APJ Vol 23 2014

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2014

Summer Issue Volume 23.

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Aesthetics Practitioners Journal

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AESTHETICS

PRACTITIONERS Journal

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The official publication of the Aesthetics Practitioners Advisory Network Pty Ltd ISSN: 1836-9812

Summer Issue Volume 23. 2014

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Award Winning Celebrity Make-up Artists' “Secret Weapon” NOW AVAILABLE IN AUSTRALIA

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INDUSTRY REPORTS, NEWS AND PRODUCTS 8-9 24-26 46

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CEO's Heart-2-Heart Report Major Global Shifts and How they will Impact the Future Induction into the Hall of Fame – Achievement for the Betterment of Others Scientific News Courage at its Best – The story of Visible Changes Fulfilling a life-long Dream Update on Australian Skincare and Beauty Services Statistics Product Innovations Aesthetic Industry Bulletin

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REGULATIONS, EDUCATION AND TRAINING 18-20 51 56-58 86-87 90-95

Taking a Fresh Look at Higher Education Medical Cosmetic Tattooing Post-Graduate Workshop Perfecting Facial Features Stress and the Immune-Brain Connection Effective Diagnosis of Skin Lesions and the Role of the Dermascope – Part 2 100-102 Improving Self-Esteem with Medical Cosmetic Tattooing

SCIENTIFIC RESEARCH, TREATMENTS AND TECHNOLOGY 32-36 48-50 64-66 83-85 207-109

The Cosmeceutical Face Committed to the Beautiful Face and Body Skin Health and the Integrative Approach The Health and Skin Benefits of Witch Hazel Australian Obesity Rates Climbing Faster than anywhere else in the world studies show 114-118 The Cosmetic and Health Benefits of Bio-identical Hormones 119-112 Why Butter is no longer a Dirty Word

BUSINESS, PERSONAL AND PROFESSIONAL DEVELOPMENT 16-17 22-23 44 60-61 103-106 123

APAN’s Different Memberships The Best Kept Secret to Client Retention and Growth Ask the Expert Star Performers – The team every business needs Business News APAN Membership

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SEMINARS, EXPOS AND CONFERENCES

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A5M Stages Another Successful Anti-Ageing and Aesthetic Medical Conference 47 APAN Conference Program – Bigger and Better in 2015 68-71 Winning the War on Change and Competition – APAN Conference, Sydney 110-113 Tasmania – A Great Success

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EDITOR’SNOTE

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Welcome to the summer issue of APJ Journal. As we approach the end of the year the aesthetics industry is well positioned to offer consumers what they love best – to look and feel their best.

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Preparing for what is considered as the busiest season for our industry will require good planning to entice current and potentially new clients to value your offerings through the level of benefits they will gain from them.

Remember that the key consideration is to offer multiple benefits that they cannot resist. This should include improving their appearance, minimising their stress levels and enhancing their wellbeing. If you can cover services that benefit these three areas you can potentially have a client for life.

If you want your clients to stay loyal to you over another competitor, give them more, service them better, treat them with greater care and consideration and honour their needs through genuine solutions that solve their concerns.

In this issue of APJ we cover some amazing information on aesthetic treatments, business strategies, trends and internal wellbeing.

You will note that we are increasing the articles on inner health as this is a growing consumer expectation from our industry and if you don't provide them with answers they will go elsewhere. Whether you have the qualifications to provide nutritional and hormonal support matters not. What is important is that you learn to identify deficiencies so that they can be directed to the right expert to address these needs, support your client's wellbeing and enhance the results on their skincare treatments. This integrative approach is the way to the future and it is important that those who wish to be well positioned for these trends start moving in that direction. However, to do so will require new knowledge on your behalf and APJ is committed to provide you with valuable articles and insight into these areas.

In this issue you will also find reports on the A5M Conference as well as the last two APAN conferences – Sydney and Tasmania. If you have never attended one of these events you don't know what you are missing out. I received an email from one of our members today, Leslie Morgan-Wesson who is based in Sydney. She attended both the APAN Sydney Conference and the Hobart Conference. These are some of the comments from her last correspondence.

“I just wanted to say a very sincere thank you for the whole Tasmanian experience, which, as always, was planned to perfection… I also enjoyed the Saturday excursions and the opportunity to get to know some of you a little better. I think those who didn't make the effort to attend only stood aside to let those of us who are more proactive steam ahead of the competition sufficiently to ensure we continue to thrive in the future…”

These sentiments were also reflected by other members, so why not plan to attend one of our conferences next year to see what you are missing out on? Check out page 47 for further dates and details.

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My best wishes for a Merry Christmas to you and your loved ones.

http://twitter.com/#!/apanetwork @apanetwork

APAN Website: http://www.apanetwork.com APAN Office Email: info@apanetwork.com

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May this year end on a high note for you and may 2015 greet you with joy and the promise of better things to come.

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Editor Tina Viney Phone: (07) 5593 0360 Fax: 07 5593 0367 Email: info@apanetwork.com Web: www.apanetwork.com

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Welcome to APJ

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Typesetting & Graphics

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Mark Viney Kharis Enterprises Pty Ltd

Advertising and Marketing Tina Viney Phone: 07 5593 0360 Aesthetics Practitioners Advisory Network PO Box 5448 Q Super Centre Qld 4218 Australia Fax: 07 5593 0367 Mobile: 0412 177 423 Email: info@apanetwork.com

Publishers Kharis Enterprises Pty Ltd

Design & Production Artwork and Editorial Kharis Enterprises Pty Ltd 8 Parkdale Court Robina Q 4226 Phone: 07 5593 0360 Fax: 07 5593 0367 Mobile: 0412 177 423 Email: info@kharis.com

Printed for Aesthetics Practitioners Advisory Network Pty Ltd ACN 136 987 169 ABN 25 136 987 169

Accounts Payable Aesthetics Practitioners Advisory Network PO Box 5448 Q Super Centre Qld 4218 Australia

Journal Advisory Board Terry Everitt – Education features Wendy Neely – PR and Marketing Dr Douglas Grose – Scientific content Caroline Nelson – Business Features

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John Fergusson Terry Everitt Bill Anton Gill Fish Vanessa Kirkham Maureen Houssein-Mustafa

ISSN: 1836-981 ㈵

Print Post Approved [100000257]

Circulation 6900

FRONT COVER Sormé Treatment Cosmetics Distributed by DYNAMIC SKIN SOLUTIONS Australian and New Zealand Distributors Phone: 02 9525 8368 or info@dynamicskinsolutions.com.au For further information see pages 12-14 The Aesthetics Practitioners Journal is the official publication of the Aesthetics Practitioners Advisory Network Pty Ltd, a network organisation established to service the needs of the aesthetics industry in the area of professional development and business networking. The Aesthetics Practitioners Journal is published quarterly for the benefit of its members and subscribers and aims to inform and educate its members on better business practices and industry advancements.

All editorials and articles that are submitted for publishing remain the property of Aesthetics Practitioners Advisory Network Pty Ltd. Reproduction in part or in whole is not permitted without prior written authorisation by the publishers. Every effort has been made to ensure that all scientific and technical information presented is as accurate as possible at the time of publishing. However, members and readers are highly recommended to also seek external advice from their accountant, registered financial adviser or healthcare professional for their recommendations.

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The CEO’s Heart-2-Heart REPORT

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The Power of Working Together COMBINED INTELLIGENCE FIGHTING FOR YOUR BENEFIT

Dear colleagues and friends If you are receiving the APJ Journal, whether you are a member of APAN or not, I would urge you and would appreciate if you took a few moments to read this report as it contains some crucial information that could be very valuable to you. As a professional, it is important that you gain in-depth insight into what drives your industry and the role that APAN is playing in protecting you and supporting your needs.

NATIONAL WORKFORCE DEVELOPMENT FUND (NWDF) ㄰ 㤵 㜵

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We are delighted to report that finally 120 therapists have undertaken and completed the government-funded Vocational Graduate Certificate for IPL and Laser Hair Reduction as part of the NWDF. This project has kept us busy for over 18 months and with its successful completion APAN plans to approach the Government for further funding, as requests are constantly coming from eager therapists who wish to undertake this qualification. While some providers are offering VET FEE Help this assistance will need to be repaid. However, the government-funded project is not a loan as the Government covers 67% of the costs of your training for which you don't need to repay them – how good it that?

As a representative industry body APAN takes its mandate to protect the industry and fight for its recognition seriously, however, in all truthfulness, we would greatly appreciate if practitioners and therapists took their own destiny more seriously.

While we have hundreds of therapists applying for funding for the above qualification, over 38% decided to drop out and not undertake the qualification even though they had completing their application forms, which were submitted and approved by the Government with funding allocated towards their application. This type of lackadaisical behaviour does not reflect well for our industry and brings it to disrepute, while putting us in the embarrassing position to report these dropout numbers, not to mention doubling our workload to replace these individuals.

It must be noted that APAN does not receive any funding from the Government for such activities. The only revenue we receive is through our membership fees. Part of our members' fees goes towards these allimportant, but often very time-consuming activities.

UPDATE ON REGULATIONS The NWDF is an initiative that has been instrumental in helping to create awareness within the beauty and aesthetics industry of the importance of undertaking formal qualifications in the use of Laser and IPL. These graduates are giving APAN ammunition to fight in their favour with potential regulations.

And talking of regulations, after almost three years working with the ARPANSA-instigated Working Group (on which APAN is also a member), the Working Group has put forward their recommendations for national regulations for the use of IPLs and Lasers for cosmetic purposes. The Draft Proposal Consultation Regulation Impact Statement (RIS) was submitted to the Department of the Prime Minister and Cabinet Office of Best Practice Regulation (OBPR) with two proposed recommendations. These were reviewed and the OBPR has responded with further requirements of evidence, so the battle towards regulations continues.

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WHO IS APAN AND WHO DO THEY REPRESENT?

Membership Classifications

As this is the last issue of APJ Journal for 2014 I would like to take the opportunity to set the record straight about who is APAN, as there seems to be many misconceptions about who we are and what we do.

APAN offers several levels of Membership to suit each and every need.

These include: ! Gold Membership for individuals and smaller enterprises ! Gold Membership (Degree) also has a classification for Degree qualified Nurses and Dermal Therapists ! Gold Membership (Medical) is also available to cosmetic medical practitioners ! Gold Membership (Cosmetic Tattoo) is available to Cosmetic Tattoo practitioners ! Corporate Platinum Membership for three or more staff ! Corporate Platinum Plus Membership – this category offers a full marketing package that includes a fully designed mobile website, monthly progress reports on your activities as well as a thorough comprehensive coaching and marketing service. We work with you to develop your marketing strategy through a comprehensive marketing plan aimed at helping businesses increase their profits and grow.

APAN is in the unique position to be the only professional industry member-based body that solely represents the top end of the aesthetics industry, which includes aestheticians, clinical aesthetic therapists, IPL and Laser therapists, dermal therapists, cosmetic nurses as well as cosmetic medical professionals. We also represent Cosmetic Tattooists and Medical Cosmetic Tattooists. We have professional members in all these categories. Our services include in-depth consultation and professional advice on a one-on-one basis. We look at and support our members' individual, business and professional needs at an EXPERT LEVEL. We also provide them support on all their legal and regulatory matters, often saving them thousands of dollars in penalty fees, not to mention the stress and pressures from error of non-compliance to regulatory requirements. This also includes wages and staffing concerns.

IS APAN AN ASSOCIATION OR A SOCIETY? APAN is a professional member-based body that is both a network as well as operating with the same mandates and responsibilities that a society or an association would do. It has a more modern structure that seems to support and better facilitate the decisionmaking process that is needed in today's fast-paced world of constant change. The evidence of its successful governance is that it has launched numerous initiatives and achieved an incredible amount in just five years since its inception.

WHAT ELSE DOES APAN DO? APAN is highly committed in bringing credible information and education for the benefit of its members. Here is just a snapshot of its activities:

Professional Collaboration APAN supports other Associations and Medical Societies. Each year we attend several medical conferences and present full reports on them in APJ Journal.

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Industry Representation APAN is the only aesthetics body that is fully represented on various regulatory consultative groups, including the Working Group for IPL/Laser regulations. It is consulted by the Australian Tax Office, Queensland Health Department and is constantly liaising with various Health Regulatory bodies in all States. It is also constantly approached by several insurance companies for advance on safety guidelines for various modalities and activities performed in salons, clinics and spas.

APAN also consults on a weekly basis with its lawyers, Pointon Partner Lawyers, on industrial relation matters for the benefit of its members.

APAN is in the Curriculum Advisory Committee for the Bachelor of Applied Health Science (Aesthetics Therapies). Vigilant about global trends APAN is recognised as the industry watchdog for global trends, new advances in technologies for equipment and skincare, as well as consumer changes to their expectations and buying behaviour. This is just one of APAN's unique areas of expertise. To ensure their members are kept up to date on changes in a timely manner they commit to over three hours per day on research in this area. We believe this information is highly valuable in guiding our members on their best possible options in staying ahead of change and maintaining a successful business that is relevant to the modern-day consumer.

WHY DO YOU NEED TO JOIN?

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These include: ! A5M – AustralAsian Academy of Anti-Ageing and Aesthetic Medicine and the A5M Conference ! COSMETEX – Staged by The Australasian College of Cosmetic Surgery (ACCS) ! ASAPS – Australasian Society of Aesthetic Plastic Surgery ! NLCMC – National Laser and Cosmetic Medicine Conference approved by the Australian College of Aesthetic Medicine

As a professional you need expert advice on a regular basis. You need specialist professionals whose commitment is to offer you reliable, professional advice for your protection. As a professional you need an industry Code of Ethics and you need business advice and support. You also need a corporate voice to represent you with government and for the development of education. By joining APAN you are not only protecting yourself, but also supporting your industry to maintain a strong voice with government and the decision-makers.

The purpose for these alliances lies in APAN’s belief that aesthetics is moving towards a more collaborative, integrative model, and we foster this direction through good relationships, professional alliances and through the promotion of education, both formal as well as through credible conference programs.

APAN Conferences

As we come to the end of another year I want to take the opportunity to wish you a Merry Christmas and I trust you will be taking some time to relax and enjoy the Christmas break. I also hope you will see the value of allowing us to support you as a professional member in 2015 as you face a new year with its challenges and opportunities. We are here to help you. Please contact us for further details on 07 5593 0360 or download an application form on www.apanetwork.com

APAN is the only Aesthetics body that stages three conference each year and in three different States.

Committed to your progress

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Industry Journal APAN's official publication APJ is committed to quality scientific and educational articles that can support the industry's progress.

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Tina Viney Chief Executive Officer

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Colour Me Beautiful and Treatment Me Well

Award-Winning Professional Treatment Cosmetics launches in Australia The trend for multi-functionality in skincare and makeup products is now well established. Since 2012 research on consumer trends have clearly identified their gravitation towards, not just performance products, but also products that deliver multiple benefits. This led to the advent of the BB and later, the CC makeup creams that are rapidly gaining popularity.

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In the professional arena multi-functionality is considered an essential element if a salon that is offering skin treatments is to also provide makeup products. This is becoming increasingly essential for several reasons. First, the continued advancement of new technologies and their multiple uses within a treatment protocol means the skin is often activated to become more receptive to absorption.

This often continues several hours after a treatment is completed. While in the past makeup was not encouraged, for obvious reasons directly after a facial treatment, this is no longer a problem. With the introduction of “skincare makeup” where colour cosmetics are formulated with herbs, vitamins and botanicals, and even peptides, and hyaluronic acid, the issue of continued absorption is no longer disruptive or counter-productive to the objectives of a facial treatment.

Skincare makeup can therefore be confidently used not just to further enhance the appearance of the skin, but also to support the treatment and even continue enhancing the results.

Recently Dynamic Skin Solutions launched in Australia Sormé Treatment Cosmetics. We caught up with the director, Jacqui Guinane, to discuss what she identified in this range that made her decide to introduce it to the Australian professional skincare market.

APJ 1: JACQUI, WHY DID YOU CHOOSE SORMÉ TREATMENT COSMETICS? JACQUI: I discovered Sormé Treatment Cosmetics when I was visiting Cosmoprof in Las Vegas, while on my honeymoon in July this year. Our stockists from our other two brands – Sranrom Body Care

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and D'Vine Skin Care – have been begging us to bring in a makeup line for over two years, to complement these two ranges. Our objective is to offer top-quality products and service so that we could be the “preferred supplier” to our partner salons, and it was essential that we offer them all the products they needed to succeed.

However, we did not have a makeup range. Sormé stood out to me in the first instance because of their eye-catching displays. They were hard to miss even in a sea of other brands that we saw – they really jumped out and made me take notice!

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I therefore met with their international sales manager to examine the quality further and the company's standing. He confirmed to me that Sormé have been making “Skin Care Makeup” for over 25 years, so even before the mineral makeup boom, Sormé recognised the need for makeup to be an extension of skincare. He showed me their “hero” products, their unique square lip and eye liners, which make application a breeze and are also smudge-proof. Sormé Undereye Shadow is a wonderful product that makes blending colours easier and helps anchor eye shadow for a smooth and longlasting effect.

What I loved about Sormé Treatment Cosmetics is that they have Traditional Makeup as well as Mineral Makeup, so we can cater for clients who need performance products for photographic and bridal, as well as mineral products for those who prefer natural based products.

APJ 2: WHAT GIVES SORMÉ A COMPETITIVE ADVANTAGE? JACQUI: We have many great makeup brands in Australia, but most of the professional brands are just becoming so expensive! Sormé Treatment Cosmetics offer high-quality Professional Makeup at really affordable prices. As a launch special we are offering free display stands and testers with our package options. Stockists also benefit from 100% mark-up on retail products. Retail prices start from just $17.95, up to $57.95 for a trio product, so Sormé pricing is going to allow salons to compete against the big consumer brands and win back clients who might be purchasing from the chemist or supermarket! Having the beautiful countertop displays really showcase the products and encourage clients to pick up and try products – the displays act as a silent salesman. Sormé Cosmetics really do sell themselves.

APJ 3: TELL US SOME OF THE SKINCARE INGREDIENTS USED IN SORMÉ TREATMENT COSMETICS? JACQUI: Sormé LipTHICK Plumping Glosses contain a peptide

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called Maxi-Lip®, which helps to stimulate natural collagen to increase lip fullness up to 40% in 30 days. Mineral Botanicals Lip Sticks contain Vitamins A, C and E to protect against environment damage.

EXTABROW™ Brow Enhancing Serum contains clinically proven Panax Peptide™, which stimulates natural brow growth and extends the life cycle for fuller brows. Sormé Mineral Botanical Eye Shadows and Blushers contain Vitamin E and Pomegranate for antioxidant protection.

Fresh Start Anti-Ageing Primer contains Dermaxyl® Peptide, which is considered as one of the most potent anti-ageing ingredients today.

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The comments we get from clients and makeup artists is that this makeup offers a wonderful non-drying satin finish with the eye shadows and blushes that deliver a much more flattering finish than many of the traditional makeup lines. The excessive sparkle may look glamorous in the palettes, but on the face they can look fake and actually ageing – unless you have a flawless, very young complexion. On the other hand, super matt finishes can look floury and dull. With our formulas the soft, dewy satin finish offers a perfect balance that gives off a nice glow without looking fake or ageing.

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WHAT DOES SORMÉ SKINCARE COSMETICS OFFER YOU? Superb makeup must be both glamorous and beneficial to your skin – the living canvas for every colour. For over 25 years, Sormé has teamed with professional makeup artists and the finest formulators around the world to bring you an exceptional blend of traditional beauty wisdom and advanced antiageing technology in every product.

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TREAT AND PROTECT YOUR SKIN

Active plant botanicals, natural minerals, healing vitamins and clinically proven, age-reversing peptides help protect and improve your skin as rich colour pigments enhance your natural beauty.

Today, Sormé is the makeup of choice for top Hollywood film studios and celebrities, their “secret weapon” to create their vision of glowing skin, pouting lips and captivating eyes. Carrie Underwood's Make-up Artist calls Sormé Brow Highlighter the “push-up bra for your eyes”. Now Australian salons and clinics can discover why Sormé has a reputation as an exceptional makeup for all ages.

SORMÉ ORIGINS Sormé is the Egyptian name for the natural black Kohl, the substance used by queens and princesses to enhance their eyes. Dating back to the fourth millennium, it was Cleopatra who made this intensely pigmented black powder a sensation with her exotic eye makeup.

Kohl is still used today to create the mysterious allure that is truly timeless.

PACKAGING The Sormé Professional difference is not only in choosing the finest ingredients, but also unique packaging that has the professional user in mind. All Sormé Professional products have been thoroughly tested and perfected to meet the high standards required by professional makeup artists to accommodate their growing demand for perfection in a highly competitive market.

INNOVATION Sormé Professional Skincare cosmetics constantly researches and consults with leading makeup artists and skincare therapists to identify specific professional needs to ensure that Sormé provide them with solutions as the leading innovative products available.

Thanks to our relationships with US-based laboratories and packaging companies, we are able to produce and bring to market innovations in the cosmetics and skincare categories much faster than the conglomerates.

Sormé also has amazing, innovative lash and brow grow products, seasonal display stands and great value seasonal gift packs!

For a limited time – various retail packages will be available with FREE Display Unit and FREE Testers! 100% Mark-up. ㄰ 㤵 㜵

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Discover the Professional Make-up Collections LipTHICK Plumping Lip Gloss, Anti-ageing Primer, Bronzers, Lipliners, Eyeliner Pencils & Liquids, Brow Style Compacts, Brow Gels, Liquid Foundations, BB Creams, Wet/Dry Foundations and MUCH MORE! Phone today and take advantage of the Special Introductory Offer.

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Sormé Treatment Cosmetics are proudly distributed in Australia & New Zealand by Dynamic Skin Solutions 02 9525 8368 or info@dynamicskinsolutions.com.au

WHY DO PROFESSIONALS AND BUSINESSES JOIN APAN?

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THE PREMIER BODY THAT ASTUTE PROFESSIONALS & BUSINESSES CHOOSE

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GOLD

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Gold Membership for Individuals and

Smaller Enterprises

MEMBERSHIP CLASSIFICATIONS APAN offers several Membership Levels to suit your individual needs. You choose what suits you best.

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Gold Membership (Degree) also has a classification for Degree-qualified Nurses and Dermal Therapists

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Gold Membership (Medical) is also available to Cosmetic Medical Practitioners

ACCESS TO LEADING INDUSTRY EXPERTS ! Industrial Relations ! Wage Rates ! Best Business Solutions ! Coaching & Mentoring ! Legal Advice ! Discounted Services ! Marketing Strategies

“APAN is the professional body I turn to when I am in need of guidance and advice. It’s simple, they save me time, money and minimise my stress. Why go anywhere else when I can go to LEADING EXPERTS at no additional fees.”

Jane Boyle, W.A, Salon owner ㄰

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APAN AESTHETICS CONFERENCES

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Education | Consumer Trends | Industry innovations | Strategic thinking

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THE STRONG VOICE REPRESENTING YOU WITH GOVERNMENT

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SERVING AND SHAPING THE NEXT GENERATION OF INDUSTRY LEADERS

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CORPORATE PLATINUM CLASSIFICATIONS

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Corporate Platinum Membership

for five or more staff !

Corporate Platinum Plus Membership for those who want a full business and marketing package and in-depth consultation.

This category includes a fully designed and optimised mobile website, monthly progress reports on your activities as well as a complete coaching and marketing service. We work with you to develop your marketing strategy through a comprehensive marketing plan aimed at helping businesses increase their profits and grow.

DOING BUSINESS BETTER ! Regulatory compliance issues ! Best Code of Ethics ! Risk Management Strategies ! Latest Consumer Trends ! Strategies for Better Money Management ! Successful Strategies for Profit Growth

“When I need expert advice on industry intelligence, trends and regulatory issues that could affect my business I go to APAN as the preferred experts. Their information is always up-to-date and accurate.”

John Jackson, NSW Practice Manager

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THE ONE-STOP-SHOP FOR INDUSTRY-SPECIFIC GUIDANCE, ADVICE AND SERVICE

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APAN – AESTHETICS PRACTITIONERS ADVISORY NETWORK Please contact us for further details Ph: 07 5593 0360 | Email: info@apanetwork.com www.apanetwork.com to download an Application Form

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highereducation ㄰

an industry. How do you believe that the Bachelor of Applied Health Science (Clinical Aesthetics) will benefit the aesthetics industry?

Professor Hayek:

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Taking a Fresh Look at HIGHER EDUCATION ㄰ 㤵 㜵

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A degree program may appear not to be a possibility for you, but are you aware of how the learning environment has changed? In this article Professor Hayek discusses with us the opportunities that the new Bachelor of Applied Health Science (Clinical Aesthetics) will bring to the graduates, what strengths it will bring to the evolving aesthetics industry and how new tools are changing learning models to better allow for flexible learning for the modern student who may be juggling business and family responsibilities.

APJ 1: Professor Hayek, as an academic you have experience on how higher-learning programs can shape

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Any procedure or practice that can have health implications must be grounded on sound academic knowledge. The new aesthetic procedures are moving towards clinical practices as ingredients and technology can now be more far-reaching into the body to achieve better and more advanced outcomes. Observing these changes, it is my understanding and belief that it is no longer adequate to learn these practices just as a trade (predominantly as a practical exercise) – they need to be underpinned with credible science if they are to be respected as evidencebased practice both by the consumer and the regulators.

This premise is well supported by consumer studies. We are seeing this expectation driven by consumer demand, as they will not hesitate to go to a medical practitioner for even microdermabrasion and skin needling if they feel that the practitioner is more qualified. There is now strong evidence that this is happening in growing numbers. I believe both from a consumer point of view, as well as with regulators, the only way the aesthetics industry can protect its future and continue to confidently offer and perform advanced procedures is by understanding and embracing the need for credible educational qualifications. As an example today's practising registered nurses are required to have a tertiary qualification. This is as a result of advances within the medical field. The same is happening to aesthetics.

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Unless these practices are entrenched in academic standards they will be derailed. It is therefore important for the industry to take a closer

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look at where they are, who they are and where they want to be in the future.

contexturalised with respect to a deeper understanding of the ageing process and its implications on skin health.

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The Bachelor of Applied Health Science (Clinical Aesthetics) provides individuals and the industry as a whole the means by which they can redefine their perimeters. The program offers an academic structure, which envelops what currently exists and delivers it in a health and medical structure so that the practicum and the academic constructs are well rounded in the same manner that health practices are traditionally underpinned.

Our graduate attributes are clearly directed to develop a new aesthetic graduate with core skills that are now required of any healthcare worker. This is a new level of standards that will benefit both the practitioner and the aesthetics industry to gain greater credibility, status and recognition, as graduates will be enable to deliver treatment outcomes to a much higher level.

APJ 2: What is this degree's point of difference compared to other programs?

Professor Hayek: This degree is unique in several areas.

First, our Human Biosciences are targeting more advanced knowledge in Anatomy and Physiology as well as pathophysiology presentations largely as manifested on the skin, so that the aesthetic practitioner becomes well-grounded in normal body function so that they can identify what is abnormal.

Second, several units are developed with an in-depth perspective and approach to health and wellness so that the graduate is well-versed also in preventative management of skin conditions.

Third, our program also includes the latest knowledge pairing in key areas of anti-ageing principles so that skin conditions are

Finally, our program is specifically engineered so that the graduate not only gains theoretical and practical skills, but the practical components will be delivered in a simulated environment where they can perform all skin-management procedures to the tune of 720 hours of hands-on practice. We believe that there is no other program that remotely matches the depth of knowledge and the comprehensive skills development that this degree offers. In fact, we believe that we offer 3-4-fold more practicum hours compared to other programs.

Graduates will be competent and skilled at a new level in all areas of clinical work, as well as advanced technologies and protocols. This will allow them to move into clinical practice, not just with a higher level of knowledge, but also competence on how to confidently apply their new skills into practice immediately at a level that will give them the recognition as leaders in their field.

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APJ 3: How do you view learning styles e.g. on-line, face-to-face etc? What is the emerging contemporary learning model and why does it better support learners to more successfully achieve their desired qualification?

Professor Hayek: My view of learning is that there should be no separation, as previously, between the different styles. Learning is learning and it is my philosophy and belief that learning has many facets on-line, access, face-to-face, self-directed, group learning, practicum as well as virtual live-classrooms. Technology now provides us an array of opportunities to make learning available to anyone where, historically, this was only possible for the privileged and the few. Now new technology opens up learning to all walks of life. The notion that learning is a by-product of a closed classroom environment is diminishing rapidly and in fact in most cases, long gone.

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This new flexibility in accessing education now provides learners so many more opportunities to assess learning pathways and undertake programs and courses that were not previously accessible. Effectively a modern learner can study, while still having a diverse lifestyle – running a salon or clinic as well as managing a home and family. If they have the desire to expand their education they will now have new tools to allow them to be able to do so, which were not previously available. This flexibility has the potential to rapidly change an industry, and those who are astute will take advantage of these new opportunities.

APJ 4: When it comes to having the right mindset how can a potential student that has to juggle study with numerous other obligations such as work and family overcome obstacles when undertaking a degree program?

Professor Hayek: I believe that many that are coming from a practice-based background may question as to the value and need for further formal education. This may cause a dilemma for them if they have this perception. They need to understand that the speed of new knowledge in technology as well as the speed of new scientific knowledge is changing many industries, including this industry.

These factors are now propagating and pushing your industry to improve its knowledge as a matter of necessity.

It is my view that any practitioner who offers services on skin improvement and anti-ageing has the ethical, moral, as well as the legal obligation as a duty of care, to upgrade their knowledge and skills. It is no longer optional to stay true to the past principles and practices. This is where evidence-based practice should be and must be considered in everything we do with our clients.

APJ 5: Do you see a need for the aesthetics industry to established formalised standards, why, and how will they help redefine the industry and protect its future?

Professor Hayek: As I underlined earlier, I think the opportunity for the industry to really make something of itself and position itself more prominently as part of the whole healthcare delivery system is very much due. After all, beauty therapists or aestheticians deal on a daily basis with the largest organ in the body – the skin. It’s true that clients will see their beauty therapist of aesthetician many times

over more than a medical practitioner. It is also acknowledged that this is also one or the fastest-growing industries. For this reason it is essential that a consolidated national approach takes place to govern the industry.

This should be the task of a national body to determine standard guidelines that will redefine this industry.

These should include three key conduct-defining structures: A Code of Ethics A Code of Conduct A Scope of Practice.

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The first two are required to buttress and support a Scope of Practice through a positional document so that current and future clients of this industry have an understanding what a practitioner can responsibly deliver.

These can be in the form of self-regulations that are embedded in sound education and training and will provide a good recipe for the industry to move forward, improve its credibility and recognition and interface better with healthcare practitioners.

Professor Ray Hayek is the Executive Dean at the Australasian College of Health and Wellness the institution that is delivering the new degree program, the Bachelor of Applied Health Science (Clinical Aesthetics) in Sydney.

For further information about this degree please contact Head of Faculty Associate Professor Sinan Ali on 02 8587 8888 | Sinan.ali@tac.edu.au www.tac.edu.au/highereducation

Editor's Note: APAN is currently commencing proceedings in drafting industry Codes. If you are interested in being part of this process or would like to contribute to this process please contact the CEO, Tina Viney, on info@apanetwork.com or phone 07 5593 0360. We would love to hear from you as this needs to be an industry initiative where stakeholders can have input in the shaping of their industry.

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Reaching a new level of

PROFESSIONAL EXCELLENCE

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Bachelor of Applied Health Science (Clinical Aesthetics)

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Studying for a degree is now more attainable than you think

Take it to the next level Bachelor of Applied Health Science (Clinical Aesthetics) The Degree boasts a rigorous academic program built around health science supported by extensive clinical practice skills. It aims to deliver the latest in skills and knowledge to equip graduates for the exciting and rapidly changing aesthetics industry.

ENROL NOW! Limited places available for Semester 1

For further information about the degree please contact Head of Faculty Associate Professor Sinan Ali on 02 8587 8888. Sinan.ali@tac.edu.au | www.tac.edu.au/highereducation

New PROFESSIONAL DEVELOPMENT PROGRAM The Australian College of Health and Wellness is now also offering PROFESSIONAL DEVELOPMENT COURSES for those who aspire for higher learning in skin science. If you would like to grow your knowledge on skin to a

higher academic level why not consider undertaking comprehensive unit in: ㄰ 㤵 㜵

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Anatomy and Physiology of the Skin Pathophysiology of the Skin Skin Differential Diagnosis and Clinical aesthetics and Dermal Therapy scope of practice Aesthetics Management of Common Skin Disorders

These units offered as a seminar series will give graduates an opportunity to gain the benefit of knowledge on the skin at a higher academic level as well as experiencing a learning environment that will open the door to a potential university degree. Should you wish to pursue a degree qualification with the Australasian College of Health and Wellness these units will provide the benefit credit points towards their degree.

To register or for further information on these units contact info@tac.edu.au or call 1800 999 963

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The best-kept SECRETS to CLIENT RETENTION AND GROWTH

By Julie Hyne Having regular interaction with the beauty and aesthetics industry, it is sad but also very true that we have so much to be desired when it comes to manners and etiquette. This is an area that is sadly lacking in our industry. Several decades ago Beauty Therapy training included a Finishing School that incorporated manners and etiquette, including the correct way to greet someone, introduce them to someone else, as well as posture, poise, body language, answering the phone and how to write a courteous letter. We were even trained in table manners and etiquette.

It would appear that etiquette is a lost discipline in the new “Facebook era” when one can get away with poor grammar and even a lack of courtesy.

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I cannot tell you the amount of mail I receive with “Hi there” when people know my name and signed off with just their first name. We deal with over 6500 individuals in every State and Territory. It makes it somewhat difficult to figure out who some individuals are when all they give us is their first name. We have to go hunting email addresses to try and locate their address and hopefully from there determine who they are.

When it comes to phone calls it is amazing how often messages do not even receive a courtesy return call, and the sloppy way that some individuals answer the phone with a tone of voice that suggests that you are a nuisance and disturbed their peace. This should not happen under any circumstance. Courtesy, first and foremost, is an attitude to

which appropriate behaviour is its expression.

Julie Hyne is a salon and image etiquette trainer and we believe that her message and information is extremely valuable and often the missing link to the improved success of a business. In this article she covers some of her five top strategies for client growth and retention.

Do you “wow” your clients so much that they would never consider leaving you? Many salons think they are creating a fabulous experience for their clients, until they check their records and see who hasn't been in for a few months, and find there are actually several familiar names on that list. The worrying thing is when as the salon owner you haven't even noticed!

Client attraction and retention is the key to maintaining a sustainable business, and for making it grow. Clients who feel valued by attending your salon will rebook and refer without thinking about it, so it's worth you thinking about what you can do to keep them.

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I read an interesting quote that went along the lines of People will sit up and take notice of you if you will sit up and take notice of what makes them sit up and take notice. Sound easy, so why don't we do it?

Impressing your clients is not always about telling them how wonderful you are. It's about paying attention to them, wholly, solely and completely when they come to see you. First impressions can easily be manufactured as they only last for a few moments, but it's the

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impressions you make while they are with you and when they leave that you want to be mindful of.

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I can’t tell you how many times I have walked past a treatment room in my own salon to hear a staff member relaying everything that happened on the weekend, or about personal matters that really shouldn't be brought up at all while at work. A client confined to a treatment room is not there to be a sounding board for solving personal issues.

Attention to detail costs nothing, and can go a long way to a client feeling like she is really important, a VIP to your business. It's the golden rule of etiquette to be able to treat another person as you would want to be treated yourself.

Go out of your way to demonstrate respect, courtesy for clients of different ages and cultural backgrounds. They will return their appreciation in kind.

Listen to what your clients are telling you. If you are asking the right questions, then there will be no end of valuable information you can use for not just prescribing and recommending other treatments and products, but as a means to really impress your client next time she does visit you. For example, what is her favourite drink, perfume, what's happening in her own life that can give you an opportunity to show care and interest? Does she prefer a certain room for her treatment, an extra hand massage, what are the little things that allow her to think WOW! It's not good enough to be that busy you can’t take note of what makes your clients sit up and take notice. This is your secret weapon for continuing to impress, generate new business and solidify relationships. It does all come down to being able to communicate well, be good at listening and asking questions, so if that is something that needs extra training on, then invest in it and your business will thank you for it.

present the technology and communicate the message of what it can do in a way that motivates the client that create the impact and the results.

5. Adjust your client information forms to include small pieces of information that are unique and special to your client. Make sure these are reviewed each time the client is attending so that you can impress with your caring , thoughtful and targeted conversation.

Impression management needs to be something that you monitor all the time. Evaluate your team and how well they are creating strong and lasting impressions with your clients. Are they presenting well, practising positive body language and gestures when greeting and farewelling clients, how is their telephone manner when taking calls?

Do you have a policy for returning calls in a timely fashion? Are you a salon that actually phones to confirm bookings, or do you rely on a text message as confirmation? Texting eliminates the opportunity to reconnect with your client and confirm small details if necessary that makes her feel like she is special.

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Remember, the little things that provide that extra positive experience to the client that make them feel like a VIP can be the one thing that keeps them repeatedly coming to you.

Julie Hyne is the founder of Business4Beauty and offers Salon Image and Etiquette training for salon owners and staff. She is the author of Invaluable: what every salon owner wanting success needs to know.

You can contact Julie for a 30-minute free salon business appraisal and get your salon in shape and achieving success. Julie can be contacted on T: 0433 114 841, E: info@business4beauty.com, W: www.business4beauty.com

My five top strategies to building your business do include some very tried and proven ways of keeping clients and attracting new ones, because they are what business and people of good character have been doing for years.

1. Treat your client as if she is the most important person in the world. Surprise her with a gift, remember her favourite tea. Ask her about her most treasured topic of conversation. Make her feel like she can trust you and that you have her interests at heart.

2. Think about the little things you can do to make visiting your salon a fabulous experience. Does your client need coins for parking meters? Is there a carwash nearby that you can book her car into while she is visiting you? What can you do to make her feel that you are the most thoughtful person she knows?

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3. Always use your client's name and be personal with her. Send out birthday greetings with heart-felt messages. Sign them personally.

APAN has some excellent birthday cards that you can purchase.

Check them out on www.apanetwork.com under merchandising. I can guarantee that they will keep your card on their bench for longer than they keep a regurgitated letter that's the same as last year’s. Include a small gift, bottle of her favourite wine, whatever will impress her and make her feel like you have taken notice of what she likes.

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4. Be courteous and kind. Manners and respect are not old fashioned.

They are very much in the now, and especially with technology moving so fast. You can never anticipate the way a person feels, thinks and acts when presented with new technology. It's the people who

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Major Global Shifts and How They Will Impact The Future

By Tina Viney In a fast-evolving world a bird's-eye view can often help us identify how the landscape is changing and the shifting dynamics that, when examined, can alter our understanding and change our definition of what the world now wants from us and our services.

The global economic downturn has shifted values and priorities in consumers, and gaining an understanding of these changes should be central to how we conceptualise our services in the beauty industry to meet with consumer expectations.

In this article I would like to share some of these trends, and my understanding of these are not based just on professional observation, but also on solid and credible research.

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I was not at all surprised when I read a recent statement presented by the Diagonal Reports that the beauty industry and consumers are out of sync. In fact, several other researchers have concluded the same.

They stated that many beauty “professionals” are less informed on new developments that are happening in their industry, not to mention what consumers are now looking for. This should not be so, for as such information is now presented through social media consumers are less likely to trust our recommendation, as they will come to believe that our knowledge is out of date.

I have to say that as I interact with the industry on a daily basis I can attest to the reality of that fact, and my mission is to support business owners and therapists to not be part of these statistics. So here are just some of the issues we need to take a closer look at on how our world is changing. Let's start with consumer needs.

CONSUMER PERSPECTIVES Today, many millions of beauty consumers around the world are talking to each other using a different language and terminology.

Consumers are not interested in how we “classify” them, they conceptualise beauty in terms of their needs. They are only interested in the end result of what we can offer them. Can we make their skin looks younger, fairer or clearer? In fact, the universal starting point for everyone today is me and my problem. This is quite a different lens to that used in the past, both by formulators and practitioners.

Beauty consumers are far less concerned with how we categorise them, the “wrapping”, the classification, the technology, the channel or the segment we position them in. They are more concerned with what we can achieve with what we do. Traditionally, this has not been the focus for the beauty industry as its prime objective was to “classify the client” and then ensure they had a wonderful “experience” and “let-us-see” what outcomes and results can be achieved. This is no longer good enough – consumers want to know measurable outcomes, “what will my end result be”. This is because we are also now competing with the instant change that can be achieved by injectables.

To become more proficient with these more personalised consumer demands our theoretical knowledge and education needs to be stepped up. We need to constantly update and develop new skills, determine how to strategically combine technologies, utilise innovative techniques, and even work with other professionals and disciplines as a team in order to achieve the new consumer expectations and desired outcomes.

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Another shift we are seeing is the growing need of consumers to engage in practices and procedures that minimise the possibility of disease. Relaxation, antistress treatments and wellness therapies were traditionally found at the spa, but this is no longer the case. The boundaries between spa, skin clinic and medical cosmetic clinic are becoming more and more blurring. Peels, microdermabrasion are no longer in the domain of the traditional skin-therapy salon, nutritional advice, wellness treatments are no longer in the domain of spas.

Our clients want us to help them outsmart their genes, and to achieve this we need predictive, personalised, preventative healthcare. According to Nasim Ashraf, MD, of DNA Health Corp, this demand will transform the landscape of healthcare over the next decade.

Epigenetic testing is essentially the science of outsmarting your genes. Asraf points out that much of our wellbeing is not destiny and can be influenced by environment. As personalised genetic testing continues to get not only more sophisticated, but also more affordable, it's possible to identify what the exact deficiencies are and mitigate them through nutrition, lifestyle and wellness strategies. With this knowledge we can substantially minimise and prevent the expression of potential diseases such as cancer, heart disease, Alzheimer's and diabetes.

Epigenetic testing is already being performed in salons and spas. In fact, at the past two APAN Conferences we conducted in Sydney and Tasmania this year, epigenetic hair analysis was conducted on delegates, and there was so much excitement about the potential of this modality with a salon, clinic or spa environment. This is now an uncomplicated and inexpensive treatment.

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THE WELLNESS INDUSTRY

Before the economic downturn there was a lot of talk of spa real estate, but many of these projects crashed and burnt right along with the economy. Now whole communities are being designed and branded with wellness at their core.

This is the future and it has arrived. Research released at the 2014 Spa Summit showed that this market is now valued at over $100 billion.

Mixed-use properties, the combination of wellness centres/spas or skin clinics partnering with regenerative medical practitioners and nutritionists are starting to emerge as a potential, viable, financial model in this sector, although one that still requires careful p l a n n i n g a n d understanding of its nuances.

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spoke with a well-known and respected cosmetic doctor who told me how he was achieving amazing results with acne because he was working collaboratively with a nutritionist. He confessed to me that when he was first told that “diet and gut health played a key role in acne,” he laughed in disbelief. But when he saw the results he was amazed. “Even as doctors, if we want to achieve excellent skin results, we can no longer work on our own,” he told me. This is an amazing shift that is redefining aesthetics and skin therapy.

THE LONELINESS EPIDEMIC We use to die of old age, however, experts are warning that we'll be dying of loneliness. Technology and demographic shifts are driving an overarching sense of “aloneness” that wellbeing centres, salons and spas will help to abate. Thirty years from now, 60% of households will be single. In Stockholm, 64% of households are already single and in Amsterdam it is 60%. As an industry of touch we can combat this trend, delivering connectedness in a world that has created a dependence on screens for company. My massage therapist told me just last week that she is amazed at the amount of lonely individuals that come to her because they crave a caring, non-sexual touch as more and more are deprived of it. We need to remember that, and ensure that the human touch is not totally replaced by technology within our services, as this is very much a growing consumer need.

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At a recent cocktail party I

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THE EXPERIENCE So what about the need for an “experience” – is that a dying trend?

No, it hasn't died, but it is re-emerging with a need for it to be truly authentic. Developing an authentic, meaningful experience is a rallying cry in unique salons and spas through wellness treatments, but consumers are bored with duplication – they now seek the “can't get anywhere else” experience, so more thought and planning needs to be put into your “experience” if it is going to be a drawcard. Indeed, your “experience” should have your own trademark on it, and this does not mean it has to be complicated, but it has to demonstrate thought and authenticity. For example, my massage therapist after my treatment served me with a deliciously chilled coconut water, while emphasising the health benefits of the drink. It was a welcoming surprise to the traditional water or herb tea that was much appreciated and left a memorable impression on me.

TECHNOLOGY ON FAST FORWARD According to Paul Price, a retail and marketing expert, good and bad technology will not only remain at the forefront of our world, but it will embed itself even deeper, altering the way we do everything, from how we shop to how companies market to us. Price warns that we should not be seduced by bright and shiny objects. He stressed that we should not let the technology drive our decisions. Instead, consider your technical department should be driven by your marketing department so your IT people are driven by your marketing planners, not the other way around.

While emails were the most common medium for communicating during the past decade, we now know that the most effective way to communicate is through mobile devices. Just think, how many emails do you receive each day and how many do you leave unread? Perhaps

your clients are doing the same. Today's consumer accesses between 70 - 80% of their information from the mobile devices. Just having a standard website is no longer enough as this may be too bulky when it connects to a mobile device.

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A MODERN SOLUTION For this reason, recently APAN launched a new Corporate Platinum Plus membership classification that offers our members the most advanced tools, including a specifically designed mobile website that deliver unprecedented results. These tools are modern and designed for flexibility and speedy communication and are helping salons and businesses achieve fast and efficient client interaction that is helping them grow their database and business through cost-effective promotions. This Client Acquisition Program also includes a monthby-month comprehensive report that measures your outcomes.

Additionally, this membership includes two comprehensive business coaching sessions to ensure you are utilising the most up-to-date promotional strategies.

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The changing on-line environment now offers enormous opportunities for businesses to capture new consumer attention, but as Paul Price stated, it is not an issue of flashy devices. On their own, they could turn out to be costly mistakes, so it is important that you have your performance measured to determine how successfully it is running.

APAN's technicians have expertise in measuring your performance and offer a report on the performance of your system. If it is working well for you then we would recommend you continue with it. What we can still offer you is business coaching on how you can create value for your client, how to identify and develop your unique brand of services and product and ways to optimise your “unique experience”. We also have over 45 documents that have been professionally written that are available for purchase so that you can streamline your operations with the minimum of fuss and expense.

On the other hand, if your system is not performing well, we can redevelop your website and offer you a modern, proven and efficient mobile website that is guaranteed to increase traffic to your business.

The benefits of optimisation of your existing website or having a new one built are that they can help your business in the following way:

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Capture consumer attention quickly Elicit client interaction e.g. calls, bookings Maintain performance information Makes the most of your information Turbo-charge a good site to provide you with better results

A good program should be both highly effective and cost efficient and can lead to some amazing business success. ㄰

IN CONCLUSION Change should not be considered as a threat, as with it, it brings amazing new opportunities.

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A survey that was conducted on the world's top 500 companies to determine winning attributes the number one common denominator that all successful businesses had was an expectation for success. This attitude is so powerful. A positive mindset that focuses on the new possibilities rather than the limitations will always identify winning strategies to overcome every obstacle.

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The Power of Healing Waters Restoring and Balancing Sensitive Skin Close to the Atlantic coast in Southern France you will find the region of Bearn, which is famous for its mineral-rich waters renowned for their medicinal properties. These waters nourish the springs of Saliesde-Bearn, a health centre that has been established since 1857.

The therapeutic effect of the Salies-de-Bearn thermal spring waters is

attributed to its high mineral salts, which contain more than 25 essential trace elements as ions (sodium, potassium, calcium, magnesium, manganese, selenium, silica, zinc, iron and copper).

These minerals are perfect in proportion (especially in the case of magnesium) and have an amazing regulating effect on skin-barrier function.

These extraordinary spring waters contain the original rich mineral composition of primitive oceans, when they were pure and free from pollution. This is only possible because the spring feeds from subterraneous waters that run under the Pyrenees through mineral layers formed by the slow evaporation of the oceans thousands of years ago. The waters have passed through a pure and clean layer that contains all the richness of the sea where life originated.

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APJ 28

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AQUATHERM CAPTURING THE MINERAL GOODNESS

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Nurturing sensitive, reactive and ageing skin conditions

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Capturing and harnessing these amazing mineral properties, Skeyndor formulated their incredible AQUATHERM Skincare range that is especially suited for sensitive, reactive and ageing skin. Soothing, cooling and nurturing all forms of irritation and inflammation, Aquatherm offers immediate relief while supporting and regulating the skin's barrier function that is usually disturbed in sensitive, mature and menopausal skin.

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It is a well-established fact that low-level inflammation is part of the ageing process and this is particularly prevalent with menopausal skin. AQUATHERM treatments are formulated to deliver immediate calming and soothing properties, which strengthens the skin's defence barrier and improves hydration levels.

The mineral-rich formulations rebalance the skin's pH, improving its immunity and protecting it from external irritations.

PRE-BIOTIC SUGARS Natural pre-biotic sugars that stimulate the proliferation of beneficial cutaneous flora further support the skin's immunity, rebalancing its pH and protecting it for the invasion of damaging micro-organisms.

CERAMIDES In sensitive skin the main lipids of the extracellular matrix that hold the cells together are often depleted. This deficit or imbalance is a common problem with sensitive skin. As if this protective mechanism is disturbed it renders the skin vulnerable to external pollution and environment toxins.

AQUATHERM PROFESSIONAL SYSTEM

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Skeyndor Aquatherm professional system provides the perfect targeted solution for salons and clinics to address stubborn skincare concerns that manifest irritation, inflammation and sensitivities such as couperose, eczema and psoriasis. Even the most challenging conditions can receive benefit from Aquatherm, which comes in a professional system, as well as effective homecare products to further support the skin.

The professional range consists of a special kit – the Aquatherm Recovery O2 Pack and includes: ANTI-REDNESS FACTOR An amazingly soothing re-mineralising complex. It contains a high concentration of plant extracts with a regulating effect on tissue permeability, soothing and calming irritation and sensitivity.

LIFT-COLLAGEN THERAMAL FACTOR Formulated with pure marine collagen (99%), this product improves sensitivity and firmness. Collagen and trace elements are combined to improve and protect the skin's defence barrier and restore skin tone to achieve a cosmetic “lifting” effect on skin with wrinkles and flaccidity.

A Q U AT H E R M ' S H I G H TOLERANCE REVITALISING CREAM

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This amazing treatment cream will rebalance and improve hydration levels in all skin types and immediately soothe and cool irritated skin. Formulated with a unique blend of synergistically combined ingredients to

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strengthen and rebalance reactive and irritated skin conditions. The main active ingredients include Q10 – a co-enzyme with significant anti-oxidant properties that biologically protects cells against freeradical damage and soothes skin with persistence redness. Also includes mineral-rich spring waters, pre-biotic oligosaccharides to defend the skin's immunity, ceramides, pumpkin extract and dermosaccharides.

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RE-BALANCING THERMAL MASK WITH O2

This delightful cream mask is formulated with perfluorocarbons to improve absorption of oxygen in the skin and revitalise the tissues affected by poor cellular respiration. It refreshes, moisturises and soothes congested and irritated skin. Contains spring water, pre-biotic oligosaccharides, decongesting plant extracts and perfluorocarbons.

The highly specialised Aquatherm Skin System is dedicated to the supreme care of the skin’s needs. It is gentle, yet exceptionally effective, comforting and calming the skin, reducing irritations and redness, eczema, quells, persistent flare-ups, relieving dry, tight skin and at the same time offering maximum rejuvenation benefits.

Aquatherm products leave the skin soothed, refreshed and supple, making them ideal for drier skin types. At the same time, the Skeyndor Aquatherm professional and homecare products target the signs of premature ageing.

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HOMECARE PRODUCTS A full range of homecare products, including:

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Rebalancing Gentle Cream Fl Deep Moisturising Cream FII Revitalising Anti-Ageing Cream Soothing Eye Cream Anti-Redness Hydra-concentrate Tinted Defence Cream SPF15 Thermal Cleansing Milk Thermal Cleansing Gel Sensitive Eye Makeup Remover SOS Anti-Redness Balsamic Serum Thermal Concentrate Water – this is available in a spray container to gently restore skin mineral levels, excellent for travellers and to restore and set makeup.

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AQUATHERM is the perfect treatment solution formulated to respond to problems of sensitive and reactive skin that cannot be treated with traditional cosmetic products.

Available through VOGUE IMAGE GROUP

1800 55 45 45 Email: info@vogueimage.com.au TRY-BEFORE-YOU-BUY SPECIAL OFFER Due to popular demand, Vogue Image Group have extended this special offer until the end of January 2015.

The success of Skeyndor Mesoscience is so profound that Vogue Image Group, the Australian distributors – are providing two salons/clinics with a unique opportunity to a TRY-BEFORE-YOU-BUY SPECIAL OFFER to experience this technology and see how it can help them increase their business profits from day one.

The successful applicants, however, must meet with specific criteria. If you would like your business to be considered please complete the details below and email to julius@vogueimage.com.au or post to:

Vogue Image Group 68 Milton Parade MALVERN VIC 3144

Entries close by 31st January 2015. cut here

TRY-BEFORE-YOU-BUY SPECIAL OFFER ㄰

Name of business: _____________________________________________________________________________

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For further information phone: VOGUE IMAGE GROUP 1 800 554 545 or (03) 9821 0033

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Are you ready for a higher level of skin improvement without the need for surgery?

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WE NOW HAVE THE ANSWER!

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For a copy of the Clinical Trials or to arrange a demonstration please contact

1800 554 545 info@vogueimage.com.au

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The COSMECEUTICAL FACE

By Terry Everitt BHSc, M.Ed When it comes to skincare the study of Cosmeceuticals and how they work on the skin is a relatively new area that progressively is starting to attract objective evidence-based research.

Meanwhile, as aesthetic therapists, we are now required to make choices based on ingredients, so determining how they actually work on the skin is critical, both for enhanced treatment results and for client recommendations.

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Following from a seminar delivered in August at the recent APAN Aesthetics Conference in Sydney, we asked Terry Everitt to provide us with a more detailed article based on his lecture at the conference. As always, Terry gave an impressive download of information titled The Cosmeceutical Face, where he presented scientific-based underpinning knowledge to understand what needs to be overcome for ingredients to penetrate the skin. This was provided along with a little chemistry to think through in making your own decision on effectiveness and mostly to ask questions as to 'how does this product work?'

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Skincare products have come a long way from the initial cold creamtype formulations that sufficed for both cleansing and moisturising.

Today there is an amazing array of ingredients available for use in skincare products and the advertising and marketing of such would lead you to believe that everything in a product will do absolute wonders. How much of this is true? Many scientific claims are made about products, but often there is very little scientific proof of the product's effect.

CONSIDERATIONS AND QUESTIONS TO ASK There is simply no way you can have an encyclopaedic knowledge of skincare ingredients and their specific efficacy of action. Even if you did have such knowledge, this is not the only area you need to know about. It is not just the individual ingredient and action. You need to be concerned with how this ingredient works with other ingredients in the total product – how much of the ingredient is in the product and is it all used on the skin or in the product itself? What of the molecular size of the ingredient – is it actually too big to get into the skin? Is the ingredient in the correct chemical structure for the skin? What about the concentration of the ingredient and what happens to it when it is included in the formula – is it diluted in the total product? Will it get to the right site for action, or will it just be held in any of the natural skin defence barriers?

Does the ingredient need a certain pH to be effective? If so, how does this happen, given the differences in pH within the skin, let alone the pH differences in the total product?

There are many individual questions you need to consider regarding the ingredient in question and then the biggest questions begin regarding the skin you are applying the product to skin condition, age, thickness? How does the multitude of individual differences of skin effect the viability of the product and its ingredients?

How informed are you with the skincare products you are using and recommending to your clients? Do you blindly believe everything you are told – do you question to find answers? Perhaps part of the problem may be that you are not even sure what questions to ask.

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Actually, you probably already know some of the answers, but perhaps you do not 'connect the dots' of information silos. To achieve this you will need to think about the skin structure and the barriers it provides and think about how skincare ingredients get around these barriers. You are already aware that the skin is great at keeping water out, otherwise you would never survive having a shower, bath or a swim. So if the skin is so great at keeping water out, how do your products manage to get in?

It is not an easy task to bypass all of the innate protective functions of the epidermis. There are of course only three ways: 1. Intracelluar (through the cell membrane) 2. Intercellular (between the cells) and follicular, or 3. Transappendageal (more technically) through the hair follicle and pores

PENETRATION OR ABSORPTION

Here we must think of the purpose of the ingredient – what is it supposed to do and where is it needed to perform its action? From this

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MAJOR PATHWAYS OF PENETRATION

Does your product penetrate or absorb into the skin – is there a difference? Let's look at that.

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Skin penetration represents the amount of a topically applied product that exists between the stratum corneum and the stratum basale (or germinativum), thus effecting only the epidermis. On the other hand skin absorption occurs when the topically applied product breaks through the skin layers to reach the bloodstream. That means the product gets to the dermis. Whether the product ingredient becomes a risk is determined by what occurs after absorption (i.e. does it remain in the dermis, or filter through into the bloodstream). In that instance we should be speaking about product penetration and not product absorption.

STRATUM CORNEUM This very small depth of skin is approx. 20% of skin volume, yet contains 80% of total skin barrier function along with being biologically active.

How many individual functions does the skin have? Sure you can recite the list from your original studies, but this is only the beginning.

At the moment I can think of at least 15 and all functions of the stratum corneum alone; such as antimicrobial, antioxidant storage, biosensor of meteorological conditions, psycho-sensory, social communication, water and chemical storage and filter, chemical mediator, cohesion force, desquamative, mechanical, inflammation initiator and controller, regulator of innate and adaptive immunity, permeability fluxuator, protective defence against carcinogenesis, photo-ageing and electromagnetic radiation.

Then we have the other layers of the epidermis to contend with and all the biochemistry going on in the different layers.

comes the mode of delivery – is it needed inside the cell (intracellular) and if we can get it inside the cell wall, what of all the other cells under the top layer. The ingredient will have to get through the cell membrane, through the cell, out the other side to get to the next cell.

Otherwise only the top layer of cells would be affected. Very little penetration of lower layers occurs with this transport method.

A more plausible way is to have the ingredient go around the cell membrane in the interstitial, or extracellular space. This space is also part of the barrier function and is primarily a lipid structure with multiple laminar layers, made of long and short chains of various ceramides, free fatty acids and cholesterol.

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If you have a water-based ingredient it simply will not work here – you already know that water and oil do not mix well unless helped.

What help does your water-based ingredient need to be transported along these lipid pathways? It will need to be either, encapsulated and protected, or somehow become attached to lipids. This you need to know about and ask questions of.

This relates to the atom structural placement of the molecule or its 'chirality' (mirror image).

Finally,what about the hair follicle – this is a nice big hole in the skin so bigger molecules can get in this way, right? Actually, no – this is not correct as the lining of the follicle is the same epithelia as the 'outside' skin surface. Added to this, the sebaceous gland is attached being the sebum producer, so possibly even more lipids will be present here than in the intercellular space of the upper epidermal layers.

Here this is a 'cis' configuration meaning same side. If you bend the molecule in half lengthways, both halves be 'even'. Notice at the top, both sides have three Hydrogens and one Carbon and the bottom both having one Hydrogen each.

PURE CHEMISTRY IS THE ANSWER If that is the answer then what was the question? It is the base question you need to ask of your supplier as to how the product works. What chemistry is used to allow the ingredient into the skin, to overcome all of the skin's barrier functions and be transported to where it needs to be to do its work, without being changed or diluted in the bottle or in the skin? ㄰ 㤵 㜵

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While the marketing material may say 'contains 10% of the active, which may be true in terms of how much was put into the bottle; however how much of this comes out of the bottle and then how much of that is actually used in the skin? The dilution factor may be a great one as the individual ingredient mixes with all the other ingredients in the total product. One other point to note here is, how do all the other ingredients affect the ingredient you are thinking about? The active concentration of the end product is important – more so than the concentration that was put in to begin with.

Is the ingredient in question in the correct configuration? This has been another confusing area by the marketers in trying to push a particular product. Is it a 'cis' or a 'trans' isomerisation?

This example indicates a 'trans' configuration (meaning other side). If you bend the molecule in half lengthways, the two sides are uneven.

Here the top part has only one Hydrogen on one side with three Hydrogens and a Carbon on the other. The bottom part of the molecule is also 'uneven', with three Hydrogens and a Carbon on one side and only one Hydrogen on the other.

This actually does make a difference. A nice example is Retinoic Acid, the trans is used topically, while the 'cis' is used internally – that is to say the difference between Retinoic Acid and 13 cis isotretinoin, better known in Australia by the trade name Roaccutaine. Now there is a difference in effect.

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What of the pH? The skin will try to neutralise the product to bring it back to pH balance. This pH balance changes in the various layers of

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the epidermis with the stratum corneum being approx. 5.5 pH, with the stratum spinosum and germinativum layers being at 7 pH. Does the ingredient need to be at a particular pH to be effective and how does the skin attempt to modify the pH affect on the efficacy of the ingredient?

shape of a cube with a surfactant liquid crystaline phase that the epidermal lipids dissolve, releasing the contents. Solid lipid matrix (SLN) is an encapsulation of liquid lipids that remain solid at body temperature – these have an occlusive capacity with the capacity of a gradual breakdown.

Another thought to consider has to do with the molecular weight (MW) or size of the ingredient. It was thought that anything over a MW of 500 D (measured in Daltons) was too big to penetrate. This come about from incorrect reading of a report by Bos & Meinardi (2000). This myth was proved incorrect by the work of Roberts et al (2013) who showed that larger MW molecules can penetrate the skin.

Luckily, however, most individual ingredients are less than the 500D anyhow. You don't really have to worry too much about MW, although it is a factor as many ingredients (once combined to other multiple molecules) may be too big for skin penetration.

Fullerenes, on the other hand, are small ball structures composed of only an even number of carbon atoms. Dependent on where the ingredient needs to go, the carrier encapsulation can be made to break down in the various skin layers to effect the target. Is this true of your product, or is the ingredient encapsulated so it is too solid to break down where you need it to be, or is it too fluid so it simply stays on the stratum corneum surface.

MICRO NANO The use of nanotechnology has helped the advance of skincare efficacy and while there is no universally accepted definition of what is 'nano' it is generally accepted that it denotes something smaller than 100 nanometres (nm – 10-9 – one billionth), not to be confused with micrometre (µm 10-6 one millionth).

Microemulsions have been incredibly successful, with an array of structures now available to encapsulate ingredient molecules.

Liposomes perhaps are the most well-known and are made from phospholipids, with Phosphatidylcholine being a favourite as it is found naturally in the skin so is bio-identical.

Transfersomes are made with a deformable membrane that allows for a more flexible transport of active ingredients. Cubosomes are in the

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DOWNSTREAM ADAPTATION What is now a common technique in serious skincare is the use of precursor molecules that have an effect downstream to the target. This allows bigger molecule materials to form in the skin. A classic example of this is the end result of wanting to get collagen into the skin. We cannot get collagen into a bottle so that we can put it into the skin for the obvious reason of size (and a host of other concerns). So to get collagen production going, we start downstream of the pathway and put in ascorbic acid, which is required to provide hydroxylation of lysine and proline, which in turn help to make procollagen strands.

There are then a number of other processes needed to finally produce collagen. Without the ascorbic acid at the beginning, collagen production would not be possible. We know that while ascorbic acid is required, this poses problems of stability, acidity in the product and irritations on the skin, so we go a few more steps downstream in the process. We use a stabilised form of ascorbic acid such as the ascorbyl phosphate salts such as Sodium Ascorbyl Phosphate or Magnesium Ascorbyl Phosphate. We know these are not as effective as using pure

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ascorbyl acid, yet we also know that the body will break away the two minerals either side of the ascorbyl molecule releasing the active, which then does what we wanted without the issues normally encountered with ascorbic acid. This is down streaming.

Another exciting array of enzymes are used as Tissue Inhibitors of Metalloproteinases (TIMPs) that inhibit other enzymes known as Matrix Metalloproteinases (MMPs), which are enzymes that break down proteins.

PEPTIDES AS DOWNSTREAM PRECURSORS

While there are approx. 28 known MMPs, the main three concerned with in skincare are MMP1 (collagenase), MMP 3 (Stromelysin) and MMP 9 (Gelatinase). These are responsible for the breakdown of collagen, elastin and glycosaminoglycans.

Another classic example is with proteins. Proteins are too big to get into the skin via a skin product, so we use the smaller molecules – peptides that build into proteins. The peptide itself at times is also too big so we go 'backwards' again in size to amino acids. Using a combination of amino acids we can then create the peptide, which in turn creates the protein.

As you are aware, there are many peptides being used in current skincare formulations. Some have scientific evidence of effectiveness and some do not. Generally speaking, however, peptides can be grouped into four major classifications of action signal, neurotransmitter (excitation or inhibitory), carrier or enzyme inhibitors.

KTTYS is a synthetic signal peptide made of the amino acids lysinethreonine-threonine-lysine-serine, which has multiple effects as it stimulates collagen I, III and VI, fibronectin, elastin and glycosaminoglycan production. A variation of this peptide is PalKTTKS, better known by its trade name Matrixyl – here KTTKS is joined with palmitic acid.

Palmitoyl Pentapeptide is a non-irritating, comparable alternative to retinol in tricking the skin into thinking it is broken down too much collagen during the catabolic process, and thus triggers an increase in collagen synthesis.

Acetyl Hexapeptide -8 (Argireline) is an inhibitor neuropeptide chain that mediates inflammation.

Acetyl Octapeptide-3 SNAP 3 is another neuropeptide that blocks the formation of the SNARE complex in the pre-synaptic membrane; ACh release is minimised, wrinkle contractions are lessened and expression lines are softened (the active is so called 'Botox in a bottle').

Acetyl Tetrapeptide-22 – increases Heat Shock Protein, in particular HSP70. Heat Shock Proteins are those required for the efficient folding of protein strains which prevents unwanted aggregation that then mutates. HSP also helps in protein transport across the cell membrane. The number that appears after HSP is the molecular weight of the peptide (which also gives indication of function).

BIOLOGICAL CATALYSTS PRECURSORS The use of enzymes is also big business in serious skincare. However these need to be approached with caution as it is a fine balancing act between too little (therefore not having any real effect) and too much (having too much effect, which can be a bad thing). ㄰

β-hydroxymethylglutaryl- coenzyme A reductase (HMG-CoA reductase) 㤵

is used to increase lipid structure, in particular it works in the enzymatic cascade converting lanosterol to cholesterol.

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Lysyl oxidase initiates the crosslinking of collagen and elastin strands. ㈵

Serine palmitoyltransferase – (a condensation of serine and palmitoyl CoA) on the other hand is required to form ceramides.

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When you think this through, you can see that while we need MMPs, we don't need too much of them as they will do what they do – reduce collagen, elastin, etc. If we need to build up these structural fibres then we can inhibit them, but just how much is enough? No one really knows. This differs greatly in wound healing as opposed to normal homeostatic dermal functioning.

CONCLUSION I hope this article, while perhaps a bit confusing for you here and there, actually has helped in getting you thinking more about the products you use. Do you really know much about them – do you know them from a scientific point of reference or just from a marketing point of view? If a client asked 'how exactly does this product work?' can you truly answer?

If you are to be taken seriously, it is no longer sufficient to only have the answer as 'it gets down into the skin' type response. How does it get down into the skin? What does it actually do – and how can it do what you say it does. Is it really possible to do what you claim it does and how do you know that anyhow?

As skincare products increasingly become more scientific and have segmental efficacy, you will need to know much more about the product to be able to answer the consumer's ever-increasing quest for knowledge as to what they are using. If you want clients to use your products rather than what is cheaper down the road, then you need to be the professional source of information, not just the purveyor of marketing, meaningless jargon. You face threats from the massmarket products sold from a suitcase, threats from the department store, supermarket and chemist with skin products. Mostly you will soon face threats to your market share by those in skincare with a scientific basis of knowledge that truly can provide professional skincare advice, based on objective analysis of client concern and skin presentation, combined with understanding of product efficacy to address those concerns.

“It is often not the ingredients in a product, but the claims in labelling or advertising that determine whether a product will be classified as a cosmetic or a drug – in effect you are what you claim you are.” Albert Kligman 1998.

REFERENCES Bos J.D. Meinardi M. H. 2000. 'The 500 Dalton rule for the skin penetration of chemical compounds and drugs'.

Experimental Dermatology, Vol. 9. pp: 165169.

Bolzinger. M. Briançon. S. Pelletier. J. Chevalier. Y 2012. 'Penetration of drugs through skin, a complex rate-controlling membrane'. Current Opinion in Colloid & Interface Science. Vol. 17. No. 3. pp. 156-165.

Roberts, D. Mekenyan, O. Dimitrov, O. Dimitrova, G. 2013. 'What determines skin sensitization potencymyths, maybes and realities.

Part 1. The 500 molecular weight cut-off' Contact Dermatitis. Vol. 68. pp. 32-41.

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Australian Skin Clinics launches the

ASC AESTHETICS ACADEMY A modern approach to skills development in Cosmetic Medicine and Skin Rejuvenation Established as a reputable Cosmetic Medicine, Laser and Skin Rejuvenation franchise clinic model, the Australian Skin Clinics are experiencing unprecedented growth with the constant expansion of their network through various franchise clinics throughout Australia.

As new franchisees are coming on board the demand for qualified and competent staff is becoming a challenge, and so to ensure and maintain the necessary training standards the Australian Skin Clinics recently launched their own training facility.

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September 11th saw the official launch of the ASC Aesthetics Academy at their newly appointed premises in Bundall on the Gold Coast with a well attended and vibrant cocktail party. The new facility boasts state-of-the art equipment and training rooms, and a variety of unique training programs to suit existing professionals who wish to improve their skills and knowledge to a more clinical level, as well or for seasoned industry professionals who have been out of the workforce and wish to return to a more exciting career opportunity.

We interviewed Deb Farnworth-Wood, the brains behind the brand and owner of the Australian Skin Clinics, and asked her for information on the new training facility, what it offers and who would be a good candidate to benefit from this training.

APJ 1: Deb, can you please share with us about the exciting launch of the Australian Skin Clinics Academy and its goals over the next 12 months?

Deb: We recognised early on as we grew that we had an opportunity to change the way in which training took place in the cosmetic and aesthetic industry. We tell all our job applicants that we retrain them regardless of their skills and experience because there is so much misinformation out there and the quality of training currently available is actually very variable, with not enough emphasis placed on supervised, practical training. As a result, The Aesthetics Academy was born.

We have been expanding so quickly and the timing was right to be proactive and fill a gap in the market by offering practical experience to enable Beauty Therapists who wish to take that extra step into the world of laser technology.

Our academy provides us the added advantage of being a natural recruitment source for our own highly trained students, with career opportunities for successful candidates.

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The team at Australian Skin Clinics have spent over 18 years honing our systems, protocols and procedures and in doing so we have developed a culture where team members are passionate and dedicated in the delivery of high-quality treatments within our clinics.

We have developed the Australian Skin Clinics Standard, which has set the benchmark in the industry, and it is for this reason that we have become an employer and trainer of choice.

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APJ 2: Describe to us what you are looking for in potential candidates for the ASC Scholarship?

Deb: The Australian Skin Clinic scholarships are offered through The Aesthetics Academy and are available to candidates with a Diploma in Beauty Therapy or a Certificate IV. The course is specifically for therapists who are ready to take that next step in their career, and who are looking to have a new set of skills added to their portfolio. We are also interested in mature age therapists returning to work postchildren.

The type of applicants we are looking for must be eager to learn, possess excellent communications skills and truly believe in delivering the ultimate customer service and achieving the best results. Having confidence in the quality services we provide as a clinic is essential, and this program has been designed to help candidates achieve this through advanced training to develop and enhance their skills in understanding skin conditions and client desires.

APJ 3: Explain to us the training program that these candidates can expect to undertake and what skills will they gain from this program?

Deb: Across Australia the laser industry governance varies, with Queensland having the highest regulation requirements. Australian Skin Clinics uses the knowledge and requirements outlined by the Queensland regulations, and the advice and research conducted by our very own medial team to develop the Australian Skin Clinics Standard for training. In Queensland the laser industry is governed by strict Radiation Health Guidelines, which require the completion of a Laser Safety Course and an application to be made for a Laser Hair Training Licence.

many women may not feel confident in their skills at this point in their lives, or may feel that technology has moved on without them, we believe we can set them back on track with their careers.

As our society evolves, more and more Australian women are going back to work after having children and the nest being empty, and Australian Skin Clinics recognises the challenges that these women face when rejoining the workforce, and we don't want a gap in their work history to stop their chances of enjoying a professional career with our industry.

We believe mums are great workers and we have a range of flexible positions to suit all types of experience and availability. Returning to work after children or a career break should not prevent mums from getting back into the work force.

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APJ 6: How will these programs benefit the industry, while also meeting with Australian Skin Clinics’ staffing needs?

Deb: The Aesthetics Academy will be providing practical courses for Dermal and Beauty Therapists who wish to move into higher-end technologies and away from traditional beauty. We are offering concentrated training with highly experienced trainers in an environment that it is structured to reflect a real world clinic rather than a training school. This is particularly important in Queensland where there are steep practice requirements to obtain laser licensing that cannot normally be achieved quickly in an everyday salon or clinic.

If you would like to contact the Australian Skin Clinics to discuss franchising opportunities or training options with the ASC Aesthetics Academy please contact 1300 303 014 or visit www.ozskin.com/franchise or www.ozskin.com

For successful candidates from the Aesthetics Academy we will run the Australian Skin Clinics Laser Course over three stages: 1. Application and Interview 2. Laser Safety Course: One day including application for Laser Hair Training Licence (Dates currently available from October, 2014)

3. Laser Hair Removal Training Course: Six days. This course begins in February 2015 (Note: Turn-around time for laser licences in Queensland from Radiation Health is between 6-12 weeks).

APJ 4: What about career/job opportunities?

Deb: Successful completion of competencies for this course will ㄰

result in you being qualified for a Full Laser Hair Removal License and an opportunity to start your professional career at a suitable Australian Skin Clinics location.

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APJ 5: Tell us also about the Return-to-Work program and who is an ideal candidate for this program?

Deb: This is a very exciting program we are running at Australian

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Skin Clinics! We know that there are a number of people out there who have previously worked as Beauty Therapists – perhaps before having children, or having time out of the industry for other reasons.

We place a lot of value in their experience and maturity, and while

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Dr James Lavalle

A5M Stages Another Successful Anti-Ageing and Aesthetic Medical Conference This year's A5M Anti-Ageing and Aesthetics Conference held in August in Melbourne was once again a great success. As world-class leaders presented an amazing conference program that comprised of two streams – internal medicine that was based around the theme of Stress and Ageing – Taking Theory to Practice and the Aesthetic Stream, which covered numerous topics and techniques on the latest in appearance-enhancement techniques from the latest bio-stimulant injectables, threads and laser, LED and other technological advancements, and the scientific findings for the benefit of their use.

from internal to appearance and, of course, the strong content of the all-important preventative approach that brings much hope to a growing ageing and ailing society.

World-renowned Integrative Medical Practitioner and internationally recognised natural therapies expert Dr Heyman is Program Director of Integrative and Metabolic Medicine at The George Washington University, USA. Dr Heyman shared advanced research and clinical data on the Hypocortisol state and the long-term effects of stress on the brain and immune system.

The event was facilitated by Dr Mark Donohoe and A5M President Dr Nathan Francis, who both in their own style added spice and their personal comments to some of the incredible topics that were presented. There is something very personable and welcoming about A5M Conference without taking away from the seriousness of the scientific and evidence-based content, but I personally find that what is unique about the A5M events is the diversity of topics they cover,

Dr Heyman revealed scientific updates on Rg3, Nicotinomide, Riboside and Tocotrienols as representing the cutting edge of herbal medicines and their use in stress-related treatment protocols. The issue of stress and stress management was addressed comprehensively from new findings on the causative reasons such as the dangers of accumulative stress and how our modern, fast-moving and changing world can contribute to mental and emotional overwhelm and Dr Donohoe, Dr Francis, Dr Khattar, Helen Anton, Dr Heyman, & Dr Lavalle the systemic impacts that it can have.

Dr James LaValle, internationally recognised Clinical Pharmacist, Board Certified Clinical Nutritionist and Naturopath, discussed research relating to the potential metabolic impact of Nutrient Depletion through PolyPharmacy on Metabolic Syndrome and Co-morbidities.

LaValle extended insights into exercise, overtraining and hormonal and immune dysregulation that can occur with intense exercise. He spoke about the “brain on fire” and the impact of stress on the nervous system and the brain, inflammation and how these can alter the architecture of the brain.

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Both speakers identified and presented biochemistry and nutritional advances in mitigating the impact of stress in cellular damage. They also identified the need for a more detailed approach to diagnosis that looks beyond the conventional and traditional parameters to more detailed biochemical changes in the body.

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Dr Mark Newman presented new research presentation revealing a comprehensive model for measuring adrenal hormones, relating to the HPA-axis puzzle, including measurement of a diurnal-free cortisol pattern along with cortisol metabolites.

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World-renowned adrenal expert James Wilson PhD Naturopath provided clinical updates on Toxicity of the Adrenal Glands and why the unique structure of these glands makes them more vulnerable to pharmaceutical and non-pharmaceutical substances.

Tina Viney and Dr James Wilson

This would have to be one of the best conferences I have ever attended. Whether you are a medical practitioner, nurse, dermal clinician or aesthetic therapist, this event should be a priority for you to attend. The diversity and amazing information presented will give you a new appreciation of where medicine is heading and how it can interface and also benefit appearance medicine. The fusion of diverse disciplines has the power to achieve much more through the new, emerging regenerative and integrative health and medical model that is providing answers to questions where the fragmented approach failed.

Dr Wilson also revealed the effect of stress on the drop in DHEA relative to Cortisol termed Pregnenolone Steal and the recommended clinical practices. Dr Wilson is recognised as the world’s leading authority of adrenal fatigue Australian Healthcare educator and Clinical Nutritionist Warren Maginn revealed current research on the importance of Methylation to our Stress Response as we age, with updates indicating multiple avenues whereby adequate cellular methylation capacity is required to maintain CRF, ACTH, and ultimately Cortisol production. We were delighted that Warren Maginn was also able to be a speaker at the APAN Conference that followed in Sydney on August 26, directly after the Sydney Spa and Beauty Expo.

Paul Taylor, who holds qualifications in nutrition and exercise physiology demystifying the complex 'neuro-symphony' of stress, presented a compelling lecture on the cascade of autonomic, neuroendocrine, metabolic and immune system

Sinan Ali, Dr Khattar, Terry Everitt, David Adamson and Maureen Houssein-Mustafa

responses that lead to psychiatric disorders and physical disorders such as Alzheimer's, depression, obesity and insulin resistance.

Covering new advances in Aesthetic Medicine, stem cells, PRP and injectable techniques included Dr Maria Agnelo-Khattar (UAE), who is renowned as an expert worldwide in minimally invasive aesthetic procedures. Dr Khattar shared updates on advanced minimally invasive techniques for facial rejuvenation using soft fillers and lipolysis for facial symmetry.

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Cosmetic surgeons Dr Simon Rosenbaum and Dr Michael Zacharia spoke on new techniques in improving the facial contour through the new minimalistic global approach and techniques, as well as thread lifting with demonstrations.

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Comprehensive workshops followed delivering further skills in the application of techniques in a clinical environment.

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Dr Andrew Heyman

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IN CONCLUSION This would have to be one of the best conferences I have ever attended. Whether you are a medical practitioner, nurse, dermal clinician or aesthetic therapist, this event should be a priority for you to attend. The diversity and amazing information presented will give you a new appreciation of where medicine is heading and how it can interface and also benefit appearance medicine. The fusion of diverse disciplines has the power to achieve much more through the new, emerging regenerative and integrative health and medical model that is providing answers to questions where the fragmented approach failed.

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The 9 Annual A5M Anti-Ageing and Aesthetic Medical Conference will be held on the 1-2 August 2015, once again in Melbourne. It pays to prioritise to attend. Here is the link for further details http://www.a5m.net/events/event/9th-annualconference-2015

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Why not register now and save on the super-early birds rate?

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APJ 42

WE NEED MUMS!

Feeling lonely, bored or in need of a challenge?

Kids left home? Returning to work after a career break can be confronting.

AUSTRALIAN SKIN CLINICS CAN REVIVE & REJUVENATE YOUR CAREER We love mums! We have casual, part-time and full-time positions available now!

Australian Skin Clinics is a leading Cosmetic Medical, Laser & Rejuvenation franchise specialising in dermal, laser and injectable treatments, and we are looking for people of all ages, experience and availability.

If you already have a Diploma of Beauty Therapy, or a Certificate IV in Anatomy and Physiology and have a passion for people, then it is time to join a company where you can love your work.

Successful candidates will be trained as Dermal and Laser Technicians at our advanced training academy.

A career break should not prevent you from getting back to work.

We want you!

Visit www.ozskin.com/careers to apply. Phone 1300 303 014.

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ASK THE EXPERT Solutions, insight and advice for problems that arise at work

The way we work is changing. Increasingly we demand flexibility in the way we run our businesses and it is now common for many business owners to work from home. If because of financial pressures you have relocated your business from your premises to home, please remember that the Tax Office will be also targeting you for audits. In fact, recently several members working from home were visited by the Tax Office, so make sure you are compliant with your obligations.

The Tax office always keeps a close eye on deductions that taxpayers claim for working from home and it is easy to make a mistake. So what are the rules for claiming expenses when you work from home?

First, if you use a computer, phone or other electronic devices for work purposes, you may be able to claim a deduction for your costs.

The other deductions you may be able to claim are:

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Occupancy expenses such as rent, mortgage interest, rates, land taxes and insurance premiums.

Running expenses such as computer, printing, phone, IPL or other equipment you have purchased or leased. You can claim the full cost (for items costing up to $300) or the decline in value (depreciation) for items costing $300 or more.

Heating, cooling, lighting and power costs proportionate to your work.

Cost of repairs to your salon equipment Bank fees and charges Linen purchases and cleaning Marketing and advertising materials Association memberships (like APAN), journals and publications you have purchased or subscribe to Conferences you attend that are specific to your work this includes travel and accommodation expenses and well as conference fees Business networking meetings expenses

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Products you use and consumables for your services are all claimable Product purchases for reselling Cleaning expenses for the space you use only Flowers, tea and coffee or refreshments you service your clients.

For these you need to purchase separate from your home use

Being able to claim for these expenses you will need to have clear sections in your home that are set aside for use for the business only.

Effective record keeping will ensure that with the appropriate receipts you can claim your entitled deductions. Make sure you claim every thing you're entitled to, not a cent less and not a cent more, and make sure you can substantiate all these purchases through receipts.

As part of membership APAN offers Members Plus Card for discounted shopping.

These discounts also apply to Coles and Woolworths. Some business purchased a vouch with this membership and save an additional 5%.

They then use this card specifically for salon purchases e.g. tissues, toilet paper, cleaning products, tea, coffee, milk and sugar, cotton buds, room spray, disinfectants and gloves. Some also purchase a coffee maker, milk frother, cups and sauces as well as glasses that are used exclusively for their clients and in their work space.

With good record keeping it is amazing how much you can save.

APAN offers numerous cost-benefits to help you run your business in a cost-effective manner. If you would like to explore how APAN can assist you please contact APAN on Ph: 07 55930360 or email: info@apanetwork.com.

Full coaching and consulting services however are available for free ONLY TO APAN FINANCIAL MEMBERS.

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APJ 44

Exclusive Scholarship Program GUARANTEED EMPLOYMENT *

* conditions apply

Join the Elite, Launch your career Australian Skin Clinics is taking applicants NOW for our exclusive Scholarship Program!

Take your beauty career to the next level. Our Scholarship Program includes a Laser Hair Removal Course which provides successful candidates the skills and certification to commence their career as a laser technician. The course includes: • Accredited Laser Safety Course • Laser hair removal training • Logged training hours • Application for Queensland laser licenses (if applicable) For more information phone Nicola Connolly on 07 5509 0000, or submit your resume and cover letter at www.ozskin.com/careers.

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industryaward Induction into the Hall of Fame ACHIEVEMENTS FOR THE BETTERMENT OF OTHERS In recent years new industry achievement awards have been introduced to the beauty industry to help honour individuals and help celebrate achievement.

Awards can be powerful because they allows us to take a break from what we are doing and view how our activities and achievements have impacted not just ourselves, but also the wider professional community that we belong to.

One worthy advocate within the beauty industry is Gay Wardle.

Tirelessly working to improve educational awareness and enhanced knowledge within the industry, she travels from Stateto-State (often to her financial detriment) delivering training to eager therapists.

Her altruism is monumental and through her knowledge, zeal and passion she is helping to impact and shape an industry that is desperately in need of becoming better equipped to meet the challenges of a changing industry environment, not to mention consumer expectations.

This is what she does and it is her own unique trademark for which she is known within the industry, and so it was befitting that the industry chose to honour her through two separate awards programs.

WINNER OF TWO AWARDS On Saturday 23rd August, Reed Exhibitions conducted their own Gala Awards at which they recognise achievement within the beauty industry. The event was held at Cockle Bay, Dockside, Darling Harbour. Over 200 guests attended the event at a gala dinner. This year the inductee to the Hall of Fame was given to a very surprised Gay and presented by Amanda Stevens.

Following this event, Sunday night 24th August was the ABIA (Australian Beauty Industry Awards). Again the event was held at Cockle Bay, Dockside, Darling Harbour. This event, which was launched just four years ago, is progressively gaining momentum and this year over 350 attended their awards gala dinner. Among their various awards ABIA also include a Hall of Fame Award. Once again Gay was honoured and inducted into the Hall of Fame of the ABIA awards.

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We asked Gay how surprised she was in receiving the award. “I was completely surprised as I know there are peers of mine that are more deserving of these awards. So it came as a complete surprise and shock that I would be presented with such an award. After winning Saturday night I never even considered that I would have won Sunday night as well. I felt very honoured at the time. My daughter, Nickie, had been contacted by both organisations and had been the source of information to deliver photos and other information. She was very good at keeping it a secret from me”, Gay stated.

“I guess when I was delivering my speech, which is a bit of blur, I was overwhelmed at the support and recognition that I was given. I mentioned you, Tina, as being a huge mentor in my life, and very briefly and quickly reflected back on my life in this industry. I recognised that an important element of achievement is to have people believe in you and help you along the way, and I am forever grateful for that and will never forget the support I have been given over the years.”

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Being a multi-award winner we asked Gay to tell us how she believes awards impact an individual and a business. “One thing about receiving awards is that they encourage both individuals and their teams towards progress and achievement, and they can fuel passion and drive to do so. Anything is possible if you give it your all and stay honest and true to yourself, while also being supportive of others. “ I have felt that winning awards encouraged me to always strive to be better than yesterday – to set standards for both myself and for my staff.

Setting higher standards for yourself is very rewarding and it encourages others to do the same. You cannot be a winner and then become sloppy at your work. The recognition is a reminder that your efforts have been identified and rewarded and this motivates you, not only to maintain them, but also to continue along the path of selfimprovement.

“I love this industry and would love to see it have formalised standards Australia-wide so that we are recognised as professionals. We are moving towards more advanced procedures, and in order to work effectively with healthcare professionals to achieve better outcomes with our clients' skin and body needs we need standards that can help consolidate our professional identity, respect and recognition, not just with the broader healthcare professional community, but also with consumers. If I can help someone lift the standards through education and inspire therapists to continue to educate themselves then that will be my greatest award ever,” Gay emphatically confirmed.

SO WHAT LIES AHEAD FOR GAY AND WHAT ARE HER ASPIRATIONS? Without hesitating, Gay enthusiastically stated, “My future goals would be to fight towards higher standards across Australia and to create awareness that education as the only way we can stop ‘opportunistic pirates’ from infiltrating our industry and degrading the reputation of the profession. I know this is a high ambition, but we need to get behind this agenda. You would understand, Tina, as you have been an advocate of this for a long time now and are making inroads to this extent.”

We wish Gay every success for the future and feel delighted and honoured to celebrate and champion her achievements and recognition. We trust that she will become a trailblazer for others to follow her example and recognise that while there is benefit in setting goals for our own success, investing in the reputation of our profession through our knowledge and skills is also a worthwhile pursuit – it is the stuff of legacies.

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APAN AUSTRALIAN AESTHETICS CONFERENCES

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BIGGER AND BETTER IN 2015 The Business of Skin Management Taking it from Theory into Practice

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Brisbane Sunday 31st May Sydney Sunday 21st June Melbourne Sunday 18th October

Your Date with DESTINY Our world is rapidly changing. Clinical knowledge is doubling every 18 months1. Are you still working on yesterday's business ideas or today's realities?

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Buckminster Fuller “Knowledge Doubling Curve”

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Each APAN Conference Program is individual. Each promises to lift the lid on the facts and deliver cuttingedge information and unveil new concepts and trends. These conference programs will leave you exhilarated and bursting with new ideas on how to create your own growth cycle.

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Latest Anti-ageing techniques New concepts and principles Leadership Strategies for Better Staff Performance Winning Business Growth Strategies

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Register today and secure your place. Visit www.apanetwork.com Ph: 07 5593 0360 Email: info@apanetwork.com

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Committed to the Beautiful Face and Body

One of the speakers at the A5M Conference this year, Dr Simon Rosenbaum is one of Australia's leading practitioners in Cosmetic Surgery, who has worked in the industry for over 25 years. He is a former President of the Cosmetic Physicians Society of Australia (CPSA) and was one of the pioneers of cosmetic surgery in Australia.

Renowned for his expertise in an extensive range of cosmetic surgical procedures ranging from breast augmentation, liposuction, thread lifting, facelifts and tummy tucks Dr Rosenbaum has both skills and experience in just about every possible cosmetic procedure and is passionately committed to his work as well as training other doctors.

We were thrilled to catch up with him and discuss his work and industry developments.

APJ 1: Dr Rosenbaum, tell us a how you got started in cosmetic surgery?

Dr Rosenbaum: I started in general practice back in 1982, but after

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five years I changed my direction and went into a computer business, but my interest was to get back into practice, this time as a cosmetic surgeon. To pursue this area of specialisation I went overseas and undertook training in Liposuction and Laser Surgery in the US and in Europe. Since then I haven't looked back. I currently perform and have perfected numerous surgical techniques and have performed in excess of 2500 breast augmentation procedures. I am committed to enhancing the natural beauty of my patients by offering them the best treatment options available.

Helping them realise their potential is the best part of my role and I strive to do that in the most natural-looking way possible.

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APJ 2: What aspect of your work do you love the best?

Dr Rosenbaum: I do everything except Rhinoplasty, which as you

know is a plastic surgery procedure for correcting and reconstructing

the form, restoring the functions, and aesthetically enhancing the nose. I consider breast implants as one of my areas of specialisation.

The best results that can be achieved are with the tear-shape breast implant, and we get a very high success rate for these, with a reoperation rate of 2% when the usual is 30%. With facelifts I can achieve great results with minimal scars. We also get great results with liposuction and we can achieve liposlender legs. We look at the patient in 3D contour to ensure we get the best results with the overall appearance. We also achieve successful body sculpturing with ultrasonic cavitation through my training with Dr Grant Stephens in the US, who is renowned for his technique.

APJ 3: How has the concept of facial beauty changed over the past 10 years?

Dr Rosenbaum: I believe that today our understanding of the ageing process has improved. The old way of looking at a facelift was to minimise the slackness of nasolabial fold. It was much more simplistic and we had limited products to work with.

Now we have a huge variety of products at our disposal, from injectables, threads, fat transplants to PRP and stem cells. The techniques have also evolved that allow us to address specific elements of ageing in a more individual way. With this multidisciplinary approach we are able to maintain facial integrity so the patient looks fresher and more youthful without appearing altered in a noticeable way. This enhancement style has a broader appeal to a wider consumer sector. For this reason cosmetic

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Cosmetic Tattooing has come a long way over the years. New, more sophisticated tools, new techniques and trends can allow a skilled and well-trained practitioner to become very much in demand. Ever-growing in popularity, Cosmetic Tattooing offers an amazing and very fulfilling career with tremendous scope, both for those who are artistic and those who are compassionate and nurturing.

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procedures are constantly gaining popularity and the demand is increasing by an estimated 20% each year.

Also, as procedures are becoming more refined we are starting to see younger patients, even in their 20s, who are seeking minimal enhancement as a preventative measure.

APJ 4: What about lip techniques?

Dr Rosenbaum: There have been major shifts in lip-enhancing techniques. We recognise now that bigger is not necessarily better.

Some lips are very hard to fill as they are prone to get the duck effect if the lips are too stiff. With the new techniques we can achieve a natural soft lift on just the edges. So many people are obsessesed with full lips when they see a particular look on another person with different proportions to theirs. While the look may work for that individual it will not necessarily work for them. What I like to do is request to see a photo of my patients when they were younger. In that way my objective is to model any enhancement on how they looked in their younger years. I aim to reverse the effects of time by attempting to make them look as youthful and natural as possible without altering them so that they look different. If you can identify that something has

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Sara Naderi is a qualified beauty therapist and Cosmetic Tattooist who has international training and over 20 years’ experience in Cosmetic Tattooing. Training with Sara will allow you to benefit from her expert techniques, while you can also qualify to receive government-approved qualifications in SIBBSKS504A Design & Perform Cosmetic Tattooing.

Sara is a APAN Corporate Platinum (Cosmetic Tattoo) Member Member of the Australasian Cosmetic Tattoo Professionals

COURSES AVAILABLE: ! Initial Training in Cosmetic Tattooing to Governmentapproved qualifications ! Refresher courses to advance your skills and knowledge in Eyeline, Lipliner, Full lip, Eyebrow techniques Zahra is also a specialist in Eyebrow Threading and offers highly skilled training in her unique method. Other courses also available.

PUREBEAU NEW GENERATION COSMETIC TATTOO PIGMENTS AND EQUIPMENT

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Sara is also the Exclusive Distributor of the German-made world-leading Cosmetic Tattooing pigments and equipment PUREBEAU. Sophisticated and outstanding new high-tech equipment that meets with European and Australian standards and offer state-of-the-art solutions to allow for safe, effective and precise application of cosmetic tattooing and medical pigmentation.

For further information on training or to enquire about our amazing world-leading devices and pigments contact PUREBEAU Australia E: info@purebeau.com.au P: 1300 667 719 | M: 0405 463 636 W: www.purebeau.com.au | W: www.schb.com.au

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been done, as a surgeon I have failed. This requires skill but the end result is always pleasing and will naturally enhance the patient's natural beauty and their self-esteem.

APJ 5: What new advances are you excited about?

Dr Rosenbaum: When looking at improving the youthfulness of the face it is important to also look at skin texture and other aspects of skin tone and elasticity. You can achieve a much more attractive and youthful affect if we look at the face globally and determine areas we can tweak to achieve balance and harmony.

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I feel the advancement in product innovations have now given us greater tools to achieve the best possible results. When improving someone's appearance it is often very much about the skin. Injections or surgery are not necessarily the only option. There is so much that can be achieved through improved protocols in the use of peels that can deliver amazing benefits in improving the skin’s smoothness and achieving a glowing skin texture.

We also now know that you don't necessarily need to use deep peels.

You can achieve some amazing results with repeated light peels that are safe and can mimic a gentle facelift. I have been asked to speak about peels at this conference and I was thrilled to present what can be achieved with them through the appropriate protocols. It would appear that with new advances, for some reason, peels have been ignored, but the benefits of their use is coming back.

There are now also incredible new skincare technologies such as peptides, more advanced hyaluronic acid formulations as well as epidermal growth factors. We also have evolving new technology that when combined can achieve a great deal. Threads have also advanced. The new ones stimulate collagen and are dissolvable. In the past we would use 4-6 threads and the results were often very average, now with the new threads we can use 20-30 to achieve a more natural, global effect with a greater end result. In fact, threads can also be used for mildly sagging breasts without the need for scarring.

Looking at supplements, we are now seeing supplements that can improve collagen integrity from inside out. You can get liquid collagen from the UK and the powdered form from Italy. I believe that supplements that support age management is going to be a growing market.

The integrative approach using equipment, cosmetic and skincare protocols, internal nutrition supported with minimal injectables is now able to deliver amazing youthful and natural results that will appeal to a much wider consumer base. Without a doubt this market sector will continue to grow.

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Dr Simon Rosenbaum is an internationally recognised cosmetic doctor with more than 25 years of industry experience. He specialises in facial cosmetic surgery, breast augmentation, laser surgery, liposculpture and abdominoplasty.

Dr Rosenbaum gained fellowship of the Australian College of Cosmeic Surgery in 1999 and is a former president of the Cosmetic Physicians Society of Australia. You can contact Dr Simon Rosenbaum at the Cosmetic Plastic Surgery Centre Ph: 03 9576 2000 or email: info@cpcvic.com.au

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MEDICAL COSMETIC TATTOOING Post-Graduate Workshop 3D Nipple Areola Sponsored by the Aesthetics Practitioners Advisory Network

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LEARN FROM THE EXPERT

Cosmetic Tattooists, do you want to advance your knowledge and education to a higher level and transition into medical tattooing? APAN is holding a post-graduate workshop for the benefit of Cosmetic Tattooists who wish to expand their scope of practice to include Medical Cosmetic Tattooing, specifically in gaining skills and knowledge in 3D NIPPLE AREOLA. This is a very rewarding career that will allow you to improve the quality of life of cancer victims who have undergone a mastectomy by improving their morale and self-esteem.

APAN is delighted to present CHRISTINE COMANS – a qualified Cosmetic Tattooist/trainer and a specialist in the 3D Nipple Areola technique. Christine is currently working with the Sir Charles Gairdner Hospital (SCGH) in Perth, W.A. on cancer patients.

SCGH has an international reputation for ground-breaking medical research and is considered as one of the leading teaching tertiary hospitals. Christine is honoured to be part of their team supporting the wellbeing of cancer patients who have undergone a mastectomy.

Join us for a one-day amazing workshop and learn from a highly respected expert.

WHEN: Monday 1st June 2015

Learning objectives will include: st

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(FOLLOWING APAN CONFERENCE Sunday 31 June 2015 Stamford Plaza Hotel).

WHERE: Stamford Plaza Hotel, Brisbane TIME: 8.30am – 5pm.

WHO CAN ATTEND: Qualified Cosmetic Tattooists YOU WILL RECEIVE: Statement of Attainment in Medical Cosmetic Tattooing (3D Nipple Areola) MEALS: Morning/Afternoon tea will be provided as well as buffet lunch COST: $1100, APAN MEMBERS: $990 REGISTRATION: There are limited spaces available for this workshop so please register early to avoid disappointment. You can download an application form from www.apanetwork.com. Go to the Conference Registration Brisbane and select the Cosmetic Tattoo Workshop form.

Registration Forms must be submitted by 1st May 2015.

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Plastic and reconstructive surgeons and hospitals, etiquette and formalities Understanding the process of breastreconstruction surgery Anatomy and aesthetics of nipple areola complex tattooing Advances in equipment, procedures and technique Design and perform nipple areola complex tattooing Review treatment and provide post treatment advice

For further information contact APAN Ph: 07 55930360 Email: info@apanetwork.com.

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SCIENTIFIC NEWS

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the advertising and claims are based on hypotheses and empiric calculations.

The New Trends in Anti-Ageing and Detox Medicine

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The search for the “fountain of youth” has fascinated people and medical researchers for centuries. Today the anti-ageing industry is projected to reach close to $300 billion in sales of various products and services promising to make users younger. As the amount of interest and sheer number of products grows, consumers are desperately in need of help navigating the treacherous waters of vast choices in anti-ageing items presented to them. Unfortunately, to date, there are no officially FDA approved medications or products that can comprehensively reverse ageing. This is because anti-ageing needs so much time and long-term follow-up that it is prohibitive in price and practicality. Because of this, most of

Experts advise if you want to become serious about age reversal, doing it on your own is a doomed project. The best choice is to consult a specialist and determine the course of action most suitable for your particular needs. We are all genetically unique we have a d i ff e r e n t m e t a b o l i s m a n d hormonal balance and as a result we will age differently some gracefully, some not. The most important part of ageing management is comprehensive medical care, thorough and regular evaluation, and diagnostic testing before attempting any serious anti-ageing therapy such as hormone therapy eg. Human Growth Hormone (HGH).

Leaving aside skin and hair care, which are topics widely covered in the media, regenerative medical practitioners focus on some more hidden “gems” becoming popular and offered in offices of some of the best anti-ageing specialists. It usually starts with saliva testing, a cheek swab for genetic analysis and a blood test. This can diagnose hormone and vitamin deficiencies and age-related imbalances of various systems. A one-size-fitsall regimen of over-the-counter supplements is extremely ineffective.

The modern approach is a hand-tailored rejuvenation treatment designed to deliver vitamin and antioxidant cocktail is directly into one's bloodstream. According to Dmitri Alden, celebrities have been spotted in infusion offices getting the weekly vitamin “detox”; although unproven, the practice has come in and out of fashion for years and is again gaining popularity. Taking these products is unlikely to reverse ageing but could help overall health and are unlikely to be harmful. There is also no serious scientific backing that taking melatonin, human-growth hormone, DHEA and others delay ageing, but they are believed to improve sleep, mood and wellbeing. Another supplement that shows promise is resveratrol, which is believed to limit the growth of cancer, act as a natural inflammatory and improve cholesterol. With these findings we will continue to see

protocols and strategies developed that when combined can work on a cellular level and mitigate damage that can contribute to disease and premature ageing. One space to look out for is the area of epigenetics.

Growing Indications for Laser-Assisted Drug Delivery A new review of laser-assisted drug delivery highlights the potential of laser technology to increase efficacy and reduce side-effects of prescription medications. “Laser Assisted Drug Delivery: A Review of An Evolving Technology,” by Lindsay R. Sklar, MD, Christopher T. Burnett, MD, FAAD, Jill S. Waibel, MD, FAAD, Ronald L. Moy, MD, FAAD, and David M. Ozog, MD, FAAD, was published in the April 2014 issue of Lasers in Surgery and Medicine.

According to the authors, “The types of lasers most commonly studied in regards to drug delivery are the carbon dioxide (CO2) and erbium:yttrium-aluminum-garnet (Er:YAG) lasers.” The study summarised the usage of both conventional ablative and fractional ablative modalities for the delivery of phototherapy agents, opioids, lidocaine and a variety of cosmeceutical ingredients. ㄰

The researchers found that laser-assisted delivery is potentially safer and faster than oral delivery, has less adverse effects, because the physician can uniformly distribute the drugs in microscopic channels directly to the desired level in cutaneous tissue, and is cost effective for the healthcare system.

“We are just now at the forefront of understanding the uses and methods of using

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APJ 52

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lasers and other devices to disrupt our skin surfaces, allowing the penetration of various medications. It is conceivable that one day your arthritis medication could come with a small device that creates microscopic pores in your skin to allow an anti-inflammatory drug applied topically over an arthritic joint to penetrate directly to the targeted area. By skipping the traditional routes such as oral delivery, many side effects may be avoided.

These new methods may be combined with nano-technology and delayed release drugs to maximise effects,” said Dr. Ozog.

The majority of studies reviewed by the researchers involved animal models, leading the authors to highlight the need for further studies to “validate the existing research and explore the many additional potential clinical applications," said Dr. Burnett. Dr. Waibel shared some of the current research being conducted in this arena. “At the Miami Dermatology and Laser Institute we have done laser-assisted delivery clinical studies on corticosteroids, 5-Fluorouracil, Poly-Llactic Acid, Hyaluronic Acid, Bimatoprost, Timolol and Antibiotics. At the University of Miami my colleagues, Dr. Evangelos Badiavas and Professor Stephen Davis have a Department of Defence grant studying the basic science of laser-assisted delivery of stem cells on acute burns in a third-degree burn porcine model. Our grant is “Scars through Laser Assisted Delivery of Stem Cells, Care for the Critically Injured Burn Patient” and we are studying putting fat stem cells, autologous stem cells and allogeneic stem cells down the laser channels to heal skin with very promising results. In addition, we are studying techniques to optimise laserassisted drug delivery by using accessories, such as the Impact Acoustic wave device, matrices and occlusion,” said Dr. Waibel.

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How cells remodel after UV radiation Researchers at the University of California, San Diego School of Medicine, with colleagues in The Netherlands and United Kingdom, have produced the first map

detailing the network of genetic interactions underlying the cellular response to ultraviolet (UV) radiation.

The researchers say their study establishes a new method and resource for exploring in greater detail how cells are damaged by UV radiation and how they repair themselves. UV damage is one route to malignancy, especially in skin cancer, and understanding the underlying repair pathways will better help scientists to understand what goes wrong in such cancers.

The findings were published in the December 26, 2013 issue of Cell Reports.

Principal investigator Trey Ideker, PhD, division chief of genetics in the UC San Diego School of Medicine and a professor in the UC San Diego Departments of Medicine and Bioengineering, and colleagues mapped 89 UV-induced functional interactions among 62 protein complexes. The interactions were culled from a larger measurement of more than 45,000 double mutants, the deletion of two separate genes, before and after different doses of UV radiation.

Specifically, they identified interactive links to the cell's chromatin structure remodelling (RSC) complex, a grouping of protein subunits that remodel chromatin – the combination of DNA and proteins that make up a cell's nucleus – during cell mitosis or division. "We show that RSC is recruited to places on genes or DNA sequences where UV damage has occurred and that it helps facilitate efficient repair by promoting nucleosome remodeling," said Ideker.

The process of repairing DNA damage caused by UV radiation and other sources, such as chemicals and other mutagens, is both simple and complicated. DNAdistorting lesions are detected by a cellular mechanism called the nucleotide excision repair (NER) pathway. The lesion is excised; the gap filled with new genetic material copied from an intact DNA strand by special enzymes; and the remaining nick sealed by another specialised enzyme.

However, NER does not work in isolation; rather it coordinates with other biological mechanisms, including RSC. "DNA isn't freefloating in the cell, but is packaged into a tight structure called chromatin, which is DNA wound around proteins," said Rohith Srivas,

PhD, a former research scientist in Ideker's lab and the study's first author. "In order for repair factors to fix DNA damage, they need access to naked DNA. This is where chromatin remodellers come in: In theory, they can be recruited to the DNA, open it up and allow repair factors to do their job."

Rohith said that other scientists have previously identified complexes that perform this role following UV damage. "Our results are novel because they show RSC is connected to both UV damage pathways: transcription coupled repair – which acts on parts of DNA being expressed – and global genome repair, which acts everywhere. All previous remodellers were linked only to global genome repair."

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The scientists noted that the degree of genetic rewiring correlates with the dose of UV. Reparative interactions were observed at distinct low or high doses of UV, but not both.

While genetic interactions at higher doses is not surprising, the authors said, the findings suggest low-dose UV radiation prompts specific interactions as well. Co-authors include Anne-Ruxandra Carvunis, Department of Medicine, UCSD; Leiden University Medical Center; Sovan Sarkar and Peter J. McHugh, Weatherall Institute of Molecular Medicine, University of Oxford; Thomas Costelloe, Erik Malta, Su Ming Sun, Marijke Pool and Haico van Attikum, Leiden University Medical Center; Katherine Licon, Department of Medicine, Institute for Genomic Medicine, UCSD; Tibor van Welsem and Fred van Leeuwen, Netherlands Cancer Institute.

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Australian Doctors Call for Ban on Teen Cosmetic Surgery

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The Cosmetic Physicians Society of Australasia is calling for a national ban on teen cosmetic surgery. The proposed ban is a reaction to media reports that a growing number of adolescents and teens in Australia

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are receiving Botox, breast implants, and the like from their parents as rewards.

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In 2009, Queensland introduced laws banning some types of cosmetic surgery on children, including breast and nose surgery, liposuction and Botox. Doctors who perform such procedures without medical reason can face up to two years in prison. The proposed national ban would place all States is in line with Queensland. Current guidelines in New South Wales require that those under 18 who are considering cosmetic surgery have a three-month cooling-off period, followed by consultation with an internist and clinical psychologist.

Blue Light Destroys Skin, Soft Tissue Infections

with approximately 14.2 million ambulatory care visits every year and an annual associated medical cost of almost $24 billion (equivalent to $76 for every American), says Hamblin.

the results of cosmetic and reconstructive procedures, new research suggests. The study, which appears in the September 28 issue of The Lancet, is the first randomized human trial of stem-cell enriched fat grafts.

Treatment of skin and soft-tissue infections has been significantly complicated by the explosion of antibiotic resistance, which may bring an end to what medical scientists refer to as the antibiotic era, says Hamblin.

"Microbes replicate very rapidly, and a mutation that helps a microbe survive in the presence of an antibiotic drug will quickly predominate throughout the microbial population. Recently, a dangerous new enzyme, NDM-1, that makes some bacteria resistant to almost all antibiotics available has been found in the United States.

Many physicians are concerned that several infections soon may be untreatable."

Researchers from Copenhagen University Hospital in Denmark recruited 10 healthy volunteers who had liposuction. The fat was then purified and injected into their upper arms. In one arm, the fat was enriched with stem cells and the other arm received a traditional fat transplant. After about four months, the researchers took MRI images of the fat transplants and removed the grafts. The grafts that were enriched with fat-derived stem cells retained 80.9% of their volume, compared to the standard grafts which retained just 16.3% of their volume. Four months later, stem cell grafts also demonstrated higher amounts of adipose tissue and newly formed connective tissues.

Moreover, there was less necrosis in the stemcell enriched fat grafts compared to the standard grafts.

Besides harming public health, antibiotic resistance boosts healthcare costs.

"Treating resistant skin and soft-tissue infections often requires the use of more expensive, or more toxic drugs, and can result in longer hospital stays for infected patients," says Hamblin.

A copy of the manuscript can be found online at http://bit.ly/asmtip0113b.

Blue light can selectively eradicate Pseudomonas aeruginosa infections of the skin and soft tissues, while preserving the outermost layer of skin, according to a proofof-principle study led by Michael R. Hamblin of the Massachusetts General Hospital, and the Harvard Medical School, Boston. The research is published online ahead of print in the journal Antimicrobial Agents and Chemotherapy.

"Blue light is a potential non-toxic, nonantibiotic approach for treating skin and softtissue infections, especially those caused by antibiotic resistant pathogens," says Hamblin.

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In the study, animal models were infected with P. aeruginosa. All of the animals in the group treated with blue light survived, while in the control, 82 per cent (9 out of 11) of the animals died.

Skin and soft-tissue infections are the second most common bacterial infections encountered in clinical practice, and represent the most common infection presentation – more than 3 percent – in patients visiting emergency departments, says Hamblin. The prevalence of skin and soft-tissue infections among hospitalised patients is 10 per cent,

Regenerative Medicine Breakthrough: Stem-Cell Enriched Fat Grafts Outperform Traditional Fat Grafts Stem-cell enriched fat grafting may enhance

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Sam Rizk, MD, a New York City facial plastic surgeon reviewed the study for Plastic Surgery Practice. "The Lancet study on lipofilling is important to substantiate the work that many plastic surgeons are doing with fat grafting in humans," he says. "I have been using fat combined with platelet-rich plasma as an adjunct with most of the facelifts I perform for the past several years”.

He adds: "In my experience with hundreds of cases, the results have been significant. There appears to be a rejuvenative effect on the skin that we can attribute to the activity of growth factors."Going forward, "I am optimistic that as more research is done in this evolving area, we will be able to predict more accurately what fat grafting and stem cells can and cannot do.”

In an editorial accompanying the new study, J Peter Rubin,MD, and Kacey G Marra, PhD, of the University of Pittsburgh wrote that "these therapies could revolutionise breast reconstruction after cancer and reconstruction of deformities after trauma, for example ". http://www.plasticsurgerypractice.com

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Study Supports Use of Autologous Fat Grafting for Hard-to-Treat Scars Fat grafting may help treat hard, contracted scars resulting from burns, surgery, and other causes, a new study shows. The findings, which appear in the September issue of The Journal of Craniofacial Surgery, add to a growing body of evidence on the benefits of fat grafting.

Marco Klinger, MD, and colleagues from the Università degli Studi di Milano in Italy, used autologous fat grafting to treat persistent scarring problems in nearly 700 patients over six years. All patients had abnormal, painful scars causing hardening or tightening of the skin, often with limitation of motion. The scars were refractory to other treatments.

Exactly how fat grafting exerts its benefits in scarred tissues is not understood, but the fat tissue includes stem cells, which can develop into many different types of cells active in the wound-healing and tissue-repair process.

Improvements Seen in Both Form and Function In the study, the fat-grafting procedure began with liposuction, usually from the abdomen or hips. After processing, surgeons reinjected the fat cells under the skin in the area of scarring.

Fat was distributed in different directions, with the goal of creating a "web" of support for scarred, damaged skin.

Fat grafting led to significant improvement "both from an aesthetic and functional point of view," according to study authors. The skin in the scarred area became "softer and more flexible and extensible, and very often color seem[ed] similar to the surrounding unharmed skin”.

After fat grafting, the patients had decreased pain and increased scar elasticity, the study showed. Improvement began within two weeks, continued through three months, and persisted through one year and beyond. In a subgroup of patients, objective testing of skin hardness and clinical ratings by doctors and patients provided further evidence of treatment benefits.

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Treatment was associated with improved motion in areas where movement was limited because of tightness and stiffness of contracted scars. For example, in patients with scarring after burns to the face, fat grafting led to improved facial motion.

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In one case, a breast-cancer patient was left with hard, painful scars after complications from breast reconstruction. Treatment with fat grafting allowed a successful second breast reconstruction to be performed.

Fat grafting is a "promising and effective therapeutic approach" to scars from various causes – not only burns and other forms of trauma but also after surgery or radiation therapy. "Treated areas regain characteristics similar to normal skin," leading not only to improved appearance but also improved function in patients with problematic scars that don't respond to other treatments, the study authors conclude.

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PERFECTING FACIAL FEATURES Revealing the latest techniques in facial rejuvenation This year at the 8TH AustralAsian Academy of Anti-Ageing Medicine Conference held on the 16 and 17th August at the Sofitel, Melbourne we were able to interview several prominent key-note speakers and presenters. In the area of Aesthetic Medicine, Dr Maria Angelo-Khattar from Dubai presented both a lecture and workshop on Enhancing Facial Shape: A Minimally Invasive Approach, at which she demonstrated the latest filler techniques.

Dr. Khattar is the Managing Director and Founder of Aesthetica Clinic, a large clinical practice affiliated with leading clinical practices in many countries of the region. She has trained over 100 medical practitioners at her teaching institute in Dubai, Institute of Medical Aesthetics. Focusing on evidence-based, minimally invasive aesthetic procedures, such as facial injectables, laser treatments and body contouring, the program boosts over 100 hours of individualised hands-on procedural learning on live patients, non-biased, evidence-based medical curriculum, mentoring from leading experts in Aesthetic Medicine and practice development tools. ㄰ 㤵 㜵

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We caught up with Dr Khattar for her to share with us a little of her knowledge of the new trends in this area of appearance enhancement.

APJ 1: How have the concepts and metrics of facial rejuvenation changed over the past five years and why?

Dr Khattar: The concept of beauty varies from country to country.

For example, in some countries the issue of volumising at a slightly

higher level is acceptable, while in others the more nature look is preferred. The issue is to ensure that you achieve harmony and balance, and the tools we now have are far more varied and sophisticated than they used to be. We now have so many evidencebased treatments in the form of injectables and numerous equipment technologies and ingredients that work together to achieve remarkable outcomes that are natural and create a wonderful, youthful appearance. Biodegradable contour threads are another option, even though I still have my reservations. They do have their place, but they are not a panacea. The old threads were made of polypropoline and were non-biodegradable. Today, threads are both biodegradable and free floating. They have cogs that anchor on the tissue causing collagen stimulation. In my opinion they achieve more of a tightening effect than a lifting effect. However, with correct training the various tools we have enable us to achieve amazing anti-ageing improvement with a more natural and youthful end result.

APJ 2: Is fat transfer to the face a stable option for volumising and is it a better option over synthetic fillers?

Dr Khattar: There are now numerous techniques that allow us to refine and customise the end result. For example mixing PRP (Platelet Rich Plasma) with stem cells so that we can achieve a more natural and controlled outcome. Previously, the outcomes were not as predictable and often were not symmetrical. I personally prefer bio-stimulating fillers rather than fat transfers that require liposuction, which can depress another part of the body. When working with adipose tissue there is a preparation procedure necessary where you have to prepare the fat with stem cells. This it is quite involved. Furthermore, fat can change when in the body. For example, if a person puts on weight their fat cells increase. They will also increase where they have been placed in the face. This could lead to an undesirable outcome. On the other hand the advantage of proprietary fillers is that you only need to use a small amount to achieve excellent results.

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APJ 3: What is polycaprolactone and how is it used in facial rejuvenation?

Dr Khattar: This is a biopolymer, which is a new generation dermal

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filler agent that stimulates the body's own collagen. A revolutionary new filler product known as Ellans (AQTIS Medical, Netherlands) boasts a tunable longevity, total bioresorbability and a sustained performance. This filler is composed of polycaprolactone (PCL).

Current fillers are composed of hyaluronic acid (HA), calcium hydroxylapatite or collagen. Ellans is composed of PCL, a wellknown, completely bioresorbable soft medical polymer that has been used for decades in CE-marked and FDA-approved commercial bioresorbable product applications.

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The PCL contained in Ellans is the same material that you find in some resorbable sutures and other devices in surgery. The experience with PCL spans over 40 years in medicine, and it has a solid, proven safety record in terms of biocompatibility. It is 100 per cent biodegradability and has a decades-long excellent safety record. The other advantage of this filler is that you can gain much quicker results than other biostimulating fillers that may take months to show their effect.

APJ 4: What lessons have we learnt on rejuvenation concepts and what new techniques are replacing old ones?

Dr Khattar: A lot can now be achieved in rejuvenating the skin by combining various approaches such as chemical peels in more sophisticated ways, the use of skin-tightening devices such as laser, and other new equipment technologies that when combined together can deliver incredible results. Skincare technology has also advanced and we now have some novel preparation with peptides, hyaluronic acid in various weights and growth factors that when used in conjunction with advanced technologies that can achieve levels of improvement that were not previously possible. Adding to these Platelet Rich Plasma and injectables and you have an array of amazing tools to achieve improvement with greater precision.

APJ 7: What are the objectives of a beautiful face today and why is intervention needed as we age? What needs correcting and how is it achieved?

Dr Khattar: The characteristics of beauty in terms of the overall shape and geometry of the face have been very well defined in the literature. Ideally, a youthful and beautiful face should be a perfect

AJP 5: How can an aesthetic therapist support a cosmetic physician and how can they best prepare the skin for more invasive procedures?

Dr Khattar: An aesthetic therapist can greatly assist in improving skin immunity, strength, clarity and flexibility in preparation for more invasive procedures. A series of mild peels, the use of vitamin A and vitamin C as well as growth factors can substantially boost the skin's integrity. Technologies such as ultrasound and radiofrequency are also highly beneficial in skin tightening and achieve a level of improvement that can then be stepped up with minimal injectables to fine tune the desired level of improvement.

This should be very much a professional collaborative relationship between aesthetic therapist and cosmetic physician.

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APJ 6: In your opinion what dietary or nutritional support will assist individuals in enhancing their anti-ageing treatment outcomes? What advice would you give a client from an internal nutritional perspective?

Dr Khattar: I am a strong believer in balancing hormones to improve

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wellbeing and skin. An appropriate blood test to evaluate hormonal levels is a good way to start as you cannot have proper perimeters to physical anti-ageing without properly balanced hormones. It is also important that a low-carbohydrate, low-sugar diet is recommended, with supporting nutritional care such as priobiotics, fish oil and various vitamins and minerals if deficiencies are identified.

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oval that is well balanced and has both malar and zygomatic prominence. Recent studies have elucidated the detailed anatomy of the facial fat pads and this has changed our understanding of both the pathophysiology of facial ageing and the strategies that are currently adopted in the rejuvenation of the face. In the majority of older patients, there is a descent and/or dissipation of the facial fat pads which results in mid-face deflation, which often contributes to an increase in lower-face volume as features drop. Moreover, a decrease in vertical facial proportions as a result of dental wear may further contribute to a distortion of facial shape. The restoration of facial beauty and symmetry is possible by the use of evidence-based, minimally invasive procedures. A combined strategy using a biostimulant soft-tissue filler for volume replacement and lipolysis for the slimming and refining of the lower face is used to restore the ageing face. These techniques are also of great value in the embellishment and enhancement of facial contours in young individuals.

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Dr. Maria Angelo-Khattar is a fellow of the Royal Society of Medicine UK. She is the clinical director of the Aesthetic Anti Aging Fellowship program of the American Academy of Anti Aging Medicine.

In addition to being a Fellow of the Royal Society of Medicine and the clinical director of the fellowship program at the American Academy of Anti Aging Medicine, she is a member of several professional organisations, which include the American Society for Lasers in Medicine and Surgery (ASLMS), the British Anti Aging Society, Scientific Committee of the Dubai Academy of Aging and Aesthetic Medicine.

Dr. Khattar has published more than 40 scientific and medical papers. In addition, Dr Khattar has presented several papers, and delivered many lectures on a variety of subjects in the field of anti-ageing and aesthetic medicine. She was the Associate Professor of Pharmacology, Faculty of Medicine, Kuwait University. In addition, Dr. Khattar holds a PhD in Pharmacology from the University of London.

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STAR PERFORMERS – The team every business needs!

By Caroline Nelson Every business thrives on productive, positive, innovative and co-operative staff personnel who are not afraid to excel in all areas of their operations. However, the secret to gaining them in the first place starts with the selection process, and then nurturing them so that they can achieve the star qualities that will benefit both them and the business. Here Caroline Nelson shares some valuable tips on this subject.

Just like any relationship, some work and some don't and often through no-one's fault, but just because they are the wrong fit. So choosing the right person for the position is critical for the employer, but also accepting the right job is critical for the employee. In fact, some business owners would be better not being in business, as would some employees be best not to be beauty therapists. So if either is a square peg trying to fit into a round hole there will be conflict and no positive outcome.

Every business owner would like to have a team of star performers, however, more and more frequently I hear salon owners complaining about employees, their lack of skills, their lack of commitment and their poor attitudes, so clearly star performers are in short supply. Or are they?

Presuming the business owner is the right person to own and operate a business and the employee is trained and keen to be part of this growing industry, how can star performers be developed? And when I say star performers, I mean both star employers and star employees, because one without the other does not make for excellence.

Yes, I will agree the majority of employees in this industry are from the Gen Y group. And yes, we do hear what poor employees they can make, but is that a valid reason, or an excuse employers bandy around?

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Possibly one reason is that some employers are just not skilled at choosing the right candidates in the first place, regardless of which generation they belong too.

Let's be fair. There are both bad employees as well as bad bosses. The thing is most do not start out with the intention of being either bad employee or bad boss, but lack of foresight, planning, and in some cases unforeseen circumstances and challenges, can soon turn the tables.

THE STAR EMPLOYER Yes, it's true. It does take two to tango. And it starts with the business owner wanting to be the best leader they can be. Great bosses have many qualities that set them apart and make them a pleasure to work with and for. But above all they value good team dynamics, so for that reason they spend quality time attracting the right people for the right job. But they also make sure if the wrong people do happen to slip through that they quickly get identified and quickly removed.

Once the business owner has employed someone they feel is the right person the work begins to integrate them successfully into the team.

This starts by engaging the newbie into the Business Vision or the 'big picture' so they clearly understand the organisational direction and purpose behind the vision and their place in it. They will understand

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the unique strengths and culture which should engage their loyalty, commitment and involvement.

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One thing great bosses do well is to integrate learning and development into every job description so that personal growth is encouraged, benchmarks and targets met and results rewarded. They constantly inspire their employees through praise, knowing that we all thrive in positivity and that star performers rise from fertile ground. While successes are met with high praise and rewards, failures must be met with encouragement, the situation discussed, solutions provided, and next-step plans implemented for improvement.

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Offering training support and encouragement is necessary, however, at some point in some cases it may be realised that regardless of the effort it is no longer reaping positive results.

Try to make it work, but be aware once this happens some employees may have reached their 'use-by' date when they will no longer contribute to or benefit the business, the team, and even themselves. Often being terminated is not a bad thing, it can in fact encourage a dissatisfied therapist no longer enjoying their work to try a new career that might better suit their temperament and attitudes.

Managing a team is also about managing resources effectively and efficiently. By providing the structure, techniques and systems to enable employees to perform at a high level of consistency will not only reduce wastage, but will show employees that their time and skills are valued. Good managers promote personal accountability by clear communication and allowing personal and group initiatives that align with the team endeavour, creating tight bonds of loyalty to the company and each other. These are qualities a star employer needs to develop, but what of the star employee?

THE STAR EMPLOYEE Occasionally a business will attract the type of natural beauty therapist who is a star from day one, but this is very rare. Most stars are not born they are nurtured, but they will need to have the essential traits to be groomed and encouraged into stardom. One thing we can be sure of is that skills can be taught and learnt, but a good attitude must be there from the start.

Most employers would expect employees to display essential good traits such as a bright, positive outlook, dependability, punctuality, honesty, integrity, and the ability to perform assigned duties. However, in a personal industry such as ours and one that is undertaking quick and vast changes, additional qualities are also required.

A star in the making would need to be self-motivated with a continuing desire and thirst for knowledge and excellence. They would need a preparedness and openness to change and a passion for aesthetics as a career and not just a job. In addition, these details need to be consistent not only for the job, but also for their personal professional presentation and grooming. Good communication skills, empathy and the ability to work in harmony would also be necessary.

CLEAR EXPECTATIONS One thing both employer and employee need is the awareness of clear expectations of what is required and what can and will be provided by each party. It starts from the very first contact at the initial job interview and all the way through the relationship. A detailed job description spelling out all duties, the level of competence and performance expected, as well as listing what management will provide should all be presented at the interview. A detailed discussion on the training the job provides and the attendance and commitment necessary by the employee.

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What is often missed or omitted is a full induction into the job. And this is something a star employer would never do. They would provide an employee manual that outlines exactly the policies, systems and procedures that must be adhered to by all. Following these guidelines allows for the business image and high standards to be maintained.

It's easy to see that star performance doesn't happen by chance or accident. It happens by design, commitment and follow-through by all participants. And while every business might need, want or desire star performers, it may not always be a reality 100 per cent of the time.

But even if it is most of the time you, your business and your team will reap excellent rewards.

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© Copyright Caroline Nelson 2014

Caroline Nelson is a beauty industry expert who specialises in helping businesses develop their brand, improve productivity, and increase bottom-line profit. For a free 30-minute business consultation register at www.SalonSpaBusiness.com or phone 07 5528 9440.

Why the CUSTOMISED FIT is in high demand as the

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NEW “It” TREATMENT

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What if you were told that when you come to see your therapist to have a treatment, she would carefully and methodically analyse your skin, examining both the deeper layers of the skin and the surface manifestations to determine precise deficiencies?

What if you were told that she then would access clinically-proven cosmeceutical ingredients, organic herbs, extracts and vitamins to custom blend a product that precisely meet your specific and exact requirements? How wonderful would that sound to you?

Well, you can do just that with Bioelements' unique customblended formulations for you and your clients’ benefit.

With so many advances in ingredients it is difficult to keep up with the latest developments. This is why the flexibility, precision and customised solutions is gaining momentum and consumer preference, with clinical results and personalised care, the objective. ㄰ 㤵 㜵

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WHAT MAKES BIOELEMENTS UNIQUE? Bioelements was the first professional skincare formulation in the world to offer custom blending. Clinicians and skin therapists can directly target specific client concerns by mixing and blending individual product preparations. Bioelements' Custom Blend Lab is equipped with 12 pre-formulated solutions that may be used individually or in combination to boost, enhance and intensify almost any base product. With up to 298 possible bespoke solutions, every client is treated as uniquely as their skin for the most advanced personalised results. The Custom Blend Lab has been expertly

designed for practicality and ease of use. With 12 solutions that have already been formulated and stabilised, therapists simply select an appropriate additive to activate and intensify treatment and products.

This process is completely exclusive and safe, with no risk of confusion or overdose.

WHAT IS THE BIOELEMENTS RANGE BASED ON? A fusion of cosmeceuticals combined with organic botanicals and pure essential oils create the Bioelements triumvirate. This unique combination of actives delivers the world's only cosmeceutically based range that creates both results and experience.

Cosmeceutically active peptides, encapsulated retinoids, multiAHAs and resurfacing enzymes are complemented with Traditional Medicine herbs, including ginseng, sumac and dong quai, combining Western advanced biochemistry with Eastern wisdom. Flavonoid and polyphenol-rich botanicals provide potent antioxidant protection, while an aromatic symphony of pure essential oils, including lavender, sage and neroli, complete every Bioelements treatment and product experience.

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Bioelements was the first clinical skin solution to harness patented power peptides and hyaluronic acid complex to activate the potential of every complexion.

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Australia's leader in tailored professional solutions, Bioelements offers:

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Up to 134% retail markup

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A reduction of professional treatment costs by up to 70% An average RRP of just $69 (including corrective serums and moisturises) Safe and effortless custom blending Cosmeceutical science with a luxury experience and a custom fit

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The Bioelements focus on education and commitment to professionals creates a successful partnership through:

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Regular product seminars Training in application and treatment techniques Advanced Post-Graduate education Monthly promotional calendar Point-of-Sale merchandising support Business, mentoring and team-building training

HOW IS THE EFFICACY OF BIOELEMENTS PRODUCTS TESTED? All of our pharmaceutically formulated peptides and complexes are medically and clinically tested to evaluate efficacy, effectiveness and skin compatibility. The formula of each finished Bioelements product is clinically tested to ensure stability, integrity, viscosity and correct pH. Preservation systems and the percentage of active ingredients are also clinically tested. All Bioelements products are TGA and FDA compliant.

WHY ARE BIOELEMENTS PRODUCTS SO AFFORDABLE? As a fusion of cosmeceutical science boosted with organic botanicals

and pure essential oils, Bioelements promotes visible skin correcting results as the number one reason consumers use our brand. The luxurious experience, decadent aromas and intoxicating facial rituals just happen to be an opulent consequence offered by the regular use and treatment with our products.

As an international powerhouse stocked by over 5000 salons, clinics and medi-spas across the globe, our Chicago-based head office utilises nearly 25 years of international buying power to keep our prices reasonable, affordable and far more competitive than many other brands.

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With no middle-man, our products are directly supplied to our Australian distributor to enable one of the highest retail markups and reduced professional treatment costs in the industry. We offer up to 134% retail markup and treatment costs as low as $2.50 to promote and ensure maximum profits. Our average recommended retail price is just $69 inclusive of corrective serums and custom-blend moisturisers. Our loyal Bioelements consumers demand results, not ridiculous prices. With such low treatment costs and products, clients are able to visit their Bioelements therapist more often and receive professional treatments, while ensuring their home-use products have been customised to their exact needs.

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SKIN HEALTH and the Integrative Approach Understanding Skin Microbiota is opening up New Horizons In Advanced Skin Therapy Protocols

By Lynette Rouse BHSc As history presents and science proves, we can accept that the digestive system is linked to all systemically-related biological issues that must include those presented on the external casing of the body the largest organ of the body, the skin.

can predispose the host to a number of cutaneous infectious and inflammatory conditions. This advancement in microbiology and immunology has, however, failed to fully address the roles of microbiota further and their functions.

We know that our skin is a frequent site of immunopathological reactions and is commonly involved in systemic diseases. Science now has identified that the gut and liver have a direct correlation to skin health. More specifically, the gut flora can directly impact the skin's flora and therefore affect issues involving the skin.

In light of the symbiotic relationships between microbial mutualism and commensalism (one organism benefiting without affecting the other) it is now confirmed as being critical to human health in studies of gut microbiota. Science has in the past decade recognised that more information is needed to expand research in skin microbiota and to revise our understanding of molecular mechanisms.

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Gut microbes may thus influence acne through a systemic effect on inflammation, oxidative stress, glycemic control, tissue lipid levels, pathogenic bacteria, neuropeptides and mood regulating neurotransmitters.

Research studies related to infectious disease have identified targets of microbial virulence factors aiming to eliminate harmful organisms of the skin and yet some of these same microbes potentially play an opposite role in protecting the host.

Some participate in inflammatory disease, yet may not be the cause of infection.

A Nizet and Galo study entitled Skin Microbiota recently proposed that the delicate balance of the skin's barrier and innate immunity combine to maintain healthy skin and that disturbance of this balance

For example, it is known that the complex host microbe and microbe interactions that exist on the surface of human skin illustrate that the skin's microbiota has a beneficial role, much like that of the gut microflora. However, unlike the intestine, the role of microbes on the skin's surface has not been comprehensively studied.

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Current information on bacterial skin flora, including Staphylococcus, Corynebacterium, Propionibacterium, Streptococcus and Pseudomonas, is specifically being reviewed and discussed to determine recent findings of cutaneous microbiota, as well as shifting paradigms in the interpretation of the roles microbes play in skin health and disease.

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IMPLICATIONS TO SKIN HEALTH Advancement in this research will greatly benefit skin therapists’ and clinicians’ understanding of principles that guide appropriate systemic and advances in topical therapies. This will advance the scope and possibilities of better treatment outcomes for the aesthetic clinician. For example, how do we address the issues presented on the skin when a client has an overuse issue of oral or topical antibiotics?

An example of this is the evidence suggesting that they have disrupted the delicate balance of both the gut flora and the cutaneous microflora, leaving the skin susceptible to pathogens previously kept at bay by the existing resident and mutual microbiota.

SYSTEMIC FUNCTIONS POTENTIALLY AFFECTING SKIN FLORA A previous article published in the Spring issue of APJ on pages 112113 addressed the importance of having a healthy balance of gut flora.

We have already ascertained that the intestinal tract harbours a complex microbiota. Disturbance in its composition has been associated with several immune dysfunctions, such as inflammatory diseases.

Gut microbes may thus influence acne through a systemic effect on inflammation, oxidative stress, glycemic control, tissue lipid levels, pathogenic bacteria, neuropeptides and mood-regulating neurotransmitters.

Phenol metabolites of aromatic acids are produced by gut bacteria and can accumulate in the skin via blood circulation and disrupt keratinocyte differentiation.

IgE – an immunoglobulin that plays a role in atopic manifestations such as asthma and eczema also appears to be substantially higher in acne patients. A further clinical study resulted in evidence from World Clinics Dermatology report that acne patients are more likely to experience constipation, halitosis, gastric reflux and abnormal bloating, and often report GI distress.

A recent scholarly review has not only provided invaluable insight into this important phenomenon, but also drawn attention to published literature that actually links acne with GI system and opens a whole new therapeutic front.

Dr. J. Wu, MD, stated that complete dermatological skincare is about more than skin. It's about taking care of the whole person, and there are many pieces of the puzzle to place together from immunity, endocrine system and the role of stress and emotions in GI barrier dysfunction, infection and good or chemical sensitivity.

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EVOLVING NEW HORIZONS If we look back to the past two decades to the beginning of the 1990s the increase in knowledge that we now have on the skin is quite astounding. This new knowledge is now allowing us to view the skin in aesthetics from different lenses. These advances have given us a better understanding of what influences skin health and utilising this knowledge will allow us to reach more advanced treatment outcomes than previously possible, whether we are aestheticians, dermal therapists of cosmetic physicians working with injectables. We now have both better knowledge and greater technologies to work with a more integrative manner for enhanced results.

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At times this progress has grown so rapidly that it is bypassing current training standards in beauty therapy. A perfect example is the advances in equipment. How many operators have gained training in these technologies while gaining the qualifications? These advances now also require that we revisit our anatomy and physiology and gain a higher level of understanding of biology principles that can underpin a more clinical approach that is now needed for the efficacious use of currently available equipment and topical therapies.

For some the idea of practitioner protocols altering to incorporate some form of internal application seems at times beyond the scope of a beauty/skin therapist, yet the industry's evolution appears to be leaning for the need of taking this approach.

Treating the whole person is not new. Some years back, Dr Perricone extolled the importance of food for healthy skin and stated that we must fix the gut after antibiotic use.

Progress in research, new evidence, commercialism and philosophies be that old or new, the scope of an aesthetic practitioner is rapidly evolving in these modern times and these are necessitating a need for new approaches in dealing with skin.

Research surveys have proven that abnormal bowel movements point to skin problem associations, such as a high frequency of dry skin.

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Further, insulin-like Growth Factor IGF-1 hormone drives acne and is present in higher quantities in cows’ milk. Melnik's study comparing the amino acid leucine in animal-derived food versus plant-derived food confirmed that the animal leucine was higher and relayed its influences of acne.

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It is possible within the scope of a beauty therapist to treat the skin from a whole-person perspective. It can be as simple as offering your clients further information that you can guide them that can make all the difference in your treatment outcomes.

SUGGESTION TO AID THE WELLBEING OF THE DIGESTIVE SYSTEM

One product that comes to mind with over 5000 relevant research papers with efficacy is colostrum. Colostrum is both a pre-biotic and a pro-biotic, is highly rich in proline-rich peptides, hosts all necessary immune properties and has been coined to be the highest form of nutritional food known, and therefore must also assist the skin.

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THE INTEGRATED APPROACH

Probiotics and/or prebiotics, or GOS, are expected to help maintain a healthy skin by decreasing phenol production by gut microbiota.

These findings support the hypothesis that probiotics and prebiotics provide health benefits to the skin as well as the gut.

A daily intake of the prebiotic galacto-oligosaccharides (GOS) restored serum free p-cresol levels and skin conditions in adult female acne sufferers.

Moreover, a double-blind placebo-controlled trial demonstrated that the daily intake of the probiotic Bifidobacterium and prebiotic GOS reduced serum total phenol levels and prevented skin dryness and disruption of keratinisation in healthy adult women.

There is evidence enough to show that a therapeutic use of probiotics, particularly Lactobacillus acidophilus, in those suffering from acne related to small intestinal bacterial overgrowth (ISBO) was beneficial.

So what is our bridge that links the known and proven therapies with our current and scientific revelations? The missing link is that internal and external approaches must work together in an integrative manner.

The idea of an aesthetic therapist combining oral and topical treatments to address skin concerns treating the whole person is not new. However, it seems that we are still at the infancy stages as a new era takes shape once again.

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There are numerous therapies and products available with supporting data that can be readily accessed. The important issue is to gain the necessary training as therapists on how to implement a structure within a business model. However, it would appear that further curricular is necessary and we are now seeing these emerging through higher education an example being the Bachelor of Applied Health Science (Clinical Aesthetics). This program has the foresight to include a rigorous biology and nutritional science program to equip the therapists and clinicians of the future.

Studies reviewing Lactobacillus paracasei offered data indicating that certain strains of probiotic exerts its effects beyond the gut and offers benefits at the skin level. It contributes to the reinforcement of skin-barrier function, decreases skin sensitivity and modulates the skin's immune system, leading to the preservation of skin homeostasis and thus a balance of skin flora.

Bring the STAR QUALITY to your Treatments through NEW ADVANCED EDUCATION and see YOUR BUSINESS GROW The opportunities to grow your current market share, while continuing to delight your existing clients, are highly achievable. They do, however, require that you take the initiative to increase your skills and knowledge.

Start preparing for an amazingly successful 2015:

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Gay Wardle is launching a NEW TRAINING PROGRAM to help you achieve just that:

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Step up your education to a more scientific level Offer your current and new clients an improved, new level of treatment result Refresh your current treatment program to include new services

New Updated Skin Analysis Training Nutrition – the missing link for amazing Skin Improvement Understanding the role of Hormones in Skin Health and Skin Improvement

Experts confirm that Clinical Knowledge doubles every 18 months. This may mean that your current knowledge has been superseded. These training programs with bring you up-to-date and give you the competitive advantage in both theory and practical skills.

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PHONE US FOR TRAINING DATES NEAR YOU ㈵

ENROL TODAY and start preparing for your best year ever!

Training Available in most States. For further details and to book Visit www.masterdermalacademy.com.au | Email: gay@m-da.com.au

Ph: 0418 708 455

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formerly Advanced Aesthetics

Masters Dermal Academy

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22/09/2014 12:27:31 PM

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Winning the War on Change and Competition Monday 25th August saw another successful conference program help by APAN in Sydney directly after the Spa and Beauty Expo. With the theme Winning the War on Change and Competition, the program was comprehensive and delivered on its promise.

Tim Green holds MBA qualifications and extensive experience and accomplishments in marketing and business growth. He presented a compelling lecture with statistical graphs that demonstrated the rapidly changing mobile marketing space and how businesses need to grow their database and retain their clients in a consistent and measurable manner.

Starting the conference program, Tina Viney once again raised the lid on new advances in both industry developments and presented new statistics on the evolving changes in consumer trends. She also challenged industry professionals on how the demands on future developments will require that the industry to re-examine its position and gain the necessary skills and qualifications to meet with future regulatory requirements and consumer demands. She clarified in detail the various areas and new disciplines that are shaping the industry.

On a more scientific level, Professor Ray Hayek presented an interesting lecture on pathophysiology, identifying skin abnormalities, their causes and manifestations and the importance for a skin therapist to correctly identify them prior to any treatment.

Following a buffet lunch, Warren Maginn, who is a Functional Nutritional Medicine Practitioner and Educator, took skin manifestations one step further by discussing internal deficiencies that contribute to various skin manifestations and effective nutrition

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that can support health and contribute towards mitigating various skin conditions through improving health and systemic homeostasis.

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Bringing the concept of the global changes to the issue of business philosophies and perspective, Isabelle Sennery presented s o m e k e y considerations that every business needs to examine to identify if their whole philosophy needs to be updated to better fit the priorities and beliefs of the modern consumer. She spoke of the importance of connecting with our clients and patients at a more fundamental level of values, as when we are aligned on this level trust is built and business decisions by the consumer are more easily made and comfortably made.

And leaving the best until last, Terry Everitt presented an interesting lecture on cosmeceuticals and uncovered facts from

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myths and how understanding skin structure and ingredient chemistry will better help us understand how products work or don't work and why. He also covered the relevance of using precursor ingredients and demystified some c o m m o n misconceptions regarding ingredients and the kind of questions that therapists need to ask their suppliers to validate how their products actually work. The purpose of this lecture is to support professionals to gain confidence in current use of cosmetic chemistry for their therapeutic purpose.

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The day was supported by some quality industry suppliers, who were given the opportunity to build relationships and grow their database of clinics, spas and salons.

APAN thanks both suppliers, valued speakers as well as delegates who took time out of their busy schedule to support this event and gain useful information for their sustainability and progress.

T h e f i n a l A PA N Conference for the year was held at Hobart, Tasmania, See page 110-113 for report on this conference.

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In 2015 Brisbane will host the first APAN Conference for the year on Sunday 31 May. Put this date in your diary because we have an amazing program for you.

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For further details visit www.apanetwork.com or contact APAN on 07 55930360 Email: info@apanetwork.com

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acupuncture, energy medicine and biomesotherapy. She is renowned for her integrative approached to health and healing.

BTTA is currently offering training and qualifications in the following areas:

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RELOCATING TO NEW PREMISES We caught up with Angie Smith, principal of the college, who had some very exciting

MEETING THE GROWING NEEDS FOR ADVANCED TECHNOLOGIES

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Laser Tattoo Removal Cosmetic Tattooing LED Light Therapy SIBBBSKS506A – Apply Microderabrasion to improve skin appearance SIB70110 Vocational Graduate Certificate in Intense Pulsed Light and Laser Hair Reduction Micro Skin Needling Paramedical Therapies Chemical Peels HLTN402B Maintain Infection Control Standards in Office Practice Settings

news to tell us. In line with the college's vision and philosophy, BTTA recently relocated to a new, innovative venue – the Beyond Good Health Clinic – a Holistic and Regenerative medical practice located at the Glades Golf Course in Robina, on the Gold Coast, Queensland.

In line with popular demand in 2015 they will also be launching Business Management qualification for Salons and Clinics, as well as educational seminars and workshops to help salons gain skills and knowledge they need to grow their businesses and practices.

“As a training facility the location is perfect,” Angie said, “as it is only five minutes from the main highway so students can travel easily either from Brisbane or from the airport if they are coming from another State or region and reach our destination with greater ease and minimum traffic,” Angie Said.

The college offers training to qualification levels wherever applicable and applicants can learn on their own devices should they prefer this.

However, through BTTA applicants have access also to quality equipment for purchase should they need to do so, “but we keep training separate to our equipment purchases,” Angie said.

Nested in the gardens at the Glades overlooking a beautiful lake, the new home for BTTA offers a serene, tranquil environment conducive to training and learning in an inspirational setting. The facility also offers treatments services to the general public, but students also have the opportunity to experience some of the new concepts of integrative treatment innovations that are redefining skin therapy.

“None of our students are pushed towards any purchases as BTTA as a Registered Training Organisation is strictly a training college and we pride ourselves in maintaining our focus and integrity on training,” she stressed.

Furthermore, the college will be operating alongside Beyond Good Health Clinic. Dr Dzung Price, who is the principal medical practitioner, has additional qualifications in nutritional and environmental medicine, herbal medicine, anti-ageing medicine,

Angie went on further to say, “We are delighted with our new college environment because it is aligned with our new approach of integrative, regenerative aesthetics, and while our training will be in skin-specific units, we believe that placed within a holistic medical environment it holds great opportunities for future training collaborations so that we can offer units in nutrition and other wellbeing modalities to support skin health.”

Reaching a new milestone, Beauty Therapy Training Australia (BTTA) – a registered training organisation on the Gold Coast, has just completed the second batch of government-funded training with 25 very excited therapists who have achieved their SIB70110 VOCATIONAL GRADUATE CERTIFICATE IN IPL AND LASER HAIR REDUCTION as well as their Laser Licences.

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If you are considering upgrading your qualifications and would like further information please do not hesitate to contact BEAUTY THERAPY TRAINING AUSTRALIA on 07 55 590 889 or email contact@beautytherapytraining.com.au

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Teresa Russo is a very gracious and kind individual with an astute business mind and a tenacity that would make Rambo proud. She is indeed a survivor who has overcome cancer, further family tragedies, and due to many pressures had to put her business dream on hold for a period of time, only to re-emerge even stronger and more successful as the owner of three highly successful clinics called Visible Changes, located in Adelaide, South Australia.

collapse of a business that was turning over $2 million a year.

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Fortunately, I survived, but having been out of action with my recovery I lost my sight and vision for my business, but I can honestly say that there is nothing more motivating than the huge debts that were mounting and the thought that this is what I would leave my children if I should die.

This was not what I wanted.

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REINVENTING VISIBLE CHANGES The strength and resilience I gained through my faith in God gave me the belief and motivation to reinvent Visible Changes by looking at every little thing that we did and making it even better and new again – from the way we offered a glass of water to the way we did an eyebrow wax or a facial treatment.

Teresa has been a member o f A PA N s i n c e i t s inception in June 2009 and she is the member of choice for this issue's Member Profile. Because

By Tina Viney we did not wish to miss out on any details of her amazing journey we allowed her to write her own story. Today, Teresa has sold two highly successful However, this time around it was more difficult to regain our market clinics and is concentrating on just one Visible Changes clinic share as there were many more competitors, and finding the right staff was also challenging. To emerge successfully I had to come up with and on the further expansion of her skincare formulations. We the Visible Changes point of difference. Once this plan was in place I trust her story will inspire you to achieve your own dreams.

Courage at its BEST The story of Visible Changes

I began in the beauty industry back in 1974 working in all aspects of beauty and aesthetics from lecturing, managing a successful chain of 14 hair and beauty salons with 240 staff, 70 of them beauty therapists, which were considered the diamonds of the business as their revenue always surpassed the hairdressing side of business. I was also involved for a period of time as a sales rep and was involved in exhibiting at expos both in Australia and overseas. At one stage I was principal at a Beauty College while studying and lecturing in cosmetic chemistry.

Throughout those years and the various roles I was undertaking I was in essence working for other people, and this was for a period of 18 years. To be perfectly honest, I really never had the desire to open my own salon as I was always very well remunerated.

However, in 1990 my third child (my son) was born with some serious health issues and this made me make the decision to open my own business so that I could have the freedom to come and go as I needed in order to work around him and not let my employers down.

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As a result, I am now the owner of Visible Changes Clinics and Skincare – a business model I launched in 1992 in Adelaide. Visible Changes has been a hugely successful business and at one point I had three booming salons, which in the very conservative and small Adelaide market has been very hard work.

To achieve this, I had to constantly evaluate my business strategies and regularly examine our business operations in order to remain profitable and successful.

While Visible Changes was highly successful I did experience a major health challenge that virtually forced me to close the business down.

As I was suffering from a life-threatening illness, 12 of my 18 staff left me within a six-month period believing that as I would not survive and die, so would their jobs and the business. This almost caused the

had to implement new systems and documented policies and procedures to ensure uniformity of standards of service each and every time a client visited Visible Changes. I didn't realise it at the time how successful these changes would be. Our new culture paid off and indeed it became our unique point of difference. Soon our clients were talking about our services and that they came to us because they knew they would get a particular service delivered at the same standard, no matter which staff member delivered it. I didn't realise it at that time, but what emerged was not just a salon business, but a clear and strong brand identity for which we gained a reputation.

In terms of staff however, I realised I was dealing with a different breed to what I had previously. Ten years before most of my employees had been previously employed in other industries. They had an established work ethic before they studied and entered our industry. However, my current employees stayed at school longer and entered work at a later age. They had never been trained to work unsupervised and therefore to establish uniform standards throughout all our activities and treatments they needed in-depth and consistent training, backed by very specific policies and procedures. This I set out implementing.

While all of this was going on my marriage was failing and it did. Soon I found myself trying to reinvent Visible Changes, bring up and relate to my three children, run a house and deal with everyday living!

Where did I get the energy? ㄰

ANOTHER CHALLENGE, BUT THE GIFT MAKES A WAY As we once again achieved success, a few years later we were hit with another blow. This time it was the Tax Office. They decided to do an audit and identified that there were errors in our accounting that left us owing thousands of dollars. Another surprise for me was that I thought that because I was paying my accountant for compliance advice that I was in safe hands. However, the law says otherwise. If an error occurs in your accounting figures, even though it may have been done by your accountant in the eyes of the law, they aren't

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responsible, you are. So again Visible Changes was under threat.

I was informed that we were targeted as our turnover was very high for a beauty salon in Australia, let alone South Australia, so the Tax Office decided to conduct an audit. Perhaps with a southern Italian surname and a successful turnover they may have thought I was laundering money, who knows. All I know was that I was the “chosen one”. Of course the next challenge was the enormous tax bill with fees going back five years. The amount I had to pay was huge and that alone was going to be bigger than my house mortgage. As a result, I was in the sad predicament of having to sell my beautiful home and uproot my children and rent again. I felt I was going back in time 30 years and I didn't know if I would survive the financial burden. Meanwhile, the global financial crisis was upon us with its share of financial challenges. The question I had was “would I survive?” But more important, what did I have to do to ensure that I survived !

Looking at our expenses, paying staff was the biggest financial burden, so I made the decision to downsize and terminate some positions, as well as also trim the number of product companies we were supporting.

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With tighter financial times ahead we decided to once again elevate our point of difference. I therefore decided that every Wednesday afternoons the clinic would be closed and the time would be used towardS staff training. This was a wonderful move. Our staff loved it as they built comradeship and enjoyed the time learning together and improving their skill sets. Through this training we were able to provide a more polished and uniform customer service and gain better skills to reach our sales targets. Our clients immediately noticed the difference in their confidence and appreciated the new standard that our staff were able to deliver. Our clients also appreciated that we were investing in perfecting our techniques so that we can provide a more enhanced client experience and better treatment outcomes. That in itself created a wow factor that negated the negative of not having any income coming on Wednesday afternoons, so the negative became a positive as our clients graining greater trust in us, and trust is a very important factor for the success of any business, and in particular a service-oriented business such as a salon or clinic.

The next step was to improve our product-sales strategy. We had to raise our product sales from 45% of turnover to at least 60%. Our decision in the end was made for us as our supplier with whom we

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The confidence in our skincare has also gained us an amazing reputation that has led to not just returned purchases, but also several plastic surgeons were so impressed by their patients’ skin results that they asked us for our products to be available to them under their own label. We now have on-going growth as a “private label” brand, which has been mainly through medical clinics as our product’s reputation continues to enjoy on-going momentum.

After almost 40 years in this wonderful industry the key strategies for success in business haven't changed. In my opinion, the key ones

are the following: ! Continual Staff Training – Staff are the face of any business. If you think about it, where would a football team be if they didn't train their team continually? They already know how to play football don't they? What training offers them is the competitive edge to excel. It is the same with staff.

! were spending on average $300,000 a year informed us that they would not stop their on-line Internet sales and this started affecting our business. We were this company's second-largest account Australiawide and had held that position for five years running, but that no longer mattered to them we were told. Furthermore, they opened a new account with a salon just 500 metres from us, so the decision was made to cease trading with that company, to the horror and panic of my accountant, not to mention it also put fear in me as I had now to make a quick decision about a new product line that would need to replace the old one.

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Actually, while this was a challenge, in essence it forced me into making the best business decision of my career. For 10 years I had been working towards formulating my own product range, so I decided to return to my chemistry and finish it. This was a huge gamble and to achieve this I had nothing on the shelves of my clinics for three months. Once again there was no better motivator to move me ahead than the mounting debts and the Tax Office debt that I had to pay. I was once again given the strength and the ideas to innovate and this led to the eventual launch of the Visible Changes Skincare brand.

These challenges gave me the courage to persevere and this launch was highly successful. Sales went through the roof, achieving 80% of our turnover. The staff loved that they have a wonderful new product that was actually our brand and they got behind it to recommend it and our clients know that our brand of skincare was exclusively sold only through Visible Changes, so securing sales was easier.

Our clients also loved the quality and results of the products and kept coming back to us for all their services and products. We also noted that our clients felt that they were part of something more exclusive…

Almost like a cult following .

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Constantly update yourself on your clients' needs – Becoming aware of consumer needs. It is important that our clients are constantly asked if we are meeting their needs. There is no point in having 50 new clients a week if we are not meeting their needs.

First impressions – First impressions and last impressions are important. Everyone wants to be part of something successful and feel a level of belonging and exclusivity, where they are treated with courtesy and exceptional service as if they belong to a very special club.

Embrace change – Do not be afraid to be challenged. In today’s world if you stand still you are actually going backwards. Use technology, but do not lose sight of core values.

To my fellow practitioners I say – Be true to yourself, do not be afraid to strive to achieve the very best for yourself. Have the confidence in your ability to deliver the very best, pass on your knowledge and skills to others. But above all, maintain the passion! Remember that every problem is like a pimple on the

skin of life and if you search enough you will always find a solution.

In business it isn't just about the big picture – it is the delivery of the finer details that collectively make all the difference in establishing client trust and loyalty and ultimately reputation and business success.

For Visible Changes these principles have been the foundation of our success.

Teresa Russo can be contacted at Visible Changes Phone 08 8223 7633 Email: teresa@visiblechanges.com.au

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When you want the perfect fit you need an

INDUSTRY SPECIALIST INSURER Take the five point business check-up for busy salons...

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Fulfilling a lifelong Dream Julie Maxwell is the founder and owner of Maxwell’s Skin & Body Clinic a well-appointed clinic in Main Beach, one of the most trendy and socially happening suburbs on the Gold Coast. Julie has been a committed therapist for many years and has always been at the cutting edge of her field of expertise, which in her case has always been the skin. We interviewed Julie, so here is her story.

APJ 1: What attracted you to this industry and how did you get started in this profession?

Julie Maxwell: From a child I have always had a great interest in skin and really never saw myself doing anything else, so I guess I am lucky to have achieved what I really wanted as a career, and I guess when you love something it is much easier to excel in this area.

I originally trained in Maitland, NSW, but then moved to Queensland in 1988 and worked in a salon and undertook a variety of industry roles. I then was hired by a cosmetic company and travelled around Australia lecturing and conducting workshops on the then new glycolic acid treatments. ㄰ 㤵 㜵

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Following that I was offered a position with the Golden Door at Willowvale in Queensland, which was considered one of Australia's leading lifestyle and spa retreats. However, it was this experience that made me realise my niche. I found working on clients who came for a one-off treatment and experience was not where my heart was. It left me unfulfilled. I wanted something more meaningful – working to resolve stubborn skin concerns and achieve breakthroughs solutions was much more exhilarating. I realised I needed a career shift that would allow me to focus on what gave me a sense of achievement, which was working mainly with the skin.

APJ 2: Share with us how you started as a business and how your business model has changed over the years?

Julie Maxwell: In 1993 I decided to step out and opened my own business – Maxwell's Skin & Body Clinic in Main Beach on the Gold Coast. I established what I believe was a new-style modern salon with proper rooms, leaving behind curtains as the only screen between rooms, which was the norm back in those days. The services I provided included a cross-section of beauty therapy procedures that included some spa treatments that were very much the trend in those days. However, I soon realised that I wanted to shift the culture of the business to become predominantly a skin therapy clinic and this led to my interest to further my knowledge and education in ingredient chemistry.

In my search for a quality world-class brand I met a highly respected skincare biochemist and formulator in the US – Rebecca Gadberry from YG laboratories.

Rebecca inspired me so much with her knowledge of the skin and ingredient chemistry that I decided to use her formulations for my private-label skincare brand. This product met all my criteria for a quality product and furthermore, it helped me build a loyal clientele who could trust me and return to me for all their skincare needs.

In 2000 Rebecca Gadberry visited Australia and we exhibited at the Sydney Beauty Expo, but the industry was still not ready for the concept of private label as a salon brand. We were ahead of our time, but it was proving very successful for me and my foresight into what would happen with Internet sales in the future would pay off tenfold.

Being exclusive is the only way to go!

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In March 2001 I attended a course at the University of California in its Los Angeles UCLA extension. This course covered cosmetic

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chemistry and cosmetic ingredients. There was no similar education in Australia at the time and the knowledge I gained really pushed my career and knowledge to the next level and made me thirsty to learn more.

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APJ 3: Tell us a little about your career highlights?

Julie Maxwell: I would have to say that my studies in cosmetic chemistry at UCLA would have to be the highlight of my career, and the turning point that gave me the impetus and drive to pursue skin therapy at a more advanced level. It helped me better understand the skin and identify more effective ways of working with ingredients and formulations and how they impact the skin. As a result, I am able to achieve more advanced, paramedical results in skin improvement and anti-ageing outcomes. This also led me to step out and work with a cosmetic medical practitioner who now offers injectable procedures within our clinic.

APJ 4: What do you love the most about your work?

Julie Maxwell: I enjoy the variety of treatments that I can provide my clients and being able to resolve more challenging skin problems, such as acne, pigmentation and other skin-corrective procedures.

With the various technologies we now have and with IPL we are able to achieve amazing visible results that were not possible a few years ago.

APJ 5. You recently participated in the GovernmentFunded training and gained your Vocational Graduate Certificate in IPL and Laser Hair Reduction through Beauty Therapy Training Australia with Angela Smith.

How did you find the training and what did you gain from it?

Julie Maxwell: I found the course excellent and gained a great deal

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also from the theoretical component, which was quite comprehensive and established me with a stronger foundation. As I had only worked with IPL before and not laser, it was wonderful to learn the differences in capabilities between laser and IPL. Gaining this knowledge was valuable, and achieving a formal qualification gave me greater confidence in my work and the ability to achieve more.

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APJ 6: What is a major challenge you have faced as a business and how did you overcome it?

Julie Maxwell: I believe that the advent of Social Media changed the

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whole communication platform for everyone. There are now many voices that can influence our clients' decision to undertake treatments and to purchase products. Add to this the global economic downturn

and businesses inherited quite extensive pressures. Unless they lift their game, it is no wonder that many are not surviving. Today, staff improvement must be on-going and a business needs to work on its unique brand identity and ensure they are kept up to date with advances to remain competitive and to continue to be perceived as the expert for their clients. There is more work involved, but for those that invest in these areas they can be successful.

APJ 7: What industry changes excite you the most and how do you view the future?

Julie Maxwell: There are many areas that I am excited about. I am thrilled that APAN is working towards the issue of industry regulations as this is very important for the industry, especially as new advances enter the industry. We have so many more option now in terms of ingredients and technology. Once we gain the appropriate knowledge and education, what we can now achieve with our treatments and for the benefit of our clients is quite incredible. Our profession now offers a lot of job satisfaction knowing that you can achieve so much more than previous years, and I believe these advances will continue to grow over the next few years. It is quite exciting really! To accommodate our growth Maxwell’s Skin and Body Clinic expanded and we had to take larger premises, not far from where we were previously. I am thrilled with our new clinic, it’s spacious, luxurious and allows for our growth and expansion.

APJ 8: Why did you join APAN and how has it benefited you?

Julie Maxwell: It's important to belong to a professional industry body that can support me as a business owner and help keep me abreast of advances, regulations, new trends and industry developments. It is through APAN that I was able to secure government-funding to undertake my qualifications in laser and IPL.

Maxwells Skin and Body Clinic is located in Tedder Avenue, Main Beach, Gold Coast Queensland Ph: 07 5591 1744 | Email: juliemaxwell@bigpond.com

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Update on Australian Skincare and Beauty Services Statistics

By Tina Viney This report is an excerpt from the lecture I presented recently at the APAN Conference in Tasmania and should be read in conjunction with my previous article on pages 24-26 on the Major Global Shifts and how they will Impact the future.

I had recently received a copy of the latest IBISWorld report on the 2013-2014 activity of the hair and beauty industry and while it required some sorting out of what pertained to hair and what to beauty, I was able to extrapolate some interesting data that pointed to the current state of affairs and the immediate forecast for our industry as far as Australia is concerned.

WHO IS IBISWorld?

IBISWorld is considered as Australia's largest provider of industrybased research, and since 1971 IBISWorld has been providing thoroughly researched, reliable and current business information that is considered priceless to many industries. They employ a team of dedicated expert analysts who research economic, demographic and government data so that businesses don't have to. This information is then provided at a fee (usually around $1300 to $1500) to interested parties. Currently they provide valuable insights on Australia's 500 industries, its top 2,000 companies and its key business environment indicators, so organisations and businesses can be guided to make business decisions based on statistics now and into the future.

As we come to the end of the year there is much that we can contemplate on what we have achieved and where we have failed, as both realities are important. However, my principles for success are quite simple. Success is the result of collaboration of three key areas:

1. Positive Attitude and Vision:

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Identify the negatives and failures, but don't waste your time on them. Spend most of your energy seeking answers and identifying positive solutions on how you can expand your vision and move forward towards achievement. You should only spend 10% of your time and energy identifying losses and problems and 90% of your time and energy finding answers and solutions to your challenges. Did you know that the one thing that the world's top 500 companies have in common? They all had a positive expectation that their future would be a good one. Positive attitude attracts answers and solutions to your needs like a magnet, so stay committed, focused and believing in positive expectations.

2. On-going Skills Development and Improvement: Don't let

anyone fool you that you can get along with yesterday's knowledge and skills. While knowledge and experience are valuable and cumulatively they can contribute to an important issue – wisdom, you can't afford to camp around yesterday's knowledge – you need to be constantly reaching for new information and evolving your current abilities and capabilities so that you can better meet the demands of a changing world and consumer expectations.

3. Incremental consistent application of intended strategies of where you are today and where you wish to be tomorrow: Progress doesn't happen without putting in place an action plan and strategies that you will act upon to propel your growth and advancement.

Today, our industry has so much more to offer us. New technologies, new ways at looking at the skin, new scientific discoveries are opening up the doors to a vast array of options with better outcomes than we never dreamt of just 5-10 years ago. Tools to facilitate your success to a constantly growing and more robust business and practice, but perhaps more importantly, change that will give you a greater sense of fulfilment and pride in what you are doing as you move forward to achieve your goals.

Anthony Robbins once said “THE REAL PURPOSE OF A GOAL IS WHAT IT MAKES OF YOU AS A HUMAN BEING, WHILE YOU PURSUE IT. WHO YOU BECOME AS A PERSON IS THE ULTIMATE REWARD”.

Let's consider the following: How do you feel when you have reached a goal? Euphoric, confident, stronger, good about yourself – correct?

How long do these feelings last? Usually a few days, or months and then they dissipate. Why? Because the exhilaration comes not just as a result of what you have achieved, but what also has happened in you when you achieved your goal. If we camp around passed successes we will slowly dwindle because we will stop growing. Goals are about growth on personal, professional and business levels. Unless you constantly challenge yourself to grow you will slowly stagnate.

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This report will present the findings as identified by IBISWorld.

However, as mentioned above, they do not represent the whole picture with regards to the Australian cosmetic and beauty industry, which is presented in my report on pages 24-26 that cover the international trends that are now also starting to be reflected in the Australian market.

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For the benefit of future planning I want to share with you a few important issues: 1. AUSTRALIAN STATISTICS and how they predict the future 2. INDUSTRY CHANGES – so that you can get prepared for them 3. WINNER'S MINDSET – How to overcome obstacles to achieve ongoing success Buckminster Fuller created the “Knowledge Doubling Curve”; he noticed that until 1900 human knowledge doubled approximately every century. By the end of World War II knowledge was doubling every 25 years. Today things are not as simple as different types of knowledge have different rates of growth. For example, nanotechnology knowledge is doubling every two years and clinical knowledge every 18 months. But on average human knowledge is doubling every 13 months. According to IBM, the build out of the Internet will lead to the doubling of knowledge every 12 hours.

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AUSTRALIAN STATISTICS

Market Share concentration The latest ABS Counts of Australian Business Data reveals:

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27.4% of the business are sole traders 71.1% employ 19 staff or less 63.3% of the industry generate less than $200,000 pa.

Looking at these statistics, if you are a sole trader and have low overheads as a sole trader that may be OK, but if you consider yourself as a business with staff, rent and numerous outgoings, earning a turnover of $200,000 will definitely be problematic. No business should be struggling with such low figures. As part of our APAN member's coaching program we show you how to achieve this amount through just two sales per week. Yet, many still consider membership as an expense instead of an investment. Those who are prudent gain amazing value from their membership and use it wisely to learn how to increase their revenue. It all comes back to reaching out and gaining benefit from the services and coaching that is part of your standard membership with APAN.

THREATS AND THE COMPETITIVE LANDSCAPE ㈵

According to IBISWorld there are six areas that are causing threat to the industry. These are: ! COMPETITION: Beauty services face a high level of competition

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MAJOR MARKETS BY AGE BRACKET In reviewing the age bracket of consumers that are visiting beauty salons in Australia the following was reported:

According to IBISWorld the Australian beauty industry has exhibited modest growth despite turbulent economic conditions. Over the past five years and during 2014-15 revenue is forecast to grow by 1.8% to reach $3.9 billion. However, these figures do not show the whole picture. They only reflect beauty as being basic beauty services – they do not reflect skin management services and clinical aesthetics.

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due to large number of businesses that will continue to enter the market due to low barriers to enter the market OVERHEADS: Rent costs represent a relatively high proportion of revenue as salons and clinics need to be situated in areas with high visibility and foot traffic.

RISING WAGES: Rising wage costs have put pressure on profitability that is hindering business growth.

CHANGES THROUGH ADVANCES: Industry is rapidly diversifying with many traditional “beauty” procedures now also offered in cosmetic medical clinics extending the competition.

PRICE WARS: Industry profitability has fallen over the past five years as intensifying competition has forced operators to offer lower prices to attract consumer growth.

FRANCHISES & COSMETIC MEDICAL CLINICS: The rise of franchise operations that are able to benefit from economies of scale and achieve higher returns offering excellent services at affordable prices has also put pressure on many salons and clinics.

15-35 years represent a smaller share of the market 29.5% 35-54 years represent the largest market 39.7% 55 years and over 30.8%

In essence, over 70% are aged 35 or over. This category is more financially secure. They are often employed or business owners.

This age group is also very concerned with their health and wellbeing as well as their appearance. This is the reason for the growing antiageing phenomenon, which is experiencing the industry's primary growth area. Due to this boom there is a growing need for mature students and a greater opportunity for mums returning to work, as the anti-ageing client does also look for empathy from a practitioner who also has an understanding of their ageing needs through experience and not just training.

BUSINESS FAILURE RATES According to IBISWorld hair and beauty service operators have a high rate of business failure – between 6-8% of salons failing each year.

However, our estimation and our own research can confirm that those figures are incorrect as they only reflect de-registration of ABN Numbers. Our figures indicate a percentage that is closer to 60-80%.

Some of the reasons include;

Low entry barrier and limited regulations: Since barrier to entry is low, some therapists establish their own salons, but lack the necessary business management skills to operate it properly. Furthermore, there are no regulatory restrictions as to who can operate a beauty therapy service and what qualifications are needed.

Low profit margin: Intensive price-based competition has also created an environment of low profit margins. Wage growth has also placed downward pressure on profitability. As cosmetic procedures are also gaining greater acceptance in the community, this is driving increased demand for these services and related treatments. However, the traditional business model of providing a little of this and a little of that is no longer is profitable. There are many services that businesses need to consider if it is worth continuing them, or if is it best to advance to a more specialised and focused business model. The industry is maturing and the demand for specialised services is now becoming the norm rather than the exception.

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KEY EMERGING TRENDS REPORTED INCLUDED THE FOLLOWING: ORGANIC SALON SEGMENT The organic salon market is expected to grow quickly over the next five years. While it is still a niche market, the number of salons offering organic-based products and treatments is experiencing growth. Consumers are becoming increasingly aware of the environmental impact of chemical and other additives contained in some skincare products, and many are selective and increasingly seeking salons that offer more natural and healthier services. The environmental movement is highly associated in health and wellness and is a natural fit for the beauty industry. This is a consumer-driven trend and should be given due consideration when planning your products and services.

GROWING TREND FOR PERMANENT HAIR REDUCTION Revenue from depilatory hair removal has declined over the past five years as more effective hair-removal techniques have become popular. IPL and Laser hair reduction have gained momentum and although more expensive than waxing it is perceived as a more effective means of reducing hair growth. The growing popularity of these services has contributed to the industry's overall revenue growth. However, innovative technologies have now developed handheld devices that consumers can purchase directly from outlets such as the Shave Shop and Harvey Norman. This trend will continue to grow and salons and clinics will have to review if they wish to provide these as a home-based option.

PRODUCTS AND SERVICES Nail Care: Nail care represents the second-largest share of industry revenue and services vary from $20 to $100, even though the new trend is towards gel and shellac gels that are considered a less risky alternative.

Indoor tanning is rapidly on the decline as State regulations follow the lead of NSW and Victoria banning solariums that were introduced in 2012 and that banned commercial solarium beds by the end of 2014.

Other States promptly passed similar laws as research has accumulated links to skin cancer and solarium beds. According to Better Health Channel, a provider of health and medical information, the number of commercial sun beds is rapidly falling to over 62%, with operators switching to spray tanning. However, media coverage is also applying pressure to this segment by focusing on the potentially harmful ingredients in sprays, including dihydroxyacetone.

SKIN SERVICES

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These represent 4.1% of industry revenue. As new technologies and advanced treatments enter the market the old concept of the traditional basic “facial category” is coming under threat, and over the past five years is slowly declining. It is no longer considered as a good investment to consumers unless it can deliver noticeable skin improvement and anti-ageing benefits. Cosmetic medical clinics are rapidly leading as the preferred option in anti-ageing skin improvement treatments as they are perceived as the “experts” in this area.

Surprisingly in this economy the businesses that are surviving are providing high-priced, value-added benefits that consumers perceive as an excellent investment.

Today, consumers think more, compare price, evaluate value for money and look for evidence of results before they commit. This means that the industry needs to provide independently validated, evidence-based results to convince consumers on the reliability of their services and the guaranteed results.

HEALTH AND WELLNESS REVOLUTION Another shift we are seeing is the growing need of consumers to engage in practices and procedures that minimise the possibility of disease. Relaxation, anti-stress treatments and wellness therapies were traditionally found at the spa, but this is no longer the case. This is also reflected strongly in the international trends by the Kline Report, which I mention in my previous article.

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ANTI-AGEING SKINCARE MARKET While information on the anti-ageing skincare market was only hinted in the ISBWorld Report however, a more complete picture is presented by global researchers in the Kline Report, and we are seeing similar trends reflected in the Australian skincare market. According to IBSWorld, clinical skincare practices – whether aesthetic therapies or medical, were not included in their report, as they defined beauty as predominantly hair and basic beauty.

Meanwhile the Kline Report stated that the Professional Aesthetics Industry shows great opportunities for amazing growth in skincare and in particular the “Premium” or anti-ageing product innovations.

Their growth in demand promises to challenge the whole skincare landscape, with continued growth in preferred consumer choice towards performance products.

Growing by almost 500% over the past 20 years, skin treatments and nonsurgical cosmetic procedures are mirroring consumers' preferences for minimally invasive treatments. And in line with the demand the robust growth continues.

In Australia we are saw a 20% growth in 2013, and 2014 so far is showing similar figures, which is quite amazing compared to the conservative 1.8% predicted by IBISWorld.

Key factors driving growth include greater consumer awareness of options available to them, and their popularity is based on their benefits, less down time and discomfort, with a whole body of treatments and increased distribution similarly contributing to the market's overall growth.

THE WINNING MINDSET Changes at the rate that we will continue to experience can be challenging. However, while we can fatigue when we are constantly coming up against challenges, if we continue to persevere something amazing happens. We develop strength to the point where we become conditioned to pressure as a normal state of being and we find it easier to keep standing. Just like building muscles when pressure is applied to it, initially it hurts, but continued pressure results in muscle growth and the muscles become stronger, so much so that they become conditioned to the pressure of weight without feeling as fatigued any more. The same thing happens to us as we continue to push through and look upon challenges as just something that we will overcome and they are only a temporary issue.

It's all a matter of attitude. There is no doubt we all have a story, about what we have had to overcome, and sometimes we even feel sorry for ourselves. However, to move forward we sometimes need to let go of that story to make room for the new story that awaits us to unfold. Our life experiences have made us more wise and we can rise above any adversity we have experienced in the past.

In closing, another inspirational and wise quote from Anthony Robbins is “THE ONLY IMPOSSIBLE JOURNEY IS THE ONE YOU NEVER BEGIN”.

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The Health and Skin BENEFITS of Witch Hazel (Hamamelis virginiana)

By Tina Viney

I was recently watching the Dr Oz show and he was interviewing a dermatologist and was asking her of an effective solution for under-eye puffiness. Without hesitation she responded – witch hazel and went right ahead to explain why this simple, yet highly active natural ingredient is so beneficial for puffy or inflammatory conditions.

Back in 1969, when I undertook my initial beauty therapy training witch hazel was considered one of the most reputable astringents and a staple in our ingredient arsenal for skin treatments. Amazingly enough it is still considered by dermatologists as a credible skincare ingredient. I therefore thought it warrants re-examination as a useful ingredient in any salon or clinic.

WHERE DOES WITCH HAZEL COME FROM?

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Witch hazel is a shrub, about six to eight metres tall and originally from North America. The witch hazel family is composed of more than 20 genera and about 100 species around the world [1]. The flowers are bright yellow and the fruits encapsulated. This shrub blooms in autumn and winter.

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It's botanical name is Hamamelidaceae and it comes from the Hamamilis Genus. The name witch hazel derives from the similitude of witch hazel leaves with those of the hazel nut.

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ACTIVE CONSTITUENTS OF WITCH HAZEL

In order to gain an understanding of why witch hazel is effective and how to use it we need to examine its active constituents. Among them you will find the following:

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tannins, bitters, gallic acid, catechins, gallotannins, hamamelitannins, flavonoids (quercentin, kaempferol), phenolic acids, saponins, and safrole Some of these constituents are big contributors to Hamamelis virginiana benefits.

The gallotannins are mainly found in witch hazel leaves. The Hamamelis virginiana leaf extracts showed a high concentration of not only gallotannins, but also procyanidins and catechins, these last two active constituents in a less considerable proportion.

Octagalloyl hexose represents the major tannin from the active constituents found in Hamamelis virginiana.

It is interesting to note that witch hazel contains a very small percentage of Safrole a known carcinogen, however, it seems as the quantity of Safrole in witch hazel is so small, it does not constitute a health hazard.

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ACTIVE PROPERTIES OF WITCH HAZEL Studies confirm that extracts from witch hazel Hamamelis virginiana, as well as green tea (Camellia sinensis) contain antioxidant polyphenolic compounds that are known to protect the skin from sunburn and photo-ageing when administered topically or systemically[6].

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Also some of the properties and characteristics that make witch hazel a very interesting herb for skin therapists is its anti-inflammatory, anti-microbial and antioxidant properties, and these are due to the high contents of tannins that this herb possesses.

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TREATMENT BENEFITS ㈵

Because of its strong astringent properties witch hazel has been effectively used for the treatment of hemorrhoids[9]. Traditionally, hemorrhoids (swollen veins) are associated with chronic constipation, straining during bowel movements and prolonged sitting on the toilet all of which interfere with blood flow to and from the area, causing it to pool and enlarge blood vessels. As a result, the veins around the anus stretch under pressure and may bulge or swell. Witch hazel when topically applied near the affected area can relieve pain and decrease the dilation of blood vessels. Additionally, the anti-inflammatory properties of witch hazel also help to reduce swelling.

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The astringent and anti-inflammatory properties of witch hazel also assists in toning the skin around the eyes and refining the appearance of enlarged pores through its constricting action.

Furthermore, witch hazel possesses antibacterial properties. The tannins are also very useful to protect the skin against bacterial attacks. This is one of the reasons witch hazel is believed to be an effective antibacterial agent and is beneficial for problematic skin with skin blemishes and even acne. Witch hazel is therefore an effective skin tonic that can assist in toning and tightening the appearance of skin pores, preventing bacterial infections and helping the skin to be better protected against external bacterial attack.

WITCH HAZEL FOR WOUNDS AND BRUISES The astringent effects of tannins also help to stop bleeding in minor wounds and bruises. However, due to the high amount of tannins this herb contains, witch hazel is only recommended for external use.

WITCH HAZEL COSMETIC PROPERTIES There are many cosmetic herbal remedies that make use of astringent herbs such as witch hazel to achieve very good aesthetic results. You will therefore find witch hazel in many well-known commercial after-shaves and facial and skincare products. Many cosmetic and anti-ageing herbal remedies make use of witch hazel astringent properties as a key ingredients, including in their masks for the purpose of refining and calming the skin.[7].

However, you can also purchase pure witch hazel from most pharmacies to use in your treatments. You can also use it mixed with aloe vera as a soothing gel, or mixed with clay masks to further refine the skin.

Another documented use of witch hazel refers to its power to treat varicose veins, mainly due again to the astringent power of tannins contained in the witch hazel, able to constrict blood vessels and minimise the effect of varicose veins. ㄰ 㤵 㜵

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As part of after-sun lotions, data provided by studies on the subject suggests that witch hazel's anti-inflammatory action is useful in protecting the skin against solar inflammation. A 10% lotion can be very effective in defending the skin against sun damage. Several studies on the subject report its use as part of liquid and dry extracts where together with other herbs such as Matricaria recutita, Aesculus hippocastanum , Rhamnus purshiana and Cinnamomum zeylanicum the extracts showed an intensification in solar-protection factors, being able to contribute their emollient and moistening properties of the after-sun creams and lotions [19].

THE EFFECTS OF WITCH HAZEL ON SKIN DISORDERS AND SKIN INJURIES The use of astringents as witch hazel ointment for the treatment of skin disorders and skin injuries in children aged 27 days to 11 years was also documented in another clinical trial performed by the University Hospital of Luebeck. In this clinical trial witch hazel ointment efficacy was compared and matched with that of dexpanthenol ointment. The results were similar in both cases but we have to highlight that the tolerability of Hamamelis virginiana was considered as excellent [14].

ANTI-INFLAMMATORY One of the key benefits of witch hazel is its impressive antiinflammatory properties on conditions such as diaper rash, razor burn and bug bites. Inflammation is caused by free radicals in skin cells, and scientists at Japan's Shiga Central Laboratory studied 65 plant extracts for their potential anti-inflammatory applications as an antiageing treatment for skin. Only two of the extracts exhibited active oxygen-scavenging effects and protective activity against cell damage, with one being Hamamelis virginiana.

HOW IT WORKS Tannins and volatile oils are the main active constituents in witch hazel. These constituents contribute to the strong astringent effect of witch hazel. Pharmacological studies have suggested that witch hazel strengthens veins and is anti-inflammatory.16,17 Topical creams are currently used in Europe to treat inflammatory skin conditions, such as eczema. One double-blind trial found that a topical witch hazel ointment (applied four times per day) was as effective as the topical anti-inflammatory drug bufexamac for people with eczema.18 However, another trial found that witch hazel was no better than a placebo when compared to hydrocortisone for people with eczema.19 Witch hazel is approved in Germany for relief of local mouth inflammations such as canker sores.

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While new innovative ingredients enter the market, witch hazel is a proven herbal remedy that can still hold its place in the professional skin therapy field.

REFERENCES

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1. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985, 221.

2. Erdelmeier CA, Cinatl J Jr, Rabenau H, et al. Antiviral and antiphlogistic activities of Hamamelis virginiana bark. Planta Med 1996;62:2415.

3. Baumgärtner M, Köhler S, Moll I, et al. Localized treatment of herpes labialis using hamamelis special extract: a placebo-controlled double-blind study. Z Allerg Med 1998;74:15861.

4. Laux P, Oschmann R. Witch hazel Hamamelis virgincia L. Zeitschrift Phytother 1993;14:15566.

5. Wichtl M. Herbal Drugs and Phytopharmaceuticals. Boca Raton, FL: CRC Press, 1994, 26870.

6. Plein K, Burkard G, Hotz J. Treatment of chronic diarrhea in Crohn disease.

A pilot study of the clinical effect of tannin albuminate and ethacridine lactate.

Fortschr Med 1993;111:1148 [in German].

7. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Foods,Drugs, and Cosmetics, 2d ed. New York: John Wiley & Sons, 1996, 16870.

8. Ellingwood F. American Materia Medica, Therapeutics and Pharmacognosy. Sandy, OR: Eclectic Medical Publications, 1919, 1998, 354.

9. European Scientific Cooperative on Phytotherapy. Hamamelidis folium (Hamamelis leaf). ESCOP Monographs on the Medicinal Uses of Plant Drugs. Exeter, UK: ESCOP, 1997.

10. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin, TX: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 231.

11. Blumenthal M, Busse WR, Goldberg A, et al. The Complete German Commission E Monographs. Therapeutic Guide to Herbal Medicines. Austin, Texas: American Botanical Council, 1998, 1156.

12. Weiss R. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd, 1988, 342.

13. Blumenthal M, Busse WR, Goldberg A, et al. The Complete German Commission E Monographs. Therapeutic Guide to Herbal Medicines. Austin, Texas: American Botanical Council, 1998, 231.

14. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985, 221.

15. Blumenthal M, Busse WR, Goldberg A, et al. The Complete German Commission E Monographs. Therapeutic Guide to Herbal Medicines. Austin,

Texas: American Botanical Council, 1998, 1501.

16. Bernard P, Balansard P, Balansard G, Bovis A. Venotonic pharmacodynamic value of galenic preparations with a base of hamamelis leaves. J Pharm Belg 1972;27:50512.

17. Korting HC, Schafer-Korting M, Hart H, et al.

Anti-inflammatory activity of Hamamelis distillate applied topically to the skin. Eur J Clin Pharmacol 1993;44:3158.

18. Swoboda M, Meurer J. Treatment of atopic dermatitis with Hamamelis ointment. Br J Phytother 1991/2;2:12832.

19. Korting HC, Schafer-Korting M, Klovekorn W, et al. Comparative efficacy of hamamelis distillate and hydrocortisone cream in atopic eczema. Eur J Clin Pharmacol 1995;48:4615.

20. Blumenthal M, Goldberg A, Brinckman J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications, 2000, 4138.

21. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 231.

22. McGuffin M, Hobbs C, Upton R, Goldberg A. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, 1997, 105.

23. McGuffin M, Hobbs C, Upton R, Goldberg A (eds). American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, 1997, 5960.

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APJ 85

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STRESS AND THE IMMUNE-BRAIN CONNECTION This year's A5M Anti-Ageing Medicine and Aesthetics Conference program held in August in Melbourne was focused on the theme – Stress & Ageing: Taking Theory to Practice.

Featuring world-authorities on this subject offered delegates an incredible array of the latest findings of evidence based information on this all important subject that was beneficial for practitioners across the board. It was encouraging to also see several APAN Members – aesthetic therapists and dermal therapists participate and take advantage of the wealth of knowledge that was presented at this event.

One of the key-note speakers was Dr Andrew Heyman, world renowned Integrative Medical Practitioner and internationally recognised natural therapies expert. Dr Heyman revealed scientific updates on Rg3, Nicotinomide, Riboside and Tocotrienols as representing the cutting edge of herbal medicines and their use in stress-related treatment protocols.

His information was compelling in addressing the incredible ways that stress can compromise health and effective new ways of mitigating its impact on human health.

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We were delighted that Dr Heyman accepted to speak to us for the benefit of our members and readers. Here are some of the highlights of his interview.

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APJ 1: Dr Heyman from your findings what factors have accelerated stress in our modern society?

Dr Heyman: I consider both the traditional points of view, as well as

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some less obvious considerations that we are now discovering that can impact the body and alter it temporarily and even permanently. The key ones are major life events such as divorce, death and even job loss

that can contribute and impact our personal sense of self worth and identity. These can contribute to accelerated ageing and wellness.

Other less obvious considerations are the inability to cope when continued stress can impact our resilience and contribute to overwhelm and psychological issues.

We are now identifying the important role of a robust social support group and the pursuit of spiritual meaning and purpose as these can give us a positive sense of identity and give us the ability to successfully building quality relationships, which is such an important issue for our wellbeing. These elements in our lives are worth investing in as they have the potential to strengthen our self efficacy and give us the power to make changes. They give us the ability to become better aware of our emotional terrain and helping us develop resilience and identify ways to support ourselves both physically and psychologically so that we can best respond to stress and manage it better.

APJ 2: What new information do we have on how stress affects the brain?

Dr Heyman: We now have sufficient scientific evidence that highlights the potential for stress to cause injury and alter the stress responses in the brain. While there is good science to identify what happens to the adrenal glands, not enough attention is given to what is happening in the brain. Some physicians look at addressing the impact of stress as an adrenal fatigue issue and often give little consideration to what is happening to the brain, which can present a different story.

Evidence-based approach is now pointing to the importance of also considering the injury that stress can play on the brain and how it can alter the brain's architecture, contribute to abnormal response and also cause injury. These findings are challenging the importance of looking at how the body is impacted by stress in greater detail, as stress matters. This is an issue that has been largely ignored in the past.

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If we look at statistics in Australia, according to a 2008 report from Medibank Private, the cost of stress-related incidences is costing Australia $14.81 billion.

work as anti-inflammatory agents in the brain, as does acupuncture, diet and counseling – both sides must be managed. You can not address the one at the exclusion of the other.

APJ 3: How does stress effect hormone levels?

Dr Heyman: The endocrine system is responsible for many different

APJ 6: You are an expert in nutrition, vitamins, herbology and Chinese Medicine. In terms of minimising the impact of stress what nutrients are the most proven to support the body?

Dr Heyman: There are some excellent Chinese herbs that have been

hormones. As far as stress is concerned cortisol, which is a hormone made by the two adrenal glands (one on each side of the kidney) is essential for life and is critical in helping us cope with stress. Cortisol helps maintain our blood pressure, supports the immune function and the body's anti-inflammatory processes. Located inside the brain, the pituitary gland regulates the amount of cortisol released by the adrenal glands. Cortisol needs to be in a constant state of flux responding and defending our body to better cope with stress.

However, with excessive and prolong stress abnormalities may occur and cortisol can get stuck and not function correctly. Cortisol can also determine the individuality of other hormones e.g. how insulin and cortisol may respond in acute stressful conditions their impact on the availability of good sugar to be readily available to the tissues.

The problem with chronic stress is that it does not allow the body sufficient time to repair and rejuvenate and this can perpetuate pathological issues that can be precipitated by long term altered insulin sensitivity. Also thyroid hormones and the conversion from T4 to T3 can contribute to issues of fatigue and weight gain.

Cortisol abnormalities in men can contribute to low testosterone, while in women it can alter the ratio of oestrogen/progesterone and cause oestrogen dominance that can contribute to infertility and decline in progesterone in menopausal women. We know that stress can also contribute to cortisol-steal and this contributes to the decline in reproductive hormones. By using therapies and strategies to balance and strengthen one's stress resilience will assist in getting their hormones into balance.

APJ 4: From the lens of the stress response, how does stress affect our immune system?

Dr Heyman: Cortisol is responsible for the body's anti-inflammatory response. When high stress is present immunity will be suppressed and this can precipitate potential infections. With low levels of cortisol you lose that regulatory response of hormones in the body and this contributes to inflammation and autoimmune conditions. The more suppressed your immunity the more you will experience pain in the body. As a compensatory shift to the pain the body may turn cortisol down to positively compensate an immune shift. We often ignore the inflammatory response, but it is important that we understand that the brain related shifts to stress may turn off cortisol levels.

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APJ 5: You stated in your presentation that the immune and the endocrine systems can become altered and damaged as a result of overwhelming stress, how do you best define “overwhelming stress”?

Dr Heyman: Any form of trauma such as emotional, physical, surgery, major illness or infection can contribute to changes in your endocrine and immune systems and this can result in your body losing its ability to appropriately respond to stress. This does not necessarily have to be a major injury, it may be as a the result of low-grade, but persistent stressful events that eventually the body can't keep up with.

It is important that talk therapy is implemented to assist the individual, but there must also be consideration of the physicality of the damage to the brain and body. There are now some excellent herbs that can

clinically proven to modulate the immune system and balance it. In fact, more and more natural compounds have now been found to be almost as active as pharmaceuticals and they are changing the landscape of the market from a regulatory perspective. For example RG3 (20 ®-Ginsenoside Rg3) is a ginseng derived neuropeptide with amazing anti-inflammatory properties. This special compound is available in a spray and it reduces neurological excitation and is also known to regenerate neuron cells.

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Another is NAD (nicotinamide) an amazing molecule – a close relative of the B-vitamin niacin, with similar vitamin activity that is proven to play an important role in certain biochemical mechanisms that affect lifespan. Nicotinamide is a chemical precursor of a molecule that definitely plays a role in various biochemical mechanisms that support health and a vital cofactor in the silencing of genes that contribute to inflammation. Nicotinamide can actually bring about a kind of rejuvenation of human fibroblast cells when they are undergoing the ageing process – it is an excellent brain food.

Sterolins are plant sterols that are known immune system modulators and balance the immune system. They are also known to benefit in conditions of inflammation. Sterolins are known to fine-tune immune system and turn on natural killer cells, which also benefit individuals who suffer from allergies. Some of these are not currently available in Australia, but it is anticipated that they will be in the near future.

APJ 7: Integrative medicine is a relatively new model of medicine that looks as not just disease, but also how to improve the body's resistance to disease, are there any advances in it acceptance into mainstream medicine?

Dr Heyman: In the US the introduction of integrative medicine is growing slowly in recognition. I have a strong involvement with various academic centres and currently over 60 universities and academic institutions are including integrative medicine in conventional medical training. I am currently academically active and retain a clinical appointment as an Adjunct Assistant Professor at the University of Michigan and I am the National Clinical Chairperson for the Consortium of Academic Health Centers for Integrative Medicine.

We are definitely seeing a growing recognition of integrative medicine and this is quite exciting.

Dr Andrew Heyman MD, MHSA (US) is Program Director of Integrative and Metabolic Medicine at the George Washington University, USA. He holds qualifications in complementary and alternative medicine and went on to receive his doctor of medicine and become the first physician to complete an integrative medicine fellowship at the University of Michigan. In addition to his formal training in family and integrative medicine, Dr. Heyman's diverse clinical interests include: Functional Nutrition, Traditional Chinese Medicine, Medical Acupuncture, Osteopathic Manipulative Medicine and Medical Aesthetics. This broad range of therapies allows him to develop a comprehensive treatment plan for both the acute and long-term health goals of his patients.

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APJ 87

productinnovations

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INFINI – A New Dimension in RF

LIMITED EDITION Where There's Smoke Eyeshadow Palette Just in time for Christmas, Jane Iredale has released a new LIMITED EDITION Smoke & Mirrors Eye Kit as well as an Electric Refillable Compact.

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The INFINI's 2-in-1 fractional RF technology was created with both physician and patient in mind, with easy to perform procedures and effective outcomes. INFINI's novel radiofrequency system delivers RF current via insulated, gold-plated, microneedles, volumising sagging tissues and treating wrinkles and skin laxity on and off the face, as well as acne scars and stretch marks.

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Aquatonale is an exciting marine-based cosmeceutical range from France boasting a full complement of targeted ingredients, including peptides, extracts, vitamins, actives, peels and complexes for enhanced skin results. A complete range of products to suit the main skin types and concerns. The range includes: Hydra Line – for dry and sensitive skin; Pure Line – for acne and oily skin types; Anti-Ageing Line – for ageing skin types with ingredients to support and prevent premature ageing; Radiance/Clarifying Line – for pigmented skins, helping to reduce pigmentation and clarify the skin tone; Eye Contour Line – specifically developed for the delicate eye contour area; Essentials Line– including cleansers, toners, makeup remover, exfoliating scrubs and peels; Body Care Line – body products for body treatments, includes clays, wraps and slimming cream. The Aquatonale Marine Cosmeceuticals range has benefits for businesses too, boasting a full 100% mark-up on products. Switch and discover a new level of retail profitability, customer loyalty and satisfaction with Aquatonale Marine Cosmeceuticals. To

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Skeyndor has just extended the Global Lift [ProGEN-in] range with its new LIFT CONTOUR ELIXIR FACE AND NECK, a revolutionary serum inspired by the latest research into the anti-ageing therapies such as Progerin and Glycobiology, which redefines the facial contour and rejuvenates the face. [ProGENin] reduces progerin, a cell ageing marker that works on the signs of biological ageing at the cell nucleus level.

The formula is based on a combination of three active substances with proven efficacy: Biomimetic peptide derived from Elafin – An enzymatic suppressor with an antiprogerin, anti-elastase effect that combats flaccidness in mature skins. Menyanthes Trifoliata Leaf Extract – A potent antioxidant that protects the cellular vitamin C content, and α-Glucans and Black Pepper Rhamnogalacturonans – Molecules that improve the mechanical properties of the skin's support structure. Additionally, it contains lipopeptides and a high percentage of hyaluronic acid. LIFT CONTOUR ELIXIR FACE AND NECK by Skeyndor is a highly concentrated new generation lifting serum with proven efficacy that redefines the key points of the facial contour, while fighting the visible signs of ageing and corrects skin tone. Global Lift is

available through Vogue Image Group Ph: 1800 554 545.

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from The Global Beauty Group 1800 006 607 or visit www.theglobalbeautygroup.com.au

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New ULTRA-DETOX CHEMICAL PEEL Reveal your clients' best skin with the new, amazing UltraDetox Peels from Bioelements, effective with detoxifying activated Charcoal, soothing Willowherb and Glycolic acid.

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Contact Australasian Medical Aesthetics on 1300 781 239, or visit our website at www.medicalbeautyequipment.com

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APJ 89

skinanalysis ㄰

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Effective Diagnosis of Skin Lesions and the Role of the Dermascope – Part 2

By Rita Massimo The following is Part 2 of an article presented by Rita Massimo in the spring issue of APJ. In Part 1 Rita covered the history and role of skinanalysing devices and their evolution through today's technology. In this article she discusses the assessment of lesions and how the Dermascope can assist a therapist or dermal clinician to identify and determine lesion abnormalities for safer treatment outcomes.

Modern dermatoscopes available have two light sources, Nonpolarised and polarised light. Both reveal different images far beyond the naked eye, and for this reason investing in a dermascope that switches between the two forms of light is recommended so no structure is missed during the analysis.

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Non-polarised light(NPL), otherwise known as a standard-form dermoscope, consists of a glass plate and a light source that travels beyond the stratum corneum (SC) with the addition of an ultrasound gel/fluid placed on top of the lesion before viewing with the NPL dermatoscope. This light form works by travelling beyond the stratum corneum, and upon hitting a structure beneath it immediately bounces back towards the surface, revealing to the naked eye an image with specific morphological characteristics such as blood vessels and pigment granules.

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This form of dermoscopy is blind to the surface and only the deeper structures are reflected, such as blood vessels in a highly vascular melanoma, melanin inferior to the dermal junction and white crystalline structures characteristic of dermatofibromas.

Both forms of dermascopes have a place in our clinics. When trained in its use the dermascope can help us to recognise specific morphological characteristics that may correlate with any nasty lesion. As I stated earlier in Part 1 of this article, our role as skincare professionals is not to establish a diagnosis on a potentially concerning lesion, but to improve our skills of recognising when it is warranted to refer a patient to a medical specialist before commencing any treatment that may put the client at risk.

For the qualified dermal clinician who has been trained in the removal of sub-cutaneous lesions such as skin tags, haemiangiomas and sebaceous keratosis warts, this device will not fail in helping and supporting the clinical evaluation. Generally, the clinical analysis

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The benefits of NP dermoscopy is that you can see structures that sit within the superficial layers of the skin, such as milia cysts, as well as those that characterise sebaceous keratosis, comedo openings, the blue-white veil covering specific to congenital nevus, or melanomas.

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light passes the stratum corneum and bounces off the structure to the first filter, the angle of the light then diverts, which accounts for the second filter to reflect the light and as a result reveals an image.

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As with polarised dermoscopy these don't require a liquid/gel contact as it works best with direct skin contact. In contrast, these devices consist of two filters that reveal the final image. Once the standard

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with the naked eye may be obvious enough to confirm these lesions.

COLOURS AND THEIR SIGNIFICANCE

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MD Natalia Jaimes and Ashfaq Marghoob along with 3Gen have helped design a chart for the dermascope user as a guide to evaluate the structures that can be seen.

Melanin appears as different colours throughout the various levels of the skin anatomy. Other colours can also be viewed via the dermascope image, which denotes a level of the skin the colour is reflecting from.

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This chart will guide the practitioner in recognising the type of lesion according to the characteristics that can be seen toggling between the non-polarised and polarised lights. The chart has been designed as a two-step approach. The two-step algorithm based on an eight-level criterion ladder is the foundation for dermoscopy evaluation of skin lesions.

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BLACK: Indicates melanin in the superior layer of the epidermis or melanin throughout all layers of the epidermis to the stratum corneum.

BROWN: Indicates melanin within the epidermis and along the

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epidermal junction; the darker the shade of brown the higher the melanin concentration.

The first step is intended to help the user differentiate melanocytic lesions from the following non-melanocytic lesion, being dermatofibroma, basal cell carcinoma, squamous cell carcinoma, seborrheic keratosis and haemangioma.

GREY: Represents melanin in the melanophages or free melanin in

The second step is intended to help further split the melanocytic class lesion into nevus, suspicious or melanoma categories, using the scoring system to assess the observed structures more clearly as being melanoma specific structures or benign nevi patterns.

BLUE /GREY: Free melanin that sits between the lower papillary and

Once these have been identified a referral to a medical practitioner will allow for a further clinical diagnosis to determine whether to perform a biopsy, maintain a visual monitoring of the lesion or advise the therapist to continue with their proposed treatment plan as a lesion that is safe for the purpose of a skin treatment.

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the upper dermis and papillary dermis. The grey shade is mainly upper papillary.

the upper reticular regions.

BLUE: Represents melanin in the deep reticular dermis or inferior papillary region.

YELLOW: When a squamous cell carcinoma shows a yellow colour it is normally a characteristic feature of keratin in a keratinising tumour lacking blood or melanin.

BLUE-WHITE VEIL COVERING: Over the surface of a raised and palpable lesion, which is a whitish film over an area of diffused blue pigment, represents dermal melanin and compact orthokeratosis.

BLUE-WHITE or DISTINCTIVE WHITE VEIL: Over a flat area. This shade commonly appears on a regressing lesion. The white represents the scarring that occurred over the lesion, and the blue is due to the melanophage’s activity during the regressing process.

RED: Is obviously the colour of blood vessels, however, in tumours it represents increased vascularity due to neo-vascularisation of cells during tumour growth or bleeding within the lesion. Obviously a concern.

ORANGE: Serous crusted ulcer, ㄰ 㤵 㜵

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SCOPE OF TRAINING The main focus of the training conducted in Montana was to cover in detail the two-step algorithm. By the end of the training we became familiar with the terminology that described the morphology standard to most users of dermoscopy. We were also taught the structures, colours and distribution criteria for the lesions that correlated to the eight levels. The information presented was extensive and it is impossible to cover the extent or detail of the information that we were taught within the scope of this article, however, we can start by examining the principles of the many colours that can be seen on the skin.

shallow ulceration.

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THE SEVEN STRUCTURES OF MELANOCYTIC LESIONS

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Following are seven common structures that are highly likely associated with a melanocytic-class lesion. These are the relevant structures within the criteria that move the diagnosis from step 1 onto step 2.

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PIGMENT NETWORK The network of pigment occurs due to melanin that sits around the

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of the lesion. There are two types of streaks, linear streaks and streaks with pseudopods. The latter are linear streaks with a bulb attached at the end of the streak. Often the users get confused as these structures don't attach to the end bulb and hence there is a gap. When the streaks are coming from the centre and have a bulb attached at the peripheral end it's classified as a streak, if, however, a space exists between the bulb and streak it's called a globule. Sometimes streaks and globules can be deceiving when assessing both these features.

Streaks, like globules, simply represent joining nests or clusters of melanocytes at the EDJ, and it is assumed that these melanocytes are travelling along the rete ridges. These are a significant structure to be aware of as it signifies radial growth of the lesion into the surrounding healthy skin. Although steaks and globules both represent radial growth they represent different lesions, such as characteristic common to melanoma, reeds or spitz nevus. As an example, if linear structures appear from the centre of the lesion as an even distributed starburst pattern presenting with peripheral globules, it is highly likely that as time progresses the globule may begin to lighten and eventually disappear, corresponding to a spitz nevus.

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GLOBULES Globules represent nests or clusters of melanocytes. When there are between 3-5 or more aggregated oval globules of various colours then the lesion falls into step 2.

epidermal junction (EDJ). Think of an egg carton as resembling the EDJ. The valley where the egg sits is comparable to the elongated rete ridge, and the top of the carton is comparable to the Supra papillary plate. The pigment network exists as melanin granules that sit within the rete ridges and shows as the network line, and the empty spaces between the network pattern is the papillary plate with no pigment present. ㄰ 㤵 㜵

NEGATIVE NETWORK This is an atypical appearance to the regular pigment network. It appears as hypo-pigmented or white dominating network surrounding elongated linear and globular brown pigmented structures.

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STREAKS

This feature of the lesion appears as hyper-pigmented linear extensions branching out from the central area towards the periphery

Brown is the most common colour globule, black can be seen in Spitz nevus or melanomas, red globules are a bad sign and represent neoangiogenesis occurring around a possible spreading tumour.

White globules represent dysplastic nevi with moderate atypical and balloon cells. When balloon cells are seen it is characteristic to balloon cell nevus.

Blue globules represent congenital nevus and the veil can be seen clearer with NPD.

HOMEOGENOUS BLUE PIGMENT Blue nevus lesions have a distinctive even pigment colour to their appearance because of the depth of dermal growth. Homogenous Spitz nevus also has quite a depth to the lesion and hence the blue white veil is also distinguishable. Network patterns that appear on the facial area and nail beds, fingers, palms and soles have a different melanin distribution due to the integumentary system.

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PSEUDO-NETWORK PATTERN The pseudo network is a pattern characteristic of polygonal lines, resembling a reticular-type pattern of slightly curved, straight, short or long, fine lines. An annular pattern of nonpigmented circles can also be seen as a pattern for a lesion on the face. This pattern is characteristic to tumours such as solar lentigos, Clarke nevus, Actinic keratosis and melanomas.

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PARALLEL PIGMENT PATTERN (Acral) The parallel pattern resembles a fingerprint image and is characteristic of the acral regions such as the palms, nail bed, fingers and soles of the feet. If the pigment is distributed in the furrows of the fingerprint image then it is likely to be benign. For a melanoma on these regions the pigment is usually spread over the lesion because it sits more over the ridge of the fingerprint pattern. This is suspicion for an Acral melanoma.

Although not directly associated in Level 1 as a common melanocytic structure, the morphology of some vascular structures can still be associated as characteristic features of both non-melanocytic and melanocytic lesions. The following vascular structures are vessels that appear in various configuration with a particular distribution pattern and are identified as additional signs that differentiate a lesion as a melanocytic tumour.

COMMA VESSELS: are slightly curved vessels that are seen to be in the shape of a comma, commonly associated under the nevus class of melanocytic tumours.

DOTTED VESSELS: are a predictive sign of a melanocytic tumour.

These red dots range from 0.01-0.02 mm in size.

SERPENTINE VESSELS: appear as irregular linear pattern.

CORKSCREW VESSELS: appear as vessels that are twisted like a

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vascular structures common to non-melanocytic tumours (level 7).

The following points will once again briefly describe only some of the structures that define these tumours into their types.

LEVEL 2: FEATURES COMMON TO BASAL CELL CARCINOMAS

corkscrew pattern.

LEAF-LIKE AREAS: grey-bluish blobs that resemble a leaf like pattern can vary in size. These consist of basal cell tumour islands grouped closely.

POLYMORPHU/LOOSELY COILED VESSELS: exist as linear with loose loops and turns and lastly a shade of a milky-red covering over the entire lesion.

BLUE GREY OVOID NESTS: these appear as converging pigmented

If none of the melanocytic structures are recognised, then the approach is to observe structures relating to non-melanocytic lesions.

This diagnosis is still approached in Step 1 of the algorithm.

Non-melanocytic lesions are defined as a dermatofibroma, Basal cell carcinomas (level2), Squamous cell carcinomas (level3), sebaceous keratosis (level4), haemangioma or angiokeratoma (level5), and

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ovoid areas, large and well defined.

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MULTIPLE BLUE-GREY GLOBULES: these are similar to the above

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structure, but much smaller in size. These also are composed of basal cell tumour islands. ㈵

SPOKE-WHEEL-LIKE/CONCENTRIC STRUCTURES: appear as well-defined radial linear projections coming from a central darker-

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COMEDO-LIKE OPENINGS: These

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correspond to keratin-filled pockets commonly seen in Seb Ks.

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LEVEL 5: HAEMANGIOMARELATED LESIONS ㈵

LACUNAE: A structure observed in Level 5 as red, maroon, blue, black lagoons. Also seen as bulbous bodies that histologically consist of vascular haemangioma. If the lacunae body appears black in any segment of the tumour then it represents thrombosis, such as in a thrombosed angioma.

When the tumour has a combination of a black body with reddish shade then it's likely to be an angio-keratoma.

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These are only some of the main common structures that differentiate a non-melanocytic lesion. Vascular structures in non-melanocytic lesions are also significant to interpret, however, differ to blood vessels in melanocytic lesions. Analysing the m o r p h o l o g y, d i s t r i b u t i o n a n d arrangement of the blood vessels will help to yield a diagnosis, along with observing any additional structure will assist in supporting the diagnosis that determines one to the other.

ARBORISING VESSELS: These are similar to branching vessels that we know as telangiectasia. They are bright red and vary between a fine capillary to a larger diameter blood vessel >0.2mm. They can be distributed randomly within the lesion and are commonly associated with basal cell carcinoma.

HAIRPIN VESSELS: These vessels

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brown area. They are brown to a grey/blue/brown mixed shade. These are actually a 100% predictive structure for Basal cell carcinomas.

They are a single structure and do not appear as aggregated clusters.

Sometimes the spoke-wheel projections aren't individually defined, however, you can still make out the central dark-brown core and a light linear pattern. This variation is referred to as concentric structures or globules, but are actually the same thing.

LEVEL 4: PREDICTIVE FEATURES FOR SEBORRHEIC KERATOSIS

are shaped as a U. They are typically predictive to seborrheic keratosis, however, depending on distribution and surrounding morphology it may suggest a keratinising tumour or melanoma.

DOTTED VESSELS: Present as red dots identical to those associated with melanocytic tumours. Red dots in non-melanocytic tumours are seen in Squamous cell carcinomas, porokeratosis, and occasionally are mistakenly assessed within an inflammed patch of psoriasis. As I mentioned earlier, this is why it is still important to assess the surrounding area of the lesion in question with the naked eye, as the observation may suggest a different diagnosis.

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MILIA-LIKE CYSTS: These are best distinguished in non-polarised ㈵

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light. They are round whitish or yellowish structures. If they are pigmented they can be mistaken for globules. Histologically they are intra-epidermal keratin filled cysts. These structures are commonly seen in seborrheic keratosis, but can also be seen in congenital nevi and malignant melanoma.

GLOMERULAR VESSELS: Composed of tightly coiled blood vessels and are commonly associated with Bowen's disease.

CROWN VESSELS: These are similar to arborising vessels yet are thinner in diameter. Some are branched while others are nonbranching, nevertheless they radiate towards the centre, but never

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cross the centre. The centre of the lesion is generally consists of a yellowish “popcorn” like globular structure. This feature is commonly associated with Seborrheic Hyperplasia.

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STRING OF PEARLS: The

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morphology of this feature composes dotted or glomerular vessels distributed in a serpiginous pattern.

Most commonly associated with clear cell acanthoma (CCA).

In a rare occurrence, if the lesion in question is totally without structure, that is there are no predictive structures as discussed to differentiate the lesion as non-melanocytic or melanocytic, then the lesion is classed into level 8 as an unclassifiable lesion. This criteria of the chart guides the user to be on the safe side and address it as a melanocytic lesion. From this point the doctor decides the immediate course of action. More than likely the doctor will treat it as suspicious and biopsy the lesion to send it off to pathology for a definite diagnosis, or if confident enough decide to short-term mole monitoring the tumour for any changes, unless it is a raised lesion.

IN SUMMARY In summarising, the structures that class a lesion as melanocytic are as follow: Pigment network, aggregated globules, streaks, homogeneous blue pigmentation and, in addition, the network pattern on the facial region termed as pseudo-network pattern and on the volar regions is called a Parallel pattern network. Keep in mind that the presence of certain vessels also classes the tumour as melanocytic.

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If any of the above melanocytic structures are recognised on the lesion in question then the evaluation moves to step 2 where the tumour needs to be further differentiated into a nevus, suspicious or melanoma type. In order to reach this diagnosis the tumour in step two is assessed further for melanoma-specific features, or if the features observed are in a benign nevi pattern (Attending training and gaining experience with using the dermascopy is recommended to understand the concept beyond this stage of the diagnosis).

If no structures are recognised than the user continues the criteria for step 1 that differentiates a non-melanocytic lesion into a benign or malignant tumour, which follows the pattern analysis between Level 2 and Level 6.

I hope you have found this basic information useful. Explaining all the features and structures that relate to tumours within all eight levels of the chart is quite an in-depth amount of detailed information to write about. As you can appreciate, there is so much knowledge and

experience required in order to learn all the skills in recognising these structures.

If you would like to consider using a dermoscopy in your clinic and furthering your skills in diagnostic accuracy, then I suggest you investigate the many courses available that are run by professionals in the area.

I recommend enquiring about courses run by The International Dermoscopy Society or investing in a book titled Atlas of Dermoscopy edited by Marghoob, Malvehy and Braun.

In addition, I also recommend you enquire about a dermoscopy device that switches between non-polar lens (standard dermoscopy) and polar lens and can take an image so that it can be referred on to a medical practitioner as well as allow you to save a copy in the client/patient's history folder for any future reference.

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AESTHETIC INDUSTRY BULLETIN

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This section presents the latest news, training dates and other Aesthetic Industry information.

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Woffles Lift is a procedure that can be performed under local anaesthetic as no skin is actually excised.

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8. Dr. Jose Juri, Buenos Aires – Founder and director of the Juri Clinic of Plastic Surgery, he believes that cosmetic enhancement is an artistic criteria and that the 'best surgeons are like concert performers' adapting to the specific needs of the client.

9. Dr. Raj Kanodia, California – Is a specialist in rhinoplasty and believes that the 'nose forms a constellation of character along with the eyes and mouth'. He aims to refine rather than reshape the nose and, with over 27 years' experience, you shouldn't trust your nose with anyone else.

10. Dr. Ivo Pitanguy, Brazil – A pioneer in aesthetic and reconstructive plastic surgery, the Ivo Pitanguy Clinic in Rio de Janeiro also specialises in the wellbeing of both body and mind.

DR DES FERNANDES NAMED AMONG THE WORLD'S TOP 10 PLASTIC SURGEONS

More info: http://www.insignia.co/voice-of-luxury/insignia-top10/the-top-1o-plastic-surgeons/

GLOBAL BEAUTY PICKS UP ANOTHER AWARD

Margi Fox Distributors of Environ Skincare and Jane Iredale makeup are proud to announce that Dr Des Fernandes has been listed by the prestigious Insignia Magazine as among the World's Top 10 Plastic Surgeons for whom nips and tucks are nothing short of an art form. Dr Des Fernades is also renowned as the formulator of the innovative cosmeceutical skincare brand Environ.

The top 10 winners included: 1. Dr. Olivier H. De Frahan, Paris and London – Specialises in plastic and cosmetic surgery, including Botox, fillers and lipostructure.

Renowned for natural-looking techniques for eyelids and facelifts.

2. Dr. Sydney Coleman, New York – Is the inventor of lipostructure, a miraculous fat-grafting technique designed to restore the youthful bloom that so often goes AWOL with the onset of ageing.

3. Dr. Sherrell Aston, New York – Former president of the American Society for Aesthetic Plastic Surgery, he is considered to be one of the foremost international experts in the field and is particularly renowned for his development of the FAME technique.

4. Dr. Michael Pfulg, Switzerland – Working from La Clinic in Switzerland, Dr. Pfulg and his team are on hand to provide a full range of innovative aesthetic medical treatments combining art and science in every procedure.

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5. Dr. Jorge Herrera, Buenos Aires – An expert reconstructive surgeon, he assists patients of every age and background. From the correction of birth defects to injuries incurred through accident through reconstructive surgery.

6. Dr. Des Fernandes, Cape Town – One of the pioneers of the Suture Suspension facelift technique, designed to minimise scarring and restore dropped tissues back to their original place. Using discreet nylon threads through tiny incisions, to lift and tighten all areas of the face from brow to jaw-line.

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7. Dr. Woffles Wu, Singapore – Is the inventor of the Woffles Lift.

Created to achieve facial rejuvenation with no downtime, the

The Global Beauty Group is thrilled to announce that they are now twotime award winners Now their two-time award-winning device, btaccent LED has just been selected as LNE & Spa's 'Best Product 2014' in the body equipment category. Previously it had also been named a favourite in the renowned 2013-2014 Asia Grand Prix de la Beauté awards. The simple, sleek and forward-thinking technology of the btaccent LED brilliantly delivers an array of skin corrective treatments from acne to fine lines and wrinkles with just three powerful treatment options red, blue and combination LED light. Combine portability, ease of use and hands-free treatment and it's not hard to see why this breezy, modern beauty solution is making its mark among aesthetics elite.

The Global Beauty Group Phone 1300 006 607 www.theglobalbeautygroup.com.au

INTERNATIONAL AESTHETIC CALENDAR 2014

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Prepared by Terry Everitt 㤵

November 12-14 Cosmoprof ASIA Convention & Exhibition Centre, Wanchai, Hong Kong T: +852-28276211 F: +852-3749 7345 E-mail: info@hkcec.com December 11-13 20th Annual World Congress on Anti-Aging Medicine and Biomedical Technologies Venetian Resort Hotel Casino, Las Vegas, Nevada T: + 1-561-997-0112 Email: doreen.brown@a4m.com

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Australian Skin Clinics launches new innovation – the ASC Aesthetics Academy Identifying a lack of adequately trained skin therapists in laser and IPL as well as other anti-ageing procedures, the Australian Skin Clinics decided to do something about it. In June 2014 they established their own training facilities and launched the ASC Aesthetics Academy on the Gold Coast.

The night continued with further celebrations, and dancing into the late hours of the night.

“With our constantly growing franchised clinics we are in desperate need of highly skilled staff,” stated Managing Director Deb Farnworth-Wood.

“In fact, by the end of this year we need to position at least 100 skilled therapists just in our Australian Skin Clinics. There is an amazing opportunity for a wonderful career within our organisation for passionate, committed and well-trained therapists, however, they have to meet with our stringent standards,” Deb stressed.

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The ASC Aesthetics Academy offers several training programs for therapists who wish to start a career in the exciting field of medical aesthetics, or who would like to re-enter the workforce and need to upgrade their skills.

ASC Aesthetics Academy offers state-of-the-art training facilities and excellent training staff who will deliver the training and supervise trainees until they reach the necessary standards to meet the growing demand of the astute consumer who is seeking both excellent results and exceptional service.

Celebrating the launch of the Academy, the Australian Skin Clinics management was joined by clients, staff and friends over cocktail drinks on Thursday 11th September. In a heart-warming address Deb thanked all in attendance and shared a little of her incredible journey in establishing the Australian Skin Clinics into an amazing and successful franchise model that it is today, while also acknowledging the contribution of her faithful and committed staff.

If you would like to contact the Australian Skin Clinics to discuss franchising opportunities or training options with the ASC Aesthetics Academy please contact 1300 303 014 or visit www.ozskin.com/franchise or www.ozskin.com

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USING AROMAS TO CREATE SALES

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When we step into a bakery and breathe the aroma of wonderful fresh bread, or the delicious smell of cinnamon, butter or vanilla from fresh buns or pastries, our memory banks are stimulated. Our mouth starts to water and we are drawn to purchase something, if nothing else just to hold on to that wonderful memory of sheer pleasure. Or have you ever walked into a florist shop and the smell of fresh-cut flowers took you back to a childhood memory of a wonderful field in spring when life was less complicated and blissfully carefree? Did this emotion made you reach out to buy some flowers to take home just for the sheer pleasure of it? Neurologists link our sense of smell with the limbic system, the centre of the brain where early, intense olfactory messages are stored and linked with embedded memories. Real estate sales experts also have identified that on walking into a home if there is a smell of freshly baked food this brings the potential buyer into a positive mood and that house is not quickly forgotten when making a decision to buy.

This is why heating a drop or two of vanilla on your kitchen's hotplate can quickly stimulate the emotions. In a salon environment adding aromatherapy to your treatment menu and using essential oils to create ambience is once again recognised as a richly rewarding way of attracting and keeping clients happy while improving a state of mind towards purchases. Why not try adding this emotional appeal and monitor what happens?

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EVIDENCE THAT EMOTIONAL STRESS MAY INFLUENCE CANCER RISK While mammograms are useful in determining the risk of breast cancer, there are certain considerations that expert are warning about. A false positive result occurs when a mammogram suggests a woman has cancer when none actually exists.

In the US, the risk of having a false-positive test mammograms is a concerning 58 per cent to 77 per cent! When a woman is told she may have breast cancer, it causes considerable anxiety and psychological distress. Meanwhile, you will be subjected to more testing, such as biopsy or surgery, which carry their own set of risks, unnecessarily.

Now, new research has found, however, that women who have received a false-positive diagnosis via mammography may be more likely to develop breast cancer years later, although no-one is quite sure why.

Out of 58,000 Danish women who had had a mammogram, more than 4,700 were found to have false positives (the false-positive test rate in Denmark is about 16 per cent, much lower than it is in the US). About 1.5 per cent of those turned out to be false-negatives, meaning that the doctors missed the cancer the first time around.

In Australia a total of 22,396 screening mammograms were falsely

reported as positive, and 560, 333 mammogram screens were reported as normal (negative), and this is in WA alone.

However, even after taking these false-negatives into account, women with false-positive mammograms were still 27 per cent more likely to be diagnosed with breast cancer years later. As for what this means for women no-one really knows, but the researchers suggested their results favor some “biological susceptibility” as an explanation.

They suggested further research to determine the true excess risk of false positives, and future studies should definitely look into all of their related risks, like the increases in stress levels, unnecessary biopsy and perhaps additional mammograms, which all have the potential to impact breast-cancer risk.

NEW RESEARCH DATA ON THE ANTI-AGEING PHENOMENON While traditionally we consider that Baby Boomers are the most concerned with the need to look more youthful, new studies reveal a growing number of younger women are concerned with the appearance of ageing. A recent study of 2000 women between the ages of 30 and 60 conducted by Lancome revealed that

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a woman as young as 45 is the new marker.

The study confirmed that 50% of the women stated they have inhibitions about their ageing and have concerns about how old they

look. Almost 37% of respondents reported these anxieties kicked in once they turned 30, while 10% were even anxious about appearing older when still in their 20s.

The research revealed that eight out of 10 women feel that being born with good genes can have a major impact on keeping up youthful skin appearance. Until the age of 45, 75% of those who participated in the survey who had good skin said they looked at least five years younger, and one in 10 said they looked and felt 10 years younger.

Brands are now looking at formulating to cater also for the younger sector. Polls such as these are driving product innovations towards formulation developments that offer cellular anti-ageing benefits for a wider age group than previously thought.

Interestingly enough, a further survey indicated that men respond to a different approach. They prefer products that protect their skin from the sun rather than “removing wrinkles”. In fact the term anti-ageing for men's formulas was considered a turn-off.

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PARABEN-FREE CLAIMS CONTINUE TO CHARM CONSUMERS Whatever your personal position may be towards preservatives, and in particular parabens, research continues to conclude that paraben preservatives used widely in cosmetics do not pose any harm to human health. However, consumers still gravitate more towards “parabenfree” claims, and so we will see more and more brands will choose to use alternative options.

It is worth noting that many researchers continue to state that the whole issue of parabens has been misinterpreted. Dr Edmund Fowler

STUDY REVEALS CONCEPTS OF ATTRACTIVENESS MIGHT BE MISUNDERSTOOD

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A new study published in the Journal of Experimental Psychology examined the role of makeup in perceived attractiveness.

The research gave 44 women different types of foundation, lipstick, blush and mascara and then told them to put the makeup on as they would for going on a night out.

The women were then photographed before and after, with the researchers then altering the photographs so they had a range of 21 images of the women wearing various amounts of makeup. The photos were then shown to 44 university students both men and women who were told to pick the photo that they thought the most attractive.

I n t e r e s t i n g l y, t h e women liked images of the models wearing a bit more makeup than the men did.

All the

of EF Chemical Consulting, a company that specialises in cosmetic safety, confirmed that parabens are absolutely safe. In his opinion as a result of all the potential risks there has been exhaustive research, which has covered all angles without any evidence of risks.

Following a study in 2004 that first ignited the concerns by suggesting that parabens can mimic oestrogen and thus cause hormone disruptions, no evidence for any link between parabens and health concerns has been found.

As consumers continue to gravitate away from products with parabens, manufacturers and packaging will be affected by this trend. As a result beauty brands such as Lush have just launched a range of self-preserving systems for products across their ranges. They confirmed that they have found a way to keep the amount of “free water”, which is the water that's left over once the chemical reaction have taken place, to a minimum, meaning that even their moisturisers can become entirely self-preserving.

Meanwhile, Neopac, a packaging manufacturer, is set to launch its new AirShield technology, which the company states “is particularly suited to oxygen sensitive contents for beauty products and natural cosmetics”. In that way cosmetics will be able to retain their consistency and colour just as the cosmetic manufacturers intended them, even after the packaging has been opened and in daily use.

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REF: http://www.cosmeticsbusiness.com/news/article_page/Neopac_AirS hield_the_safe_solution_for_sensitive_beauty_products/98227

participants assumed men would like the models with more makeup on than the women would, but that turned out to be untrue. Men and women both preferred images of models wearing 40% less makeup than they initially put on. The research concluded that women are putting on makeup for a perceived standard of beauty that may not actually exist. Taken together these results suggest that women are likely wearing cosmetics to appeal to a mistaken preference of others.

According to Dr Alex Jones of the School of Psychology at the Walesbased Bangor University, the take-home message from this study is that our ideas about what the opposite sex find attractive are often inaccurate, whether it relates to body size, weight or even something like makeup use.

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underwent plastic surgery to correct that feature were more positive about their outcome a year after surgery than those who were unhappy with a particular physical feature and chose not to undergo plastic surgery. The results of this study revealed that those who underwent plastic surgery generally had positive psychological effects across all areas, including producing increased feelings of quality of life, life satisfaction, attractiveness, self-esteem, and wellbeing.

Improving Self-Esteem and the MEDICAL COSMETIC TATTOOIST

By Christine Comans The art of Cosmetic Tattooing is far-reaching – it goes beyond improving features to improving self-esteem, particularly in the case of changes to the body due to illness.

Christine Comans is a qualified cosmetic tattooist based in Perth who specialises in medical cosmetic tattooing. Christine is passionate about helping ease the trauma of changes or deformities as a result of illness and restoring self-esteem to men and woman who have been plagued with illnesses that have left them with hair loss or scarring. In this article she shares information on multitrepannic Collagen Actuation that can improve scarring and key considerations when reviewing client/patient suitability for cosmetic tattooing.

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When it comes to the topic of cosmetic procedures, controversy strikes. Many people believe that patients who undergo cosmetic procedures are putting themselves at risk, all in the name of beauty.

While that is true, there are always various risks and side-effects with different procedures. Researchers have found that these cosmetic procedures can provide numerous positive psychological effects.

The study concluded that for people who are dissatisfied with a particular facial feature and are considering plastic surgery to improve that feature, those who undergo plastic surgery appear to benefit psychologically more than those who do not undergo plastic surgery.

Medical Tattooing

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In March 2013, European scientists published an article in Clinical Psychological Science, a journal for the Association for Psychological Science, regarding the psychological effects of plastic surgery. The study compared a group of 544 people who had plastic surgery with a group of 264 who were interested in plastic surgery, but had not undergone any procedure.

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The study followed these people for one year post surgery and found that those who were unhappy with a particular physical feature and

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SELF-ESTEEM AND COSMETIC TATTOOING In this article I would like to discuss my experience as a cosmetic tattooists with a few of my own patients that have shared their emotional journey with me, and bring attention to a person's disposition to determine if they are the right person to have cosmetic tattooing.

A recent alopecia patient described to me how being given back the eyebrows she lost transformed her life. She admits she was a recluse for years after developing the condition and felt self-conscious, and pencilling in new brows was no substitute for the real thing. This patient felt increasingly embarrassed and uncomfortable talking to people face to face.

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Alopecia

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After her procedure she said her friends and family couldn't believe they were tattooed because it looked so realistic. “It's something we take for granted until you don't have them,” I was told.

“I was so paranoid because when I drew them on I always ended up rubbing them off as one was always higher, longer or thicker. It took me so long in the mornings to pencil them in,” she said, “and it was too hard to draw it right. My new brows make me feel wonderful.”

Many women have a secret tattoo and it's hidden beneath their clothes.

It may be discreet, but the nipple areola cosmetic tattoo on my patients' right breast changed her life. After being diagnosed with breast cancer, the nurse and mother of three underwent a unilateral mastectomy and endured long, painful surgery through reconstruction. The nipple areola tattoo was the missing piece of the puzzle that helped her regain her confidence. Before she had the tattoo there was a constant reminder that something had changed. Losing a breast makes you feel you have lost a part of yourself. Now when she looks in the mirror she sees matching nipples and areolas and no longer notices the scars. “I feel like me again,” she said delightedly.

Advances in technology mean cosmetic tattoos can be quite realistic.

Digital machines have helped to refine the quality of the tattoo. One of the most cutting-edge techniques is to create "3D" nipples for women who have not had a full reconstruction. The illusion is created with shading and highlighting, allowing the patient to avoid any more painful surgery.

Medical tattooing is vital for patient recovery. It is not just a cosmetic procedure, it is the icing on the cake, the final cherry on top that they need to make them feel whole again. This is such an important procedure for cancer patients as it enables them to gain the psychological boost they need that will allow them to move on with their life after going through that horrendous journey.

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Cosmetic Tattooing skills are now being recognised by health professionals. Often referring patients that suffer burns, cleft lips and surgical scars, these can be subtly disguised or corrected by carefully needling matching flesh-coloured pigment into the affected area. But there is more to the treatment than just covering unsightly skin conditions – medical tattoos are also helping to heal deeper psychological wounds.

WHAT IS MCA? For scar victims, improving the appearance of their skin may not even require the use of pigment. A technique is called MCA. (Multitrepannic Collagen Actuation), otherwise known as dry-skin needling. This is a non-surgical and entirely natural way of getting the body's own cells to regenerate and minimise both scars as well as wrinkles. This process can be used to relax constricted scars, plump the "valley" of wrinkles (causing them to fill in), and "white scars" can

often be repigmented to better match the surrounding skin tones. In Cosmetic Tattooing it involves using very fine needles, but without implanting a product into the flesh. By causing trauma to the scar tissue, the raised skin is flattened and feels softer.

Performed correctly, MCA can even plump lip tissue and alleviate small unsightly wrinkles around the lip area. MCA is a great alternative to injectable fillers such as collagen injections and muscle relaxants such as Botox. The results of MCA are much longer-lasting and therefore more affordable. However, MCA is a specialised technique that requires correct training to achieve the best results.

Cosmetic Tattooists use the MCA technique to stimulate the skin's natural collagen, allowing the tissue to repair itself. After the scar tissue has been flattened the medical tattooist often camouflages the area by implanting flesh-coloured pigments that perfectly match the patient's skin tone.

Cosmetic tattooists who specialise in tattooing hair to cover baldness (hair simulation) can even create facial stubble for male alopecia patients.

The emotional impact of providing a Cosmetic Tattooing procedure can be a double-edged sword. Getting it right can be very rewarding and even life-changing for the client, however, sometimes even if you get it right the client may not be happy with the procedure based on their psychological disposition.

INTERESTING BACKGROUND INFORMATION ABOUT MULTITREPANNIC COLLAGEN ACTUATION Before we look at further information on how to determine the ideal client for cosmetic tattooing, l would like to share with you a little about the interesting background history of MCA. The first written works on MCA advocating the benefits of this technique was Dr André Camirand, a surgeon from Montréal (Québec) in Canada. Driven by the constant need to reach perfection, he developed and refined several avant-garde techniques, one of them being the technique he called multitrepannic. He made his observations in the late ‘80s and published them in 1992. Dr Camirand discovered that scars of some clients that he had tattooed with pigment were in fact repigmenting naturally.

Meanwhile, Dr Des Fernandes, the South African plastic surgeon and inventor of Environ, read this article and also experienced that abraded scars would plump up with this technique. This led to the development of the first derma-roller, which Dr Fernandes introduced to the aesthetics industry.

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In the US Dr Kristan Matzek, who is a leading micropigmentation specialist and who is also the Vice-President of the American Academy of Micropigmentation, also discovered that using dryneedle technique to scars and wrinkles would give favourable results to minimise these and other problems. Today, it is possible for highly skilled and experienced practitioners to erase up to 10 years from the ageing face of men and women using this technique without the use of injectables.

DETERMINING CLIENT/PATIENT SUITABILITY FOR COSMETIC TATTTOOING Just because a client wants to have Cosmetic Tattooing doesn't mean they are an ideal candidate for this type of procedure.

Assessing your clients' disposition is important before you proceed with any form of cosmetic tattooing. Conducting a thorough consultation for cosmetic tattooing is extremely important.

Among a multitude of other things it allows to screen for the following:

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Is or does the client present as highly stressed?

Do they appear to be indecisive?

Are they extremely sensitive to pain?

Do they have unrealistic expectations even when the procedural outcome is explained to them?

Generally if a client exhibits these characteristics they are most likely not a suitable candidate for cosmetic tattooing, but if you decided to proceed to tattooing a client that presents with one or all of these dispositions you may just want to allow more time for this client pre and post-procedure, and be aware that this client will most

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often require multiple procedures to be satisfied with the outcome.

Screening and understanding our client's or patient's disposition before a procedure is very important in achieving positive patient outcomes.

If you are a cosmetic tattooist APAN now have a membership classification for you, visit www.apanetwork.com. If you are a practising cosmetic tattooist, you can join as a Gold Member (Cosmetic Tattoo). You will receive the same benefits as an APAN Gold Member, with special support and training opportunities in Cosmetic Tattooing.

MEDICAL COSMETIC TATTOO TRAINING Christine Comans will also be conducting a training program in medical cosmetic tattooing as part of the APAN Conference Program in May 31st. Medical Cosmetic Tattoo Training will be conducted for a full day on 1st June 2015 in Brisbane. If you are interested in further information please phone 07 5593 0360.

THE PERSONAL APPROACH IN MARKETING – POSTCARDS APAN have designed a collection of some 14 cards and gift vouchers that are niche, personalised and high-quality. Themed Gift Vouchers include Mother's Day, Just for Him for Father's Day, Christmas Day, Valentine's Day and a generic one that just says With Love. They are attractive and enticing. We also have postcards for you to wish your clients a Happy Birthday, Thank You for new clients and we also have two cards for clients you have not seen for some time. Visit www.apanetwork.com to see the full collection. Purchase 50 for just $40 or 100 for $70 and we will send them to you free of postage and handling. Phone 07 5593 0360 to place your order.

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Scan to see APAN’s complete range of cards for you to order. ㈵

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APJ 102

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BUSINESS NEWS

Business & Legislation, New Tools and Research Outcomes Moroko says. "Ask them what they would like you to do to fix the problem. They may have suggestions on how to improve customer service.”

THE SEVEN DEADLY SINS OF SMALL BUSINESS Sins – every business owner is guilty of them now and again. But which deadly sins could bring your business down? If there was a small business bible, these would surely be the seven deadly sins to avoid.

Gluttony – Unrealistic wages: Dr Lara Moroko, a lecturer at the Macquarie Graduate School of Management, says business owners who take too much cash out of their business risk losing everything. "Taking too much salary out of the business is like sucking the air out of the business," she says. "So many people don't budget and haven't got enough money to live off. Problem is, the business needs cash to keep going."

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Pride – I'm better than anyone else: Those with an overinflated sense of skill may consider themselves above the business planning tasks that are essential to business growth and survival.

But such pride is a curse. Xero Australia managing director Chris Ridd recommends developing a clear vision to steer a business in the right direction. "It's crucial for business owners to set goals, because otherwise they'll just get caught up in the day-to-day running of their business instead of taking control and driving growth," he says.

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Wrath – don't take it personally: Controlling your temper when it comes to irate and irrational clients is a difficult task for even the most patient business owners. Before you commit this deadly sin, remember that it takes years to cultivate a good reputation and just one unsatisfied customer to ruin it. "Instead of losing it and being snappy with complaining clients, hear them out,"

Lust – don't get over-ambitious: Lust for the latest mod cons in the business world is a trap many fall into. Elephant Property owner Kirsty Dunphey says it's a sure-fire way to kill off cash reserves and with it, the future of the business. "I've seen so many small businesses go under because they were insistent they had to have the $10,000 photocopier to start, or the huge shiny office space, or the important–looking cars," she says. "I'm a big believer in bootstrapping at the beginning and keeping an eye on costs all the time. It should be an ongoing process regardless of the size of your company.”

Envy – stay focused Green-eyed business owners who are envious of their competition can easily sacrifice their own goals. No matter how successful the competition appears Moroko says business leaders should march to the beat of their own drum. "When you let envy of another business set your strategy instead of setting your own goals, you lose focus," she says.

"You're keeping too close an eye on the competition and losing track of where you're going. And when that happens your resources are stretched too far and it's just a disaster."

Sloth – don't avoid the upkeep of your responsibilities: This is perhaps the most common deadly sin of them all. Slothful business owners who fail to perform the difficult, yet important, tasks such as keeping their financial records up to date, face going under.

Nicole Jones, owner of marketing solutions business Market Me Marketing, says a basic but often ignored responsibility is keeping in contact with clients through building an email database. "The rise of social media took the focus off email marketing as a way of communicating with potential customers and a way to keep people informed," she says. ㄰

Greed – taking your clients for granted: Greed can destroy small and big, new and old companies alike. It all starts to unravel when greed dictates pricing and customer service, Moroko says. "Greed is thinking you can charge or do what you want to loyal customers, thinking they'll never leave you," she says. "The truth is there is always going to be another business out there who is hungrier than you, ready to snatch your customers away.”

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APJ 103

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THIS SHOULD KEEP YOU AWAKE AT NIGHT Sarah Findlay says it is important clients fit the culture of the business. If you run your own business, you're probably no stranger to the occasional sleepless night. But will the problems you're stressing over really have an impact on your future success? You need to talk to real people experts such as your industry body or association, not just friends who politely tell you your idea is great. These are the five questions that should be keeping you awake at night, according to experts and business owners.

comes to employee happiness. It doesn't have to be hard to make your employees feel appreciated.

"It can be as simple as saying thank you," says Mr. Buchanan who also heads Recognise Every Day (RED), an employee recognition program to help other companies improve staff retention. "If you have a formal program, you need to recognise your employees with something that's meaningful to them, whether that's a handbag, or a handwritten card. Experts say the one size fits all approach doesn’t work.

1. Do I know what my clients really want?

4. Who is going to do all the work?

Knowing what your clients want is not the same as offering them what you have. You need to do some legwork at the beginning and show people your idea and get feedback. If you get the concept wrong and you don't hit the genuine needs of the market, you won't be able to grow your business. Before launching a new idea speak to experts and pass it by them. They will guide you in making sure you have asked the right questions that will make your innovation relevant to your current and future clients.

Business owners worry about how they are going to wear every hat in their business, Australian Businesswomen's Network CEO Suzi Dafnis says. This is especially true for small business owners who don't have the resources to bring on staff right away. "The key is to do what you are best at and leverage as quickly as possible, the roles which do not produce income," she says. Your job is to plan and grow the business, to provide leadership and head up systems, not to be involved in every little detail. “Start by outsourcing small jobs and gradually increase from there," she says.

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2. What's my business model?

The type of business model you choose could make or break your business, particularly in that crucial first year. Especially if you are going to introduce packages, make sure you have payment-plan policies and place. It is also a good idea to look at companies who are skilled in these services and can take pressure off you. These companies, however, need to be carefully screened. APAN specialise in screening for such companies. They can help make this work for you.

3. How do I hold on to my employees?

Salaries and bonuses are important, but if your employees don't feel appreciated and recognised, the chances are they'll move on. Experts advise that factors such as professional development, recognition and a flexible work environment are just as important as money when it

PENALTY RATES DEBATE HEATS UP WITH ARA CALLING FOR ACTION ON WEEKENDS AND PUBLIC HOLIDAYS

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5. How do I attract the right clients?

You need a good filtering system when it comes to taking on clients, particularly if you are in an industry where long-term contracts are the norm. If you don't set expectations upfront, you could end up with high-maintenance or difficult clients who are a drain on your time and energy, Dawn til Dusk Publicity director Sarah Findlay says.

Behaviours such as consistently making unreasonable demands or not paying bills on time fall under the “high-maintenance” umbrella.

“People always talk about how important it is that your employees fit the culture of your business, but it's also true of your clients,” Findlay says. What if you do get a client who is not a good fit? Fire them nicely, she says. “Plant a seed in their mind that you're not the right person to help and let them decide for themselves, she says. “This way the relationship can come to end without any hard feelings.”

Commission recommendations would delay action needed to combat youth unemployment numbers.

The Australian Retailers Association (ARA) has thrown its voice behind calls for immediate action to reduce penalty rates in the face of high youth unemployment figures.

It is not good enough for the Government to look at penalty rates via a productivity inquiry later in the year, and then take their recommendations to the next election.

The debate was reignited recently by Liberal backbencher Alex Hawke, who called for weekend and public holiday penalty rates to be reduced, as reported by the ABC.

ARA executive director Russell Zimmerman said reducing penalty rates is a crucial step in creating higher levels of employment for Australians.

Prime Minister Tony Abbott has previously ruled out lowering or abolishing weekend penalty rates during his first term and has promised to set up a Productivity Commission inquiry into industrial relations. As it currently stands, any recommendations the Government supports from the inquiry will be taken to the next election. However business groups are calling for changes now. Last month the Australian Chamber of Commerce and Industry's (ACCI) praised Hawke's comments and said waiting for the Productivity

“There's no denying the fact that small businesses would employ more staff if they did not have to pay penalty rates. SME retailers in regional areas in particular, who do not currently open on Sundays, would definitely consider their options if penalties were reduced.

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“Seeking to be the voice of reason, the ARA is not calling for penalty rates to be abolished but there is a strong need to get the balance right so that retailers can operate competitively on weekends and offer increased employment opportunities,” Mr Zimmerman said.

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BECOME A VALUE CREATOR

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Managers who adopt a mindset to create value hold the key to becoming truly successful leaders, say Brian J Hall of Harvard Business School.

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Hall recalls an experience he had when he called on longtime professor James Cash for a favour. Hall wanted to study the inner workings of General Electric, and he needed Cash's help to get in touch with top-level executives who could provide insights for his research. Later, Hall asked how he could pay back the favour. Cash put his arm around his colleague's shoulder and said, "You don't owe me anything, Brian. This is the way we do things here. Just pay it forward."

"I will never forget that," says Hall, now the Albert H. Gordon Professor of Business Administration. "That had such a huge influence on me." It's an example of what Hall calls "value-creating behavior” doing a favour for the good of the business without expecting anything in return. Hall argues that managers who adopt a value-creating mindset hold the key to becoming truly successful leaders.

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"Business is a team effort. Nobody plays by themselves and wins in business," Hall said during a seminar on value creation versus "value claiming". “You will never succeed until you become a good team player, somebody who thinks about other people and checks their motivations at the door."

Here are examples of this principle and the benefits you can expect:

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As a value creator work cooperatively with others to make the corporate pie bigger for all, whereas value claimers focus on taking more of the pie for themselveslike a thief steals for personal gain. The business world is filled with value claimers, and this allfor-me attitude becomes apparent in a variety of ways.

For example, at a brand presentation to staff some managers focus only on their own needs without considering the requirements of how the staff can also benefit from the plan that will move everyone forward.

Then you have workers who hoard information like gold, believing that guarding certain treatment know-how gives them more power and so they keep information confidential. Encourage staff to share their knowledge and experiences so that they can

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empower the team to be successful. You can do that by asking your staff to share with the others their weekly highlights of something positive that has happened to them through client feedback and results they have achieved.

Managers should actively choose to be a value creator, someone who always looks for the win-win outcome, leaving enough room for both sides to benefit from a deal without feeling the need to swipe every last cent in just their favour. They need to look at how they can give back, ensuring they strengthen staff confidence, morale and identify how staff performance is blossoming and offer praise for that. Sometimes you may have to give up something you want, but if you make it your goal to be a value creator, then it becomes an instinct, it becomes the lens you have on things, and it becomes easier. If you focus on how everyone can benefit that is the way to win.

The purpose of business is simple and well-defined, Hall says: It's to make the world a better place, to create value. After all, businesses that make their purpose just about profit often do poorly because both their clients and their employees sense this quest for the almighty dollar, which makes them feel as if they are being squeezed rather than served.

It is hard to wake up in the morning and not be excited about shared values and benefits for you as well as for your work environment and the business you are working for.

Engage your staff in creative ideas will make them feel valued and important. How do we produce this at better costs, or how do we make this more valuable for our clients? The profits follow from such interactions.

INDUSTRY SEEKS M AT U R E - A G E D THERAPISTS

professional who can empathise with their concerns are very much preferred. Recently several clinics across Australia have reached out to APAN asking for advice on how to establish an incentive plan to recruit the mature-aged therapist.

It does not take too much research to surmise that older female workers who are over 45 according to demographics are not exactly high on recruiters' hit lists. The reasons are well-documented; apart from age-old prejudices, many have had children and been out of the workforce for extended periods. An unbroken career path counts in recruiters' eyes.

“We want to encourage mothers who now have teenage children and are looking to re-enter the workforce to take the step toward seeking positions, as they are out there,” Tina Viney, CEO of APAN, said. They will, however, need to update their skills and there are numerous options in doing so either through a college nearby who offer post-graduate courses or through an industry leader like Gay

However, for the aesthetics and the cosmetic medical industry this is all changing. Anti-ageing treatments are attracting the more matureaged client or patient, treatments delivered by a more mature

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Wardle.

If you are interested in re-entering the workforce APAN would love to hear from you and guide you in the right direction. Ph: 07 5593 0360.

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APJ 105

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THE CHANGING PURPOSE OF THE BUSINESS PLAN – DO YOU REALLY NEED IT?

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Many just sit in a drawer collecting dust, and some business owners say they are a waste of time.

Eve and Alex John's business has grown very quickly. In the past 12 months their product, Bent Over Silicone Nozzels, has gone from being sold in 15 hardware stores in Victoria to being distributed in 22 separate countries.

Not only did they achieve this without a business plan, Eve John says not having a business plan was a key factor in the rapid growth.

“A business plan would have slowed us down,” she says. “It just seemed a little bit too rigid.” Most business advisers and business coaches recommend drawing up a business plan, but many SME owners opt to go without.

Put simply, a business plan is a formal statement of goals for a business, the reasons they are believed attainable, and the steps for reaching those goals. Financial forecasts are usually included, as is background information about the organisation or team attempting to reach those goals and the market they operate in.

Proponents say a plan can help business owners focus their energy and keep their company on track. But Eve John said that sticking to a business plan would have blinded them to opportunities, such as when the chance to have their nozzles for applying silicone and other plumbing sealants sold overseas arose, in a different way to that which they'd been expecting.

“It just didn't seem right to limit ourselves, and we basically didn't know what we were doing so it just ended up that we never initially wrote up a plan,” she said, adding that she and her husband set goals for the business nonetheless.

John, who used to teach business skills at TAFE, has seen a lot of people limit themselves to their business plan. “They limit themselves and if a new opportunity comes in they say 'oh, no, I've got to limit myself to my business plan',” he says.

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However, Andrew Graham, national head of business solutions RSM Bird Cameron, says that for new businesses, the analysis in of the target market, their competitors and their customers is a valuable exercise, but many fail to do this. “Implications of this approach for longer term growth include capital being more difficult to obtain due to a lack of a well-documented plan for the lender and missing breakthrough strategies if the time is not invested in examining the market thoroughly and searching for real differentiation,” Graham says.

“While dedicating time and energy to a business plan can be tedious and challenging, the effort is well spent. Business owners should be prepared to review, change and adjust the business plan to ensure the business goals continue to be attainable.” Business plans also don't need to be many pages long to be effective, says Graham. “The real

skill is not in writing pages of detail, but in developing the ability to get the real story across succinctly,” he says. “A one-page outline of the business vision, values, objectives and how you will use your competitive advantage to achieve them will ensure you have the best tool to communicate the business plan.”

James Eling, the owner of Marketing4Restaurants, says business planning brings clarity to his business. He draws up a five-year, oneyear and 90-days goals for his company, which then reveal the missing pieces in his strategy that are needed to meet those goals. “It raises a whole heap of questions and those questions form part of your shortterm goals,” he says.

In his business plan, Eling also includes analysis of his industry, the customers and competitors. That work revealed, for instance, that distribution channels was the biggest hurdle the business faced, allowing him to focus more effort there.

Eling says he also knows the costs of not having a business plan.

Extreme Networks, an IT business founded by he and his wife was named a BRW Fast 100 company in 2004 and doubled its revenue in 2007, but soon after gave up on business plans. “At that point we thought we were really good at running an IT company and we just lost focus and were going backwards,” James says. “Probably our biggest regret in the 15 years that the company's been running was those five years that were completely wasted.”

Jacob Aldridge is an international Shirlaws business coach, and has one simple piece of advice about business plans. “The greatest business plan, kept in the bottom drawer, is useless in business,” he says. “Bullet points on the back of a beer coaster, which are implemented, can be worth millions.”

What your business plan should include: Business plans don't have to be long, but most experts say they should contain at least the following information: ! A description of your business ! Your business goals ! An analysis of your target customers ! An analysis of your competitors ! Your strategy ! Your business' financial statements and projections.

In a rapidly changing world the key is to be more flexible to accommodated opportunities that may arise that are a perfect fit, but were not part of the original plan.

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APJ 106

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AUSTRALIAN OBESITY RATES CLIMBING FASTER THAN ANYWHERE ELSE IN THE WORLD, STUDY SHOWS Obesity rates in Australia are climbing faster than anywhere else in the world, according to a new study. The results of the global study into obesity rates, published in the medical journal The Lancet, show almost a quarter of the country's children and 63 per cent of the adult population is overweight.

According to the Australian Institute of Health and Welfare, three in five Australians are overweight or obese, which translates to 12 million people. Unmonitored weight gain can lead to impaired glucose tolerance that can lead to Type 2 diabetes and heart disease.

Australia's obesity levels are now on par with the United States, but slightly less than New Zealand. The study has prompted health experts to call on the Federal Government to commit to a national anti-obesity strategy.

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Obesity Policy Coalition spokeswoman Jane Martin says obesity is an issue that governments can tackle in a number of ways. The government is also appealing to healthcare professionals and personal services professionals to establish strategies to support and assist individuals with their weight management.

In the aesthetics industry there is a huge growth in the demand for the treatment of cellulite and weight-loss. The percentage of ultrasonic cavitation devices has doubled in the past five years as salons and clinics attempt to assist the public to better manage this problem.

However, while these services are beneficial, to gain permanent benefit “we need more irons in the fire”, experts stress. While diet and exercise are important to any weightloss strategy there are other

hidden factors that are also contributing to this epidemic.

At the recent A5M Medical and Aesthetic Conference the issue of Metabolic Syndrome and what current studies are saying about this were also presented. One of the experts to address this topic was Dr James LaValle.

Dr LaValle is an internationally recognised clinical pharmacist, author and certified clinical nutritionist, naturopathic doctorate, founder of LaValle Metabolic Institute, an interdisciplinary medicine facility in Cincinnati in the US where he has served thousands of patients using his metabolic model for health. We interviewed Dr LaValle to share with us some of his knowledge for the benefit of our industry.

APJ 1: Dr LaValle, in your opinion what are the key factors that contribute to weight gain and metabolic syndrome?

Dr LaValle: There are many reasons why people gain weight that are well known, but what is coming to light is the specific role that certain micro-nutrients play in weight gain, and if these are depleted they contribute to making weight management and weight loss very difficult. These nutrients include magnesium, chromium, zinc and vitamin D, which are all critical in supporting the body in this area.

When these are insufficient in our diet they can contribute to metabolic syndrome. We now also have a better understanding of the enormous role that stress plays in weight gain and obesity. We are finding that as our stress responses become less efficient in regulating

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APJ 107

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our energy levels they can contribute to alterations in our hormonal architecture.

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Additionally, environmental toxins, organic pollutants, pesticides and viral compound can all lead to insulin resistance. Chronic stress can also disrupt thyroid and glucose metabolism. We often don't realise that being constantly bombarded with on-going stress, even if it simple everyday pressures like rushing to finished tasks, answering emails, meeting deadlines, running to fit everything in and completing tasks in our daily lives without appropriate breaks, can contribute to poor sleep patterns, hyperactivity and an inability to switch off and rest. Stress also leads to poor absorption of our nutrients and can contribute to a leaky gut. As a result, less-efficient nutrient absorption can contribute to chronic immunological suppression and this can lead to a tendency towards inflammation. Unless this inflammation is addressed you will not be able to lose weight.

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Two important chemicals in the brain that also play a role in our predisposition to food and eating are dopamine and serotonin, and their activity can be influenced by chemical changes in the body, due to stress or nutrient deficiencies. Both are a type of chemical known as a neurotransmitter. If you are asking what is the function of serotonin or dopamine, it depends on where in the brain they are being released.

Dopamine is quite often tagged as the “reward” chemical, because it is released in the “reward pathway”. It is not a coincidence that recreational drugs also bind to the same receptor sites as dopamine!

When we are predisposed to dopamine we often crave things like chocolate that we must have without knowing why.

The release of serotonin is thought to be often involved in appetite craving patterns and mood. The widely used anti-depressant Prozac, is a serotonin re-uptake inhibitor. When you take this drug it slows down the rate that serotonin is re-absorbed after being released into the synapse. This means there is more serotonin floating around in the synapse, and so it is more likely to bind to, and affect, the neurons involved in making us feel depressed.

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These imbalances can lead to insulin resistance and metabolic syndrome. To help you understand how insulin resistance comes about, consider the following. Normally, food is absorbed into the bloodstream in the form of sugars such as glucose and other basic substances. The increase in sugar in the bloodstream signals the pancreas (an organ located behind the stomach) to increase the secretion of a hormone called insulin. This hormone attaches to cells, removing sugar from the bloodstream so that it can be used for energy.

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In insulin resistance, the body's cells have a diminished ability to respond to the action of the insulin hormone. To compensate for the insulin resistance, the pancreas secretes more insulin. People with this syndrome have insulin resistance and high levels of insulin in the blood as a marker of the disease rather than a cause. Over time people with insulin resistance can develop high sugars or diabetes as the high insulin levels can no longer compensate for elevated sugars. ㄰ 㤵 㜵

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What Are The Signs of Insulin Resistance Syndrome? ! Impaired fasting blood sugar, impaired glucose tolerance, or type 2 diabetes ! High blood pressure. The mechanism is unclear, but studies

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suggest that the worse the blood pressure, the worse the insulin resistance.

Abnormal cholesterol levels. The typical cholesterol levels of a person with insulin resistance are low HDL, or good cholesterol, and high levels of another blood fat called triglycerides.

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Heart disease. The insulin resistance syndrome can result in atherosclerosis (hardening of the arteries) and an increased risk of blood clots.

Obesity. A major factor in the development of insulin resistance syndrome is obesity – especially belly fat and abdominal obesity.

Obesity promotes insulin resistance and negatively impacts insulin responsiveness in a person. Weight loss can improve the body's ability to recognise and use insulin appropriately.

Kidney damage. Protein in the urine is a sign that kidney damage has occurred, although not everyone uses this component to define insulin resistant syndrome.

To address these issues we focus on getting the receptors to work normally again. This is achieved through appropriate nutrients and diet correction, as well as improving sleep patterns and balancing stress levels. Unless these areas are brought into balance it is very difficult to lose weight.

APJ 2: How do drugs contribute to nutrient depletion?

Can you give us some examples of perhaps cholesterol or high blood pressure drugs?

Dr LaValle: We now know that certain drugs can actually steal nutrients from our body and these deficiencies can lead to further health problems. For example, we know that the statin drugs used for lowering high levels of cholesterol and to reduce the risk of a heart attack, or stroke, can deplete nutrients in the body that can contribute to side-effects and ultimately other health problems. By restoring these nutrients we can reduce a doctor's liability and downstream some of these side-effects. For example, we now know that statins steal nutrients such as magnesium, Zinc, D3 and Co-Q10. This

contributes to the well-known statin side-effects, which include: Muscle damage and pain – Statins often contribute to muscle

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Liver damage – Occasionally, statin use can cause the liver to increase its production of enzymes that help digest food, drinks and medications Digestive problems – Some people taking a statin may develop nausea, gas, diarrhoea or constipation after taking a statin Rash or flushing – You could develop a rash or flushing after you start taking a statin. If you take a statin and niacin, either in a combination pill such as Simcor or as two separate medications, you're more likely to have this side-effect Increased blood sugar or type 2 diabetes – It's possible your blood sugar (blood glucose) level may increase when you take a statin, which may lead to developing type 2 diabetes.

Neurological side effects – The FDA warns on statin labels that some people have developed memory loss or confusion while taking statins.

APJ 3: How can we minimise the impact of stress on ageing? What are your key strategies that you believe practitioners and therapists should recommend?

Dr LaValle: There are several simple, yet effective ways to minimise

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stress levels. Here are just some recommendations: ! Develop mindfulness – It is important to review our thought patterns and practise regular slow, deep, breathing techniques as an effective ways of lowering the harmful effects of stress. ! Improve sleep quality – Managing such issues as room temperature, lighting, eliminating electro-magnetic devices in your sleep zone and looking at ways to promote restful and adequate hours of sleep is very important. ! Managing over-commitment – Chronic overload may require counselling so that individuals can address these issues and identify ways to better manage their workload. ! Emotional overload – Women in particular tend to take on too much. They need to be nurtured and assisted in being less stressed and anxious. ! Stress responses – Look at stress response and invest in improving coping mechanism.

APJ 4: Do stress responses change as we age and in what way?

Dr LaValle: We now know that with effective strategies we can minimise the negative impact of ageing. Ageing no longer needs to be feared. Much can be achieved by improving the efficiency of the nervous system and protecting the body from harmful hormonal

changes that can lead also to changes in the brain/body structural architecture. We have evidence that the brain has a level of plasticity that makes it possible in the right environment and support to repair itself. This is great news, because as we learn to manage stress, hormonal integrity and our glucose levels we can live longer and healthier lives. By learning how to cope better, maintain a wonderful attitude to life, we can help keep our hormonal reserves and age gracefully, while protecting ourselves from many diseases.

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APJ 5: In closing, what are the metabolic effects of chronic stress and cortisol elevation?

Dr LaValle: There are multiple effects of stress and

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cortisol elevation, but in summary there are three major areas of the body that can be altered. These are: GUT: Compromising gut permeability and contributing to IDO elevation BRAIN: Cortisol elevation, NMDA excitation, reduced neuroplasticity and SNS/PNS imbalance IMMUNE: Th1/Th2 imbalance, Microglial activation and IL-6, TNFα

More specifically, chronic stress and cortisol elevation can affect body function in the following ways:

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Increased insulin secretion Increased fat deposition Alteration in immune function Muscle wasting Hypothyroidism (adrenal exhaustion) Memory loss Alteration in sex hormones Mental and Emotional instability Bone loss/mineral loss Sodium and water retention Elevated blood lipids Loss of REM sleep Increase plaque formation Increase in cardiovascular risk factors Receptor Site activation on Tumor cells

The good news is that there is much we can do to improve health, through lifestyle changes, nutrition, exercise, diet, relaxation techniques and mindfulness. There also excellent adaptogen herbs that can further assist the body to overcome inflammation. These include Aswaganda, Eurycoma, Ginseng root and Rhodiola rosea. All these herbs are adaptogens, which means they have the capacity to stabilise physiological processes in the body and the promotion of homeostasis, an example being by decreased cellular sensitivity to stress.

James B. LaValle R.Ph.,C.C.N is the founder of Integrative Health Resources, which is focused as a natural products industry consulting company. He has 27 year’s experience integrating natural therapies into various medical and business models. Dr LaValle is best known for his expertise in natural therapeutics application and drug/nutrient depletion issues and uncovering the underlying metabolic issues that keep people from feeling healthy and vital. He is the author of 16 e-books and 17 books and has writtened hundreds of articles for a variety of industry journals and publications, and has lectured for thousands of healthcare professionals and consumer audiences globally on these topics. Dr LaValle also served as an adjunct associate professor at Cincinnati College of Pharmacy for over 14 years and currently serves as Adjunct Professor in Metabolic Medicine at the University of South Florida Medical School.

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TASMANIA – A Great Success Tasmania brought out the sunshine to greet us for the last APAN Aesthetics Conference for 2014 on Sunday 12th October.

As planned, delegates were invited to join us for a fun day on Saturday 11th as we explored the renowned Salamanca Markets in Hobart, which was just walking distance from the Grand Chancellor where the conference was held. As most locals were working in their salons or clinics a small group of us, including Leslie Morgan-Wesson who came from Sydney to join us, our MC Terry Everitt also from Sydney and Sandra Mole from Queensland joined us as we explored the markets.

Greeting us at the beginning of the market was an antique car exhibition, which was quite a spectacle, attracting motor enthusiasts as colourful and time-honoured vehicles were lined up, some over a century old.

From there we moved to the various stalls displaying a variety of produce and unusually artefacts. Bursting with the abundance of colour from local crafts to the amazing local flowers, aromas of fresh

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coffee, fresh garden vegetables and an array of local produce made meandering through the stalls so much fun.

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Leather goods, including incredibly crafted handbags, and amazing wood carvings from unique woods such as lemon myrtle or beech,

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made for great shopping as did meticulously crafted hand-made jewellery from genuine silver, rose gold and gemstones, which were a shopper’s delight for those who were seeking something unique and delicate.

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From there we visited Richmond for a leisurely lunch at a wonderful restaurant garden, discussing everything from business to the gorgeous native flora that surrounded us. Following lunch we disbursed to explore the quaint boutiques of exquisitely crafted pottery, jewellery, handcrafted, unique lace and leather goods. The day ended with some cheese and wine tasting and enjoying the amazing scenery.

The following day the temperatures rise to a lovely 22 degrees, which is unusual for Tasmania at that time of the year, but we were thrilled because several salon and clinic owners were driving from Launceston for the conference, which is a two to 2.5 hour drive.

The lecturers featured Professor Ray Hayek, who presented a clinical perspective to assessing the skin and determining not just the symptoms, but also questioning the potential causative reasons for lesions and abnormalities, and the role the aesthetic therapist and clinicians have in alerting clients and potential pathology.

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Dr Stephen Newbery from Ta s m a n i a n R a d i a t i o n Health explored the whole reason for legislation, the scope of its purpose and objectives and how regulations fit into the national framework in determining practitioner behaviour and minimising risk to the consumer.

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Dr Christine Houghton explored the antioxidant theory and looked at how nutrigenomics provides new answers to optimising health for both body and the skin.

She also introduced how nutrigenomics is now moving into skincare formulations and their benefit and objectives.

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Tina Viney presented some interesting research findings from IBIS World Research specifically as they relate to the Australian Beauty and Aesthetics Industry, and compared them with global trends in consumer behaviour and advances in technology. She also presented the latest findings of the “knowledge curve” as determined by Buckminster Fuller which demonstrated the alarming speed by which information is doubling every 12 hours.

Threats and opportunities were also identified and the evolving changes to the aesthetics industry.

APAN lawyer Michael Bishop from Pointon Partner Lawyers presented some compelling information on commissions and the rules that govern implementing commission-based remuneration within a business.

He alerted businesses to areas that non-compliance can cause them grief and how to avoid these situations. ㄰

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To conclude the event Mark Viney spoke on the advances in communication technologies and pitfalls to avoid.

He expounded on various tools and their effective use such as effective use, of QR Codes in drawing consumers to your products and services. Mark also covered information on the changing landscape of web extensions that are about to change the whole Internet space and ways that consumers interact with business.

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The event was supported by several cosmetic and equipment companies who provided delegates with an opportunity to identify ways of enhancing their services to their clients.

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The event was very successful and delegates who attended commented on the high calibre of information they gained, and also appreciated the opportunity to meet quality suppliers in a more relaxed and less rushed environment.

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The next APAN Conference will be conducted in BRISBANE at the Stamford Plaza Hotel on Sunday 31st May, 2015 which promises an amazing program for all industry professionals and business owners. For further details visit www.apanetwork.com

Salamanca Markets

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THE COSMETIC AND HEALTH BENEFITS OF BIO-IDENTICAL HORMONES

By Dr. Julie Bradford There is so much talk about the role of hormones in health and wellbeing, but what about the skin? What role do hormones play and why is it important that our hormones are correctly balanced to support skin health and vitality?

New research points to some amazing new findings. As a skincare therapist understanding the role of hormones in skin health has never been more important, especially if your treatment goals aim to improve, correct and even reverse skin damage.

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Dr Julie Bradford is a Regenerative and Cosmetic Medical Practitioner with over 30 years’ experience, and one of the first Cosmetic Medical Doctors in Queensland and a leader in this area of innovative medicine.

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This article is an excerpt from a lecture she presented at Cosmetex Conference this year entitled Cosmetic Benefits of Bio-identical Hormones. While you may not be qualified to prescribe hormone therapy, understanding their impact on the body and skin will give an appreciation of the value of working collaboratively with a regenerative medical practitioner for better treatment outcomes.

When hormones are out of balance they accelerate the ageing of the skin and the body. This is because hormones determine the skin and body's biological age by controlling many physiological processes in the skin, muscle and bone cells, and take care of circulation, collagen formation, cell regeneration and skin moisture.

BIO-IDENTICAL HORMONES When we speak of hormone balancing we know that bio-identical hormones can offer some amazing benefits and superior results to synthetic hormones. This is because they have the same biochemical structure as endogenous hormones. They are biochemically identical and have the same effect on the body and, therefore, well tolerated.

These include: Natural estrogens Progesterone DHEA Testosterone Melatonin Thyroid hormones Growth hormone

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Let's look at these more closely.

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OESTROGEN – THE HORMONES OF BEAUTY Oestrogen is typically responsible for the shape of the female body, but it is also a key component of hormonal health for men. In men it is responsible for bone metabolism, prostate function, fertility and brain function.

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Oestrogen has an amazing 400 functions in the body.

These are too numerous to mention in this article, however, here are some key functions:

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Production of choline acetyltransferase, an enzyme that prevents Alzheimer's disease Increase metabolic rate Improves insulin sensitivity Regulates body temp Helps prevent muscle damage and maintain muscles Improves sleep, lower risk of cataracts and help maintain the elasticity of arteries

In terms of the skin oestrogen helps maintain the amount of collagen in the skin, improve the water content of the skin and improve thickness and softness of the skin. Oestrogen also helps decrease wrinkles.

Additionally, oestrogen helps to enhance energy, improve mood, maintains bone density and has an anti-inflammatory effect.

NATURAL OESTROGEN Not all oestrogen is equal. In fact there are three types of natural oestrogen with each one offering different benefits. This is why each individual's needs are different and tests are needed to determine where the deficiencies lie so that a customised compounded formula can target to deliver the necessary benefits.

The three oestrogens are: E1– estrone, E2– estradiol and E3– estriol.

Each one of these offers unique benefits that are slightly different.

ESTRONE 1 Estrone 1 is the main oestrogen made by the body post-menopause.

Many researchers believe high levels increase a woman's risk of breast cancer, so levels need to be monitored.

ESTRADIOL E2 This is the strongest oestrogen and is responsible for many functions, including helping maintain bone structure, supporting serotonin levels, growth hormone and endorphins. It helps the absorption of Ca, Mg + Zn and helps maintain Vitamin K levels, improves sleep, helps maintain memory, minimises fatigue and works as an antioxidant.

ESTRIOL E3 Large quantities of estriol E3 are made during pregnancy.

Considerable evidence exists to show that it protects against breast cancer, and it is used in Europe to treat breast cancer instead of Tamoxifen. However, it does not have the bone, heart or brain protection of estradiol.

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content in adults decreases by 1% every year. Approx. 30% of skin collagen is lost in the first five years after menopause.

Oestrogens reverse this trend and increase skin collagen. Oestrogens also enhance the synthesis of hyaluronic acid and promote water retention.

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SKIN BENEFITS OF OESTROGEN As far as skin is concerned studies have found the effects of oestrogens on the skin include:

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Greater epidermal and dermal thickness from increased collagen production 'Filling-in' of wrinkles Better structure and ordering of elastin fibres Greater vascularisation Higher levels of hyaluronic acid and mucopolysaccharides – increased dermal hydration Inhibition of excessive sebum production Diminished hyperpilosity and virilisation of facial hair (ie. less facial hair, less masculine in type – less coarse and dark) Antioxidant action, protecting the skin against free radical damage

There is now sufficient evidence to support that oestrogen promotes youthful skin. Oestrogens prevent skin ageing. They increase skin thickness and improve skin moisture. In fact, skin ageing can be significantly delayed by administration of oestrogen. A critical mechanism by which oestrogen maintains a youthful plump appearance is to increase synthesis of collagen. Collagen atrophy is a major factor in skin ageing. Studies now confirm a strong correlation between skin collagen loss and oestrogen deficiency at menopause.

Skin ageing, especially in the face, is associated with progressive increase in sagging tissues and reduction in elasticity. In menopausal and post-menopausal women, oestrogen administration increases collagen content, dermal thickness and elasticity, while decreasing ageing dry skin. Furthermore, oestrogens exert significant effects on skin physiology by modulating the effects of key epidermal and dermal cells. The skin is an important oestrogen-responsive endocrine tissue. The very thin skin observed in the elderly can be directly correlated to lack of oestrogens needed to generate collagen and maintain skin thickness.

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DOES OESTROGEN PREVENT SKIN AGEING?

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OESTROGEN INCREASES COLLAGEN AND HYALURONIC ACID The first signs women experience at onset of menopause is increasing skin dryness, followed by a loss of skin firmness and elasticity. These symptoms correspond to changes in collagen and elastic fibres, reported to be due to oestrogen deficiency. Both total collagen content and ratio of type III and type I collagen decline with age. Skin collagen

A study using postmenopausal women evaluated relationship between oestrogen use and skin wrinkling, dryness and atrophy. Oestrogen use was associated with a statistically significant decrease in the likelihood of senile dry skin. The study confirms that wrinkling was substantially lower in oestrogen users.

Oestrogen use was not associated with skin atrophy. Results further suggest that oestrogen use prevents dry skin and skin wrinkling, thus extending the potential benefits of postmenopausal oestrogen therapy to include protection against selected age and menopause-associated dermatologic conditions.

PROGESTERONE Pre-menopausal production of progesterone is mostly from the ovaries, while post-menopausal sees some production of progesterone from adrenals. Progesterone is the most common hormone deficient in peri-menopausal women.

Natural progesterone is often needed after a hysterectomy and can be administered orally or through transdermal delivery as a nocturnal dose of 80-300mg daily.

Synthetic progesterone or progestins have a different chemical structure to natural progesterone and therefore do not reproduce the same actions of natural progesterone.

The side effects of progestins is that it can increase appetite leading to potential weight gain, fluid retention, irritability, depression, headache, low energy, bloating, breast tenderness and low libido.

They can also contribute to acne and nausea in some individuals.

On the other hand, these symptoms are not found when using natural progesterone.

Benefits of natural progesterone include:

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Helps balance oestrogen Natural calming effects Aids use and elimination of fats Lowers cholesterol May protect against breast cancer Increases scalp hair Normalises libido Helps balance cellular fluid Has anti-proliferative effect Does not change positive effect of oestrogen on blood flow Increases metabolic rate Natural diuretic Natural anti-depressant Helps sleep Lowers high blood pressure

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TESTOSTERONE Testosterone is made by the adrenals and ovaries in females and decreases with age. In males it is mostly made by the testes.

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The key function of testosterone in woman is that it increases libido and improves a sense of emotional wellbeing, self-confidence and motivation. It also supports muscle mass and strength. Testosterone also helps maintain memory, improves muscle tone and down regulates excessive body fat. It also protects against body deterioration.

Symptoms of low testosterone include muscle wasting, dry, thin skin with poor elasticity, thinning and dry hair, droopy eyelids and sagging cheeks.

On the other hand, excessive testosterone can manifest symptoms of anxiety, depression, fatigue, salt and sugar cravings, acne/oil skin, hirsuitism, irregular periods, weight gain (apple body shape), fluid retention and even alopecia (male pattern).

DHEA DHEA is made by the adrenal glands. A small amount is also made in the brain and skin. It is usually produced between 9pm and 1am.

DHEA production declines with age, starting from late 20s. DHEA is a precursor of other sex hormones such as oestrogen, progesterone and testosterone. Functions of DHEA include, supports immune system, helps the body repair itself and maintain tissue integrity, improves sleep, helps the body deal with stress, improves sense of wellbeing, brain function and memory.

Causes of low DHEA can be attributed to menopause, stress, ageing, smoking and OCPs. DHEA replacement therapy can improve insulin sensitivity, improve damaging effects of stress and improve muscle strength and lean body mass.

DHEA also has a protective effect against cancer, diabetes, obesity, increased cholesterol and auto-immune diseases.

stimulated by exercise, especially anaerobic exercise. Growth hormone is also stimulated by a high-protein diet as well as fasting.

Our levels of growth hormone are reduced by stress, alcohol, high carbohydrate and sugar diets, ageing, sleep deprivation, smoking and drugs such as marijuana.

The hormonal stimulators of growth hormone include testosterone, Estrogens (transdermal), Progesterone, Thyroid hormones, Melatonin, DHEA, Cortisol (physiological doses only). On the other hand, the hormonal inhibitors of growth hormone include cortisol and other gluco-steroids in high doses, oral oestrogens and endogenous insulin (insulin resistance).

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Growth hormone is highly beneficial for skin integrity. It assists skin thickness and elasticity, decreases sun damage-type wrinkling and total body fat (14.4%). It increases lean muscle mass (8.8%). It also increases bone-mineral density, improves cholesterol profile and also improved exercise capacity. Growth hormone also improves blood flow to kidneys, general energy levels, allows for faster wound healing, it improves sleep, mood elevation, hair regrowth, exercise performance and sharpens vision and hearing, as well as enhances collagen synthesis and repair.

Symptoms of excessive growth hormone include carpal tunnel syndrome, joint aches, muscle aches, oedema and increase in blood sugar (temporary).

Excessive DHEA symptoms include sugar cravings, restless sleep, irritability, weight gain, acne, mood changes, fatigue and anger.

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Melatonin is a powerful antioxidant and controls the diurnal rhythm. Melatonin improves sleep disorders, prevents jet lag, strengthens immune system and can slow down the ageing process. Symptoms of excessive melatonin include bad dreams, drowsiness and low oxytocin production.

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Growth hormone is made by the anterior pituitary gland. It is produced in spikes, not continuously. Major production is during the first hour of sleep (before midnight). Growth hormone is also

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THYROID HORMONE A well-balanced thyroid will increase energy and minimise fatigue, improves tolerance to cold, improves dry skin, minimises headaches/migraines, increases fertility, controls obesity, improve cholesterol profile, improves depression, improves foggy head and improves constipation.

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TRANSDERMAL FACIAL HORMONES The administration of medical hormone cosmetics can influence skin

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ageing at its roots and therefore are highly beneficial. Only when all hormones are in balance can the skin cell physiology work perfectly and the skin develops its natural beauty. Studies show that the use of hormone cosmetics can delay the skin's ageing process by up to 10 years and existing skin damage can be repaired.

OESTRADIOL E2 INCREASES COLLAGEN ㈵

Studies confirm the evaluated effect of topical E2 on the skin in improving collagen and elastin in postmenopausal women, aged 52 76, using topical E2 daily. Content of skin hydroxyproline; levels of carboxyterminal propeptide of human type I procollagen (PICP) and aminoterminal propeptide of human type III procollagen (PIIINP) were measured along with number and quality of collagen and elastic microfibrils. The amount of hydroxyproline in the skin significantly increased 38% during E2 treatment. Topical E2 treatment increases the amount of skin collagen. The increase in the level of PICP and PIIINP indicates that E2 treatment stimulates collagen synthesis.

Results show that topical E2 treatment has a greater influence on the amount than on the quality of skin collagen.

A RECENT STUDY COMPARED EFFECTS ON THE SKIN WOMEN AGED 44- 66 0.01% estradiol cream (0.1mg E2/g) and 0.3% estriol cream (3mg E3/g) applied 1g of cream to the face once a day. Dramatic improvement on all measures in both E2 and E3 group were identified.

After only four months, both dermal and epidermal thickness was enhanced, as well as dermal collagen levels. E3 group showed the improvement somewhat sooner – the chief advantage of E3 was lack of side-effects. Serum levels of E2 and E3 were unaffected by facial treatment.

TRANSDERMAL ESTRIOL E3

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A four-month study using topical DHEA confirmed a significant activation of sebaceous glands in mature skin, decreased eye wrinkles, improved skin thickness, increased androgen receptors and pro-collagen expression. It also improved skin brightness, counteracted papery appearance of skin and epidermal atrophy and decreased the product and cornification of keratinocytes that form rough skin.

MELATONIN AND ANTIOXIDANTS In numerous studies, melatonin produced in the skin has been found to protect against the sequelae of UVB and UVA-induced oxidative stress. In vitro studies involving UVB irradiation of keratinocytes, fibroblasts and leukocytes, melatonin applied in both pharmacological and physiological doses decreased the fraction of damaged cells. Melatonin applied to the skin before UVB exposure protects against the development of cataract and erythema. Thus only intracellular melatonin may protect cells against the effects of UVB exposure.

IN CONCLUSION

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TOPICAL DHEA

MINIMAL SYSTEM IMPACT OF TRANSDERMAL OESTROGEN

Studies were conducted to determine if E2 and glycolic acid creams produced a significant reversal of epidermal and dermal markers of ageing and if the cumulative effect of the creams was greater than either alone. Patients applied a cream containing 0.01% E2 or 15% glycolic acid, alone or in combination, to one side of the face. E2 treatment produced a 23% increase in epidermal thickness; the glycolic acid, a 27% increase; and the combination, a 38% increase.

All groups showed a statistically significant improvement in reversing markers of skin ageing. A cumulative effect was seen when E2 and glycolic acid creams were used in combination.

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Another interesting study was conducted on women aged 48-59. with moderate xerosis and photo-ageing. Subjects applied twice a day for two months a nanocolloidal gel and/or took a supplement containing ascorbic acid (Vit C), tocopherol (Vit E), alpha-lipoic acid, melatonin.

Oxidative stress and consequently lipid peroxidation decreased from 30-40% in blood serum of all subjects treated with antioxidant compounds topically and by oral route. The study confirmed that the compounds used play a role as topical and systemic photoprotectants.

ESTRADIOL E2 AND GLYCOLIC ACID

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A further study conducted with peri and postmenopausal women using 2% progesterone cream confirmed a significant increase of elastic skin properties in the treatment group was demonstrated.

Clinical monitoring showed a reduction in wrinkle counts (29.10%), wrinkle depth (9.72%) around the eyes, greater decrease in nasolabial wrinkle depth (9.72%) and a significantly higher increase in skin firmness (23.61%). Progesterone was well absorbed in the systemic circulation. Mean blood levels rose minimally. No serious side-effects of treatment were observed. Topical 2% progesterone increases elasticity and firmness in the skin of peri and postmenopausal women.

Estriol is a weak oestrogen when systemically administered, but it can induce potent anti-ageing effects as a topical treatment. Topical creams have been developed to nourish the skin with E3 without the potential dangers of therapies containing more potent forms of oestrogen. There is evidence that E3 may inhibit some of the unwanted effects of E2 by binding preferentially to the oestrogen receptor-beta.

Another study evaluated cytological vaginal smears of women aged 46-66 before and after three months of dermal oestrogen (1g of 0.01% E2 ointment or 0.3% E3 ointment once daily), applied to the face for dermatological indications. Both groups had gynaecological examinations, including cervical and vaginal smears before and after treatment, and also monthly measurements of serum FSH, prolactin and E2 levels. Serum hormone levels and the appearance of vaginal smears showed no significant change during treatment.

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PROGESTERONE INCREASES ELASTICITY

These days we have a much better understanding of the role of hormones in health and wellbeing as well as for skin health. As new research continues to confirm their role and benefits we will see hormone therapy continue to take centre stage as a valuable tool in both optimised health and for anti-ageing purposes.

Editor’s Note: References available on request.

Dr. Julie Bradford has over 30 years’ experience as a Medical Practitioner and was one of the first Cosmetic Medicine Doctors in Queensland. She now trains doctors nationwide in the art of cosmetic injecting and thread lifting. She has a Fellowship with the Australian College of Cosmetic Surgery (Medical Faculty). Dr Julie also has a Fellowship in Preventative and Wellness medicine and is a leader in this innovative area of medicine, and is one of Queensland's only few Fellows of the American Academy of Anti-Ageing Medicine. It has taken more than two years of study to attain this award. This latest accolade is on top of Dr Julie's numerous Australian medical qualifications.

The Bradford Clinic: info@drjulie.com.au Ph: (07) 4639 1250.

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I grew up in an era when eating a diet that was low in fat and high in carbohydrates was advocated as the way to good health. In my teenage years the health pyramid placed fats at the bottom of the triangle – fats were considered the villains and we were cautioned to eat them sparingly.

WHY BUTTER IS NO LONGER A DIRTY WORD New Science Reveals Fat Isn't What's Hurting Our Health

By Tina Viney

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Now that I am well into my menopausal years and having gained a few kilos, I went on a medically supervised diet with literally no fat for a period of time. While I lost much of my fat and reached my ideal weight, my doctor discovered that virtually all of my hormones were also totally depleted. Interesting enough, good fats are essential in processing hormones. As a result I was advised to start increasing my fats by eating abundant quantities of oily fish, organic butter, coconut oil, olive oil, avocado and eggs. Within six weeks my hormones were once again balanced and I did not gain any weight. In my case, what I discovered was that I was gaining weight when I combined fats, starches and sugars, with sugar being the main culprit for weight gain and insulin resistance, which was also starting to give me diabetic symptoms.

Today, you will still find that most mainstream dietary advice recommends low-fat or non-fat dairy. But a growing number of experts argue that it's far healthier to eat and drink whole dairy products with all the fat left in.

Dairy foods contain roughly 50 to 60 per cent saturated fat, and conventional thinking is that saturated fat is bad for your heart. This idea has been thoroughly refuted as false. It's a mistaken interpretation of the science. In a 2010 analysis,1 scientists said: “There is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease.” ㄰

LOWERING RISK OF DIABETES THROUGH FULL-FAT DAIRY

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More recently, research presented at the European Association for the Study of Diabetes (EASD) in Vienna, Austria, found that eating fullfat dairy products, such as whole milk, cream, cheese and butter actually reduces your risk of developing diabetes.

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The study included nearly 27,000 people between the ages of 45-74 who were followed for 14 years.

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As reported in The Telegraph,2 those who ate eight portions of full-fat dairy products a day cut their risk of diabetes by nearly 25 per cent, compared to those who ate fewer portions.

One serving counted as:

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200 millilitres (ml) of milk or yoghurt 20 grams (g) of cheese 25 grams of cream 7 grams of butter

Also, consuming 30 ml of cream or 180 ml of high-fat yoghurt daily reduced the risk of diabetes by 15 per cent and 20 percent respectively, compared to those who ate none. According to lead author Dr. Ulrika Ericson of the Lund University Diabetes Center in Malmö, Sweden:3 “Our observations may contribute to clarifying previous findings regarding dietary fats and their food sources in relation to type 2 diabetes.

The decreased risk at high intakes of high-fat dairy products, but not of low-fat dairy products, indicate that dairy fat, at least partly, explains observed protective associations between dairy intake and type 2 diabetes.

Our findings suggest that in contrast to animal fats in general, fats specific to dairy products may have a role in prevention of type 2 diabetes,” the study concluded.

In 2010, a study published in the Annals of Internal Medicine4 proposed that it's the palmitoleic acid, which occurs naturally in fullfat dairy products, that protects against insulin resistance and diabetes.

People who consumed full-fat dairy had higher levels of transpalmitoleate in their blood, and this translated to a two-thirds lower risk of developing type 2 diabetes compared to people with lower levels.

RESEARCH SHOWING FULL-FAT DAIRY HAS EXCELLENT HEALTH BENEFITS

BUTTER ACKNOWLEDGED AS A BETTER OPTION More and more people are starting to realise the fallacy of the low-fat myth. As noted by NPR,8 in 1992, 44 per cent of household cooks surveyed reported being “concerned about the amount of cholesterol in their food”. Today, that number has dropped down to 27 per cent.

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THE MANY HEALTH BENEFITS OF GRASS-FED BUTTER Other research backs up the suggestion that butter is a health food that offers both short-term and long-term benefits for your health. One study0 found that fat levels in your blood are actually lower after eating a meal rich in butter than after eating one rich in olive oil, canola oil or flaxseed oil.

What this means is that a significant portion of the butter you consume is used immediately for energy – similar to a carbohydrate. But, unlike a carbohydrate, it doesn't adversely affect your insulin and leptin levels. The primary nutrients found in butter are outlined in the table below.

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The next best is pasteurised butter from grass-fed or pastured organic cows, followed by regular pasteurised butter common in supermarkets. Even the latter two are healthier choices by orders of magnitude than margarines or spreads.

Besides lowering your risk for diabetes, previous studies have also shown that consuming full-fat dairy may help reduce your risk of: ! Cancer: Conjugated linoleic acid (CLA), a type of fat found

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Keep in mind that butter's nutritional value depends on how the cows are raised, as the fatty acid composition of butterfat varies according to the animal's diet. The very best-quality butter is raw (unpasteurised) from grass-pastured cows, preferably certified organic. (One option is to make your own butter9 from raw milk.)

The scientists' main explanation is that about 20 per cent of butterfat consists of short- and medium-chain fatty acids, which are used right away for quick energy and therefore don't contribute to fat levels in your blood. Other oils (canola, flax, etc.) contain only long-chain fatty acids, which are more readily stored as fat.

naturally in cow's milk, significantly lowers the risk of cancer. In one study,5 those who ate at least four servings of high-fat dairy foods each day had a 41 per cent lower risk of bowel cancer than those who ate less than one. Each increment of two servings of dairy pr o d u ct s r ed u ce d a woman's colon cancer risk by 13 per cent.

Weight: Women who ate at least one serving of full-fat dairy a day gained 30 percent less weight

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Other countries have also switched over from margarine to butter in ever-increasing numbers. According to dairy economist Brian Gould, American butter export has grown from zero to just over 10 per cent of the market since the early 2000s.

Experts stress that if we want to gain the best nutritional value from our dairy products we should avoid pasteurised foods if possible.

Unfortunately, research on raw dairy – which is always full-fat are few and far between, so here are some studies using pasteurised dairy for the sake of showing that the full-fat versions are the better choice.

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over a nine-year period than women who ate only low-fat (or no) dairy products.6 Heart Disease: People who ate the most full-fat dairy were less likely to die from cardiovascular disease, according to a 16-year study7 of Australian adults.

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result, drinking pasteurized milk can tax your pancreas and promote disease – particularly allergies.

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A number of studies have also demonstrated the superior safety of raw milk compared to pasteurised. Contrary to popular belief, the vast majority of foodborne illnesses are actually linked to factory farmed and highly p ro c e s s e d f o o d s , n o t r a w f o o d s .

Unfortunately, despite overwhelming evidence of safety and health benefits, in Australia we can get some organic milk that is non-homogenised, however, all raw milk products including cream must be labelled “for cosmetic use only”. That's in sharp contrast to Europe, where some nations even sell it in vending machines, but there's really no need to fret about the safety of raw milk, provided it comes from organically raised, pastured cows.

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BUTTER IS RICH IN FAT-SOLUBLE VITAMINS There are a lot of fat-soluble vitamins in butter. This includes vitamins A, E and K2.

I'm not going to make a big deal out of A and E. If you're eating a healthy diet that includes animals and plants then you are probably getting enough of those already. But I do want to talk a bit about Vitamin K2, which is fairly rare in the modern diet and which many people don't know about.

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Research by Dr. Ted Beals,14 MD, featured in the summer 2011 issue of Wise Traditions, shows that you are actually about 35,000 times more likely to get sick from other foods (most of which are processed) than you are from raw milk.

You can easily ascertain the quality of grass-fed milk, butter, and yoghurt by its colour. The carotenoids in the plants cows eat on pasture

Vitamin K2 can have powerful effects on health. It is intimately involved in calcium metabolism and a low intake has been associated with many serious diseases, including cardiovascular disease, cancer and osteoporosis.

Dairy from grass-fed cows is particularly rich in Vitamin K2. The bottom line is that butter contains a lot of fatsoluble vitamins. Grass-fed butter is particularly rich in Vitamin K2, which can have powerful health benefits.

BUTTER AND SKIN BENEFITS Looking at the above nutritional chart it is quite evident why butter can also benefit and support a healthy skin.

Loaded with vitamins such as A, E, K2 and D as well as the various mineral such as selenium, zinc and copper are all important nutrients to improve skin health and flexibility.

In my case losing weight aged my face substantially.

However, once I reintroduced good fats in my diet, within two weeks I saw a vast improvement in skin-tone and elasticity, with many of my lines plumping up and even disappearing. It was quite amazing.

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RAW DAIRY IS PREFERABLE OVER PASTEURISED

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While the featured research focused on the fat content of the dairy, I also want to point out that the issue of pasteurisation is another important consideration. Raw milk from organically raised grass-fed cows is far superior in terms of health benefits compared to pasteurised milk.

Pasteurisation destroys enzymes, diminishes vitamins, denatures milk proteins, destroys vitamin B12 and vitamin B6, kills beneficial bacteria and actually promotes the growth of pathogens. Many of the enzymes that are destroyed in this process are needed for digestion. As a

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gives grass-fed products a more yellow-orange cast. When cows are raised on dried grass or hay, opposed to fresh-growing grass, you end up with a whiter product, which is an indication of reduced carotenoid and antioxidant content. Raw-milk yoghurt is also very thick and creamy, compared to pasteurised commercial varieties. The same goes for pastured eggs, which can be ascertained by their deep-orange yolk. CAFO chickens, which never go outdoors, and are fed grains rather than bugs and insects, produce eggs with pale-yellow yolks.

BENEFITS OF BUTTER AT A GLANCE 1. Butter is rich in the most easily absorbable form of Vitamin A necessary for thyroid and adrenal health.

2. Contains lauric acid, important in treating fungal infections and candida.

3. Contains lecithin, essential for cholesterol metabolism.

4. Contains anti-oxidants that protect against free radical damage.

5. Has anti-oxidants that protect against weakening arteries.

6. Is a great source of Vitamins E and K. 7. Is a very rich source of the vital mineral selenium.

8. Saturated fats in butter have strong anti-tumor and anti-cancer properties.

9. Butter contains conjugated linoleic acid, which is a potent anticancer agent, muscle builder and immunity booster 10. Vitamin D found in butter is essential to absorption of calcium.

11. Protects against tooth decay.

12. Is your only source of an anti-stiffness factor, which protects against calcification of the joints.

13. Anti-stiffness factor in butter also prevents hardening of the arteries, cataracts and calcification of the pineal gland.

14. Is a source of Activator X, which helps your body absorb minerals.

15. Is a source of iodine in highly absorbable form.

16.May promote fertility in women.9 17. Is a source of quick energy, and is not stored in our body’s adipose tissue.

18. Cholesterol found in butterfat is essential to children's brain and nervous system development.

19. Contains Arachidonic Acid (AA), which plays a role in brain function and is a vital component of cell membranes.

20. Protects against gastrointestinal infections in the very young or the elderly.

BUTTER LOWERS HEART-ATTACK RISK COMPARED TO MARGARINE Mainstream nutrition guidelines tend to backfire and have the opposite effect of what they were intended to do. A prime example of that is the recommendation to replace butter with margarine.

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However, margarine is totally different. It is a highly processed food that was invented to replace butter. The primary ingredient is vegetable oil along with emulsifiers, colorants and various artificial ingredients.

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Vegetable oil is liquid at room temperature. This is why margarine is often hydrogenated, which gives it a harder consistency and extends shelf life. Hydrogenation also turns some of the vegetable oils into trans fats.

A study in the US, known as the Framingham heart study, examined the effects of butter and margarine on cardiovascular disease. The following graph shows the results:

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400 Age-adjusted CHD incidence ‘1000

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Butter

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0 1 to 4 Teaspoons per day

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Margarine significantly increased the risk of cardiovascular disease, while butter had no effect.

Another study revealed that high-fat dairy consumption reduced the risk of heart disease by a whopping 69%, most likely due to increased Vitamin K2 intake.

The results of this study revealed that margarine raises heart-attack risk, while natural butter does not. Grass-fed butter may even reduce heart-attack risk due to the high Vitamin K2 content.

BUTTER IS A GOOD SOURCE OF THE FATTY ACID BUTYRATE The 4-carbon fatty acid butyrate is created by bacteria in the colon when they are exposed to dietary fibre. This may be the main reason fibre has health benefits for humans. But there is another good dietary source of butyrate fatty acid in butter, which is about 3-4% butyrate. In fact, butyr-ate derives its name from butter.

Studies confirm that butyrate supplementation prevents weight gain on an unhealthy diet by increasing energy expenditure and reducing food intake. It also improves the function of mitochondria and lowers fasting triglycerides and insulin.

CONCLUSION There are several sources that state that Australian margarine does not contain as many trans fats. However, there are now numerous studies that confirm that butter is the best and safest option. Furthermore, butter tastes so much better than any margarine. For me and my health butter has proven to be the best option.

REFERENCE: Full Fat Dairy May Reduce Your Risk of Diabetes and Other Health Problems www.Mercola.com 1 The American Journal of Clinical Nutrition March 2010: 91(3); 535-546 2 Telegraph September 16, 2014 3 Telegraph September 16, 2014 4 Annals of Internal Medicine 2010 Dec 21;153(12):790-9 5 American Journal of Clinical Nutrition October 2005: 82(4); 894-900 6 American Journal of Clinical Nutrition December 2006: 84(6); 1481-1488 7 European Journal of Clinical Nutrition June 2010:64, 569-577 8 NPR September 6, 2014 9 Positron Handmade Organic Cultured Butter Science Daily February 10, 2010 Weston A. Price Foundation January 1, 2000 12 Medicinenet.com July 8, 2014 13 Modern Farmer March 25, 2014 RealMilk.com

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