Home' Spa and Clinic : Volume 60 February 2015 Contents template for the aesthetics industry: consumers want to look
relaxed, healthy and happy, with their skin even and toned.
According to internationally renowned dermatologist Dr
Jean-Louis Sebagh, whose London-based practice is a magnet for
supermodels (notably Cindy Craw ford) and jet- setting socialites, the
obsession with wrinkle-free skin is passe.
An industry leader and a pioneer of Botox use in the 1980s,
Dr Sebagh says:
“It’s ver y much about age maintenance today and not anti-
ageing. We are now using Botox and filler with restraint.”
Plastic surgeon and president of the British Association of
Plastic Surgeons, Dr Rajiv Grover, adds: “Take a look back through
the history books and you’ll see that we’ve been slow to catch on.
Looking younger was never about wrinkles.
“In teaching young artists how to portray a subject’s age,
Leonardo da Vinci explained 500 years ago that wrinkles should
come relatively low on the pyramid, under complexion and volume.
“In the same way that a human eye perceives age, for Da Vinci it
was about creating an impression of youth, something that the small
detail of wrinkles would actually have little bearing on.”
The primary culprits of uneven skin tone are
hyperpigmentation, acne, dilated pores and scars.
In this special we look at the causes, types and the variety of
professional treatments and prescribed home care available.
According to leading cosmetic physician and skin cancer specialist
Dr Gabrielle Caswell, President of the Cosmetic Physicians’ Society
of Australasia (CPSA), treatment depends on the depth and type of
Therefore, it is essential for therapists to know in what layers of
the skin the pigmentation is presenting:
• Epidermis – outermost layers of the skin.
• Dermis - layer of skin between the epidermis and subcutaneous
• Hypodermis – sub -dermal layer mainly composed of loose
connective and adipose tissues.
TYPES AND CAUSES OF PIGMENTATION
While all skin tones suffer from pigmentation, those with darker
Asian, Mediterranean and African skin tones are particularly
prone, especially if they have a lot of sun exposure.
UV stimulates the pigment cells (melanocytes) in the epidermis
to start making melanin. This is what causes suntans – and also
However, there are other inherent factors that are exacerbated
by UV exposure.
Hormones: This is a biggie. Hormonal hyperpigmentation looks
similar to that caused by UV exposure, so this means it is essential
to be spot-on (see below) about the true source of discolouration.
From the years spent on oral birth control pills to the months of
pregnancy to the transition of menopause, fluctuations in the levels
of oestrogen or progesterone can prompt hypersensitivity in the
This over-enthusiastic generation is called melasma (or
chloasma, as in the case of pregnancy), a disorder that appears
as areas of dark, irregular, demarcated skin, ranging in size from
macules to patches on the forehead, nose, lips, and cheeks in a
mask-like configuration. People with olive or darker skin tones are
Genetics: That is, inherited. People can be born with, or develop,
odd, speckled neavi or other discolourations that can be quite large.
Heat: Env ironmental heat can trigger hyperpigmentation.
Even the most vigilant about using sunscreen and physical sun
protection can still attract discolouration because thermal heat also
encourages melanocytes to produce melanin.
Injury: When you squeeze or pick at spots, or have suffered
significant acne outbreaks, healed skin can form red-brown
patches. These fade ver y slowly, if much at all. It’s not scarring but
post-inf lammator y hyperpigmentation. It can also happen after
accidents, surgery, needles, injections and burns.
DIAGNOSIS AND TREATMENT MUST BE SPOT-ON
To effectively treat pigmentation, a therapist should have a solid
understanding of different skin types, the anatomical structure
of the skin, possible causes of pigmentation and how types of
pigmentation differ from one other. All these factors determine
what treatments can be used – or not.
For “lay” therapists starting out intending to specialise in dermal
science, or established therapists who want to advance their skills
base and expertise, there are excellent accredited courses in skin
analysis and diagnosis to suit most needs available at universities
and colleges around the country, as well as online.
You must stress to a client that if they can’t or won’t commit to
good sun-safe policies, they be frustrated when the pigmentation
returns – maybe even worse than before.
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