Rosacea is a chronic condition that cannot be cured. But treatments can keep the symptoms under control. It most commonly starts as rosy cheeks and nose. Sometimes there are tiny vesicles that should not be extracted. While it can appear at any point in life, it often first shows up in the 30s.
To know if your rosy cheeks are rosacea, you should have it diagnosed by a doctor. Estheticians can help you keep it under control, but diagnosis is the scope of the physician. Sometimes the doctor will prescribe an oral product. Be sure to let him know of any side effects. Pair this with good professional skin care treatments.
There are several different levels of rosacea. If it is ignored, rosacea can worsen. Rosy flushed cheeks with some tiny vesicles is the mildest form. Papules and nodules along with the redness is more severe. Occasionally, it can affect an eye. The most severe form causes reddening and enlarging of the nose.
Once you know you have rosacea the best way to control it is to learn what your triggers are. Triggers are the things that cause it to flare up. It could be stress, heat, spicy or hot foods and many other things.
A journal can be your friend. If you note your face feels hotter, redder or breaks out pause. Think about what you have done in the last few hours or previous day. Note this in your journal.
- If you had four cups of coffee instead of your normal two and you are more flushed… that could be a trigger.
- Spent the day on the mountains or at the beach… sun/heat could be a trigger.
- More problems in the summer? Heat could be a trigger.
There are an almost endless list of possible triggers, so learning what yours are can be invaluable.
Scientists are still debating the causes behind rosacea. Bacteria, skin inflammation, vaso-dilation, fair skin and genetics are all contributing factors.
Look for skin care for chronically sensitive skins. Avoid perfumes, harsh stripping ingredients strong chemical peels or abrasive treatments.
Think calm, sooth, heal.
- Anti-inflammatories or anti-redness formulas help reduce the red appearance.
- Calming and soothing ingredients help make your skin more comfortable.
- Anti-bacterial ingredients help those with combination or oilier skins.
- Studies have shown rosemary helps control the demodex mite.
- Hot humid climates can worsen the condition. Be sure to have those calming soothing products on hand.
- Treat your skin gently.
- Avoid extreme heat, showers or saunas.
- Learn your triggers and avoid them.
- Learn stress management techniques to keep stress levels down.
- Work with a skin professional experienced with rosacea to find what works for you.
It may take a little practice but those symptoms can be kept at bay and your skin look and feel its best.
Recently I have seen the term microbiome pop up in blogs, articles and discussions. Slightly skeptical after 35 years, I wanted to know what it was all about and what its real importance is to us in the spa and permanent cosmetic industries.
Time for research – my favorite pastime…
Definition: microbiome is defined as “the microorganisms in a particular environment (including the body or a part of the body).”
We knew that the human body was covered in microorganisms but that the stratum corneum did a great job of keeping them on the outside. We also knew that our gut had to have microorganisms to digest food. Now we have a new name for these groups of workers – microbiomes.
Internally, if the microbiome group is out of balance we have digestive disorders or even disease. Each of us has 10 – 100 TRILLION microbiotic cells in our bodies. These are found in the greatest numbers in our gut and allow for the proper digestion and absorption of nutrients. When the microbiome is out of balance disease, obesity, personality disorders and many other problems occur. When microbiomes are in balance we “live long and prosper.”
With new technology, microbiome studies have blossomed all over the world. Study of the human microbiome date back to the late 1600s but the human geome project completion, and expanded abilities of computers, has launched us into far greater understanding. It has also created even more questions.
Of greatest interest to those who have direct physical contact with clients is understanding the microbiome of human skin. The surface of the skin has 100 trillion microorganisms living on it. That is 10 times the number of skin cells. Hand hygiene is of crucial importance to reducing transfer of microbiome from one person to another.
In our industry practicing good hand hygiene and regular hand washing are the best defense to prevent contracting or sharing of disease. Routine use of gloves when there is the risk of exposure or transfer of OPIM (other potentially infectious materials), is the best practice. If we need to touch something and there is a risk our gloves may be contaminated – change gloves! Wash hands before work, between clients, before eating, after using the restroom and before going home.
Scientists are just learning about the hand microbiome and its relationship to health outcomes. Better control and studies will expand our knowledge. In the meantime, keep practicing good hand hygiene.
Rosacea is a chronic skin condition that if not controlled can worsen over time. It used to be thought to be a form of acne, but research has shown that it is more vascular in nature. While it can occur on any skin it tends to be more prevalent on lighter skin tones. It is more common in women than in men, but it can be more aggressive in male sufferers. In the United States it affects more than 16 million people but some are never diagnosed or know what is behind their ruddy cheeks.Rosacea can manifest at any age, but it is more common to show up in the 30’s to 40’s. Symptoms include redness on the cheeks, nose, chin or forehead, small blood vessels on the face, watery eyes and sometimes acne like breakouts. Typically breakouts look like tiny bumps or pimples. In more severe cases nodules or cysts can form which must be treated by a medical professional.
For each person different things can trigger the face to become more red and or a breakout to occur or “flare”. It is important to become aware of what your individual triggers are. Keeping a diary is handy. If you have a flare think back to what you have been doing and eating in the last 24 hours. For most people sun will cause a flare. Always wear sun protection when going outdoors and don’t let the fact you are using an SPF lure you into staying too long. Some sufferers find sun protection products can trigger a flare. If you have this problem, look for “physical” blocks. These typically have zinc oxide and or titanium dioxide in them. They seem to be much less problematic for those with rosacea. Other common triggers can be caffeine, wine, spicy foods, or heat, especially humid.
Look for skin care products designed for sensitive skin as these will be free of triggers like fragrance. Rosacea skin is sensitive skin. Gentle cleansers not harsh soaps are the best choice. In moisturizers go for something light weight. Look for products with calming, soothing ingredients like chamomile, allantoin, arnica Montana, panthenol, sea whip, reversatrol and many others. The guidance of a well trained skin care professional can be quite helpful. Avoid rough or abrasive scrubs, harsh masks, extreme heat, or stimulating facial treatments. Think calming and soothing.
As a skin care professional for over 30 years, I have found gentle enzyme treatments, ultrasonic treatments, LED therapy all work very well for my rosacea clients. Avoid most chemical peels unless they are specifically designed for your skin type and microdermabrasion treatments are not your best choice. Properly selected products and treatments can keep your skin in balance and the redness controlled or eliminated. Some of my clients have reported even a doctor did not realize they had rosacea.
Only a doctor can diagnose rosacea. Because it can worsen over time, it is best to get it diagnosed so that if appropriate a topical or oral prescription therapy can be implemented. This in conjunction with learning your triggers, selecting gentle sensitive skin products, using SPF and finding a good esthetician to help you in the ongoing battle and your skin can look its best leaving you less concerns and more able to enjoy life.
With the huge demand for ways to stave off the signs of age medical technology is working overtime. First there were facelifts – but a rhytidectomy (face lift) has significant down time, risk of infection, scarring and is very expensive. A facelift is normally the lower 2/3 of the face and if you add a forehead lift and or blepharoplasty (eye lift) the price will go up. Typically it runs $20,000 – $50,000. So options were explored for ways to get a more youthful appearance without the full surgery. CO2 resurfacing can smooth the skin and get rid of brown spots, but it doesn’t remove excess skin or give you that “tuck”.
The next evolution uses radio frequency most commonly sold under the trade name Thermage. It markets that it can tighten and smooth the skin non-surgically. While it can lift and tighten it won’t remove excess skin like surgery can. Thermage describes its Ideal Patent as:
- Patients who are not candidates for surgical face lift
- Middle-aged women beginning to show signs of neck/brow/eyelid sagging
- Middle-aged women beginning to show signs of drooping jowls/cheek folds
- Patients who want to achieve subtle lift or tightening of the face without invasive surgery
- Patients who have had a prior face lift and desire further tightening of the skin.
Cost runs from $1000 – $5000 depending on the area to be treated. The skin will look improved immediately but results will continue to improve for several months. By the results from their own studies, about 50% of the clients report being happy to very happy with the results. There is generally no down time or skin discoloration. They state that typically results last about 2 years. The results are permanent but that the natural aging process could indicate the need for one or two maintenance treatments. While this has been a popular service, the discomfort and success rates triggered more research.
Another new technique is using ultrasonic sound waves to transfer heat into the skin in a manner similar to radio frequency. The surface of the skin is not damaged but tiny micro-wounds place at varying depths in the dermis and below trigger tightening and collagen production. Patients have reported that afterwards it feels like the muscles have been doing ab crunches. While there may be some visible tightening this is a long term process where the skin appearance continues to improve over 3 – 6 months. Recent studies have shown that new collagen is still being deposited 2 years following a single treatment. That indicates this is a very long lasting therapy. The ideal patient would be similar to that for Thermage. Nothing will remove very lax or excess skin outside of surgery. But if you start younger, before the problem becomes severe, then yes, there are non-surgical ways to lift the face.
Because of post treatment tenderness of the muscles and along bony ridges, patients should wait 4-6 weeks before resuming facial treatments and permanent cosmetic procedures that involve pressure or stretching. A light touch treatment can probably be tolerated well at 2 weeks. If in doubt have the client get an ok from their medical professional.
Whether you are in your 20s, 40s or 60s your individual hormone balance plays a hugs part in how you feel physically and emotionally, how you look – quality of the skin, and all the aspects of your life. BHRT refers to bio-identical hormone replacement therapy, something that has been around for over 70 years, but that mainstream western medicine, dominated by male physicians, has ignored. In fact many will tell their clients no hormones – your issues are just part of aging that you have to live with. Each person is different and so are their hormonal needs. Fortunately there are a growing number of physicians and naturopaths who offer women better alternatives.
Did you know that there are many forms of testosterone therapies that are accepted by the medical community for men, and they are all covered by insurance, while for women the options covered by insurance for women are much more restricted? It is important that women become pro-active for their own health and use the internet and other resources to find a specialist who can best meet your needs whether that be to control bothersome symptoms of hot flashes, night sweats, painful intimacy, breakouts, thinning skin or more.
Within the field of BHRT there are many options available including creams, suppositories, vaginal rings and pellets. The doctors that offer these also take a look at the whole person to see what other factors may be affecting hormonal balance including diet, thyroid issues and much, much more. They will always need some sort of a chem-panel to see where your hormones are. In addition to the hormones they may also suggest natural supplements to make sure your body is functioning not just at normal, but at optimal level.
In 1900 most people did not live far beyond menopause. By the time you reached 50 you were old and the life expectancy was under 60. Loss of hormones didn’t matter much. Now in 2015 80 is considered the new 60 and life expectancy is well into the 80s for the bulk of the population. I recently heard through a client whose mother is 100 that doctors are expecting more and more people to reach or live beyond this landmark. With that kind of a change, it is crucial that we work to keep all of our internals operating at optimum so they will last as long as we do.
It is time we wake up and take care of ourselves so that we can have a long, active, healthy progression into maturity.
This is a common question clients often ask and the one word answer is Yes, medications can affect even the most simple skin care services. Many medications have effects on the body aside from the reason they are being taken. This is easily demonstrated – just listen to one of the many television commercials for prescription medications. The list of possible side effects is rather staggering. Of course not every person has these side effects but they can happen. Be sure to let your esthetician or permanent makeup artist know about all prescription and non-prescription drugs, supplements, topically applied products, eye drops, etcetera. The more they know about what you use, the better an outcome they can help you achieve. Do NOT stop taking your medications. Depending on the problem there are often workarounds. If your medication is a contraindication to doing the desired service your technician will probably recommend you talk to your doctor. Or they may request you confirm with your physician that having this procedure is safe for you. Your health and safety is our number one concern.
Cholesterol and blood pressure medications while not blood thinners, work to make the blood platelets not stick together. In permanent cosmetics this often means there may be more chance of a blood droplet coming to the surface. The down side is this molecule is bigger than the tattoo pigment molecule and can wash some of them away. This leads to more color loss than would experienced on a client not on these medications.
Clients on thyroid medications often need permanent cosmetic procedures re-enhanced a little more frequently. We have noticed that for whatever reason their color fades a little more quickly.
Blood thinning medications can also cause issues with permanent cosmetic procedures. You may be referred to get clearance from your physician.
Diabetic clients who are insulin dependent often do not heal as well and may be at a heightened risk for infection. They may need clearance from their physician for permanent cosmetic services, waxing or other more aggressive skin care treatments.
Use of retinoids (Vitamin A) or acids like Glycolic, Lactic or blends work to thin the dead skin of the epidermis. This means that a service like waxing, microdermabrasion or other exfoliating therapy increases the risk of skin irritation or even creating a wound. Be sure to discuss use of any of these products, prescription or over the counter with your technician.
Restasis is a new concern as it has been observed that those who use it have increased sensitivity of the eyelid to the point that a permanent cosmetic eyeliner procedure is not well tolerated. Your technician may want you to discontinue use for 30 days before doing the tattoo procedure. Do not restart use of the restasis for at least two weeks after your technician has determined it is completed. (Wait until all follow up work is finalized.)
Patients on chemotherapy drugs have a compromised immune system and may not heal well. All of these drugs need your doctor’s written permission that this procedure is safe for you.
Botox and injectables are extremely popular today. Any skin care or permanent cosmetic procedure is fine before having botox or injectables. If you have had either a neurotoxin or filler injectable wait at least 2 weeks before having a facial massage, other skin care treatment, waxing, or permanent cosmetic. The manipulation of the skin has a small potential for affecting the outcome and lasting of your injection site. For a lip coloration procedure the best timing is before any fillers are injected. This has been clinically observed to produce the best most predictable outcome.
Herbs and supplements can also have an impact on the skin. Some can cause blood thinning or skin thinning. Be sure to provide your technician with a complete list of everything that you take so that we can avoid unexpected complications and make sure you have the safest procedure with the most positive outcome.
Having to undergo chemotherapy is a challenge in itself but some of the drugs that are necessary to treat the cancer can bring their own set of challenges to the skin. According to Dermatology Times, November 5, 2014 review of a research report from the European Medical Journal Dermatology the new generation of anticancer drugs are more apt to cause skin reactions than their predecessors. In addition to hair loss and drying out of mucous tissue, skin side effects can range from mild widespread dryness to severe debilitating issues.
Here are 5 key points:
* Wide spread skin dryness and papulopustular rash (acne like) are known skin side effects of epidermal growth factor receptor (EGFR) inhibitors. These inhibitors include cetuximab, erlotinib, gefitinib, lapatinib, panitumumab. EGFR eruptions do not have comedones, instead they present at a rash and their severity is related to improved tumor response and survival.
*A side effect called hand foot syndrome because it most commonly occurs on the palms of the hand and soles of the feet occurs in 30-60% of patients. If you develop these symptoms be sure to advise your doctors so it can be managed.
In mild to moderate hand-foot syndrome, the following symptoms may occur on the palms of the hands and/or the soles of the feet:
Redness (similar to a sunburn)
A sensation of tingling or burning
Tenderness (sensitive to touch)
Tightness of the skin
Thick calluses and blisters on the palms and soles
Symptoms of severe hand-foot syndrome include:
Cracked, flaking, or peeling skin
Blisters, ulcers, or sores on the skin
Difficulty walking or using the hands
*Paronychia, an infection that occurs around the nails, affects 10-30% of those receiving EGRF inhibitor therapy.
*Cranial radiation therapy and neuroleptic drugs, (antipsychotic drugs that are now being used to treat other disorders), can trigger a variety of skin rashes.
*Studies have shown that hydration, antimicrobials, sterile tissue, protective ointment, and specific dermatological therapies can reduce the side effects of chemotherapy and radiation therapy. It is important to be aware of and manage skin dryness and see dermatologist if there are signs of peeling, blistering, bleeding or pain. Your dermatologist or esthetician may be able to provide you with skin care products with ingredients that have been shown to be helpful in research studies. These ingredients include: calendula, corticosteroids, topical sodium hyaluronate, urea and allantoin. Plain, non-scented, lanolin-free hydrophilic (water based hydrating) creams may help prevent radiation skin reactions.
Menopause is a nasty word that no woman enjoys dealing with. It is the time when the body transitions from having ovulation and the menstrual cycle to the complete cessation of this. While for most of us loosing the ability to have more children at 50+ is not a big issue, the challenges we must endure as we go through this process are not so great. Not only do we have to deal with hot flashes, nightsweats, poor sleep, hormonal imbalance triggering diminished sexual desire or discomfort during sex, mood swings, headaches, changes in hair growth patterns, and breakouts, but also what seems like a sudden aging appearance to the skin.
Actually, when you think about it, many of these symptoms are similar to PMS with hotflashes being the main difference. And some of the medical therapies are the same. Know that if this is an issue you deal with You are NOT ALONE. Women between 44 and 65 now make up America’s largest demographic group. By 2015 nearly one half of American women will be either menopausal or post menopause. That’s a rather staggering figure – sorry guys, not something you want to hear. But with your help, we can deal with this. Its not just us average gals, its the celebrities and female politicians also. Fortune Magazine in a recent report ran a cover story on the world’s 100 most powerful women. If we use their ages as a guide, then 90% of them are menopausal.
Side note: 6000 US women enter menopause every day with an average age of 51!
With menopause comes a loss of estrogen. Unfortunately, appropriate levels of estrogen is what helps keep the skin young looking, our emotions in balance, and our libido interested in intimacy. With the loss of estrogen the skin tends to be more dry, there is an increase the development of wrinkles and loss of skin tone. Women often note their skin seemed to suddenly age. Its common to have hair loss both on the head and of the eyebrows. While we can’t stop the time clock, there are things we can do to improve the appearance of the skin.
1) Skin Care. Find a good, well trained esthetician who understands the problems and how to address them. A variety of facial treatments can be beneficial including microdermabrasion, chemical exfoliation, hydration and facial toning. To improve the appearance of the skin it is important to exfoliate the dead skin cells off. This process tends to slow down with menopause and the skin takes on a dull appearance. Exfoliation counteracts this. Hydration improves the moisture in the surface layers of the skin. Facial toning helps give the face a subtle lift that just keeps getting better the longer it is done. I know women who have used Facial toning as their go to treatment for over a decade and they look far younger than the calender would indicate. The secret to success is think “series” instead of an occasional treatment, you will see much better results. Home use of mild AHAs or Retinols in skin care products plus incorporation of peptides and topical antioxidants generally give very impressive results. Use your esthetician as your “skin care coach” and get their recommendations to the exact products that will be the best for you.
2) If you want a quick fix, find a well qualified doctor who specializes in neurotoxin and filler therapy. Botox is the most commonly recognized brand but there are others that are FDA approved. This type of treatment requires redoing every few months, but many women (and men) find it gives them that mental boost and confidence that makes it well worth the expense. Extend the life of your injections with the home care products mentioned above (AHA’s or retinols, antioxidants and peptides as ingredients in your cosmetics.) Facial toning also works to extend the life of your injections.
3) Light therapies do improve skin appearance. IPL and laser can quickly improve the appearance of sun damage. Radio frequency can help sculpt. LED can help the skin perform better and self correct to appear younger and act healthier. LEDs are very safe to use and have no contraindications except for those with epilepsy. For laser and IPL the darker your skin tone, the more cautious you need to be as it can trigger post inflammatory hyperpigmentation.
4) Hormone therapies are another way to fight back. Many women and their doctors have been scared away from hormone therapy for long term use due to the problems with products like Premarin which is derived from processed pregnant mare urine. This product was chosen due to the high level of hormones in it. But Premarin has many side effects. There seem to be alternative choices now available to physicians that are more specific with the hormones they choose to prescribe. Lesser known but (at least in my experience) more effective and without side effects are bio-identical hormones. However, if you google this on the web, you will find controversy does exist. Commonly used are plant derived hormones including estradiol, esterone, progesterone and sometimes testosterone. With these the doctor would test your exact hormonal levels and only prescribe just what you need. These can be prescribed as topical creams, suppositories or little pellets that implanted under the skin of your butt. While the creams or suppositories are used on a daily or weekly basis the pellets last for about six months. The biggest challenge seems to be finding a doctor that really understands these therapies and that will customize the recommendations to suit the specific individual.
5) Reduce stress. Stress is a huge contributor to the aging process in the body. It is crucial to find ways to keep it in balance. Very helpful are yoga, exercise, good rest, avoiding excesses, and a healthy diet. Find something you like to to that helps you relax whether it is a walk with your favorite person or dog or that nice hot bath. Since when we are under a lot of stress, weight management becomes more challenging, finding ways to reduce your stress and/or deal with it can be very beneficial. Get and give Hugs. Research has shown that good hugs are extremely beneficial to both your physical and mental health. A good hug and/or laugh triggers the body to release soothing, healing chemicals which boost your mood and create happiness. Try for 8 hugs a day and watch your stress levels decline.
Sleep Issues – Causing Skin Conditions?
Yes, your sleep problems can be causing skin problems. Sleep is our time to internally refresh, restore and heal. Anything that interrupts this process can lead to the skin looking less than its best. All of us have gotten up and looked in the mirror after a bad night’s sleep and noted the dark under-eye circles and the dull cast to the skin. The bad sleep and the diminished skin appearance are directly related. Anything that triggers poor sleep can make us look, and feel tired and older.
Inadequate sleep: whether it is odd working hours, stress, a baby in the house, insomnia, or anything else that prevents us from sleeping, it is going to result in daytime tiredness, under eye circles and a dull cast to the skin. We can slather on all the lotions and potions we want, but if we don’t address the problem it won’t get any better.
If you do shift work, try to create an environment where you can get maximum rest when you do get to sleep. Consider a device that will create white noise and blank out the potentially interruptive sounds. Solicit the support of family and friends that “x” hours you need to be sleeping. Rotating shifts are even harder as your body’s natural Circadian rhythm is fighting with the schedule you need to keep. Our body’s natural desire is to sleep when it’s dark and be awake in the light.
Stress: we all know the hazards but often don’t think about them showing up on the skin. They do. Each of us needs to find ways to deal with the stresses in our life and there are a lot of them. Family, babies, marriage, divorce, work, bills, friends, all can be stressful. Even exercise or a change in routine can be stressful to the body and it will need time to adapt. Stress affects our hormone levels which affects about everything else. Be prepared with your little emergency kit if stress triggers skin breakouts. Try some form of meditation or relaxation to reduce stress before you go to bed to sleep better. Yes, that cup of herbal tea is a more restful nightcap than anything else. No caffeine of any form including sodas or chocolate for 4 hours prior to bedtime also is a great help.
Baby: It’s nothing new that a baby in the house will mess with your sleep. So what is a mom supposed to do? Go with the flow. If you have are at home with the child, the best answer is probably napping. When you put the baby down, take a power nap. This may help you feel more refreshed and rested in the evening when the rest of your family is home and hoping for a bit of companionship and a meal. If you are back at work and napping when baby does isn’t an option, try catching a power nap at lunch. Learn to do a bit of self-hypnosis and you can feel rested and refreshed in 15 minutes. The slow cooker is your friend. Not only do slow cookers create very tasty and lower glycation meals, you can start it in the morning and forget it. No time to do it in the morning because of family and baby demands? Consider making it a family together time and assemble it the night before. Get everyone involved and let them help. In the morning, just put it on the heating base and turn it on.
Snoring: Well this was a new one for me. Yes, snoring can mess with your sleep – and I don’t mean waking your partner and them being grouchy. Snoring loudly enough to wake yourself or your partner may mean sleep apnea. Sleep apnea can be a potentially life threatening disorder if untreated. During the sleep cycle breathing stops and starts multiple times. The problem is easily recognized in men because they tend to snore loudly. Women though, (my doctor told me) are much sneaker and harder to discover. Women may or may not suffer from loud snoring but still have sleep apnea. The problem with sleep apnea is the interrupted breathing means that the brain is not getting its routine oxygen supply. This is what can lead to some pretty nasty health problems. Here is a listing of the symptoms and information from the Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/symptoms/con-20020286 I don’t have many of the classical symptoms like daytime drowsiness, but I do have sleep apnea. Learning and treating this I can avoid the health problems and wake up refreshed in the morning.
There is only one thing more damaging to the skin and aging it than the sun, and that is a tanning bed. It doesn’t burn the skin because it only uses UVA rays. UVA rays penetrate more deeply and cause damage to the dermal tissue. UVB rays are more focused on the surface of the skin and cause burns. Unprotected, both can lead to skin cancer.
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