What I truly love about the skin care profession is not necessarily the “how” of treatments, products, and results; but the “why”. This is probably why I am so passionate about teaching. It is not enough in our business to simply be able to make recommendations and deliver visible results to our client’s skin, if we do not know precisely why we are capable of achieving such results.
As consumers place increasingly more confidence in our hands regarding meeting their skin needs and concerns, our professional responsibility to meet those needs has grown, requiring aestheticians to have a deep understanding of how those concerns even came to be. That being said, one of the most influential contributing factors to the condition of the skin, at many different ages, is fluctuations in hormones.
The human body has two types of glands, exocrine glands and endocrine glands. Exocrine glands secrete material out of the duct and onto the surface of the body (I like to think of them as exiting), such as salivary glands, sudoriferous glands, and sebaceous glands. Endocrine glands are composed of a special group of cells that form ductless glands, and secrete substances directly into the bloodstream; these substances are know as hormones.
The Endocrine System
The major endocrine glands in the human body are the pituitary gland, pineal gland, thymus, thyroid, adrenal glands, ,-and pancreas. Let us take a brief look at the role of each one.
The pituitary gland is a small pea size gland located at the base of the brain, often referred to as the “Master Gland”. Hormones secreted by this gland function to regulate homeostasis and stimulate other endocrine glands. The pituitary hormones help control growth, blood pressure, uterine contractions during childbirth and the formation of breast milk, metabolism, water regulation in the body and kidneys, the functioning of sex organs in males and females, temperature regulation, and most importantly, the production of growth hormone.
The pineal gland is a small gland shaped like a tiny pine cone, and is located near the center of the brain, between the two hemispheres. Often referred to as the “third eye”, the pineal gland produces melatonin – a hormone that affects an individual’s sleep patterns, as well as alterations in seasonal functions. The production of melatonin is stimulated by darkness and inhibited by light. Specialized photosensitive cells in the retina detect light and directly signal the suprachiasmatic nucleus (SCN), a tiny region in the brain that controls circadian rhythms; the body’s natural functioning within a 24 hour cycle. The human pineal gland grows in size only until about one to two years of age, and then remains the same throughout life.
The thymus gland lies just beneath the top of the breastbone and is a specialized organ in the immune system. The thymus is responsible for processing a type of white
blood cell called a T-Cell (hence the “T” for thymus). T-lymphocytes are known to regulate cellular immunity by assisting other cells in recognizing and destroying foreign substances such as bacteria, viruses, and even abnormal cell growth such as cancer.
The thyroid gland is one of the largest endocrine glands in the body. It is located in the center of the neck and is also known as the “Adam’s Apple.” This gland controls the rate at which the body uses energy, produces proteins, and controls the body’s sensitivity level to other hormones. The function of the thyroid gland depends upon the production of its’ two primary hormones, thyroxin (T4) and triiodothyronine (T3). These two hormones regulate the rate of metabolism, calcium levels, and affect the function and growth of many other body systems. The thyroid gland is controlled by the hypothalamus and pituitary.
The adrenal glands are triangular shaped glands found on top of the kidneys. Their main function is the release of hormones associated with stress by means of adrenaline, cortisol, and corticosteroids. Each gland is separated into two sections, the cortex and the medulla. The cortex mainly produces cortisol, as well as aldosterone and androgens; while the medulla primarily produces epinephrine (adrenaline) and norepinephrine. The adrenal glands also stimulate fat breakdown in adipose tissue, inhibit protein synthesis, and provide both an immunosuppressive and anti-inflammatory role.
Last, but certainly not least, the pancreas. The pancreas acts as both an endocrine and exocrine gland. For the purpose of this article, I will focus on its endocrine function of producing key hormones, by means of the Islets of Langerhan; such as insulin, glucagon (which raises blood glucose levels, having an opposite effect from insulin), and somatostatin (a peptide hormone that affects cell proliferation and neurotransmissions).
External Hormonal Stimulators and Their Relationship to the Skin
At this point you may be wondering what any of this has to do with the skin. Research has shown that hormones and hormonal changes have the greatest impact on the health of the skin, and most notably, on the aging process. There are multiple factors that influence hormonal changes, but there are six that are the most prominent and frequent; stress, pregnancy, menopause, a menstrual cycle, oral contraceptives, illness, and/or disease.
Knowledge of these factors and of their potential influences on the skin are terrific “red flags” acquired during the consultation process, and from the consultation form. Understanding that most of these factors are beyond our scope of practice, and are even beyond individual control allows us to improve the skin, knowing that permanent improvement is unlikely until the external factor is negated. In this section, we will look at each of the most common external factors that affect hormones.
Triggers hormones that affect the immune system and the adrenal glands. As you will recall these glands produce cortisol and growth hormones. When negatively impacted due to stress there is an impact on immune efficiency, proper inflammatory responses as well as cellular growth,
Increases fluctuations in estrogen and progesterone. These fluctuations in turn trigger melanocyte activity, stimulate blood flow, and enhance skin sensitivity as well as increase the risk of acne during the first trimester.
Causes a drop in estrogen levels. This drop decreases blood flow, decreases cell renewal, causes drier, more fragile skin, and a loss of collagen and elastin.
The Mestrual Cycle
Triggers fluctuations in estrogen and testosterone levels. In week one of the cycle, estrogen levels are higher, minimizing acne breakouts. However, once ovulation occurs, testosterone levels rise, stimulating the sebaceous glands and promoting acne breakouts.
Have similar hormonal effects to those of pregnancy. Higher doses of estrogen are frequently used for the treatment of acne.
Illness and Disease
Within the various endocrine glands will alter hormone production resulting in various skin manifestations:
Thyroid Disease: May present manifestations such as atopic dermatitis, ecchymosis, sarcoidosis, vitiligo, xanthomas, and edema.
Pituitary Gland Disease: May present manifestations such as excessive hair growth and thickening of the skin.
It is never a “given” that these manifestations will occur. Nor is it a “given” that they are the result of these external stimulators; but the relationships between them are well proven and documented. It is these relationships that will act as a guide for determining proper skin care protocols.
A Closer Look at Key Hormones
Regardless of the various external and hereditary factors that may influence an individual's specific hormonal functioning, there are three primary hormones that have the greatest influence on the condition of the skin; estrogen, thyroxin, and androgens (testosterone). Keep in mind that while there certainly are a multitude of various hormones, these three are the most prominent, influential, and most easily fluctuated. Each of these common hormones interestingly can have an effect on both the skin as well as the hair.
Estrogen is important for maintaining collagen and skin moisture by increasing mucopolysaccharides and hyaluronic acid and enhancing the skin's barrier function. It has also been noted that estrogen plays a role in promoting cutaneous wound healing. Estrogen-deprived skin; thins, loses collagen, and slows down the cell renewal process. Estrogen also plays a role in maintaining a full, healthy head of hair by encouraging hair to stay in its growing phase (anagen hair). This is easily recognized in the significant thickening of hair towards the end of many pregnancies. Likewise, when estrogen levels take a significant plunge, such as during and after menopause, the lower estrogen level allows the scalp hair to grow closer to the falling out stage (telogen hair), resulting in finer, more sparse hair. Unfortunately, that same drop in estrogen has the opposite effect on facial hair, which tends to increase and thicken most likely as a result of higher testosterone levels.
Thyroxin, produced by the thyroid gland, also has an influence on the appearance of the skin. Excess production of thyroxin results in a warm, smooth, sweaty, flushed skin appearance; whereas an under-activity of thyroxin produces a dry, coarse, thickening of skin with reduced ability to sweat.
Androgens, the male hormones, most specifically, testosterone, play a key role in the production of sebum in the skin. The oil glands of the skin are in part controlled by the level and activity of the hormone testosterone by having a direct impact on the stimulation of the sebaceous glands. This is seen in conditions such as acne; as well as polycystic ovary syndrome, which produce some elevation in testosterone, resulting in increased facial hair, irregular periods, and acne.
As we age, the turnover of human epidermal stem cells begins to slow. Over time, these critical cells function less efficiently. Hindered by a finite number of potential cell divisions, lost and dying cells start to outnumber fresh new cells, and, sooner than later, they culminate in signs of aging.
Plant stem cells, however, have the ability to divide over many generations and the unique capacity to stimulate and protect human stem cells. The results are a reduction in the appearance of fine lines and wrinkles, collagen loss and other common signs of aging.
The most common plant-derived stem cell used in skincare today is the Swiss Uttwiler Spätlauber apple. First cultivated in the 18th century for its hardy, long-lasting fruit, this tannin-rich fruit offers a rich source of anti-aging activity.
By forming small wounds in “explants” of the stem cell tissue, scientists are able to stimulate large cell masses known as calluses, which contain the “unprogrammed” and undifferentiated cells of the plant. It is within these “blank canvases” that exciting, new applications in skincare yield promise, including the ability to increase the longevity of human skin cells and stimulate new ones.
In a Swiss in-house study published in the SOFW Journal in 2008¹, scientists showed that a 0.1% concentration of stem cells extracted from the Uttwiler Spätlauber apple stimulated the proliferation of human stem cells by 80%.
In followup experiments, the scientists irradiated a human stem cell sample with UV light. While nearly half of the cultured stem cells died when exposed to the UV light, the number of living cells grown in the culture containing the apple extract experienced only a small decrease.
Further Swiss studies showed that incubating fibroblast cells — the building blocks of collagen and other skin structural tissue proteins — in a 2% Uttwiler Spätlauber apple extract neutralized factors that lead to aging and, in some cases, actually reversed the process.
Dermascope - Jaskiran Brar
The teenage years are wondrous days filled with new discoveries, fun, and friends. For a number of kids, these years are also filled with acne. In addition to causing painful whiteheads, blackheads, and red lumps, acne can leave scars and affect self-esteem during those critical adolescent years.
According to the American Academy of Dermatology, between 85 – 95 percent of American teenagers develop acne, and many of them will continue to battle the condition into their 20s and 30s.
A number of factors such as diet, personal hygiene, genetics, and hormones seem to play into the incidence of teenage acne. During puberty, hormone levels surge, often causing a hardening of the oil in the pores of the skin, preventing sebum from naturally making its way to the surface.
While almost all teenagers experience a few zits, the severity of the problem depends on hereditary factors. Over time, untreated acne can even leave permanent scarring, not to mention the emotional distress the teenager has to endure.
Along with good nutrition and healthy lifestyle, regular skin treatments during adolescence can make a world of difference in a teenager’s complexion. Parents need to address the condition early, and make sure their teens follow proper skin care routines at home. A diligently followed routine, along with regular acne facials, for many of these teenagers can mean the difference between smooth glowing skin and permanent scarring.
Dermascope - October 2010
A wide range of plant stem cells, including extracts from edelweiss, echinacea, gotu kola and several lilac varietals, may offer significant future skincare applications.
For instance, edelweiss, an Alpine flower with a special affinity to survive extreme altitudes and solar radiation exposure, offers potent antioxidant and anti-inflammatory benefits. Edelweiss stem cells inhibit the enzymes that break down hyaluronic acid and collagen.
To illustrate, a cream with 1% edelweiss stem cells used twice daily reduced wrinkle depth of the eye contour area by 15% after 20 days of treatment in a clinical study involving 20 individuals.
The stem cells from echinacea, a botanical revered for its immune-strengthening properties, have also demonstrated an ability to inhibit collagenase, the enzyme that breaks down collagen, while stimulating the synthesis of new collagen in vitro.
Likewise, stem cells from the gotu kola plant, also known as tiger grass, have been shown to decrease the skin-degrading enzyme, hyaluronidase, by up to 90% and therefore retain the skin’s hyaluronic acid, a key extracellular matrix ingredient responsible for hydration and elasticity.
Other plant-derived stem cells may offer new applications in fighting acne. Syringa vulgaris L., otherwise known as common lilac, has been shown to inhibit 5α-reductase, an enzyme involved in sebum production, as well as decrease the pro-inflammatory chemokine IL-8. In clinical studies, a cream containing 1% of a patented plant stem cell extract reduced lesions in 29 acne patients by 40% in 30 days and showed a significant decrease in inflammation and melanin pigmentation.
By combining these plant-derived stem cells with other anti-aging actives, such as peptides, proteins and cell-active folic acid, we can rejuvenate skin cell DNA, the core center for all cell renewal processes, and literally give aging skin a fresh new start.
by Christine Healthman
The course of rosacea is prolonged. Recurrences are common and difficult. Rosacea is a skin in trauma and out of balance. When tissue repairs itself, it requires more amino acids for cell proliferation. Peptides are organic chemical compounds composed of one or more basic amino acid groups and one or more acidic carboxyl groups. Select a peptide product that contains palmitoyl-pentapeptide-3 and other peptides with a low molecular weight in the amino acid chain. Peptides are non-irritating and more stable than vitamin C and Retinol. Not only do peptides have the capability to reduce the inflammation associated with rosacea; they reduce the aging factors that compound rosacea sufferers linked with photo-damaged skin. Peptides must be an integral step in treating rosacea skin.
Carbohydrates constitute the main source of energy for all body functions and are required for the metabolism of other nutrients. This is why balanced nutrition is necessary, incorporating non-inflammatory foods augmented with antioxidant supplements help with rosacea skin detoxification.
Treatment of rosacea requires patience from the client and a thorough understanding of the histology, anatomy, and physiology of this disorder in relationship to the skin by the skin care professional. Rosacea is currently incurable; however it is a great skin challenge to treat because much can be done to relieve its signs and symptoms. An important goal for clinical treatment is to limit progression to the more severe, end-stage manifestations of the disease.
It is established that rosacea clients can have sensitive skin and misled that this hyper-reactive condition could be affected by topical agents such as cleansers and AHAs. This hypersensitivity link has not been convincingly demonstrated, nor is it proven. For example, rosacea patients are not especially prone to stinging after an application of 10 percent Lactic Acid. Clinical studies of this disease in relationship to these acids are reassuring because rosacea can readily accommodate irritating agents. Because rosacea is photodermatosis, it is absolutely imperative that a rosacea compatible SPF 30+ and protective makeup such as a camouflage base is part of the daily treatment program to protect against the environment. Selection of sun protection for rosacea must be a formula that does not increase inflammation. Know your skin care company and be sure they provide an SPF product for rosacea. Not all SPF products are rosacea compatible and many sun protection products will irritate the condition and hold heat in the skin causing more redness.
Rosacea is often a difficult, stubborn, humiliating disease to treat if not properly understood. It is a challenge for the creative skin care therapist. Great therapeutic triumph comes when using AHAs in the clinical environment for rosacea. Many topical acne agents include retinoids that may be too irritating to the rosacea skin type and could aggravate the telangiectasiac component. AHAs have not been shown to promote angiogenesis and therefore may be a more effective keratolytic agent for rosacea. In addition, these actives have been substantiated to possess antioxidant and anti-inflammatory impact on rosacea.
The properties of AHAs may help account for the decrease in erythema and telangiectasias in thicker skin, masking some of the superficial vascular plexus, and may also account for the ability of sensitive skin to tolerate the AHAs. AHAs may also provide an alternative to topical steroids for mild inflammation as the steroids may actually worsen rosacea and thin sensitive facial skin, further aggravating the telangiectasiac component.
AHAs have also been shown to improve cutaneous atrophy due to potent topical steroids by increasing epidermal thickness and dermal components. With their unique affect on corneocyte cohesion, AHAs may prevent the attachment of the demodex mite in the follicle, exhibiting clinical effects similar to that of sulfur. Thus, AHAs applied daily and through chemical peeling may improve the erythema and papular component of rosacea, providing additional treatment alternatives for this recalcitrant condition. It is believed that use of a low pH AHA can deplete bacterial nutrients, resulting in decreased numbers of pathogens. In addition, enhancement of ground substance (Hyaluronic Acid, glycosaminoglycans, elastic fibers, and collagen) in the dermis by AHAs could also potentially make telangiectasia less noticeable. AHAs also increase the internal hydration residents by stimulating the lamellar bodies of the cell. This action helps compensate for any lipid imbalance and increases the barrier repair function of the skin.
Acne sulfur masks and resorcinol up to four percent are additional effective topical to retard the onset of bacteria and the activity of the demodex mite that resides in the follicle. These should be applied at least once a day, preferably in the evening before 10 p.m. in conjunction with a complete skin care circadian balanced program.
Nutrition plays a key role in treatment. Avoidance of foods such as chocolate, nuts, cheese, soft drinks, iodized salt, seafood, alcohol, spices, and hot drinks is imperative.
When treating rosacea, it is important to detoxify and nourish the connective tissue from within. Cleansing and replenishing is central to the ayurvedic medical principals of health by cleansing the body of toxins before you begin treating the condition. Always ensure the client is using a supplement manufactured for this purpose and that the ingredients include detoxifying complex of water balanced nutrients, cleansing herbs, and fiber blends. In addition, the acne skin formulas must contain anti-inflammatory ingredients that treat the rosacea skin from within with healing zinc, blood purifiers, in addition to vitamins A and C for healthy tissue recovery.
Rosacea also responds favorably to topical applied nutrients including vitamin C and other water and lipid soluble vitamins such as E and A. These ingredients are known for their radical scavenger abilities and with twice daily use, these powerful anti-inflammatories can drastically reduce the facial erythema that accompanies rosacea’s chronic redness in as little as 48 hours. They can also be effective moisturizers since dryness of the skin can further irritate and redden the rosacea skin condition.
The skin’s own functions should be naturally supported and rebuilt by using proven substances that correspond to its own natural chemistry:
The Lymphatic structure is recognized as the body’s second circulatory system and are small, blind-ended afferent capillaries lined by a single layer of epithelium that run parallel to the vascular network. The smallest lymphatic vessels begin in the upper dermis and drain lymphatic fluid from this region, emptying into a superficial plexus, which in turn flows through interconnecting vessels into deeper plexuses located between the dermis and the subcutaneous fat and then on to the central lymphatic system. Lymphatic treatment boosts the immune power of the skin and this healing massage can reduce erythema and promote healthy skin activity by cleansing the skin’s connective tissues of nasty waste by-products and remove the toxins exacerbating a rosacea condition.
There are rosacea factors that can be controlled by your client and the number one step to success is educating them to what these irritants are and understanding what impact they have when managing the disease. The following is a list of foods, drugs, environmental conditions, and other factors a rosacea sufferer should be aware of:
Rosacea Food Irritants
Women treated with the green tea extract cream had a 70 percent improvement in rosacea compared with women treated with a placebo, says Tanweer Syed, MD, PhD, an Associate Professor of Dermatology at the University of San Francisco, Calif. This study was presented at the American Academy of Dermatology meeting in New Orleans.
Medical treatments are part of the life of many rosacea sufferers, and your client may have already been on one or more of the following agents. It is the responsibility of the aesthetician to familiarize themselves with these medications.
Oral Medicine—several agents can be used to treat rosacea. Erythromycin and tetracycline are the main oral antibiotics used. Other antibiotics that can be used are doxycycline, flagyl (metronidazole), and minocycline. Some people only need to take antibiotics for flare-ups, while others have to take antibiotics every day to suppress symptoms. The antibiotics help more with the red bumps and acne-like lesions on the face, yet they don’t help as much with the redness and blood vessels. Isotretinoin (Accutane) has been used for stubborn rosacea but can have severe side effects.
Topical Medicine—several topical agents can be also be used to treat rosacea. The most commonly used agent is Metrogel (metronidazole). Another topical agent is sulfacetamide and sulfur lotion that can be found in a flesh-colored formulation to help hide some of the redness.
Surgery—the enlarged nose cannot be reversed with medicine. Cryosurgery, laser surgery, and electrosurgical therapy have been used for this with variable effectiveness. Electro surgery and laser therapy are useful for the blood vessels.
In conclusion, the treatment of rosacea can be challenging, but highly rewarding. The skilled aesthetician should avoid the conventional therapy and establish a protocol that includes both clinical remedies and home care skin products that are reassessed periodically. Completing this program for treatment must also include nutritional dos and don’ts, approved herbal supplements, and an SPF 30+ specifically for rosacea augmented with camouflage makeup protection.
Red Bell Pepper. Everyone thinks citrus fruits corner the market on vitamin C but one red pepper has 2 to 3 times more vitamin C than an orange. Vitamin C keeps skin healthy because it helps protect us from the sun (which also means it’s an anti-ager) and it’s a key nutrient in collagen production, which keeps skin firm.
Avocado. This unsaturated, heart-healthy fat helps keep skin moist and it contains vitamin E, a potent antioxidant, which protects skin from aging.
Shrimp. This iron-rich protein helps us grow thick, shiny hair and strong nails while the zinc in shrimp is great for our skin.
Sweet Potato. Beta-carotene is important for new skin cell turnover and these have a ton.
Kale. This vegetable powerhouse is packed with both beta-carotene and vitamin C.
Wild Salmon. This fish is loaded with omega-3 fats, which keep toxins out of cells and allow good ingredients in.
Wheat Germ. An excellent source of vitamin E and Zinc for its versatility, suggest sprinkling some on yogurt or oatmeal in the morning. Mix wheat germ and whole wheat flour to bread chicken cutlets.
I’ve had many clients come to my office to receive help in getting rid of or reducing their acne scars. Collagen Induction Therapy (CIT) or also known by other names, including Micro-Needling, Dry Needling, Multitrepannic Collagen Actuation (MCA), , and Per Cutaneous Collagen Induction (PCI) is very effective in achieving this goal. If you can imagine a wall with holes then think about how you might go about filling-in these holes…most likely your approach would be to fill in and plaster over the holes making the surface smooth… This concept is basically what CIT does for skin afflicted with acne scars. The collagen induction process works via small needle clusters which target only afflicted areas; the needles penetrate through the epidermis into the dermis where the skin is “tricked” into believing it is wounded. This fake wounding triggers the inflammatory response, the cascade of growth factors and finally the formation of healthy collagen. The healthy collagen is similar to the plaster used to smooth the surface of the walls. The major benefit of the CIT approach in reducing acne scars is that the epidermis is left intact, which means that it is not traumatized. Chemicals peels and ablative lasers do traumatize the epidermis, which may cause pigmentation problems, scars and thinner skin. Additionally CIT is reasonably priced and offers less risk.
to dermagrace cosmetic rejuvenation blog and information center. If you're looking for dramatic and long lasting skin improvements…look no further. My goal is to provide the most authoritative skin care protocols, research and articles. Everyday I search for relevant and reliable information. I look forward to any comments or questions.