort). The esthetician controls the pressure, angle and direction of the spatula to delicately work debris from the clients’ pores, focusing on problem areas and exfoliating the skin gently without aggressively brushing or peeling it. Since you are using water or a hydrating toner with the spatula, and not a gritty scrub, your clients’ skin will feel very clean and smooth after the treatment.

In addition to these devices, another basic tool we are all familiar with is the high frequency machine. The high frequency machine is used after extractions on clean skin, or over gauze to close the pores and kill germs and bacteria. High-frequency treatment uses low-current high-frequency alternating currents, delivered via a glass electrode. 

Because the high frequency current converts some of the oxygen in the air into ozone, the treatment has a germicidal action, and is also drying and warming. Consequently, the treatment is used to aid healing and also to help desquamation and stimulate sweat and sebaceous glands. At up to 250,000 Hz frequency, the hollow glass electrode behaves like a glow discharge tube. When applied to the surface of the skin or scalp, a mild high frequency current passes through the neon or argon gas filled glass electrode causing it to light up with a neon orange or argon purple glow. 

Cleanse the skin first, exfoliate, and perform extractions. Then, after the extractions have been performed, treat blemished area by lightly whisking the glass bulb tip of your high frequency wand across the surface of the client’s skin using circular motions. Concentrate on larger blemishes and the areas most affected for at least 30-40 seconds. The total treatment time with a high frequency machine is 3-5 minutes, and treatments can be repeated every other day. Similarly to the galvanic machine, the contraindications for this device are: pregnancy, metal implants/pins in the face or body, epilepsy, pacemaker, high blood pressure.

To kill acne-causing bacteria, and reduce inflammation, one of the best modalities is LED – light emitting diode - a tiny computer chip encased in glass. Blue LED therapy for acne is non-invasive, painless and requires no recovery time. It is safe for all skin types and tones, and requires only 5 -15 minutes. The best combination of lights for acne is blue and red together – the blue kills germs and bacteria that cause acne, and the red renews the skin, and encourages new collagen production. Such lights are available for home use in a handheld, as well as panels for faster and more convenient treatment room services.

Cupping for Acne

Cupping, a favorite of mine, is highly effective for cystic acne. In Traditional Chinese Medicine acne is often caused by heat, dampness, and stagnation, and cupping is effective at reducing heat and moving stagnation. Cupping is performed by depressurizing the inside of the cup with a flame or a vacuum, so it then lifts up the skin below it. Traditionally cupping works to increase circulation and remove heat from the body, and is used for a wide range of conditions including stress, muscle pain, arthritis, chest colds and fevers, and even some skin conditions.

Plastic and glass are the most common materials used today. Cupping therapy types can be classified into four main categories.

1. Technical Types

• Dry
• Wet
• Massage
• Flash Cupping

2. Power of Suction

• Light
• Medium
• Strong 

3. Method of Suction

• Fire
• Manual Suction
• Electrical suction 

4. Materials Inside Cups

• Herbal
• Water
• Ozone
• Needle 
• Magnetic cupping

Cups may range in size from 1 to 3 inches in diameter.

Dry cupping commonly involves creating a small area of low air pressure next to the skin. The low air pressure required may be created by heating the cup or the air inside it with an open flame or a bath in hot scented oils, then placing it against the skin. As the air inside the cup cools, it contracts and draws the skin slightly inside. More recently, vacuum is created with a mechanical suction pump acting through a valve located at the top of the cup.

Fire cupping, my favorite (pictured), involves soaking a cotton ball in alcohol, then clamping it by a pair of forceps, setting it on fire and, in one motion, placing into the cup and quickly removing. Then, the cup is placed on the skin. Fire heats the inside of the cup and a small amount of suction is created by the air cooling down and contracting. Massage oil may be applied to create a better seal as well as allow the cups to glide over muscle groups in an act called "moving cupping". Immediately after, dark circles will appear where the cups were placed because of rupture of the capillaries just under the skin. 

Wet cupping, or Hijama, is performed by letting the area under the cup fill with “bad” dark blood. The cups are applied to the skin using the fire or suction method, and left to cling to the skin for a few minutes, then it is lifted off and several very small incisions are made in the skin. The cup is then put back as it was before until the flow of blood subsides. Hijama is considered a form of energy medicine because it has been claimed to "unclog" purported meridians in the body.

When treating inflammatory conditions, such as acne, the goal is to remove heat and toxins. This is generally done through cupping on the back, even if the acne is on the face or chest.

There are a number of small studies and reports for cupping alone or in combination with other therapies that have been successful for treating acne, particularly for inflammatory and cystic acne. In TCM, it is very common to combine cupping with other modalities such as acupuncture or herbal medicine. 

A meta-analysis of cupping concluded that cupping alone or in combination with herbal interventions is more effective than herbal interventions alone, and cupping combined with acupuncture was found to have a trend toward being more effective than acupuncture alone. A study that examined cupping found that 10 out of 11 people with acne had improvement in their symptoms. In these patients, cupping also reduced inflammatory chemicals circulating in the blood.

Online Retailing for Spas - an Introduction

How/where should spas get started with online retailing?

Online retailing is as easy as setting up a shopping cart option on the spa’s website. It can be done by a web designer, and the payments can be processed by regular credit cards, as well as by paypal. All that’s needed is a business bank account, and the right software.

As a brand owner, do you want to know if your clients are selling products online? What might be involved with that?

As a professional brand owner, one wants to keep the value of the products high, and avoid underselling by distributors. Underselling, essentially means selling below the MSRP (manufacturer’s suggested retail price). While it may not be an issue to sell cheaper in person at the salon, selling online at discounted prices is discouraged. In addition to pricing issues, online sellers have to make sure the directions and skin type information is listed in a detailed fashion on their site, especially for professional products. When consumers purchase online, they are often confused as to which product suits them best, and how to utilize it, unless consulted by the esthetician prior to purchasing. 

What help can you provide from a brand perspective? Do you help with fulfillment? Providing images, descriptions? Is pricing set by you, the brand?

The inspiration for SAIAN Natural Clinical Skin Care comes from our customers. We are not just a skincare company, we are a lifestyle brand, dedicated to bringing our customers the best in skincare, anti-aging supplements, ergonomic equipment, supplies and education. We are the esthetician’s partner in creating her most successful beauty business - no minimum order, $2-$7 cost-per-treatment, free samples, and support from our friendly staff. 

We don’t do fulfillment, or set the prices, and we discourage online sales that are less than double wholesale price. Of course, all the images and descriptions are provided by us!

What are some of the advantages of having spas sell products online? 

The biggest advantage to having spas sell products online, is the additional retail income that the sales will bring in. Treatments will only bring in so much revenue, but product sales can make or break a spa’s success. In addition to bringing in revenue, product sales keep the customer’s skin looking good between facials, and maintain an ongoing relationship between the customer and the spa.

Fact or Fiction - Facial Exercises Can Help Prevent Sagging Skin

How many of us have heard about facial exercises or face yoga, but are unsure if these methods really work for tightening sagging skin? There are a number of YouTube tutorials, as well as books on the subject, and miscellaneous information available online, which may confuse the general public. Articles in Cosmopolitan and Marie Claire boast facial exercise as an effective solution to a younger face – if muscle training works to strengthen the body, it must work the same way on the face, right?

Face yoga expert Danielle * says: “The exercises work the hypodermis or the lower layer of the skin, the dermis or the middle layer and the epidermis or the upper layer. By working all these layers correctly it will increase the blood circulation, allowing more oxygen and more nourishment to reach the cells of the skin. The result is a clear, healthy complexion with a beautiful glow which has less toxins and has a better ability to absorb moisture.”

The reality is, there has been absolutely no research confirming this to be true. On the contrary, plastic surgeons unanimously agree that facial exercises can indeed cause deeper expression lines, and more wrinkling, but why?

The hypodermis (subcutaneous tissue) is mostly made up of fat tissue and fibrous bands that anchor your skin to the deep fascia. This layer may vary in the body from very minimal, such as in areas of the eyelids, or as a thick layer as in the fat around the abdomen and waist. Hypodermis aging is observed by the loss of fat tissues which affects the shape of our face, neck and hands, i.e. sagging skin. Our cheeks and eye sockets may hallow out, and the skin on the neck, breasts and hands may lose its firmness.

Muscular stimulation by facial exercise doesn’t correct this issue, furthermore, more expression lines are created in the areas where the hypodermis is thinnest. Through repeated strenuous facial muscle engagement, more lines are formed in the same way crow’s feet, marionette lines and forehead wrinkles are created naturally.

What methods actually work to reduce sagging skin? Manual facial stimulation such as Dien Chan multireflexology, facial acupressure, facial acupuncture and European massage are all effective at toning the facial muscles and stimulating circulation, which gives a plump, revived appearance to sagging skin. There are also numerous devices to tone and lift sagging skin, including microcurrent machines, phototherapy LED, and Radio Frequency modalities. In a medical setting, machines such as ThermiTight, ThermiSmooth, IPL, Fractional laser are all beneficial in tightening the skin, without surgical involvement.

Topical products based on hyaluronic acid, peptides and growth factors hydrate and nourish the skin, giving it a supple and youthful glow. In addition to anti-aging products, regular use of sunblock protects the skin from sun damage and elastosis.

Hyaluronic acid supports the structure of connective tissue by acting as a water magnet to maintain extra-cellular fluidity. HA forms a viscous fluid with exceptional lubricating properties necessary for the vital functions of many parts of the human body including the skin. If sagging skin is a concern, 200mg of hyaluronic acid may be taken as a dietary supplement, as well as 6000 mg of bioactive collagen types 1 & 3.

Growth Factors, Neuropeptides, Stem Cells and Men's Products - New Items are In!

New items are in! We have a new Botanical Stem Cell Sleeping Mask, men's line, and a Neuropeptide Growth Factor Serum (for men and women) which prolongs the life of Botox injections using 5 biomimetic peptides. These products are the hottest in anti-aging peptide technology, only from SAIAN Natural Clinical Skin Care. 

Neuropeptide Growth Factor Serum contains Hyaluronic Acid, and five of the most potent biomimetic peptides currently available to address the affects of aging on the skin. Using the latest Biomimetic technology, SAIAN Neuropeptide Growth Factor Serum delivers 5 of the newest peptides into the skin, lifting, hydrating, reducing wrinkles, and prolonging the effects of Botox® injections. The peptides we use are inspired by nature, and identical to the growth factors found in human placenta. With time, our natural peptides lose their effectiveness, which is why our skin starts to look older. To correct this, we have discovered that polypeptide chains can be boosted to produce more stable and effective molecules called biomimetic peptides. Biomimetic Peptides mimic the function of growth factors as messengers in the skin, allowing the epidermis and dermis to communicate more efficiently. When our intelligent Biomimetic Peptides are infiltrated into the skin, they naturally work on the different levels of the damaged skin and help it to regenerate itself without producing toxic side-effects. What’s even more remarkable, our new incrdible serum is able to prolong the effects of Botox® injections by months, allowing for less frequent visits to the doctor. Absolutely pure and active. Perfect for both men and women.

SAIAN remarkable Botanical Stem Cell Mask uses the latest stem cell technology to derive powerful actives from Acai Palm, Chinese Basil, and White Oak resource materials. These derivatives impart antioxidant, protectant, and anti-aging benefits. The secret is in this mask’s unique transparent, breathable, nourishing, odorless, and non-sticky film base. Simply apply by smoothing gently over the entire face, avoiding eye area, wait until completely dry, and go to sleep with it on. While you sleep, SAIAN Botanical Stem Cell Mask sits comfortably on the face, and doesn’t rub off on your pillow. Its hydroscopic and breathable barrier properties ensure the skin locks in moisture, and breathes uninterrupted. It is easy to remove with a light wash, upon waking up.

New Herbal Toner Formula is now Available

SAIAN Herbal Toner is light, ‪natural‬ and fragrance-free. It refreshes and soothes the skin with its abundant bouquet of herbs and hyaluronic acid. Our gentle toner is enriched with ‪Sage‬, Witch Hazel, Hops, ‪Calendula‬, ‪Lavender‬, Licorice, Lemon Peel, Horsetail, Burdock Root, Yarrow, Comfrey, and Sage! Soothes damaged, irritated skin. Contains ‪antioxidant‬ and regenerative properties, stimulates cell regeneration in stressed, affected skin. Improves rough and chapped skin. Paraben-free and formulated especially for sensitive skin. http://saian.net/product/herbal-toner/

Selecting a Receptionist for your Spa or Salon

As the first person your customers communicate with – on the phone and upon entering the spa, the receptionist needs to make a good first impression. A great receptionist is someone on the front lines who has a professional appearance and attitude. Not many people know this, but I have spent 8 years out of my 17 years of industry experience as a spa receptionist. I know exactly what it takes to select a great receptionist, and will give you some pointers on what to look for as you go through the interview process.

First thing to look for in a qualified spa receptionist is a tidy, put together appearance. Your spa or salon is a place of beauty, health and tranquility, so having a receptionist with chipped nails, or messy oily hair will create disharmony in the overall image of your business. By any means, your employees don’t have to look like supermodels, but excellent hygiene is a must! A tidy and put-together person will also be wonderful at organizing the desk, and keeping the work area clean and manageable. This type of employee will never write an important phone message on a post-it in a pile of papers.

During the interview, you can role-play with the candidate, and him or her take down a message. Look for legible handwriting, correct spelling, and take notice of the tone of voice. A good phone presence is a crucial skill. You can trust that an empathetic person will be a wonderful listener who can accommodate your clients’ requests, and will help work out any slipups that may occur, such as double-booking, or other issues. It is important to choose a team player who shows enthusiasm in discovering the spa’s treatments and products. A good receptionist will ask many questions to get better acquainted with the different types of facials, and massages, and will try treatments to know how they feel. First-hand experience with treatments and products is the best way to passionately talk about them, and suggest them to clients.  

A very important quality in a front-desk person is the ability to multi-task without feeling overwhelmed, anxious, or frustrated. A candidate who is well-versed in a multitude of computer programs and apps is an asset to your organization. Not only will this receptionist quickly acquaint him/herself with your spa booking software, but he or she will be able to manage multiple tasks with ease. Someone who is technologically savvy is wonderful at implementing the newest apps and programs to help take the clutter out of, what may seem to be confusing, tasks.

Look for candidates with a humble and agreeable personality. A person who easily takes directions, and can handle constructive criticism will be a breeze to work with for both you and your clients. Look for someone with great integrity who can show initiative and improvise, and avoid those who will walk past a candy wrapper on the floor, and use the excuse “that’s not part of my job description” to justify not tossing it into the trash can.

These simple tips are what I believe will help you select the right person for your front desk. I have worked as a receptionist at the same spa for 8 years, prior to joining my mother to start our own skin care brand.  My previous employer, co-workers, clients and I still keep in touch, because that job was my passion and my priority. I never brought in negativity, and I always made everyone I worked with feel loved and well taken care of.  The most important attributes to look for are integrity and a good nature, and the rest of the technicalities can be learned in time!