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Autumn Volume 40 2019

Aesthetics Practitioners Journal is the official publication of the Aesthetics Practitioners Advisory Network PTY LTD.


POWERHOUSE Australia’s revolutionary new skincare fuses expert skin aesthetics with cutting-edge cancer and anti-ageing science.

40mls / 1.35 fl.oz.


APAN AESTHETICS CONFERENCE Providing you with unbeatable value WE ARE DELIGHTED to announce that this year the APAN AESTHETICS CONFERENCE is expanding. We are changing our format to provide you with amazing additions to our programme giving you extra value. The event will still run over one day, but the lecture structure will expand from SIX LECTURES to 16 LECTURES. Here is what you can expect:

These two segments will deliver an excellent balance of the very latest in education, as well as techniques and technologies for practical solutions to some of the more challenging problems you encounter in your practice. Meet some of the industry’s leading experts in a vibrant and dynamic event and join us for a day of learning and fun with other like-minded professionals.

The conference will consist of SIX 30-MINUTE LECTURES on topics relating to:

There will also be some additional inspirational features that will make your experience even more memorable, but we are keeping these as a surprise.

Scientific advances



Ingredients and Skin Science

Business strategies

Consumer trends

This year we will also be launching an additional 10 lectures, 15-MINUTES each. This segment will focus on PROBLEM-SOLVING SOLUTIONS providing you with the latest strategies and technologies for achieving leading treatment outcomes and results. We believe the new format will provide you with a stronger two-pronged approach: •

Global education on the latest scientific advances

Practical solutions you can immediately implement

Join us for an incredible day of leading education, fun, and a buffet lunch like you have never seen before. Be first to learn the latest developments. We know this year will be an exciting and memorable experience for you. We can’t wait to share it with you. If you are staying at the Matra on Sunday night, why not Join us for a seafood buffet on Sunday 26th May? Register on-line for this at the special conference rate of $59. Conference accommodation rate $115. For this register direct with the hotel, but request registration form from APAN to secure that rate info@apanetwork.com

Register Today!

APAN AESTHETICS CONFERENCE 2019 New Format, greater value! If you are serious about your profession and business this event will provide you the industry’s leading and the most up-to-date information. WHO SHOULD ATTEND: • Aestheticians • Dermal therapists • Dermal clinicians • Cosmetic nurses • Cosmetic tattooists • Trainers College principals and staff • Student • Industry suppliers This is an industry-certified Conference Educational Program. Attend and gain 6 CPD POINTS towards your professional development as an APRAP and CTARP registered practitioner.

GOLD COAST Monday May 27 LEGENDS MANTRA 25 Laycock St, Surfers Paradise QLD 07 5593 0360 info@apanetwork.com www.apanconf.com


@apan.page #apanconf












































































Editor Katherine McCann (07) 5593 0360 info@apanetwork.com www.apanetwork.com

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Accounts Payable Aesthetics Practitioners Advisory Network PO Box 5448, Q Super Centre QLD 4218

Advertising & Marketing Tina Viney Phone: (07) 5593 0360 info@apanetwork.com Fax:(07) 5593 0367 Mobile: 0412 177 423 Aesthetics Practitioners Advisory Network PO Box 5448, Q Super Centre QLD 4218 Australia Publisher TEV Group Pty Ltd Design & Production Artwork and Editorial TEV Group Pty Ltd Unit 7D 76-84 Robina Town Centre Drive, Robina QLD 4226 Australia Phone: (07) 5593 0360 info@apanetwork.com Fax:(07) 5593 0367 Mobile: 0412 177 423


National Advisory Council John Fergusson Terry Everitt Chris Testa Gill Fish Vanessa Kirkham Carole Jackson ISSN: 1836-9812 Pint Post Approved [100000257] Circulation 6900




Journal Advisory Board Terry Everitt - Education Features Wendy Neely - PR and Marketing Dr Douglas Grose Scientific Content Caroline Nelson - Business Features

Autumn Volume 40 2019

Front Cover Qalin Scientific Skin Wellness professional@qalin.com.au

Aesthetics Practitioners Journal is the official publication of the Aesthetics Practitioners Advisory Network PTY LTD.


POWERHOUSE Australia’s revolutionary new skincare fuses expert skin aesthetics with cutting-edge cancer and anti-ageing science.

For further information see pages 10-13

40mls / 1.35 fl.oz.


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. APJ 5

EDITOR’S NOTE Katherine McCann

WELCOME to the Autumn issue of APJ. We have so much to share with you in this issue, from news, our upcoming conference program and as always, you will find rich and in-depth educational content that will help to keep you at the forefront of new advances.

age in their own unique way, as well as how the various cultures view beauty differently and seek different outcomes from our procedures. As our populations is becoming less and less a Caucasian majority, our training and skillsets will need to be stepped-up to include both academic, as well as practical techniques to accommodate our clientele’s ethnicity. This is where post-graduate training is so essential as at present there is still very little information beyond the Fitzpatrick scale of skin colour in formal qualifications within our industry.

It was only the other day that I was thinking that we are drawing very close to the birth of Harry and Megan’s baby and what a wonderful surprise awaits us to see the outcome of the bi-racial mix of the baby’s parents. In fact, I would not be surprised if the baby is welcomed into the world by the time you receive this journal.

As APJ is the official publication of APAN you will find articles that in themselves can be considered at a post-graduate in content.

I bring this issue up because we now live in a mobile world where more and more we are experiencing ethnic and racial diversity in our communities that is also impacting our professional community and the type of clients or patients that enter our doors. My recent experience in visiting Vietnam, where I participated in an advance cosmetic tattooing training workshop, allowed me to comprehend the importance of gaining a deeper understanding on how to address and treat our clients who come from a mixed, ethnically-diverse, racial background. The issue is not just skin colour, we also need to understand how the bone structure and features



k.mccann@apanetwork.com www.apanetwork.com APJ 6

Researchers are now warning that “specialists” who do not explore knowledge or education outside of their direct discipline can become myopic and lose sight of opportunities for progress and even refining their specialisation. Experts are stressing the importance of seeking what they call pattern recognition by exploring knowledge outside of our core area of expertise. They state that by developing peripheral knowledge that interfaces with what we do, we can develop a better “flow” towards refining and improving the relevance of our skills and this will help us achieve a higher level of excellence in what we do and how we can benefit our clients. APAN is very much in touch with both the latest research, as well as consumer trends. With every issue of APJ we strive to deliver a balance of various topics that address both current and future development to ensure you are kept up-to-date. Please enjoy this issue and keep growing in your knowledge. I do hope you will prioritise to attend one of the APAN Aesthetic Conferences, as this year we are truly stepping up our program to provide you with truly leading education.

OUR REGULAR APJ CONTRIBUTERS TERRY EVERITT Terry Everitt is regarded as a ‘Master Skincare Professional’ due to his extensive knowledge in the art and science of skincare. A very competent educator and regular lecturer on aesthetic and medical conferences where he presents up-to-date information from an evidence-based scientific perspective. Terry is the Director of Aesthetic Educators Pty Ltd. To contact Terry you can email him at aestheticeducators@gmail.com.

CAROLINE NELSON Caroline Nelson is a beauty industry expert with over 40 years industry experience. She specialises and is passionate in helping clinics and spas develop their brand, improve productivity, and increase bottom-line profit. To learn more about her step-by-step program for salon spa success visit www.SalonSpaBusiness.com or phone 041 0600 440.

GAY WARDLE Gay Wardle is a well-known multi-awarding winning industry expert and a renowned lecturer who conducts advanced skin analysis training for businesses and their staff on all issue pertaining to skin science. If you would like you and your staff to undertake training with Gay please contact Gay on 0418 708 455 or book online at www.gaywardle.com.au. You can also email her on gay@m-da.com.au.

JACINE GREENWOOD Jacine Greenwood is an internationally recognised educator who is known within the industry for her up-to-date knowledge and her ability to deliver training in an easy to understand method. Jacine holds six Diplomas, including a Diploma of Cosmetic Chemistry and a Bachelor of Nursing. Her knowledge is highly respected in the cosmetic industry. With over 22 years experience in the industry and a background of cosmetic formulation, Jacine has an immense knowledge of current trends in research and new developments in the industry. Contact her on 07 3807 1429 or email jacine@roccoco.com.au.

DR ZAC TURNER Dr Zac Turner has a broad medical background specialising in regenerative and aesthetic medicine. Aesthetically, Dr Zac feels that a natural look is best, and truly believes that his ‘less-is-more’ approach. Dr Zac is involved in both the men’s health and preventative health space. He sees prevention and body optimisation as the ultimate way to prevent chronic disease, obesity, and many other conditions. He has owned and is currently involved with clinics in the holistic health arena and believes that through an holistic assessment of someone’s health we can enable them to live longer, healthier, and happier. Contact Dr Zac by Email: zac@drzac.co.

TRISH HAMMOND Trish Hammond is an award-winning blog and social media expert and the director of Plastic Surgery Hub. She is renowned for her skilful writing and interviews in all facets of the social media space. Her company specialises in the Aesthetics, Cosmetic Surgery and Cosmetic Medicine industry sectors for which she provides personalised and comprehensive services to help businesses communicate powerfully, grow their brand and capture new clients and patients. If you would like to speak to Trish about your blogging needs please contact her on 0429 264 811 or Email info@plasticsurgeryhub.com.au.


Keep your eyes on the stars and dream big, but keep your feet on the ground fixed to high standards and integrity. Build your future on solid ground. — TINA VINEY

Tina Viney A message from the CEO I WISH YOU ALL a very successful year and I do hope it is shaping well for you. However, if you can benefit from some encouragement and support please check out the various new initiatives APAN is launching, or expanding in 2019. Whatever we develop is for your benefit, so please take advantage of them as they could potential provide you with the answers you are looking for.

Starting with our conferences this year we are introducing 10 additional lectures expanding the total conference program from six to 16 lectures. The 10 additional lectures will focus on the “how to” factor, to provide practitioners and business owners with up-to-date, strategies, techniques, protocols and technologies that can deliver leading problem-solving solutions.

As always, our focus and goals at APAN is to introduce programs that strengthen the industry’s integrity and recognition through initiatives that continually raise the standards and improve best practice.

While the pressure of competition is on-going, new advances are promising more efficient ways to achieve better treatment outcomes. It is therefore a matter of survival to continue to refine our skills. We also need to investigate the possibilities of new modalities to expand our scope of practice and remain


remain relevant to the on-going consumer demands who are constantly seeking better outcomes delivered through highly skilled and competent practitioners. These solutions-oriented conference segments will aim to provide you with answers to some of the most challenging problems you encounter in your business. If you haven’t already registered please do so and join us as this year’s conference programs promise to offer you a wealth of knowledge and an incredible experience. In 2019 we are conducting our first conference on Monday 27th May on the Gold Coast and the second conference will be held in Melbourne Monday 12th August. Please plan to attend at least one event, but if you can attend both that would be amazing as they will be two different programs. Please also note that your attendance at each of these events will secure you six Continued Professional Development Points (CPD). STEP UP YOUR RECOGNITION As procedures become more advanced so the cost of providing them also increases. Statistics confirm that consumer demand will continue to rise, however, studies also point to the rise in consumer expectations. If they are going to increase the financial investment in their appearance and wellbeing, they want to know that the practitioner is capable and competent. While there will always be those who go for the cheap prices, I can assure you that the vast majority are seeking information about accessing the most skilled, qualified and capable practitioner who can deliver what they are looking for. The number of consumers who quietly reach out to APAN to check on credentials is also on the rise. They are asking us to validate the qualifications of practitioners. IS YOUR PROFESSIONAL TITLE TRADEMARKED? In today’s world anyone can create a certificate on their compute or call a product-knowledge certificate a qualification. However, true qualifications are about proven competencies and currency of knowledge. Mindful of the need to review qualifications APAN introduced the ARAP and CTARP accreditation program. Members are invited to submit their qualifications for assessment by an educational panel. If their qualifications meet with the appropriate merit criteria, they will be issued the appropriate registration. ARAP and CTARP registration represent the highest level of industry recognition that your qualifications meet with industry standards. The title of APAN REGISTERED AESTHETICS PRACTITIONER (ARAP) is also trademarked, that means that you can stand out from the rest as only approved ARAP practitioners can use this title. NO OTHER QUALIFICATION TITLE IN OUR INDUSTRY IS TRADEMARKPROTECTED. Become a Registered Aesthetics Practitioner and make this your competitive advantage. If you perform aesthetics or dermal therapy procedures you can apply for this registration. Visit www.arap.com, or if you are a cosmetic tattooist, visit www.ctarp.com for further details. Also please note that ARAP and CTARP practitioners are now required to continue their professional development by providing evidence of achieving six CPD points each year to retain their CPD registration. UPDATE ON TOPICAL ANAESTHETICS BILL We have been informed that our submission with recommendations for our industry when the Drugs and Poisons Bill was up for review has been included into the Health Department’s submission, which has now gone to the Parliamentary Committee for consideration. We will keep you informed of updates.

practitioner that is using topical anaesthetics for their procedures, be they cosmetic tattooing, skin needling or other aesthetic procedures that require pain management, must make sure they are operating within the legislative guidelines as set out by their State. You have a duty-of-care to both your clients as well as to the reputation of your profession to act in line with current requirements, whether you consider them fair or not. If you are unsure, please contact your State Health Department or APAN. We strongly suggest that you seek advice on these matters through the appropriate authoritative channels and not through social media where only opinions are shared. You can discuss whatever you wish on social media, but for regulatory issues please ACT only on information you have gained from appropriate authorities. WHAT DOES APAN OFFER ITS MEMBERS? CHECK OUT OUR NEW FAQs SECTION To assist with both members and general enquiries we have introduced this year a new feature on our website FAQs (Frequently Asked Questions), which you will find under the membership banner. This section presents some of the most common questions we are asked and provides you with answer that you can access in your own time. This will allow you to determine how to gain the most from your membership. Members, please check this out, as it will allow you to see how you can gain maximum benefit from APAN. To all the amazing, dedicated practitioners and business owners who renewed their membership at the end of last year a big THANK YOU for supporting us in our mission to service you, protect you and continue to provide you with on-going initiatives to strengthen your reputation and your future. If you have not cashed in on your Mentoring and Coaching Voucher, please phone today and make a time to do so. This is an amazing one-hour session that can help you gain valuable recommendations and leading strategies to help grow your business. This year, we have incredible new strategies to help you reach your goals with greater ease and help you also elevate your competitive advantage. For all our new members, we are delighted to welcome you to our community of practice and look forward to helping you gain quality support in your profession and business. Please make sure you check all the documents included in your membership pack and go through our folder carefully. Don’t forget to contact us if you feel you need advice or help in anything that may concern you. We are accessible 9am to 5pm Monday to Friday. Ph: 07 5593 0360 or E: info@ apanetwork.com. Both new and old members, please like and share the APAN Facebook and Instagram platforms and look out for educational information and industry updates. Each month you will also receive an EDM from APAN which will come to you via your email. Please check these out and inform your staff not to delete our emails so that we can continue to reach you. Please also remember to notify us if you change your contact details – phone, email or postal address. I do hope we will get to meet you in person at one of our events this year. Wishing you every success for the year.

Meanwhile, please note that it is imperative that each



QALIN leaps ahead in Epi-Genetic Skin Science Revolution Cancer science meets anti-ageing skincare in world-first new model “Right from the very start, the whole premise of doing this was to make a brilliant product. And that’s what we believe we’ve done.” Professor Derek Richard, Chief Scientist Cancer and Ageing Research Foundation.

Derek Richard, QALIN combines cutting-edge anti-ageing and epi-genetic science with intelligent trans-dermal delivery in luxurious Australian-made skincare. QALIN’s unique formulation creates a new level of skin cell wellness that users can see and feel. But just as important as QALIN’S unique science and proven effectiveness, is QALIN’s unparalleled purpose. THE QALIN STORY

QALIN Scientific Skin Wellness is a world-first collaboration between expert skincare and an internationally-renowned scientific research institute that has made breakthroughs in treatments and cures for cancer and ageing conditions. QALIN works unlike anything you’ve seen and, uniquely, every sale directly helps the scientists move their discoveries from the laboratory to clinical trials and to patients faster. QALIN is the culmination of highly-experienced skin aesthetic professional Lynette Rouse’s life’s work. By collaborating with world-class cancer and ageing scientists, led by Professor APJ 10

The collaboration with the scientists of the Cancer and Ageing Research Foundation, based at the Translational Research Institute in Brisbane, joins academic research and skin aesthetics together in a revolutionary world-first new model. The scientists specialise in finding treatments and cures for cancer based on a breakthrough discovery that manipulates the ageing switch in cells to help protect our genetic code. They believe stopping the genetic code deteriorating helps protect people against all types of cancer as well as ageing diseases such as Alzheimer’s. The scientists bring this trailblazing discovery to QALIN’s innovative skincare. In

return, QALIN directly supports further research and trials of new drugs and treatments. “This is ground breaking new science for cancer and makes our science in QALIN unique in skincare, anywhere. We’re achieving incredible things with skin that weren’t possible before, this is a major leap forward,” Lyn said.

change the epi-genetics of cells as well as contribute antimicrobial properties, is at its optimal concentration in the QALIN Q1 SERUM. A third key ingredient is Nicotinamide Riboside that is found in every cell in our body. As we age, this compound drops, so QALIN Q1 delivers a supplement to the cells to help them regain peak health.


Each of the ingredients is scientifically tested using a process called mass spectrometry, which measures the mass of molecules, and High-Performance Liquid Chromatography to test more complex molecules, to ensure every molecule is pure.

The major breakthrough behind QALIN was a very significant discovery by Professor Richard and the team, published in the scientific journal Nature that isolates a way to protect our genetic code. The potent active ingredients in QALIN are all scientifically proven to change epi-genetics in the cells that are treated. By changing epi-genetics, our body is instructed to read different parts of our genetic program and looks after our genetic code better. The real advance for the QALIN range is not only the active ingredients, it is using the ingredients in concentrations scientifically proven to work epi-genetically. “We haven’t diluted anything down, we haven’t cut costs, we are actually using everything at a dose that will work and has been proven scientifically to work in laboratory studies,” Professor Richard said. REAL SCIENCE QALIN’s powerful active components are all added for one reason: to improve the health of skin cells. All of the individual active ingredients have been scientifically shown to individually improve epi-genetics of cells. When combined, they help tackle skin problems together to help make cells think they are younger, healthier, fitter and protect cells from stress that can cause the deterioration of your genetic code. This helps make cells more hydrated, helps increase mitochondrial health within cells, helps reduce redness on the skin, and helps minimise the signs of ageing. QALIN’s complex set of ingredients also includes carriers designed to take the ingredients down to the cells. “The base is brilliant at carrying the active ingredients trans-dermally to the cells, while the active ingredients work so well epi-genetically it is like nothing the industry has ever seen before,” Lyn said.

HOW DO YOU SUPPORT CANCER AND AGEING RESEARCH? Using QALIN means you directly support the Cancer and Ageing Research Foundation. Every bottle sold directly helps the scientists take their research from the laboratory to clinical trials and a step closer to treating patients with cancer and ageing conditions such as Alzheimer’s Disease. “Right from the very start, the whole premise of doing this was to make a brilliant product, and that’s what we believe we’ve done. The other part of the whole picture was to make a product that would actually bring money back into research,” Professor Richard said. “This is new, it is exciting, and we are very proud we are a part of it.” Footnote: Richard DJ, et al. Single-stranded DNA-binding protein hSSB1 is critical for genomic stability. Nature. 2008. For further information email professional@qalin.com.au

“We are achieving incredible things with skin that just weren’t possible before.” Lynette Rouse, Founder, QALIN

QALIN Q1 The QALIN Q1 SERUM, using QALIN’s unique EPI-GN Formulation, has a matchless list of natural ingredients, including some found in our own bodies. One of the key ingredients in QALIN Q1 is French Lilac. French Lilac contains a compound that has been shown to help epi-genetic changes in the way cells signal each other under stress, and so reduces stress in cells and helps reduce inflammation. QALIN has added another twist, by doing a double extraction of French Lilac for the powerhouse QALIN Q1 SERUM. Curcumin, that has been scientifically proven to

40mls / 1.35 fl.oz.

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HOW EPI-GENETICS WORKS 1. We have approximately 2m of DNA in every cell in our body. To store this much information in such a small space, the cell wraps the DNA into structures called histones with the bits that are not needed wrapped up tightly and stored (heterochromatin) and the genes the cells do need packed less tightly (euchromatin). 2. In each cell there is also a team of proteins called epigenetic modifiers that unwrap the genes that need to be read and wrap up the genes that are not required. 3. This epi-genetic modifier team also unwraps damaged DNA to allow repair proteins in to correct the damage, and then wraps fixed DNA back up again. This is important as each cell (that’s about 60 trillion in our body) gets damaged around 30,000 times per day. 4. As we age, unfortunately the body decides to switch off the DNA repair proteins. This means that while the epi-genetic team opens the DNA for repair, the repair takes longer and is often not completed.


5. As a result, mistakes are introduced to your genetic code, which drive diseases such as cancer. Because the repair process is not working properly, the epigenetics also fail to be restored, compounding the problem and ultimately slowing down the production of proteins. In skin cells this is seen as a loss of collagen and elastin. APJ





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Real science, real results. A real purpose.


Q1 SERUM Through a collaboration with internationally-renowned Cancer and Ageing Research scientists in Queensland, we bring Australian cutting-edge ageing and epi-genetic research to skin wellness. Q1 SERUM’S Unique EPI-GN Formulation delivers a powerhouse epi-genetic boost to skin’s cellular wellness to help amplify gene expression, regeneration and hydration. The optimal concentrations and combinations of key ingredients uniquely help hydrate, smooth and enhance your skin. Every sale of QALIN supports the Cancer and Ageing Research Foundation fund further cancer and anti-ageing projects.

U N I Q U E E P I-GN F O R M U L ATI O N 40mls / 1.35 fl.oz.

Our science is unique in skincare, anywhere.

Our science is unique in skincare, anywhere.


UNI QUE EPI-GN F ORMUL AT I ON 40mls / 1.35 fl.oz.

Australian Made Australian Owned

L A U N C H I N G M AY 2019 Professional and stockist enquiries, please email professional@qalin.com.au

APJ 13




A UNIFORMALLY pigmented skin is generally a visual sign of youthfulness that is beautiful and glowing. Yet in a world where the impacts of harmful ultraviolet radiation and oxidative stresses from the environment are never-ending, particularly as the ozone layer is slowly being depleted, achieving this goal seems elusive to many clients. As we know, hyperpigmentation is localised excess pigmentation of the skin and can be induced by numerous intrinsic factors, including inflammatory diseases, medications, hormonal fluctuations and of course the ageing process. It can also be spurred on by extrinsic factors including most notably, ultraviolet exposure and physical or chemical wounding, which can either be accidental or brought on by therapeutic treatments such as chemical peels, IPL or Laser or even some deep microdermabrasion treatments. What I will be dealing with mostly in this article is your understanding of the various pigmentation problems that are faced by people in a sunny country like Australia and how to safely treat them, knowing that there is a limit when we are dealing with Melasma, mostly caused by hormonal issues that are deep seated or in the dermal layers. SKIN STRUCTURE AND THE PIGMENTATION PROCESS To understand the production and distribution of melanin, a basic understanding of skin physiology is required. The skin is comprised of two distinctive, but interdependent tissues: the epidermis and the deeper or highly vascularised layer of the dermis. The epidermis serves as the primary protective layer for the dermis and soft tissues beneath it and as result, receives the full impact of the sun’s radiation. The Epidermis consists principally of keratinocytes, which replicate at the basal layer, and push up to the outer surface as they mature, eventually dying and leaving a stacked layer of keratin-filled cellular envelopes of the stratum corneum. Melanocytes sit among the young keratinocyte cells in the basal layer at an approximate ratio of one melanocyte for every 10 keratinocytes. APJ 14

“Melanin” is a word derived from the ancient Greek word “Melanos” meaning dark pigments that are biosynthesised inside the melanocyte cell from tyrosine in response to several initiating factors, including ultraviolet radiation. Tyrosine, an amino acid, is converted to L-DOPA by Tyrosinase, a key enzyme that is present in the cell, and through the action of additional enzymes that produce either pheomelanin or two types of eumelanin. Pheomelanin can be characterised as a light yellow to red brown pigment, whereas eumelanin can be divided into black and brown pigments. Ultimately, the ratio of these pigments defines skin colour with fairer skinned individuals expressing higher levels of pheomelanin, red hair being one example, and darker skin and hair comprising of more eumelanin. Once melanin is produced inside the melanocyte, it is transported out of the cell in small cellular packages called melanosomes. These melanosomes travel through branchlike appendages called dendrites, which extend from the outer surface of the melanocytes and latch on to multiple surrounding unpigmented keratinocytes and introduce pigmentation to these cells. The epidermal-melanocyte unit is typically composed of one melanocyte attached to 30 or more keratinocytes. Studies have shown that once the pigment is inside the keratinocyte, it typically resides on the sun facing side of the cell to protect the nucleus and its DNA from damaging ultraviolet exposure. The pigmented keratinocyte will then slowly migrate to the upper layer of the skin via the natural process of desquamation and appear in the stratum corneum. This is one reason why regular but gentle exfoliation is a necessary form of treatment, before starting any professional treatment. This also explains why tanning is experienced in response to ultraviolet exposure. As one ages, however, the re-pigmentation of the skin in response to ultraviolet exposure slows due to a reduction in the melanocyte population. It has been estimated that 10 to 20 percent of epidermal melanocyte cells are lost by the age of 30 and drop at the rate of 10 per cent per decade thereafter.

HOW HYPERPIGMENATION IS FORMED On a biochemical level, there are two paths that can lead to hyperpigmentation: The first is through an increase of melanin and melanosomes. This pathway is usually instigated by either internal stimulus, such as hormonal changes, or external irritations, such as ultraviolet or chemical exposure. The second pathway is through hyperplasia (enlargement) of melanocytes and melanosomes, which is most often caused by sun exposure and sometimes idiopathically in certain disorders. However, hyperpigmentation is most commonly found to be an after-effect of inflammation in the skin, commonly referred to as PIH or post inflammatory hyperpigmentation. This can be characterised as the excess pigmentation of the skin due to a wide spectrum of inflammatory processes in response to mechanical insults such as scratches, burns, insect bites, abrasions, cuts, acne, chemicals or ultraviolet exposure. Inflammation can be visually detectable, such as skin erythema associated with a sunburn, healing wound or acne or invisible such as low-grade ultraviolet exposure. Inflammatory processes in the skin stimulate or introduce a wide array of biochemical signal molecules to the site of inflammation. These signals are associated with the body’s complex immune response, blood clotting and damage repair mechanisms including cytokines, prostaglandins and stemcell growth factors. Inflammation resulting from skin damage can provoke the release of reactive oxygen species, including superoxide and nitric oxide and melanocyte-stimulating hormones. All of these molecular species can trigger the production of melanin and melanin transfer to keratinocytes, leading to hyperpigmentation. When treating your clients, consider this response as the longer an inflammatory process lasts, the more melanin deposition can occur, as is seen in chronic acne. Mitigating inflammation is key to slowing or preventing the hyperpigmentation process and re-establishing even skin colour e.g. try cooling the skin after an inflammatory process, or using anaesthetics prior to your professional treatments such as in micro-needling or performing it without causing any bleeding which will in turn cause inflammation. While hyperpigmentation is commonly associated with excess melanin deposition and/or the gathering of melanocytes in the epidermis, melanin stimulated by an inflammatory process can also migrate into the dermis, typically by being absorbed by tissue macrophages and resulting in dermal pigmentation. In many cases, the tissue the hyperpigmentation appears in, determines the colouration – e.g. epidermal hyperpigmentation produces a brown discoloration, while deeper-seated dermal hyperpigmentation produces a blue-grey colour and a mixture of the two types creates a brown-grey appearance. When it is difficult to distinguish between the two, a Wood’s lamp can be used to facilitate detection in most skin types, with the exception of Fitzpatrick types 4, 5 and 6. The life cycle of melanin-filled tissue macrophages (also known as melanophages) is embedded in the deeper dermal tissue and is much longer than the melanin-filled epidermal cells. As a result, dermal hyperpigmentation such as Melasma is much more difficult to treat without the use of a Q-Switched MLA (Micro Lens Array) hand piece or one that produces Picosecond or shorter pulses than the Nano-second pulses.

Some commonly known pigmentation issues that you will encounter with your clients are Ultraviolet Radiation, wound-healing process, post-trauma acne, diseases and drugs and hormones. It is the last that I want to focus my attention on in this article. Hormonal changes can cause melasma which is often associated with pregnancy or the use of medication containing artificial hormones. Melasma can be very bothersome to clients when it covers large facial areas, and is often on both sides of the face, in a symmetrical pattern. Common medications that can cause melasma are birth control pills and thyroid medications. In extreme cases clients may choose to cease using these medications causing the reversal of the pigmentation. Chloasma or the mask of pregnancy may manifest itself as dark patches on the face or abdomen of a pregnant woman. It will typically dissipate after pregnancy, but in some instances, it may only reduce in size. In those cases, topical treatments to lift and remove it such as professional soft peels or enzymes are recommended, with home care for daily use and if you do not have a Q-Switched system for treating those clients professionally on a biweekly or tri-weekly basis. Additional conditions associated with discoloration and pigmentation are due to intense and intermittent sun exposure, allergies from foods or perfumes, scar tissue and post-inflammation (Acne, IPL or Laser burns, Waxing, etc.) and environmental pollution. These blemishes are frequently responsible for significant aesthetic problems, to such an extent that they influence the personal lives of those who are affected by them. There is a wide spectrum of treatments today for hyperpigmentation. From topical treatments to using LED with specific wavelengths to reduce the inflammation process or energy and light treatments performed by physicians, dermal therapists or laser specialists who also prefer to use a combination of treatments to get the best results quicker. Clients must be warned that using HRT in post-menopausal situations will require patience to control but will not completely remove their pigmentation problems, as long as they are on HRT. Daily use of crèmes containing a mixture of ingredients like Tranexamic Acid, Arbutin, Kojic Acid, Azelaic Acid, Polyphenols and Antioxidants with Vitamins A, B, C and E must be initiated for 20 days at least, before commencing any professional treatment for eradicating various pigmentation problems including “age-spots”. Consultation with a precise diagnosis is

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Boswellic acid: this is a patented dermo-active complex, containing the active ingredients in the resin of Boswellia Serrata, which has antioxidant, protective and antiageing properties (it protects the functions of elastin and collagen). It is also a skin conditioner that evens out pigmentation by its progressively and uniformly lightening action. Substances with Antioxidant and Detoxifying properties: •Green tea polyphenols •Grape seed extract •Tetrahydro-curcuminoids • Colourless carotenoids • Ferulic acid Substances with exfoliating properties: • Lactic acid • Glycolic acid • Salicylic acid essential and it is up to the skin therapist, cosmetic physician or dermatologist to look for initial causes, and where possible, remove them. SPECIALLY-FORMULATED LIGHTENING AND BRIGHTENING CRÈME Clinical Skincare Naturaceutical Lightening and Brightening treatment exploits the synergic presence of anti-oxidants, exfoliators, emollients and active ingredients that depigment at various cellular levels and cellular mechanisms by using a synergistic complex of substances capable of capturing free radicals, inhibiting their formation or deactivating them. Cutaneous hyperpigmentation, or so-called “dark spots,” are a rather widespread problem that affects both men and women, though the latter are more concerned with this issue. Hyperpigmentation manifests itself as blotches of more or less intense darkening of skin colour appearing mostly on the back of hands, face, neckline and in more sensitive areas of the body, such as external genitalia, anal and perineal areas. Normally, melanin that accumulates in the horny layer is removed by normal cell regeneration, and pigmented skin spontaneously returns to its natural colour. However, in many cases, hyperpigmentation can be persistent and of increasing intensity. Various etiological factors can determine the appearance of skin discoloration. First, the ageing process: melanogenesis of the skin becomes more irregular over time. This is how age-spots appear, especially on the back of the hands and on the sides of the face. Second, other causes of melanogenesis alteration can be hormonal changes, caused by oral contraceptives, hormone replacement therapy during menopause, and lastly pregnancy (chloasma gravidarum). This particular formula contains a synergic blend of various substances, a physical sunblock, and an absorption promoter which ensures targeted action to prevent the appearance of dark spots, plus slow the process of skin ageing. This creamy emulsion is highly tolerated by all skin leaving it protected and glowing with perfume-free sunblock. Its action is attributed to key ingredients and their actions: Hinokitiol: a natural substance that can reduce the production of tyrosinase enzyme and the MITF transcription factor and consequently lessens the synthesis of melanin, with a definite skin lightening effect. The depigmentation benefit of Hinokitiol is enhanced by epigallocatechin gallate (green tea), with which it develops a synergistic action Niacinamide: is a proven depigmentation ingredient inhibiting the transfer of melanosomes rich in melanin from melanocytes to epidermal keratinocytes. Hydantoin derivative: it’s been shown that it also inhibits tyrosinase of melanocytes in vitro and in vivo tests by depriving melanocytes of oxygen.

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Indications: The Clinical Skincare Naturaceutical Lightening and Brightening Crème is recommended for any epidermal or dermal-cosmetic treatment of skin pigment alterations, such as melasma and/or uneven skin discolorations and skin colour. Regular use slows any recurrence due to sun exposure, skin ageing, hormonal changes, chemical agents and post-inflammatory effects. A tested and proven formula for treating face, neck and deck, hands and sensitive areas around the body. It is non-clogging, paraben-free, perfume-free and recommended for all skin types RESURFACING PEELS In order to speed up the desquamation process, several resurfacing agents can be used. These agents range from carboxylic acids - including the alpha hydroxyl, glycolic and lactic acids to beta hydroxyl acids like salicylic acid to name a few. In addition to acid peels, retinoids or retinaldehyde preparations are also very effective in speeding up the epidermal turnover process and as a result, accelerate the lift-off of the hyper-pigmented epidermal cells. However, resurfacing agents are most effective for epidermal hyperpigmentation, especially when used in combination with a good pigment-suppressing and sun protection regimen. Dermal hyperpigmentation on the other hand, calls for more aggressive modalities like pigment- erasing lasers. These specific laser wavelengths target various chromophores in the skin, including vascular, hair and pigment. Pigment-erasing Lasers with specific wavelengths to break down melanin are often best combined with a series of peels. The less downtime and inflammation, the better the results. Most importantly, it is imperative that any skincare professional that attempts to correct hyperpigmentation makes an even greater effort to prevent future hyperpigmentation via a daily pigment-control regimen. APJ For further information or to contact Metro-Dora Clifford from ClinicalPRO please call 1800 628 999.


APAN AESTHETICS CONFERENCE 2019 Facing your profession with real answers

8.30-8.45AM WELCOME 8.45-9.00am



Topic: THE ROLE OF MICROBIOTA IN DERMATOSIS Dr Tiina Meder – Cosmetic Dermatologist (Switzerland)

peptides and how after years of clinical research the new Myo-Fix six-step protocol developed in Switzerland can deliver effective facial lifting through a targeted approach on mimic muscles.

10:00-10.30AM MORNING TEA BREAK 10.30 – 11.00am


Dr Tiina Meder is internationally-renowned Cosmetic Dermatologist with over 25 years’ experience in Aesthetic medicine and a regular speaker and educator at medical conferences world-wide. She specialises in the development of topical solutions for aesthetic concerns, as well as theoretical research of their safety and efficacy. She is the founder of Meder Beauty Science and author of the book, The Urban Myths of the Beauty Industry.

Professor Laurence J. Walsh AO is a specialist clinician with 30 years’ experience in using multiple types of lasers and IPLs in practice. As a trained photo-biologist he has worked to explore many aspects of the safe use of lasers and intense light with patients, and he has published widely in the laser and biomedical optics literature. He has contributed to the development of Australian laser safety standards for over 25 years and is a senior lecturer at the University of Queensland.

This lecture will address the specific role of the skin’s microbiota and how it impacts conditions such as acne, rosacea, seborrhoea, psoriasis and eczema. Dr Meder will also discuss strategies on how to restore these skin conditions to better health.

This lecture will provide you with a new understanding of photo-biology and how to practically use this knowledge when determining correct treatment settings for various skin conditions. An amazing and dynamic presenter this lecture is a must for all laser and IPL practitioners.


11.00 – 11.15am

Topic: LEADING TECHNIQUES FOR FACE AND BODY SHAPING Presenter: Ronald and Helen Greenberg Sponsor: Diamond Natural Beauty This lecture will present leading strategies and protocols to successfully achieve body shaping, as well as muscle toning for face and body that flow with the body’s natural physiology and also achieve wellness benefits using modern technology and specific protocols.


Topic: NEW-GENERATION EYE AND FACIAL LIFTING WITHOUT INJECTABLES OR SURGERY Presenter: Dr Tiina Meder Sponsor: Spectrum Science and Beauty

TOPIC: UNDERSTANDING THE DIFFERENCE BETWEEN MELASMA AND HYPERPIGMENTATION AND SUCCESSFUL STRATEGIES IN TREATING BOTH CONDITIONS Presenter: Metro-Dora Clifford Sponsor: ClinicalPro The success of treating pigmented skin conditions is based on understanding the contributing factors, origin and where the pigmentation is located in order to address the problem at its root. This lecture will present how melasma and hyperpigmentation differ and the most successful strategies and protocols for each to achieve successful treatment outcomes.

In this lecture you will learn the role of neuromodulating

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APAN AESTHETICS CONFERENCE 2019 Facing your profession with real answers

11.15 – 11.30am

changes that inevitably present as skin issues and ageing concerns. Learn how with scientifically-optimised doses of key actives to create a positive epi-genetic effect and help reduce the symptoms associated with inflammation and skin ageing.

More than 15.5% of Australians will get tattoos in their lifetime and over 40% will at some stage wish to remove them. This procedure is experiencing growth in demand and now there is a safe and cost-effective way of removing tattoos through saline solution. Learn the process and protocols for tattoo removal using the A+Ocean system. The treatment can achieve great results, but can also be used in combination with laser tattoo removal for residual colour that cannot be totally removed.




TOPIC: CUTTING-EDGE CANCER AND ANTIAGEING SCIENCE – THE LINK TO SKINCARE AND BENEFITS FOR CONSUMERS Presenter: Professor Derek Richard PhD – Cancer and Ageing Researcher Professor Richards is a Chief Scientist of the Cancer and Ageing Research Program, Translational Research Institute, Princess Alexandra Hospital in Brisbane. He specialises in Biochemistry and Cell Biology Microbiology, Oncology and Carcinogenesis. This lecture will present the global advances and breakthroughs in cancer research and how they translate to skincare. The role of epi-genetics in cancer, skin and skin wellness as well as what epi-genetic ingredients are now scientifically-validated for their anti-ageing properties and in supporting skin health. 12.00am-12.15am TOPIC: CHANGING EPI-GENERITCS TO IMPACT INFLAMMATION THAT CAUSE SKIN DISORDERS Presenter: Lynette Rouse Sponsor: QALIN Scientific Skin Wellness Inflammation is a complex biological function designed as one of the body’s major defence mechanisms. However, when the inflammatory mechanism is consistently activated, it can lead to low level and chronic inflammation contributing to DNA gene expression APJ 18

TOPIC: THE BENEFITS OF SKIN REJUVENATION OF DERMAPLANING Presenter: Riana Janse van Rensburg and Karen Geiszler Sponsor: DermaplanePro Australia This lecture will present the effects, contraindications, treatment protocols of Dermaplane. What you can achieve by adding this treatment to your services and the skin types that can benefit from this procedure.

12.30-1.30PM LUNCH BREAK

1.30 – 2.00pm

TOPIC: WINTER-PROOFING THE SKIN Presenter: Jacine Greenwood Jacine Greenwood holds a degree in nursing and qualifications in cosmetic chemistry. She is a renowned lecturer and educator both in Australia and internationally in her area of expertise, which is ingredient science. Jacine has a wealth of knowledge in new trends in cosmetic ingredients. Her lectures are delivered in an easy-to-understand manner and she loves to empower therapists to understand their skincare ingredients and use them wisely. In this lecture you will learn about skin structural changes as they are impacted through climatic changes, specifically during the winter months. The role of physiological lipids versus the non-physiological lipids, humectants and emulsifiers and how to effectively restore skin balance.

2.00 – 2.15pm

Topic: PIGMENT RETENTION IN COSMETIC TATTOOING – ARE YOU GETTING ENOUGH? Presenter: Robert McGowan Sponsor: ThiNK Aesthetics When it comes to a successful cosmetic tattoo procedure the issue of pigment retention is a critical factor to ensure client satisfaction and this is an area that often challenges practitioners. This lecture will present key considerations to ensure the success of your results including technique, equipment, quality pigments, topical anaesthetics, scarring and skin condition prior to treatment.


TOPIC: ELIMINATING POST INFLAMMATORY ERYTHEMA Presenter: Jacine Greenwood Sponsor: Roccoco Botanicals Post-inflammatory erythema can contraindicate many treatments due to the skin’s intolerance, or limited tolerance to skin rejuvenating treatments. This lecture will address ways of eliminating post-inflammatory erythema and discuss which cytokine pathways need to be targeted and which cosmetic actives show promise.

2.30 – 3.00pm

TOPIC: HOW GUT HEALTH IMPACTS THE MIND, SKIN AND BODY Presenter: Nicky Wood, ND Nicky Wood is a qualified and experienced Naturopath with over 22 years in clinical practice. She is also a qualified Clinical EFT practitioner, keynote speaker, spa industry business consultant and published health writer. Gain inside information on the very latest research findings on the gut microbiome and what science is discovering. Learn why this information is important to both you and your clients. This knowledge will help you understand how to benefit both mental and physical health and provide you with further insight into this amazing topic.

3.00 – 3.30PM AFTERNOON TEA BREAK 3.30 -4.00pm

TOPIC: PERSONAL AND BUSINESS PERFORMANCE FROM WITHIN Presenter: Phillip Fernandez – Director of Wizard Consulting Phillip Fernandez is a renowned Human Strategist, business coach and author. He has extensive experience in both the corporate world as well as the Hair and Beauty Industry and understands the challenges in both business growth and staff performance facing business owners in a fiercely competitive industry. This lecture will help you redefine your own identity. Starting with you as the business owner, it will provide you with the tools to refine your personal brand and establish effective strategies for more personable and successful engagement with your staff and clients.

4.00 – 4.15pm

TOPIC: ANAESTHETICS AND BEYOND Presenters: Chris Testa and Brigitte Paroissien Sponsor: Tugun Compounding Pharmacy While many procedures require safe and effective anaesthetics to ensure client comfort during a painful procedure, there is much more that can be compounded exclusively for you. Evidence-based cosmetics with excellent delivery systems are imperative to the treatment outcome when working with the skin. This lecture will present an update on both topics. REGISTER TODAY! www.apanconf.com 07 5593 0360 info@apanetwork.com

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NEUROMODULATING PEPTIDES How they work on wrinkles Dr Tiina Meder THE AGE when individuals first experience lines and wrinkles can vary from one person to another. For some, wrinkles may appear as early as just age 30 to 32, while for others they may appear much later, as late as 40 to 45. As a general rule, applying quality skincare and limiting sun exposure will help protect the skin and maintain a youthful appearance for longer. More recently, studies have identified that the age that wrinkles first appear in women is the age when they have childbirth and for many women today that is usually in their 30s and beyond. This paradox leaves us with a predicament – during pregnancy and lactation a number of injectable therapies are strictly contraindicated. Furthermore, many doctors advise against injectables at the pregnancy planning stage so that a woman doesn’t end up receiving treatments when she is already pregnant. Fortunately, we now have alternative methods of wrinkle correction that do not require injections and are therefore safer option during pregnancy and lactation. Many medical practitioners are sceptical about the ability to gain real results without fillers or Botulinum toxin injections. This is quite understandable because the market recently has been flooded with numerous creams, serums and other cosmetics claiming injectable-like effects, but they cannot deliver the results they claim. Social media’s dubious before and after photos, as well as photo-shop filters are also contributing to consumer scepticism as to what can realistically be achieved without injectables. So why don’t most of these cosmetics work? There are several reasons: •

The dose of actives, which could theoretically reduce wrinkles is insufficient for real results

Often, they are applied incorrectly, or in combination with other brands that neutralise or inactivate them

APJ 20

Consumer expectations for immediate results and when this does not occur, they stop using the product or are not consistent with application.

NEUROMODULATING PEPTIDES New advances have now identified substances that can reduce the mimic wrinkles that most commonly appear on the upper third of the face such as the forehead, brow and eye area? Introducing neuromodulating peptides. The peptides used in cosmetology are small protein molecules able to penetrate the skin’s protective barrier. Peptides can have a wide range of effects on the skin’s structures and the neuromodulating ones have the capacity to block the impulse transmission from the nerve fibre to the muscle. Botulinum toxin generally works in the same way: it blocks the transfer of the signal towards a facial muscle, stopping it from contracting which makes the wrinkles disappear. A common question is “how do peptides get into the muscle?” As we know the muscles are located deep beyond the skin, so it is difficult to imagine that any ingredient with a cream applied onto the skin’s surface can reach that far, it is however entirely possible and here is how: At the points where mimic muscles are attached to the skin their fibres are intertwined with the skin throughout all of its layers up to the skin’s surface. So, if a solution is applied precisely onto the spot where the mimic muscle is intertwined with the skin the paralysing ingredients can take effect. So how can one find these spots? Luckily, it is fairly easy – the wrinkles are lines connecting the spots of the muscles’ attachment to the skin. If the solution is applied right onto the wrinkles, it will be exactly where it needs to be. There is no need however in applying it around the area of the general wrinkles as the solution will not reach the muscles and it most likely will not work at all, so correct application is important. So how do we know which peptides are neuromodulating?

Studies have identified the following neuromodulating peptides as follows:

Here are examples of what you can expect from the Myo-Fix treatment. APJ

Acetyl Hexapeptide-8;

Acetyl Hexapeptide-3 (Argirelyne);

Leuphasyl (Pentapeptide-3, Vialox);

For further information and to introduce this treatment into your salon or clinic please contact SPECTRUM SCIENCE & BEAUTY 1300 766 198.

Syn-Ake (Dipeptide diaminobutyroyl) benzylaminide diacetate);

SNAP-8 (Acetyl Octapeptide-8) and a few others.

Meder Beauty Science has developed several highly effective treatment options delivered through specific protocols that are able to achieve cutting-edge results. Specifically, for treating wrinkles, the Myo-Fix treatment and protocols can deliver amazing results and is suitable especially for clients who have an aversion, or for whom injectables are contraindicated. Myo-Fix is the world’s first effective non-injectable mimic wrinkle correction. The Myo-Fix treatment follows an exclusive six-step protocol, developed in Switzerland after years of clinical research and extensive testing: The first three steps involve preparation of the skin to allow the active ingredients to maximise their penetration: •

The process begins with a purifying and energising cleansing emulsion, which destroys the dead cells from the upper layer of the skin

A light enzyme peel continues the skin’s purification process, releasing toxins from the pores and nourishing the skin

A powerful cocktail of antioxidants is then applied to oxygenate the skin and prepare it for application of the bioactive ingredients, specifically to each treatment. The results are quite impressive.


SMOKING AND THE SKIN Terry Everitt IN A RECENT issue of APJ, TERRY EVERITT has been exploring how lifestyle choices affect the skin. If you are involved in skincare, then you already know that smoking nicotine is harmful to the skin. Many do not know much more than it is terrible - how bad and precisely what is it doing to the skin that makes it so wrong? In this edition, our resident scientific evidence-based contributor, Terry Everitt looks at the effects of cigarette smoking on health and specifically how smoking takes a toll on the skin. It is thought that tobacco smoking exerts its harmful effects on the skin via its irritant components on the epidermis and indirectly on the dermis via the blood circulation. Due to some of the toxic compounds, smoking decreases epidermal moisture content leading to dehydration. Pursing the lips during smoking, contraction of facial muscles and squinting due to smoke irritation help cause the familiar wrinkling around the mouth and in the crow’s feet area of the face. Macromolecular metabolic dermal changes lead to the host of dermal damage. The accumulation of elastotic material is in part due to the degradation of matrix protein, which is mediated by matrix metalloproteinases (MMPs), destroying the dermal structure, via the decrease of collagen synthesis and abnormal accumulation of elastic fibres and proteoglycans. Accumulation of abnormal elastic material (solar elastosis) is the prominent histopathologic alterations in photoaged skin. Tobacco smoke induces a significant increase in tropoelastin mRNA in cultured skin fibroblasts. Although elastic fibres account for only 2–4% of the extracellular matrix, these provide elasticity and resilience to healthy skin. The precise ways in which tobacco smoke damages, or changes skin remain not fully understood, although scientific studies have produced evidence regarding several possible ways. Most epidemiological studies indicate that tobacco smoke exposure decreases capillary and arteriolar blood flow in the dermis. From this, the flow-on effects causes multiple individual causative damages. This damage results in far

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more than a few wrinkles and collectively, smoking results in premature ageing, and not only of the skin. Tobacco smoke is comprised of at least 4000 constituents, comprising of both water soluable and insoluable compounds. One group of water-insoluble compounds are the polycyclic aromatic hydrocarbons (PAHs). These in turn damage something called the aryl hydrocarbon receptor (AhR) signaling transcription pathway. This pathway is involved in the regulation of human development, hypoxia signaling and circadian rhythms amoung others; belonging to a family of proteins that reside in the cytoplasm in an inactive complex with accessory proteins. Some of which encode proteins involved in growth control, cytokines, nuclear transcription, and regulators of extracellular matrix proteolysis. It is therefore easy to see the extent of damage that smoking induces.

For most, extrinsic ageing is far more problematic and noticeable than intrinsic ageing causative factors. Of the external ageing accelerator factors, Ultra Violet Radiation is the number one culprit. You may be surprised that smoking is number two. Tobacco smoke is phototoxic, becoming more toxic to the skin with the interaction of UVR, causing more damage than either in isolation. Now that we have established the big picture (which I guess you already knew anyhow), let’s get a little technical and see why these changes occur. Lined for life We know that smoking increases the ageing process causing profound changes to the quantity and quality of the elastic fibres and collagens of the dermal extracellular matrix (ECM). Come with me as we take a closer look at some of the fantastic biochemistry that causes this to occur. Much of the work in defining how tobacco smoke causes harm metabolically is credited to Yin, Morita and Tsuji (2000, 2001, 2003), who showed three separate yet interlinking pathways of destruction.

Lysyl Oxidase (LOX) The structural integrity of the ECM proteins relies on several biochemical pathways with the central requirement being a precise enzyme-driven formation of crosslinks by the lysyl oxidase (LOX) family of amine oxidases; which have the primary role in catalysing the final step of collagen and elastin cross-linking. This allows the structural integrity needed for their efficient working. (To be clear – this cross linking is the right kind; not the lousy crossing linking such as with Advanced Glycated End Products and such). Previous studies have shown that when this precise orchestration does not occur, then the disruption results in misalignment of the structure.

Molecular mechanisms of tobacco smoke-induced premature skin ageing. (Morita, Torii, Maeda, & Yamaguchi, 2009, p. 54) Matrix Metalloproteinases (MMPs) A recent study has been undertaken on matrix metalloproteinase-1 (MMP-1) mRNA expression in human fibroblasts after Yin, Morita and Tsuji (2000) showed that both smoking and UVR caused ageing in human skin through additive induction of MMP-1 expression, while production of the collagen precursors, procollagen types I and III, was decreased significantly in supernatants of cultured fibroblasts exposed to tobacco smoke. Therefore, tobacco smoke not only impairs collagen biosynthesis, but also causes collagen degradation by inducing MMPs. It is interesting that the expression of TIMP-1 and TIMP-3 (tissue inhibitor of MMPs) remained unchanged, thus increasing amounts of MMPs that are produced. A year later, the authors found the MMP-1 induction was significantly higher in the low glutathione (GSH) content fibroblast compared to that in the high GSH fibroblast, indicating that the differences in glutathione content define the susceptibility of fibroblasts towards UV- or tobacco smoking-induced MMP-1 expression (Yin, Morita and Tsuji, 2000). While MMP 1 was the initial focus, we now know that increases of MMP 3 and 7 are also induced by tobacco smoke. The authors found the risk for developing wrinkles was 11.4 times higher than that of non-smokers and those with less sun exposure (<2 h/day) at the same age. Transforming Growth Factor- β (TGF- β) TGF- β 1 is a multifunctional cytokine that regulates cell proliferation and differentiation, tissue remodelling and repair. In the epidermis, TGF- β 1 is a potent growth inhibitor, playing an essential role in the maintenance of tissue homeostasis. Conversely, TGF- β 1 acts as a growth factor, not inhibitor in the dermis, inducing the synthesis of extracellular matrix proteins. A further study by Yin, Morita, & Tsuji, (2003) showed tobacco smoke creates a non-functional latent form of transforming growth factor- β in skin fibroblasts. Cellular responsiveness to transforming growth factor-β1 is blocked by this nonfunctional form, and the downregulation of the transforming growth factor- β 1 receptor results in decreased synthesis of extracellular matrix proteins. One promising line of cosmetic research is finding an ingredient that could provide an exogenous addition of TGFβ 1 that could stimulate collagen production or to protect against the deleterious effects of tobacco smoke.

Langton et al., (2017) showed how this was possible. The study team used advanced immunohistochemistry technology, in describing the activity of LOX and LOXL1 amine oxidases, resulting in aged skin. Mainly, they found increased amine oxidase activity in smoker’s skin was attributed to both LOX and LOXL1, whereas in photoaged skin, to LOX only. It is the increased amount of specific amine oxidases caused by smoking that is the causative problem. It is interesting that mechanisms important for both the development and maintenance of ECM integrity are, in part, responsible for contributing to premature ageing caused by the independent factors of chronic sun exposure and tobacco smoke. What this means is that there will be renewed study on this group of biochemicals and identification of ingredients that could prevent or at least delay this increased production of essential LOX groups. While the damage is occurring throughout the body, smoking worsens the damage in skin resulting in upper eyelid skin redundancy, lower lid bags, malar bags, nasolabial folds, upper and lower lip wrinkles. While not new knowledge, a study by Chien et al., 2001 showed that smoking and sun exposure are independent risk factors for wrinkling in these areas with Chung et al., (2016) and Jamal, et al., (2017), reporting the same findings. Skin damage due to tobacco smoke is primarily irreversible, however, further damage can be avoided by stopping smoking (Urbańska, Nowak, & Florek, 2012) who stated that “It has been observed that the skin of smoking addicts at the age of 40 years resembles skin of non-smoking 70-year-old adults” (p. 1112). Advanced glycation end products (AGEs) If you have read some of my earlier work, you know I love writing about Advanced Glycation End products (AGEs). [In the Summer Edition, Volume 39 of this journal, I gave an update on glycation].

RESEARCH While the damage is occurring throughout the body, smoking worsens the damage in skin resulting in upper eyelid skin redundancy, lower lid bags, malar bags, nasolabial folds, upper and lower lip wrinkles. While not new knowledge, a study by Chien et al., 2001 showed that smoking and sun exposure are independent risk factors for wrinkling in these areas. APJ 23

al., (1977) titled ‘Tobacco smoke is a source of toxic reactive glycation products’. This is great in-depth information. Psoriasis and Smoking Of all the conditions that stem from smoking, psoriasis is the most visible. Smoking has repeatedly been identified as a potential risk factor for psoriasis. Not only are psoriasis patients more likely to smoke, but smoking also appears to have a role in the onset of the disease, and a marked dose-response relationship has been found. To isolate that smoking is a single factor has been difficult as many factors may be correlated with smoking, such as alcohol consumption and stressful life events, and therefore may have a confounding effect on psoriasis. There are a vast array of these cute yet damaging moieties of non-enzymatically fused protein and reducing sugars formed via the Schiff and Amadori processes, otherwise known as the Maillard reaction. AGEs are a significant by-product of tobacco smoking. Reactive glycation products are present in aqueous extracts of tobacco and in tobacco smoke (termed glycotoxins) in a form that can rapidly react with proteins to form AGEs. Glycotoxins are transferred to the serum proteins of human smokers where they become mutagenic. Glycotoxins are highly reactive and can induce AGE formation in hours, rather than the days/weeks of the sugar-protein variety. AGEs are not only a skin concern as they affect the entire body and the smoke-induced AGEs are significant players in the various carcinogenic outcomes attributed to smoking. Atherosclerosis Perhaps most people think the real danger of smoking is lung cancer, yet one of the most prominent smoking-induced killers is atherosclerosis. There is abundant in vitro and in vivo evidence that AGEs play a role in the pathogenesis of atherosclerosis. Here is the short version of how this occurs: • AGEs have been shown to cross-link connective tissue collagen, which serves to increase connective tissue rigidity (in this case of the blood vessels). •

Collagen-linked AGEs serve as reactive ‘‘foci’’ to covalently trap circulating serum proteins, such as lipoproteins.

Binding of endothelial cell AGE receptors increase vascular permeability, decrease synthesis of the anti-coagulant thrombomodulin, and increase integration of the procoagulant tissue factor.

Tissue-bound AGEs chemically quench cell-derived nitric oxide activity, thereby inhibiting the nitric oxidedependent vascular relaxation.

AGE modification of ApoB prevents the normal uptake of Low-Density Lipoprotein (LDL) by tissue LDL receptors, thereby increasing the circulating LDL cholesterol levels (these, of course, are the ‘bad’ cholesterol).

AGE-modified albumin causes vascular alterations such as increases in vascular wall permeability, increased mononuclear cell migratory activity. (Information modified from Cerami et al., 1977).

It is not surprising that this list of damage results in variations of atherosclerosis and resulting cardiac complications with high morbidity rates. Additionally, markedly elevated vascular tissue and circulating AGEs are linked to the accelerated vasculopathy of end-stage diabetic renal disease. If interested in how this plays out, an old study, yet a landmark one to source is from Caerami et

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Cigarette smoke contains many potentially toxic materials which affect the immunopathogenesis of psoriasis. Primarily these toxins act by activating T cells leading to overproduction of pro-inflammatory cytokines that we know are associated with psoriasis such as TNF-ᾳ, interleukin (IL-2, IL-6, IL-8 and interferon-γ. Keratinocytes have nicotinic cholinergic receptors, and the uptake of nicotine exerts inhibitory effects on the keratinocyte, accelerating cell differentiation, adhesion and upward migration in the epidermis. Hence the build-up of the epidermis in psoriasis. Smoking induces functional and morphological changes in polymorphonuclear leucocytes, and it may cause an exaggerated release of chemotactic factors including IL-4, IL-1, TNFα, transforming growth factor β (TGFβ) which has been associated with psoriasis severity (Khan, Malik, & Jahangir, 2010). This provides a biologic explanation for the association between smoking and psoriasis. While we are concerned with the superficial treatment of psoriasis, the client has greater concerns as statistical data shows that the genetic predisposition to develop diabetes and obesity is related to psoriasis. Psoriasis and its comorbidities share a common etiological linkage. It is hypothesised that proinflammatory cytokines contribute to dyslipidaemias, atherogenesis, peripheral insulin resistance, type II diabetes and hypertension. Many researchers reported a strong association of psoriasis with diabetes, hypertension and hyperlipidaemia (Khan, Malik, & Jahangir, 2010). Various studies had provided somewhat conflicting outcomes due to the multiple variables within the studies until Lønnberg, et al., 2016 studied 34,781 twins and found the risk for psoriasis increased substantially (OR 2.18, 95% CI 1.82– 2.61; P < 0.001) for smokers with a history of >2 pack-years, even after adjusting for age, sex, and childhood exposure to environmental tobacco smoke (ETS). The smoking twin has a significantly increased risk for psoriasis compared with the never-smoking co-twin. Pack years is a statistical value used in most studies of smokers, where one pack year is calculated as smoking 20 cigarettes a day for a year. Two pack years would be average of 40 cigarettes per day for a year, etc. A larger risk for psoriasis among smokers with late-onset psoriasis compared with early-onset psoriasis was found, indicating that smoking precedes psoriasis, which had been reported in other studies. The present study showed no influence of sex or age on risk for psoriasis from smoking. Interestingly, it was reported that 78% of smoking patients with psoriasis had begun smoking before the onset of the disease; again, confirming the outcomes of previous studies. (Lønnberg et al., (2016) found that Palmoplantar pustulosis is highly associated with cigarette smoking; 75–100% of patients with palmoplantar pustulosis smoke cigarettes. What is particularly surprising is it was found that childhood exposure to ETS also increases the risk for developing psoriasis

reviewed 40,465 and not surprisingly concluded that smoking was found to impact surgical complications differently depending on the location and type of procedure performed. Smokers had a higher likelihood of surgical (1.37) and medical complications (1.24) with increased occurrence of wound complications (1.49) and wound dehiscence (1.84). In a similar study, Toyoda et al., (2018) of 36,454 patients found that smoking was an independent risk factor for deep incisional surgical site infection, incisional dehiscence, and reoperation. Interestingly, superficial surgical-site infection rates were not significantly different.

Schematic representation of the relationship between smoking and psoriasis (Naldi, 2016, p. 67) (Lønnberg et al., 2016). Naldi (2016) also confirmed smoking affects the onset of psoriasis. In a pooled analysis of 25 case-control studies, he articulated the odds ratio of psoriasis among smokers was 1.78, almost double the risk. A dose-effect relationship was also found. In a pooled analysis of three cohort studies, the risk of incident psoriasis was 1.81 in those who smoked 1–14 cigarettes per day and 2.29 in those who smoked ≥25 cigarettes per day. Alina et al., (2018) found in patients who were previous smokers; there was a significant relationship between the severity of psoriasis and the number of cigarettes smoked. There was no significant relationship between the years since quitting and severity of the disease. If you are treating someone with psoriasis, then you need to know their smoking status and have it documented. From the literature, it is absolute that psoriasis will not successfully respond to treatment if the client continues to smoke. Psoriasis is a visible and debilitating condition, and the client may be more motivated to consider quitting smoking because of it than in consideration of other nonvisible health problems. As their skincare provider, you have an immense responsibility to understand what you are treating and the possible barriers in preventing treatment success. Smoking and surgery Smoking is known to impact postoperative wound healing and increase infection risk negatively. Multiple studies to date have shown that complications of wound healing, such as necrosis and infection are more common among current smokers and are thought to be attributable to the vasoconstriction and deoxygenation effects of nicotine and other tobacco-related chemicals. A recent study (Goltsman, Munabi, & Ascherman, 2018)

A study by Troiano et al., (2019) showed no difference in the rate of flap necrosis between rats exposed to cigarette smoke and those exposed to electronic cigarette vapour. However, both groups had considerably more necrosis than rats that were unexposed. The results suggest that vaping is not a better alternative to cigarette smoking in the context of wound healing as smoking and vaping appear to be equally detrimental to wound healing. While e-cigarettes appear somewhat safer than traditional cigarettes, they may still be harmful in the long term. More on e-cigarettes below. Cigarettes – not all the same Possibly you think that cigarettes with filters are safer – most people do, yet you would be incorrect. This is what the manufacturers want you to believe, but the truth is they are more dangerous than non-filtered cigarettes. Cigarette filters were initially introduced by the tobacco industry in the 1960s to make cigarettes “safer”. Initially it was professed that filters reduced tar and other toxicants and prevented tobacco flakes from entering the lungs - all this is incorrect. Most Australian cigarettes are engineered to have vented filters (holes in them), to introduce air to make smoking easier on the throat. To extract a constant nicotine dose, smokers compensate for this, by taking deeper puffs, and more of them. These cigarettes were deceptively named “light” and “mild” until the ACCC stopped this deception in 2005 and getting $8 million from British American Tobacco Australia Limited and Philip Morris Limited to fund anti-smoking information campaigns. This enforcement was only regarding the naming of such cigarettes, not how they are made, with approximately 90% of cigarettes made with vented filters. This has led to an increase in the often-fatal Lung Adenocarcinomas (Song et al., 2017). Around 7 billion butts become litter in Australia every year. Did you know that more Australian women die from lung cancer caused by smoking than from breast cancer? Although breast cancer is more common, it is less fatal than lung cancer. Tobacco product content regulation and disclosure requirements for tobacco products was a report from the Tasmanian Government to the Federal Department of Health which was ignored as the Commonwealth Government makes too much money off tobacco tax. There are no safe cigarettes, which brings me to e-cigarettes.

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E-cigarettes E-cigarettes (more technically known as Electronic Nicotine Delivery Systems (ENDS)) continue to be promoted as a safe alternative to conventional cigarettes, or as a quit smoking aid. The Australian Government National Health and Medical Research Council, in a media release dated 3 April 2017, found there is a lack of evidence to support these claims. Vaping is increasing in popularity, with most of the current body of research focused on the chemical composition of e-cigarette liquid before it is vaped. E-cigarettes have developed significantly in the past decade, increasing in complexity and capacity. They are now considered to be in the fourth generation, comprising highly modifiable devices capable of modulating the energy input used to generate vapour. Using ever increasing energy input, sub-ohm atomiser resistances and custom mixtures for electronic cigarette liquid (ECL), the effect of user exposure is becoming more uncertain and potentially a new health hazard. Several potentially cytotoxic metal and silicate particles are present in e-cigarette vapour equal to or exceeding the levels found in traditional cigarette smoke. E-cigarette vapour has been reported to contain up to 7×1011 free radicals per puff (Leigh, Lawton, & Hershberger, 2016). Scott et al., 2018 looked at what vaping does to the lungs and found E-cigarette vapour boosts the production of inflammatory chemicals and disables key protective cells in the lung that keep the air spaces clear of potentially harmful particles. The vapour impairs the activity of alveolar macrophages, which engulf and remove dust particles, bacteria, and allergens that have evaded the other mechanical defences of the respiratory tract. Franzen et al., (2018) found that smokers of e-cigarettes experienced the same, if not higher level of cardiovascular elevation for prolonged periods after smoking the e-cigarette. Selected components in tobacco smoke Particulate phase Polycyclic aromatic hydrocarbons N-heterocyclic amines Nicotine Phenol, cresol Hydroquinone Naphtylamine Benzo(a)pyrene Indole, carbazole Trace metals (e.g., arsenic) Vapor phase Nitrogen Oxygen Carbon dioxide Carbon monoxide Formaldehyde Hydrocyanic acid Acetaldehyde Acrolein Ammonia Nitrogen oxides Nitrosamines Hydrazine Vinyl chloride (Naldi, 2016, p. 66)

For this study, the smoking lasted for one cigarette, at least five minutes, and the vaping lasted for one session for five minutes. Vital signs were monitored for two hours from when smoking commenced.

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Researchers found that using e-cigarettes and cigarettes, in comparison to nicotine-free e-cigarettes, had the same significant impact on vital signs, with the participant’s blood pressure and heart rate being adversely affected. The findings have significant implications for our understanding of the use of e-cigarettes on long-term cardiovascular risk. Queensland, Victoria, Tasmania, ACT and NSW all have laws banning the use of e-cigarettes (vaping) in public places, and since 2018 in NSW, retailers must notify NSW Heath they are selling e-cigarettes. If you want information that is ‘client-friendly’, then look at this link from Tobacco in Australia. You could use the information provided to construct your own ‘fact sheet’ – with appropriate citation of course. http://www.tobaccoinaustralia.org.au/chapter-3-health-effects/314-effects-of-smoking-on-the-skin For a looping video for your reception, this link takes you to a great offering. https://www.ted.com/talks/krishna_sudhir_how_ do_cigarettes_affect_the_body?language=en Not so fun facts The country with the highest rate of male smokers is Indonesia (57%), and surprisingly the country with the highest percentage of female smokers is Nauru (56%). (The Tobacco Atlas: American Cancer Society and World Lung Foundation; 2015. Available from http://www.tobaccoatlas.org/). Northern Territory has the highest percentage of both male (23%) and female (18%) smokers. ACT has the highest rate of non-smokers (63% male) and (69% female). (Greenhalgh, EM, Bayly, M, & Winstanley, MH. 1.14 Smoking by Australian states and territories. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2017. Available from http://www. tobaccoinaustralia.org.au/chapter-1-prevalence/1-13smoking-states-territories). Somewhat unreliable figures suggest that smokers in Australia smoke less than their counterparts in the US, Canada and France, but more than smokers in Italy, the UK and New Zealand. Everyone knows that smoking is not good for you so I trust this information gives you more knowledge and some of the scientific based evidence that you can use in your client education. The simple fact is, if you are treating the skin of a client who smokes, then no-matter what you do with what, you will never win, as the damage is constantly being accumulated faster than you can reduce it. APJ This article has 21 referenced citations and not listed here, yet are available from the editor. Terry Everitt remains an acknowledged multi-skilled thought leader in the movement to bring a scientific evidence-based knowledge to the aesthetic field of care. An accomplished and very competent Higher Education Senior Lecturer and prolific writer, Terry remains at the forefront of the art and science of skincare. APAN continues to be grateful that he willingly shares his knowledge in his insightful writings and the scientific news section for this journal. Terry posts random and spasmodic posts of interest on the Facebook page Aesthetic Educators Pty Ltd. Terry can be contacted at aestheticeducators@gmail.com

For a list of references, please contact the editor.


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Delivering an impressive health punch for Skin, Hair and Body Tina Viney

I JUST LOVE researching and discovering the benefits of exotic fruit and plants and I am not alone. With the ever-growing consumer interest in natural solutions for prevention and health, scientists are now exploring the validity of some ageold anecdotal health claims to identify if they are scientifically supported. One recent discovery I made was Alma, also known as Indian Gooseberry – arguably one of the most important plants in Ayurvedic medicine. Alma fruit is plump globular shaped and is yellowish-green in colour. Available in dried, powder or capsule form for its medicinal uses, as well as commonly used to make different vegetable dishes, pickles, and chutneys. Why is the renewed interest in Alma? Wait until you see its benefits. Amla was traditionally used to increase vitality, to enhance digestion, treat asthma and cough, stimulate hair growth, and promote longevity. However, modern science is now discovering how its medicinal compounds are able to provide incredible benefits for a number of health conditions. ACTIVE COMPOUNDS IN AMLA Although all parts of the amla plant have medicinal properties, the fruit has the most significant beneficial effects. Compounds found in the fruit include tannins, alkaloids, and phenols. The main tannins in amla, which contain strong antioxidant properties, include: •

Emblicanin A and B



Phenolic compounds include: •

Gallic acid

Ellagic acid



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Natural Amla oil also has an interesting synergy of vitamins and minerals required for good hair growth and healthy body. A quick look at its nutritional profile will help identify how it is beneficial for the hair, skin and overall health: The Nutritional Elements of Amla Oil per 100 gms: •

Total Calories: 48

Total Fat: 0.5 gm

Carbohydrates: 10 gm

Protein: 1 gm

Vitamin A : 6% of RDI

Vitamin C: 800% of RDI

Iron: 6% of RDI

Vitamin B-6: 4%

Magnesium: 2%

As you can see Amla oil is very high in natural vitamin C making it an effective antioxidant. Additionally, vitamin A is fairly abundant, while the synergy of the vitamins and minerals is what makes this oil highly beneficial. Let’s look at some of the benefits of Amla: MAY HELP PREVENT AND FIGHT CANCER Studies have found amla to be successful in fighting cancers of the lungs, liver, cervix, and breast and ovaries. Extracts of Amla were toxic to cancer cells in rats. Both the amla extract and chyavanaprash, a herbal formula that is 50% amla, slowed tumour growth. Total tumour volume decreased by 60% following amla consumption. Studies on rates also confirmed that amla extract increased the lifespan of rats with tumours by 20% while chyavanaprash increased lifespan by 60.9%. Cancer is commonly caused by damage to DNA that leads to suppression of anticancer genes. Mutations caused by DNA damage are also common causes of cancer. Amla

extracts increase the activity of O6-methylguanine-DNA methyltransferase, an enzyme that removes harmful mutations in immune cells.

HDL cholesterol (HDL-C) is considered to be the good form of cholesterol and LDL cholesterol (LDL-C) is thought to be the bad form of cholesterol.

Cancer also develops when the natural cell cycle is disrupted. Usually, cancer causes increases in cyclin-dependent kinases (CDKs) and cyclins - molecules that increase cell growth and division. Gallic acid found in amla decreases levels of CDKs and cyclins.

A study in 32 diabetic and healthy volunteers found that 2 g and 3 g of amla powder daily for 21 days increased HDL-C and decreased LDL-C and total cholesterol levels.

One of the most dangerous aspects of cancer is that it can spread from one area of the body to another (metastasis). Kaempferol, a constituent of amla, is proven effective in preventing breast cancer cells from spreading. Amla protects the body against DNA damaged caused by cadmium, lead, aluminium, nickel, cesium chloride, arsenic and chromium. It also protects the body against 3,4-benzo(a)pyrene: a compound found in tar, tobacco, and grilled meats and is caused by incomplete burning of materials. Benzo[a]pyrene: a compound similar to 3,4-benzo(a)pyrene. Cyclophosphamide: an immunosuppressive drug that can treat certain cancer (leukemia), but can also cause cancer years after treatment. Studies also confirmed that gallic acid was proven to prevent stomach and liver cancer cells from spreading. PROTECTION AGAINST RADIATION Amla is also radioprotective, meaning it protects against damage from radiation. Radiation is a common form of cancer treatment. Providing rats with fruit pulp of amla for seven days before lethal radiation increased survival rates from 0 to 87.5%. Another study found that treatment with amla before radiation increased white blood cell and haemoglobin (oxygen transporters) count. INCREASES HDL AND REDUCES LDL AND TOTAL CHOLESTEROL High levels of cholesterol can play a role in causing different heart diseases, including heart attacks, and strokes.

A study of 60 patients with high cholesterol levels (> 240 mg/ dl) found that 500 mg amla daily for 42 days increased HDL-C and reduced LDL-C and total cholesterol levels  The effects were similar to the popular statin drug Zocor (simvastatin). Also, the high levels of vitamin C and fibre in amla are thought to be responsible for its cholesterol-lowering effects. Amla also reduces triglyceride levels in the blood. High level of triglycerides (TG) fats in the blood are linked to low levels of high-density lipoprotein-cholesterol (HDL-C), insulin resistance, obesity, and increased risk for heart disease. Amla reduced levels of TG in the blood of 60 patients. AMLA PREVENTS HARDENING OF THE ARTERIES Amla prevents hardening of the arteries by reducing the build-up of molecules such as LDL-C, cholesterol, and TG. This not only reduces chances of strokes but also provides better blood flow. Many heart diseases such as coronary artery disease are prevented and treated through such antiatherogenic effects. ANTI-INFLAMMATORY AND ANTIOXIDANT PROPERTIES The vitamin C in amla accounts for 45-70% of its antioxidant activity. Reactive oxygen and nitrogen species (ROS and RNS) cause inflammation. The phenolic compounds in amla decrease both ROS and RNS. Studies confirmed that amla fruit extracts decreased both acute and chronic inflammation. AMLA IS ANTIBACTERIAL An extract called Triphala, which includes amla and two other popular herbs, was found to inhibit the bacteria Salmonella typhi, which is resistant to multiple antibacterial drugs.

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AMLA INCREASES WOUND HEALING Amla applied topically over wounds in rats increased the rate of wound healing closing times. Triphala, which includes amla and two other popular herbs, also increased wound healing in rats. The extract improved the wound closing through increased levels of collagen, the protein responsible for wound closure. It also decreased the bacterial count leading to less infection. AMLA INCREASES HAIR GROWTH Amla applied topically increased hair follicle count by 91% and hair growth and was more effective than the popular hair growth medication Rogaine.

The study looked at 54 different herbal extracts and Triphala had one of the strongest antibacterial effects. A cell study of amla showed that amla had antibacterial effects against all 186 bacterial strains studied. Other studies have found the same results. A cream made up of different herbs, including amla, called Basant inhibited the growth of the Neisseria gonorrhoeae bacteria, which is resistant to common antibacterial agents such as penicillin, tetracycline, nalidixic acid and ciprofloxacin. The Basant cream has also shown inhibitory effects against HIV and human papillomavirus type 16 (HPV 16). AMLA IS ANTIVIRAL Pentagalloylglucose (PGG), a compound found in amla, contains antiviral properties against the influenza A virus. Incubating the virus in PGG reduced the total level of the virus.

ENHANCES THE IMMUNE SYSTEM Natural killer (NK) cells are the body’s most powerful immune cells that attack tumours and cells infected with viruses. Amla powder increases the activity of NK cells 2-fold. AMLA IMPROVES MEMORY Tests also showed amla fruit extract increased shortterm memory in rats. It also reversed amnesia, reduced cholinesterase in the brain, which is also beneficial in helping disorders such as dementia and Alzheimer’s. EYE AND VISION HEALTH We all know that vitamin A and carotenes can protect and improve your vision. As we have seen amla is outstandingly rich in vitamin A and offers great protection against visual deterioration. Tests confirm that it will assist in: •

Improved near-sightedness

Reduced risk of cataracts, macular degeneration, and night blindness

Reduced intra-ocular tension. That’s the pressure inside your eyes that keeps them from bulging (too much pressure) or growing lazy (too little pressure), often a precursor to glaucoma and blindness

Reduced blurry vision, spots, glare at night, flashing lights

PGG also prevented the virus from leaving infected cells (viral budding) and spreading to new cells. AMLA IS ALSO ANTIFUNGAL Amla, also showed inhibitory effects against the fungi Candida glabrata, Candida albicans and Candida tropicalis. All three fungi are resistant to common antifungals such as azole drugs and amphotericin B. AMLA PROMOTES BALANCE IN THE BODY’S HOMEOSTATIS Stress can disrupt bodily balance and weaken the immune system and reduce brain function. Amla fruit extract has adaptogenic properties, meaning it works to maintain balance in the body. In stressed individuals, amla maintained: •

Glucose tolerance

Sexual behaviour

Behavioural wellness

Cognitive function

Immune system function

THE BENEFITS OF AMLA OIL Unlike other oils like Sesame, Coconut or Sunflower, Amla oil is not directly extracted from the fruit. Instead, amla fruits are dried in sunlight and are soaked in a carrier or base oil. The resultant oil turns green in colour due to the seeping of Amla juice into the oil. Carrier oil can be either coconut, almond or sunflower oils. Amla Oil can be used directly on skin and hair and will deliver anti-inflammatory and antioxidant properties. For hair problems, Amla oil can be used on scalp and must be massaged till it gets absorbed. In terms of its antioxidant benefits amla demonstrates impressive results when compared with other compounds. Here are the results of a recent comparison:

AMLA PROTECTS THE SKIN Amla protects the skin against oxidative stress caused by free radicals and metals.

75 times the antioxidant power of goji berries

60 times the antioxidant power of pomegranates

50 times the antioxidant power of raw blueberries

Amla fruit extracts also protected human skin cells from UV damage and increased growth of collagen, a protein that makes up a large part of the skin.

13 times the antioxidant power of black raspberries

PROTECTS THE GUT Non-steroidal anti-inflammatory drugs (NSAID) can cause stomach ulcers. Amla fruit extracts decreased the formation of ulcers. APJ 30

While many of these results were tested on rats, there are also numerous human studies that have been published, such as in the Journal of Pharmaceutics. APJ

For a list of references, please contact the editor.


IS YOUR MISSION STATEMENT CONTRIBUTING TO YOUR GROWTH AND SUCCESS? Tina Viney THERE IS A COMMON misconception that Mission Statements are old fashioned and have no real value in today’s fast-paced world. Yet nothing could be further from the truth. If that is your opinion then the following article will help you see what you are missing out on, and if you do have one, it will help you gain even greater value from it. Let me start by taking you on a journey. Imagine for a minute that you are a first-time client who is visiting your clinic. Recently, life has had it challenges and the stress has made those lines around your eyes and mouth so much more obvious. You are not just feeling older, you are looking older. You finally make up your mind to invest in a few more advanced facial treatments. The clinic recommends a series of dermal needling and laser treatments. It all sounds painful, but you are assured it will be worth it and the appointment is made for a week’s time. Meanwhile, the day before your appointment Today Tonight runs a gruelling story of a laser treatment that has gone horrendously wrong burning the client’s face. Doubt start to penetrate your thoughts, but you soldier on and face the day. You enter the clinic with trepidation and find a seat. The thoughts and emotions of undertaking your treatment leaves you both excited and anxious. Did you make the right decision? Will this experience make a difference? Will you be in capable hands? Your eyes scan the walls in search for reassurance and suddenly there it

is – the clinic’s MISSION STATEMENT: “Renew Clinic is dedicated to creating a caring, welcoming environment designed to offer unparalleled, state-of-the-art aesthetic services delivered with safety and efficacy. All our practitioners are highly qualified, trained and experienced in leading techniques and technologies. We seek to make each client’s experience unique by skilfully combining the most advanced technologies and protocols to deliver groundbreaking results that are natural and aesthetically-pleasing.” You breathe slowing a sigh of relief as your mind is set at ease to face the day. A MESSAGE THAT GENERATES TRUST Creating an environment in your business that reflects the values of your brand can be achieved through various tools – your conduct and decorum of how your staff greet and interact with your clients, the message you reflect through your written and visual communication including colours, textures and the ambience you create, all coming together to communicate the desired message about your brand. Additionally, the more risk there is to your services, the more you need to communicate messages that mitigate that risk – qualifications, industry body recognition and privacy policy. This is also where your Mission Statement can be the silent

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“Renew Clinic is dedicated to creating a caring, welcoming environment designed to offer unparalleled, state-of-the-art aesthetic services delivered with safety and efficacy. All our practitioners are highly qualified, trained and experienced in leading techniques and technologies. We seek to make each client’s experience unique by skilfully combining the most advanced technologies and protocols to deliver groundbreaking results that are natural and aesthetically-pleasing.”

comforter of what you stand for and what the client can expect from their experience with you. There are very few businesses in our industry that fully appreciate and understand the power and purpose of a Mission Statement and profile it in their premises, so let’s take a closer look at its purpose and intent and how to craft a Mission Statement that serves you and reflects who you are to your world. WHAT IS A MISSION STATEMENT? A mission statement is a short statement of why an organisation exists, what is the goal of its operations: what kind of product or service it provides, its primary clients or market, and the scope of practice of its services. This statement should be brief – just a one, or at the most two sentences. It should be thought-provoking and emotional enough that it tugs on the heartstrings of the client. Your mission statement will invite clients and potential clients to test you on what you will deliver every time. It should automatically raise the service bar and hence raise the benchmark. It should compel excellence and consistency in your business and from your staff. Sometimes business owners ask me if it is really that important to have a written MISSION STATEMENT as for many, it’s just a plaque on the wall with little or no value. Here is why I think it is critical that every business (even small businesses) should have a clear, written mission statement.

where we want to go in the future. 3. It provides a template for decision-making Far from being just something that only speaks to the clients about who you are, a clear mission sets important boundaries which enable business owners to delegate both responsibility and authority. Mission is to the company what a compass is to an explorer, a map to a tourist, a rudder to a ship, a template to a machinist. It provides a framework for thinking throughout the organisation. It provides the boundaries and guardrails you need in order to stay on the path to your preferred future. When you are unsure about a decision that will affect the business, look at the mission statement and ask yourself, “if we take this path, is it congruent with our mission statement?” 4. It forms the basis for alignment When a new employee is hired, it’s critical that the new staff member is clear about what the business does, what it stands for and where it is going. The mission statement forms the basis for alignment not only with the owner, but the entire team and organisation. Your team will all be on the same page when it comes to what you do and why you do it, which will lead to maintaining your standards of best practice and efficiency.

1. It determines and clarifies your business’s direction Smart business owners use this statement to remind their teams why their company exists because this is what makes the company successful. The mission statement culminates what the company stands for at its heart, and it keeps everyone clear on the direction of the organisation, and it’s your direction, not your intention that determines your destination and what you will achieve.

5. It supports the need for change that leads to progress Many people are resistant to change because it causes us to feel insecure and sometimes it challenges our comfort zone. However, if the mission is clear, then team members are more likely to see the value of the change and how it helps the organisation to maintain its integrity and relevance in the market and ultimately, accomplish its mission. Use your mission statement to create a culture that welcomes change when warranted.

2. It focuses on the company’s identity and how it will manifest in the future Many people refer to this as the “vision” which is different than the mission. The vision is about a preferred future, your dreams and aspiration of where you want to be in one, two or three years. The mission tells us what we’re doing today that will then take us

6. It shapes strategy Every business, its owner and staff need a strategy. But strategies must not be created in a vacuum. Instead of looking at what’s new or what competitors are doing and trying to copy them, wise business owners create the most effective strategies possible to accomplish the mission their company is set out to accomplish. A

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good mission statement will help you stay on track in making sure your brand is true to its own identity and purpose. 7. It’s a powerful tool for evaluation and improvement It has been said that “What you measure will be your mission.” If you have a clear, written statement of your mission you will know exactly what to measure and how to measure it. In fact, a clear mission will bring clarity to every other level of the organisation. MISSION STATEMENT WORKSHOP To come up with a statement that encompasses all the major elements of your business you need to start with the right questions. Here are a few questions to help identify the verbal picture on which to craft your mission statement:

1. Why are you in business? What do you want for yourself, your family and your clients? Think about the spark that ignited your decision to start a business. What will keep it burning? 2. Who are your clients? What can you do for them that will enrich their lives and contribute to their success— now and in the future? 3. What image of your business do you want to convey? Clients, suppliers, employees and the public will all have perceptions of your company. How will you create the desired picture? 4. What is the nature of your products and services? What factors determine pricing and quality? Consider how these relate to the reasons for your business’s existence. How will all this change over time? 5. What level of service do you provide? Most salons or clinics believe they offer “the best service available,” but do your clients agree? Don’t be vague; define what makes your service so extraordinary. 6. What roles do you and your employees play? Wise business owners identify strengths in their staff and develop a leadership style that organises, challenges and recognises employees. Smart leadership is about balance between encouraging and complementing achievements and fostering an environment for on-

going growth and skills development in their staff. 7. What kind of relationships will you maintain with suppliers? Every business is in partnership with its suppliers. When you succeed, so do they. 8. How do you differ from competitors? Many business owners forget they're pursuing the same dollars as their competitors. What do you do better and more efficient, or faster than competitors? How can you use competitors’ weaknesses to your advantage? 9. How will you use technology, capital, processes, products, and services to reach your goals? A description of your strategy will keep your energies focused on your goals. 10. What underlying philosophies or values guided your responses to the previous questions? Some businesses choose to list these separately. Writing them down clarifies the “why” behind your mission. PUTTING IT ALL TOGETHER Here are a few more thoughts to make your mission statement the best it can be: Involve those connected to your business. Even if you're a sole proprietor, it helps to get at least one other person’s ideas for your mission statement. Other people can help you see strengths, weaknesses and voids you might miss. If you have no partners or investors to include, consider knowledgeable family members and close friends, employees or accountants. Choose supportive people who truly want you to succeed. Set aside several hours, even a full day if possible to work on your Mission Statement. While Mission Statements are typically short, it is important that they capture the key elements of your business, what motivates and drives you, what you are offering your clients and your values that will govern your future. It must effectively describe the heart and soul of the business that will inspire others to trust and engage with you. It must also remind you and your staff what you stand for and to stay true to who you are and your objectives. Make your Mission Statement is something that you can be proud of – a living document that acts to promote and encourage engagement and a compass that allows you to stay on course with your goals and objectives. APJ APJ 33


ASHWAGANDHA the master stress reliever Tina Viney

THROUGHTOUT my career I have had the privilege of interviewing some of the world’s leading academic and medical minds and among them have been several neurosurgeons. One question that always gets me the exact same response is, “what is one of the most important things we can do to maintain brain health, as well as overall health”. The answer is always the same – minimise our stress levels. HOW STRESS IMPACTS US While stress is not always bad, the cumulative effect of longterm stress can creep up and ultimately harm our health. According to the National Institute of Mental Health over time, continued strain on your body from routine stress may contribute to serious health problems, such as heart disease, high blood pressure, diabetes and other illnesses, as well as mental disorders such as depression or anxiety. Health problems can occur if the stress response goes on for too long or becomes chronic, such as when the source of stress is constant, or if the response continues after the danger has subsided. With chronic stress, those same life-saving responses in your body can suppress immune, digestive, sleep, and reproductive systems, which may cause them to stop working normally. Different people may feel stressed in different ways. For example, some people experience mainly digestive symptoms, while others may have headaches, sleeplessness, sadness, anger or irritability. People under chronic stress are prone to more frequent and severe viral infections, such as the flu or common cold. Routine stress may be the hardest type of stress to notice at first. Because the source of stress tends to be more constant than in cases of acute or traumatic stress, the body gets no clear signal to return to normal functioning. Over time, continued strain on your body from routine stress may contribute to serious health problems, such as heart disease, high blood pressure, diabetes, and other illnesses, as well as mental disorders like depression or anxiety.

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While there are many strategies, we can put in place to help manage our stress levels, for the purpose of this article I want to highlight an amazing adaptogenic herb known as Ashwagandha. It is one that I have found to offer great benefits and which also has a great deal of science to back it. WHAT ARE ADAPTOGENIC HERBS? Adaptogens are amazing natural substances that work with a person’s body and help them adapt; most notably, to stress. Unlike drugs that force the body to respond, adaptogens are a natural ally in dealing with persistent stress and fatigue because they work with regulating important hormones. Studies confirm that adaptogens offer several other health benefits, including: •

A boost for the immune system

Support for managing a healthy weight

Increased physical endurance and mental focus

Reduction in discomfort caused by poor health

Encouraging a balanced mood

Benefits the skin

All these benefits can come from something as simple as adding adaptogens into your regular diet. While there are a number of ways to increase your adaptogen intake, consuming adaptogenic herbs is arguably one of the best and easiest ways to offer your body valuable support against the detrimental impact of stress. So, let’s take a closer look at Ashwagandha and review its benefits. WHAT IS ASHWAGANDHA? Ashwagandha is supported extensively by studies as an adaptogenic herb that has been used for more than 2,500 years. It’s actually the most commonly used and extensively researched adaptogen herb. It’s valued for its thyroidmodulating, neuroprotective, anti-anxiety, antidepressant

and anti-inflammatory properties, which are just some of the many ashwagandha benefits. In India, ashwagandha is known as the “strength of the stallion” because it has traditionally been used to strengthen the immune system after illness. It has also been referred to as “Indian ginseng” because of its ability to enhance your stamina and work as a natural stress reliever. In fact, it’s ashwagandha’s ability to work as a stressprotective agent that has made it such a popular herb. Like all adaptogenic herbs, ashwagandha helps the body to maintain homeostasis, even in moments of emotional or physical stress. But the many ashwagandha benefits don’t stop there. This powerful herb has shown incredible results for lowering cortisol levels and balancing thyroid hormones. Plus, it’s been used for mood disorders and in the prevention of degenerative diseases.

Improves Underactive Thyroid Function One of the most incredible aspects of adaptogenic herbs like ashwagandha is that they help people with thyroid problems. Ashwagandha has been shown to support a sluggish thyroid for people diagnosed with Hashimoto’s disease, or underactive thyroid. For the millions of people who are struggling with thyroid problems, many of whom don’t even know it, ashwagandha may serve as the solution they’ve been waiting for. A 2017 pilot study published in the Journal of Alternative and Complementary Medicine, ashwagandha benefits for helping patients with subclinical hypothyroidism were evaluated. The 50 participants were diagnosed with thyroid disorder, but didn’t display obvious symptoms of thyroid deficiency.

According to research published in Alzheimer’s Research and Therapy, “Ayurvedic medicinal plants have been the single most productive source of leads for the development of drugs.” Many of the plants used by Ayurvedic practitioners, like ashwagandha, have proven to be useful in relieving a number of health concerns.

During an 8-week period, the treatment group received 600 milligrams of ashwagandha root extract daily, and the control group received starch as the placebo. Researchers found that ashwagandha improved serum thyroid stimulating hormone (TSH) and thyroxine (T4) levels significantly compared to placebo. It was concluded that ashwagandha may be beneficial for normalising thyroid levels in patients with hypothyroidism.

In Ayurvedic medicine, ashwagandha is characterised as a “rasayana,” which means that it’s used to promote your physical and mental health, to defend your body against disease and damaging environmental factors, and to slow down the ageing process. In India, ashwagandha has been used as a broad-spectrum remedy for centuries, but more recently scientists have proven that is possesses antiinflammatory and antioxidant properties that play a major role in the many ashwagandha benefits.

And a study published in the Journal of Ayurveda and Integrative Medicine also found that ashwagandha has thyroidenhancing properties. They discovered this while researching ashwagandha for bipolar conditions. In the study, patients with bipolar disorder used ashwagandha to improve cognitive function for an 8-week period. Lab testing found that some of these patients experienced T4 increases during the treatment period, although that was not the original purpose of the study.

As research continues to investigate the benefits of ashwagandha studies are confirming very interesting and impressive results. These include:

Research suggests that, since ashwagandha increases thyroid function, it may not be suitable for people with hyperactive thyroid, such as those with Graves’ disease.

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that it thereby improves people’s self-assessed quality of life. As stress is a known cause of depression, as is hormonal imbalances, ashwagandha can potentially work as a natural remedy for depression. In a 2000 experimental study involving rats, ashwagandha efficacy was compared to the antidepressant medication imipramine. Researchers found that ashwagandha exhibited antidepressant effects that were comparable to imipramine when rats were exposed to “behavioural despair” and “learned helplessness” tests. It was concluded that ashwagandha can be used as a mood stabiliser in clinical conditions of depression.

Relieves Adrenal Fatigue Research shows that ashwagandha may be useful in supporting adrenal function and helping individuals overcome adrenal fatigue. Our adrenals are endocrine glands that are responsible for releasing hormones, specifically cortisol and adrenaline, in response to stress. If your adrenals are overtaxed due to an overabundance of emotional, physical or mental stress, this can lead to adrenal fatigue. When your adrenals become exhausted, this can also disrupt other hormones in your body, including progesterone, which can cause infertility and lower levels of DHEA, a hormone that’s tied to longevity and maintaining a strong skin and body. Combats Stress and Anxiety One of the most well-known ashwagandha benefits is its ability to work as a natural remedy for anxiety. In a 2009 study published in PLOS One, ashwagandha was shown to be comparable to common pharmaceutical drugs lorazepam and imipramine, without the side effects. In the 12-week controlled study, 75 participants with anxiety were divided into two groups, one that received naturopathic care and another that received standardised psychotherapy intervention. The naturopathic care group received dietary counselling, deep breathing relaxation techniques, a standard multi-vitamin and 300 milligrams of ashwagandha twice daily. The psychotherapy intervention group received psychotherapy, deep breathing relaxation techniques and placebo pills twice daily. When anxiety levels were measured after the 12-week period, the group who received ashwagandha had anxiety scores that decreased by 55 per cent and the psychotherapy group’s scores decreased by 30.5 per cent. Significant differences between the two groups were also found in mental health, concentration, social functioning, vitality, fatigue and overall quality of life, with the ashwagandha group displaying greater clinical benefits. In addition to these positive findings, researchers indicated that no serious side effects occurred in either group. A major ashwagandha benefit is that there are no or minimal adverse reactions when taking it, compared to antidepressant and anti-anxiety medications that may cause drowsiness, insomnia, loss of sexual desire and increased appetite, among other side effects. Improves Depression Not only does ashwagandha benefit people who deal with anxiety and chronic stress, but it can also be helpful for people who experience signs of depression. Ashwagandha improves our resistance towards stress and studies show APJ 36

Balances Blood Sugar Levels Ashwagandha has been evaluated for its anti-diabetic effects, which are possible because of the presence of phenolic compounds, including flavonoids. Research shows that flavonoids possess hypoglycaemic activities and a study involving rodents concluded that both ashwagandha root and leaf extracts helped to achieve normal blood sugar levels in diabetic rats. An animal study published in Reports of Biochemistry and Molecular Biology found that when ashwagandha was given to fructose-fed rats, it inhibited the fructose-induced increases in glucose, insulin resistance and inflammation. This data suggests that ashwagandha extract may be helpful in improving insulin sensitivity and reducing inflammatory markers in humans. What about the skin? Due to the fact that ashwagandha is packed with the goodness of antioxidants it also offers great benefits to the skin by successfully fighting the damaging effects of free radicals produced via exposure to harmful UV radiation from the sun. Studies also confirm that ashwagandha also helpful in preventing skin cancer. Helps to Fight Cancer Research suggests that ashwagandha has promising antitumour effects, can help to reduce tumour growth and may work to prevent cancer cells from growing. The extract has been shown to help inhibit the proliferation of cancer cells — specifically breast, lung, stomach and colon cancer cells, which are among some of the leading types of cancers in the world. It’s believed that ashwagandha helps to prevent the growth of cancer cells mostly due to its immune boosting and antioxidant abilities. In addition to the anti-cancer ashwagandha benefits that have been displayed in multiple studies, researchers also suggest that the herb can help to reduce the side effects of anti-cancer agents that can reduce immunity and quality of life. According to an overview published in the African Journal of Traditional, Complementary and Alternative Medicines, ashwagandha acts as an immunomodulator that can enhance the life span of cancer patients, who are especially at risk of lowered immunity. An animal study published in the Journal of Ethnopharmacology found that supplementing with ashwagandha was correlated with an increase in white blood cells within the body, which indicates that the immune system is better able to protect the body from disease and harmful invaders when using this herb. The decreased count of white blood cells in the body after chemotherapy is a major concern because it puts cancer patients at a much higher risk of health issues like contracting an infection. This is why ashwagandha may serve as a complementary addition to conventional cancer treatments.

Reduces Brain Cell Degeneration and Improves Memory Emotional, physical and chemical stress can all have damaging effects to the brain and nervous system. Recent research has proven that ashwagandha is more than a stress reliever, it also protects the brain from cell degeneration, which can lead to neurodegenerative diseases like Alzheimer’s and Parkinson’s. One of the main reasons ashwagandha is so effective at healing the brain is because it contains powerful antioxidants that destroy the free radicals that cause ageing. A 2017 pilot study published in the Journal of Dietary Supplements found that ashwagandha effectively enhanced both immediate and general memory in people with mild cognitive impairment. The herb was also able to improve attention, information processing speed and mental skills. The study involved 50 adults who received 300 milligrams of ashwagandha root extract or placebo for an 8-week period. Researchers concluded that ashwagandha treatment was able to boost memory and other cognitive skills. Boosts Immune Function Because ashwagandha works as an adaptogen that can reduce the body’s stress hormones, it can help to boost your immune system and reduce inflammation within the body. Animal and laboratory research show that ashwagandha can enhance immune function by increasing immunoglobulin production. It is also able to promote an anti-inflammatory environment by suppressing pro-inflammatory cytokines. By down-regulating the immune system when it’s compromised, ashwagandha might be a useful tool in the treatment of various inflammatory disorders. Increases Stamina and Endurance Studies have shown that ashwagandha can boost endurance during physical activity by sharpening brain function and reducing bodily pain. Due to its positive calming, yet energising effects on the brain, and its ability to lower stress hormones, ashwagandha showed improvements in concentration, motivation and stamina in conducted studies. A 2015 double-blind, randomised and placebo-controlled study conducted in India evaluated the efficacy of ashwagandha extracts in enhancing cardiorespiratory endurance in 50 healthy adult athletes. During a 20-minute shuttle run test, the oxygen consumption of each participant’s peak physical exertion was measured. The participants were also given a questionnaire about their physical health, psychological health, social relationships and environmental factors to access changes in their quality of life after ashwagandha treatment. Researchers found that ashwagandha extracts improved cardiorespiratory endurance at eight and 12 weeks of treatment, and significantly improved the quality of life scores of the participants in the ashwagandha group. A study involving rats found that ashwagandha was able to increase swimming performance during a physical endurance test. The rats that received ashwagandha before the test swam for a mean time of 740 minutes, while the control group swam for a mean duration of 385 minutes. Ashwagandha treatment almost doubled the swimming time, which suggests that it benefits rodent endurance. Scientists believe that it’s ashwagandha’s anti-stress properties that help to improve your stamina and similar effects may take place in humans because of the herb’s ability to balance adrenal hormones that are involved in physical activity. Helps to Increase Muscle Strength Perhaps a surprising ashwagandha benefit is its ability to increase your muscle mass and strength. For this reason,

ashwagandha can be a helpful tool for people engaging in resistance training and other forms of exercise that can be strenuous on your muscles. A 2015 study published in the Journal of the International Society of Sports Nutrition found that ashwagandha supplementation is associated with significant increases in muscle mass and strength. The 8-week study involved 57 males between the ages of 18 and 50 with little experience in resistance training. The men in the treatment group consumed 300 milligrams of ashwagandha root extract twice daily, and the control group consumed starch placebos. Researchers found that the treatment group had significantly greater increases in muscle strength on the bench-press and leg-extension exercise. Those receiving ashwagandha also displayed significantly greater muscle size increase of the arms and chest, had a significantly greater reduction of exercise-induced muscle damage, had increased testosterone levels and greater decrease in body fat percentage. Even with increased muscle mass, your joints must be strong to operate at peak performance levels. Ashwagandha can help with that, too! Clinical trials studying general joint pain and joint pain related to rheumatoid arthritis have found extremely positive results, with ashwagandha relieving major pain and causing no documented side effects. Ashwagandha Nutrition Ashwagandha contains many beneficial elements, including flavonoids and antioxidants such as catalase, superoxide dismutase and glutathione, which is known as the “mother of all antioxidants.” It also contains alkaloids, amino acids (including tryptophan), neurotransmitters, sterols, tannins, lignans and triterpenes. It is these valuable compounds that allow for ashwagandha’s pharmacological activities. Ashwagandha Side Effects and Precautions  Ashwagandha should never be used by women who are pregnant or breastfeeding, as there is some evidence it may induce miscarriages and there is no available safety information about breastfeeding while on ashwagandha. People using diabetes medications, blood pressure medications, medications that suppress the immune system, sedatives or medications for thyroid problems should not use ashwagandha unless they’ve consulted with their doctor first. Those with hyperthyroidism may notice an additional increase of thyroid function when taking ashwagandha and should only do so under the controlled supervision of a doctor, if at all. Because the herb also works to modify these conditions, there may be adverse interactions. If you are going to have surgery that requires anaesthesia, you should stop taking ashwagandha at least two weeks beforehand in case the herb further slows down your central nervous system. As with all supplements it is recommended that you consult a healthcare practitioner, especially if you are on any medication. It always pays to be cautious. APJ

For a list of references, please contact the editor.

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MANAGEMENT STYLES UNIQUE TO THE AESTHETICS INDUSTRY Caroline Nelson EACH ONE OF US brings our own unique management style to the workplace. This is often determined by our personality, and while there are strengths with the different styles, there are also weaknesses that can create a great deal of stress. In this article CAROLINE NELSON presents ways to mitigate the impact of some of the weaknesses and hopefully bring harmony back into the workplace. There are many things unique about the aesthetic industry, but one thing that stands out is the misassumptions many of us had when we first entered the ranks of this profession. Regardless, whether it was employee or employer, many do not consider the fact that an industry surrounded by beauty could be sheer hard work and this is the reason why a high number of new graduates drop out of the industry within 12 months. It’s also the reason why many new businesses do not survive past the first few years. In this article I would like to shed light on the various management styles that I’ve identified over a career spanning nearly 50 years in this industry and how these can often determine success and/or failure of a business.

of us, usually one type will be more dominant. While there are many ways to manage, there are right and wrong ways and then there is the best way. HERE ARE THE FIVE MANAGEMENT STYLES

1. The Juggler – this management style has too much on the go at once. Often not completing a task or project, before frantically switching to something else. They are generally hyper-stressed, and stress everyone else around them including their family and staff as well, they often work themselves to a state of exhaustion, before seeking help and/or delegating tasks to others. 2. The Pleaser – wants to be everyone’s friend, her empathic nurturing nature makes it hard for her to be assertive with the result employees often hold the upper hand. She will go out of her way to cater to her employee’s needs to the detriment of herself and the business.

I will also offer recommendations on how each unique management style can navigate through a minefield of issues, and overcome challenges that might have otherwise impacted negatively on the business.

3. The Trailblazer – this super-motivated type has two speeds - fast and faster. They are ambitious, so much so that they often don’t listen to employees’ views and ideas, instead just steamroller on regardless. This attitude has a tendency to cause employees to feel devalued, and disengaged.

From my observation I have identified five management styles in our industry and while there could be a little of each in all

4. The Accidental Owner – often this type has gone from being a great employee to owner, but really is

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want is a good job and a reliable wage for the work they do. Keep that in mind, and when one resigns, wish them well, replace them and move forwarded. My advice for this business manager is to be very professional from day one of the prospective candidate’s job interview by clearly outlining job description, job requirements, and expectations both in work standards and sales. This will set the tone of the ongoing business relationship with the employee. Provide a detailed employees handbook and procedures manual which states in full their duties, making sure all instructions are clear. At all times require tasks to be completed fully and correctly, and for each employee to accept responsibility for their own high work standards. And one final piece of advice, do not invest emotionally in your employees. The Trailblazer has to learn the art of balance, balancing their ambition and impulsiveness with measured time appropriate planning. If they fail to do this, they can be like fireworks blazing brightly into the sky only to ultimately fade out.

happier treating clients than managing the business. By and large they try and let the business and staff run themselves, and only emerge from the treatment room when things have moved to a state of crises. And even at this point is more likely to not address the issues or challenges instead leaving things to build to the point of no return. 5. The Bossy-Boots – the “my way or the highway” attitude finds this type in a constant revolving door hiring firing mood. Their dogmatic and demanding personality means they often fail to listen to others advice or suggestions. Their “reactive” approach is based on responding to issues, instead of adopting a more “proactive” way of eliminating problems before they become an issue in the first place. As you can see, each style has its unique strengths and weaknesses, but in this article, I will focus on looking at the weaknesses and identifying ways on how they might be turned around and changed to positives to benefit the business. Here are some approaches that can help: The Juggler needs to stop, slow down, take stock, and recalibrate. By this I mean recognising they can’t do everything themselves, both at home and at work. They may need to get extra help and support on both fronts, and start to delegate some tasks. In addition, the Juggler often has time-management issues so work will need to be done in this area. Things to consider before starting to delegate tasks would be to assess their employees’ skill levels, motivation, and dependability. And if they are best suited for the particular task. Matching the right person to each task can be difficult so start small and don’t expect too much. Make sure they have been equipped with all the information and training necessary to perform to the required standard. And be available to give additional support in the early stages. The Pleaser is often the one who suffers the most when employees let them down in any way, and especially when someone resigns which they take very personally. Few employees want, or need another best friend, what they do

These types often only have a “Plan A” and because they’re so confident of their abilities never consider any other eventualities so they fail to have backup plans or strategies. My advice is while still keeping motivation high to link goals to planned actions, avoid over commitment of resources and develop realistic time-lines to avoid burn-out of themselves or employees. The Accidental Owner has to man-up, stop burying their head in the sand and accept full responsibility for the business, its success or failure for that matter. First, reduce personal client load and get out of the treatment room more often, freeing up time to manage. Provide employees with quality procedures and processes, and implement quality control of all services. Streamline all services and tasks, and create effective checklists to oversee they are completed to standard and create a training program to improve employee skills so they can take over part of your client load. And finally, we come to the Bossy-Boots. This type also needs to stop, and take a hard look at how their actions might be affecting the business and employees. Keeping in mind if the same thing is creating the same issues, and changes aren’t made the same results or outcomes will still keep happening. Time to stop the merry-go-round. This type also has a tendency to expect people to read their minds, and or to know the standards required without giving any instruction. They often fail to provide proper induction to the employee at commencement, and rely heavily on quick verbal training. When things go wrong, they overreact, or react poorly. Some form of communication skill training is needed so they can learn effective ways and strategies to get their message across without stressing themselves and others. In addition, providing a written procedure manual, employees have access to will reduce some miscommunications, while regular team meetings to address any issue/s before they become a problem is a must. As previously mentioned, most have a little or more than one management style and may recognise some of the traits mentioned. While every style has its strengths and weaknesses, any changes for the better will have a positive impact on the staff and the business and will contribute to reducing stress, creating a more harmonious workplace. APJ © Copyright Caroline Nelson 2019

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EPIDERMAL GROWTH FACTOR Examining the Facts Danielle Hughes

THE TERM Epidermal Growth Factor (EGF) conjures a lot of excitement in the aesthetics industry for the effect it can potentially have on skin health. Just some of the claims made around EGF in skincare include ‘strengthen skin elasticity’, ‘increase epidermal thickness’, ‘increase collagen production’ and even ‘reverse the ageing process’.

sources were harvested, however most recently plant sources are extracted to avoid the presence of harmful bacteria endotoxins and any infectious agents resulting from the animal sources.

Now before we get carried away by what surely sounds like a little miracle-worker, let’s look at the whole picture and most importantly, what regulations govern its usage in Australia.

In a nutshell, only plant-made EGF is permitted in cosmetic preparations. The most commonly used plant made EGF used in skincare is Oligopeptide-1 (however there are others out there).

SO, WHAT IS EGF AND WHY IS IT USED? In short, EGF works like a peptide to stimulate cell growth and cell differentiation by binding to a specific cell EGF Receptor (EGFR). It is made naturally in the human body, in animals and most relevantly with regards to the skincare industry, has recently been extracted from plants. EGF and EGFR was first discovered by Stanley Cohen, who subsequently won the 1986 Nobel Prize in Medicine with Rita Levi-Montalcini for this discovery.


Prior to February 2018, all EGF was considered a Schedule 7 Poison and therefore banned for topical use in a cosmetic. This scheduling was updated in February 2018 to except “topical cosmetic preparations containing 0.0002% or less of transgenic, plant made epidermal growth factor”. Of course, this update would present an obvious question – would an ‘active’ ingredient, such as Oligopeptide-1, still have an effect on the cell at 0.0002% concentration of the product formulation?

The unearthing of EGF is considered one of the leading factors (no pun intended) in the avalanche of studies into skin cell communication and the isolation and development of peptides to enhance and correct age-related skin issues due to a declining metabolism.

It needs to be noted that many countries around the world do allow this ingredient in cosmetic products, and at higher (and arguably effective) concentrations of 2-10%.

There is also anecdotal evidence that its presence is related to increased collagen production, however the pathway for this outcome has not been identified.

Over the past few years, trendy, ‘quick-fix’ treatments have launched on the global aesthetics stage, many making it to Australian shores – and let’s be honest, the claims are pretty enticing.

HUMAN VS. PLANT EGF The topical application of EGF requires ‘peptide harvesting’ from a valid source. In the early days, animals and yeast APJ 40


But what consideration is given to the risks associated with their administration. In an industry where there isn’t a ‘global regulation’, is the treatment even legal in Australia? Has

the treatment been performed for a period in-vivo that can determine long-term side effects and safety concerns? What level of education is required? And most importantly, is it within a therapist’s scope of practice? One particular treatment claims to deposit actives and ‘plant based’ pigments into the skin to ‘semi-permanently’ even-out skin tone and promote ‘anti-ageing’ leaving the skin with a youthful, healthy glow, that requires little to no makeup.

‘hero’ ingredient that builds demand and of course, sales. But here’s the thing – at the legal concentration of just 0.0002%, can any honest claim really be made about the performance of the EGF within the skin? It certainly couldn’t be advertised as the main ingredient at this concentration, at best, it can legally only be considered a ‘skin conditioning agent’.

According to the TGA, a treatment of this nature, that is, a treatment designed to deposit ingredients beneath the outer layer of the skin, “… would not be considered to be either a ‘topical product’ or a ‘cosmetic product’ according to the Poisons Standards definition.”

The claim made is therefore either illegal or just plain deceptive. And think twice, read carefully, when you see “EGFlike” or “stimulates natural EGF response” marketing hype phrases – don’t be misled into thinking there is actual EGF included.

Therefore, a product containing any concentration of EGF, being needled or deposited into the skin is illegal in Australia.

The reality is, that for any topically applied, cosmetic skincare in Australia to be legal, the inclusion of EGF on the label appears to be effectively limited to being just a marketing claim. APJ

WHY THE STRICT REGULATIONS IN AUSTRALIA? As with every utopian discovery, especially something so wonderful as nature’s ‘fountain of youth’ – brought to you in a topical cream – there is a dark side. Without going into great detail here, there are studies that conclude that aberrant EGF is directly related to ‘out of control’ cancer-clusters, and to their credit, the TGA moved a long time ago to limit the Australian public’s exposure to what is still very much a largescale experiment with regards to the long-term effects of topical EGF application. FALSE AND MISLEADING CLAIMS Sadly, the skincare industry is well known for spinning a ‘hopes and dream’ campaign about a product and presenting convenient science to support a claimed benefit. Let’s face it ‘Growth Factors’ have long been promoted in skin care as a

Danielle Hughes is the Managing Director of Skinfaktor Australia who distribute the Technology and Skincare of the European Group, Dermia Solutions. Her career over the past 12 years in the hair and beauty industries has included roles as Australian Education Manager and National Brand Manager for leading imported cosmeceutical brands and currently also includes an international role as Marketing Manager using digital communications for a new to market European Medical and Aesthetics provider with patented technology. Danielle Hughes can be contacted on 04370 13777 E: danielle@skinfaktor.com.au

APJ 41



Promising to revolutionise skincare APJ DISCUSSES the latest epi-genetic advances and what they mean for professionals in skincare with PROFESSOR DEREK RICHARD, Chief Scientist at the Cancer and Ageing Research Program, Translational Research Institute, based at Brisbane’s Princess Alexandra Hospital.

genetics back to a healthy state. Importantly, genetic damage and epi-genetic changes drive the initiation and progression of cancer. The same process is implicated in other diseases associated with ageing. We aim to develop drugs that can stop these diseases from even starting.



Epi-genetics is a large and growing field of research. What it refers to is how our cells read their genetic code. As we age, our epi-genetics change, and this is caused primarily by how much genetic damage our cells have had in our lifetime. These epi-genetic changes are the most accurate way to tell someone’s biological age. European police use this when determining how old an immigrant is if they have no birth certificate or passport. What we do know is that we can alter the epi-genetics of our skin cells by changing factors including diet and skincare. This way you can slow, and indeed reverse, some of the signs of ageing.

Our work centres on how the cell protects the genetic code. As we age however, the pathways that should protect us stop working as well. The result is we get more and more damage to our genetic code and this drives a change in the cells’ epi-genetic state. Our research team were the first to describe a new family of DNA repair proteins and we reported this discovery in Nature in 2008. We have identified one of these proteins that is absolutely essential for the detection of damaged genetic code. As well as being involved in protecting the genetic code, the protein we called hSSB1, also works to regulate the epi-genetic changes that occur with this damage. In normal cells this protects us from deleterious genetic damage and epi-genetic changes, however we also found that cancer cells highjacked this protein to allow them to grow faster and to develop resistance to drugs. For cancer, we have developed a therapy to target hSSB1 and we hope to treat our first cancer patients later this year. Using this protein, we are also starting to unlock some of the answers as to why our cells stop repairing DNA damage as we age.

APJ Q2: ARE THERE ANY NEW DISCOVERIES IN EPI-GENETIC? The new frontier in epi-genetics is actually in the world of ageing research. This new research is looking at different ways the biological clock can be turned back. Our research team in Australia works on how genetic damage changes the biologic clock and we are looking to develop therapies that can reduce this genetic damage and restore the cell’s epiAPJ 42

APJ Q4: HOW WOULD THIS DISCOVERY THAT YOU ARE WORKING ON FOR CANCER ALSO APPLY TO CONDITIONS ASSOCIATED WITH AGEING SUCH AS ALZHEIMER’S? First, you need to ask what the differences are between Alzheimer’s Disease and cancer. In cancers, the problem is that cells divide uncontrollably, while Alzheimer’s is caused by cell death. But both diseases are actually caused by defects in the ability of the cells to repair genetic damage. For some cells in our body, genetic damage can result in a loss of cellular programming (a cell forgets what it is) and can become cancerous. In the brain, cells are much more sensitive and are not designed to increase in number, so they die, which leads to diseases such as Alzheimer’s. This is why we contend all of these diseases are associated with age because they are all due to a failure of your cells’ ability to repair damage to the genetic code. What we are doing in our research program is to turn back on the DNA repair proteins and stop the damage to your genetic code. We hope this means we will ultimately be able to provide a pill that greatly reduces the risk of cancer, Alzheimer’s Disease, arthritic and even heart disease. APJ Q5: HOW DOES A DISCOVERY TO HELP PROTECT PEOPLE FROM CANCER AND AGEING CONDITIONS THEN TRANSLATE TO SKINCARE AND AESTHETICS? Your skin is actually the largest organ in the human body. It is also the organ that we can usually most clearly see the effects of ageing. However, the good news is that we can directly treat the skin with products that seek to turn back the biologic clock. Using the information, we have learned from developing cancer treatments, we can use our technologies to intervene in the ageing process. We bring some of these technologies into QALIN Q1 SERUM. When we made Q1 we wanted it to be completely different from other products, we wanted to put the science at the front so that the product could truly deliver. We have taken natural ingredients with proven capabilities in the lab, and put them at effective doses in our formulation. Q1 is different on a number of other fronts. When we first approached this problem, we also realised that there was an almost universal approach to go for clear and non-coloured formulations for skin products. But if you look out your window, how many things in nature are clear or white? Q1 is naturally a golden colour with a faint scent of maple syrup. That’s because Q1 actually contains critical natural products that are not clear or white. APJ Q6: HOW ADVANCED IS THE INDUSTRY IN APPLYING EPI-GENETICS TO SKINCARE?

ingredients to help control bacterial growth on the skin, which can also be a major problem for skin health as we age, and other ingredients to help control the redness we often see with damaged skin. APJ Q8: IS EPI-GENETIC CHANGE IMMEDIATE, DOES IT LAST, AND WHAT CAN BE ACHIEVED FOR SKIN CELLS? How quickly it works and the impact it has really depends on how damaged your skin is. If, like me, you had never before used a skincare treatment, you should see noticeable differences within 24 hours such as the skin’s redness cooling down. Within a week, you should feel a difference as the new skin cells push upwards. If your skin is damaged you may also see some skin being exfoliated from the surface as the new, revitalised skin cells push their way up from the stem cells below. Epi-genetic change is no 24-hour wonder or quick fix. This is a totally new concept in skincare and your skin should reach peak health after 3-4 weeks. As the ingredients are designed to help fight the impact of ageing, stopping use of the product will mean cells will reset to your original biological age. So, once you start, don’t stop.

While we are working at the cutting edge of this field to make drugs to turn back the biologic clock in our whole body, these still remain a few years away. What we can do currently, is apply this knowledge and our skills to the skin. We think this will be a truly revolutionary formulation of ingredients working in concert to deliver the epi-genetic changes we are after.



Every purchase of QALIN contributes financially to our research foundation, and goes directly towards furthering our research. APJ

While some ingredients make epi-genetic changes, other ingredients must be there to help deliver these ingredients into the skin. We have these delivery ingredients in the complex formulation of QALIN Q1 SERUM, along with

For more information and an opportunity to donate go to www.carf.org.au. Professor Derek Richard can be contacted at the Cancer and Ageing Research Foundation www.carf.org.au

Our research team is striving to make this happen. We want to make a product that does not only impact the skin, but your whole body, a product that can turn back the clock and protect you from disease.

APJ 43


HOW PSYCHOLOGICAL WELLNESS CONTRIBUTES TO SKIN HEALTH Tina Viney WHEN TREATING SKIN CONDITIONS it would come as no surprise that a connection between the skin and the mind exists. For example, someone may break out into hives when stressed, while others flush red if embarrassed. But in recent years, studies have shown that a person’s mental and emotional state can have a profound effect on the body’s largest organ. Stress, depression, anxiety and other psychological conditions can contribute to a host of skin diseases including acne, rosacea, eczema, psoriasis, alopecia and vitiligo.

conditions that affect the skin can be traced back to elevated levels of stress and anxiety.

In this article I want to present results of some studies as well as discuss ways that you can assist your clients in managing stress that may also be impacting their skin.

Under normal circumstances, Greco says, the parasympathetic nervous system helps bring the body back into balance once the danger has passed and the body can go in healing and repair mode. But when faced with relentless stress or anxiety, the body is always bathed in these stress hormones. As a result, Greco adds, the skin suffers from the body’s chemical responses to psychological stressors. “The skin – the human body’s barrier against the damaging effects of the outside world – is less able to act as a shield,” Greco says.

THE IMPACT OF THE NERVOUS SYSTEM ON THE SKIN As we are aware the central nervous system is intertwined with the skin therefore, it’s not surprising that almost any and all skin diseases can be impacted by changes in the nervous system. When the nervous system is under pressure it can impact the skin in two ways: •

Sebum production: Bodies under stress produce more skin sebum, oily discharge that can contribute to clogged pores and aggravate acne.

Increased inflammation: Stress can also increase inflammation in the body, which can worsen eczema, a chronic inflammatory skin condition. It can also trigger cold sores, caused by the herpes simplex virus, on and around the lips as well as irritate and contribute to the onset of conditions such as acne, psoriasis and eczema, just to name of a few.

Research published in 2008 in the Indian Journal of Dermatology, Venereology and Leprology revealed that more than a quarter of 50 subjects suffering from psoriasis were experiencing stressful life events such as unemployment, major personal illness or family death. And a 2012 a study published in the Dermatology Research and Practice found that 45 per cent of 100 patients with psoriasis had anxiety. According to Dr Carla Marie Greco, a clinical psychologist based in Santa Rosa, California, many psychological APJ 44

When the body is free of worry and stress, hormone levels remain relatively balanced, Greco explains, but when faced with conditions that are psychologically or physically stressful, the body’s “flight or fight” response is triggered, and the sympathetic nervous system sends signals to the adrenal glands to flood the system with adrenaline and cortisol, both major stress hormones.

As we know, skin serves as the body’s primary system of protection, it provides the first level of defence to infection, not just as a physical barrier, but also as a site for white blood cells to attack invading bacteria and viruses. A 2007 study from the University of California–San Francisco found that mice subjected to psychological stress experienced a decrease in the expression of antimicrobial peptides in their skin, thus making them more susceptible to skin infections than mice cared for under normal conditions. The study concluded that stress can also affect the body’s immune system in effectively defending it against disease. Given that the skin is the most visible organ, the emotional impact of skin diseases can be overwhelming and damaging. Social ostracism and feelings of insecurity only fuel the pathophysiology of these conditions, often making them worse. It becomes a vicious, perpetual cycle between the skin and the nervous system, both having a cause-effect impact on one another. THE PSYCHODERMATOLOGY APPROACH Stress can manifest itself on one’s appearance in many

ways, primarily by making the skin more sensitive and more reactive. For example, another study noted that stress can make rosacea more inflamed, resulting in acne lesions that are more persistent. It can also contribute to brittle nails and ridging of the nails, cause hair loss, cause or worsen hives, and cause excessive perspiration. In addition, stress also is a known trigger or can be a worsening factor for fever blisters, psoriasis, seborrheic dermatitis and has even been shown to impair skin barrier function and dehydrate the skin, allowing more irritants, allergens, and infectious agents to penetrate the skin and cause problems. Stressed skin often appears stressed, distressed and older. Beyond the physiological effect, another observation of individuals who are suffering from on-going stress is that they may also tend to neglect or abuse their skin, lacking the energy and motivation to adhere to their skin care regimens. There also might be signs of stress-related behaviours, such as scratching, pulling or rubbing, which can exacerbate problems. To successfully treat stress-related dermatologic conditions, Dr. Phillip Fried, a New York dermatologist recommends that traditional dermatologic therapies should be used in conjunction with appropriate stress management strategies. For example, he discussed how stress reduction interventions and techniques can reduce the culmination of negative events that can worsen many of these problems. To illustrate the seriousness of living with skin problems, Dr. Fried points to studies showing that people tend to be more distressed by skin, hair or nail problems since they are so visible and uncomfor­table, than by other serious medical conditions, such as heart disease or diabetes. "When dermatol­ogists treat both the skin and stress, the skin often clears more quickly and completely as the native influences of stress are diminished,” said Dr. Fried. “Consequ­ ently, their overall anxiety level can decrease and they may start to feel better about how they look and how they’re feeling emotionally.” Moving to the microscopic level, Dr. Fried added that stress reduction can decrease the release of pro-inflammatory stress hormones and chemicals. For example, release of neuropep­tides, stress chemicals released from the nerve endings, can be reduced with stress management techniques. This often results in skin that looks and functions better. These interventions can reduce blood vessel overactivity, resulting in less blushing or flushing. Decreasing stress allows the patient to focus more positive energy on good skin care rather than negative behaviours. “It is fair to say that when people are under stress, they tend to fall off the wagon in terms of practicing good skin care,” said Dr. Fried. “They may not use their sunscreen or their skin care products when they’re feeling stressed, because all of their energy and focus is being diverted by their ongoing stress. They also might not be eating or sleeping as well or staying hydrated, which all can contribute to a dull or lacklustre appearance.” In the event that a client or patient exhibits high levels of stress it may also be helpful to refer them to a mental health professional who can help them address the emotional burden and this can be a helpful part of the overall treatment regimen. The two main types of psychological treatment usually given are: •

Beliefs: working on challenging irrational beliefs and fears

while enhancing coping skills; this may include stressreduction techniques for self-soothing. •

Past trauma and insecurities: The other method tries to get to the root cause of stress – attachment insecurity, fear of loss, unprocessed childhood trauma. This method provides a vehicle through which people can learn about emotional experience and speak rather than somatising their emotions. Gaining power over their emotions in this conscious way will be of lifelong benefit.

Janice Pastorek, a registered nurse and medical skincare specialist based in New York City, emphasises the need to address psychological issues, which can accelerate recovery. “Our bodies offer us personal guidance, showing us where and why we are holding tension," she says. "We just haven’t been shown how to interpret the messages, or how to incorporate good wellness practices into our everyday life to quell the anxiety or stress that contributed to triggering the condition.” Along with a change in diet, such as more water and less sugar, as well as exercise, which she states is the number one treatment for depression, Pastorek also adds that the most important thing her patients can do is to change the predominant focus of their thoughts – “stress is a thought you keep thinking that doesn’t make you feel good.” And activities such as medication and writing can help do just that. “Writing is a powerful way to focus your thoughts, she says.” Additional, guided relaxation, visual imagery and breathing exercises and mindfulness are among the practices useful for stress reduction, while proper sleep is the key to a healthy immune system and a very important factor in treating skin conditions. You will soon discover that a balanced mind equals a balanced physical body. MEDICAL AND COSMETIC INTERVENTIONS While skin rejuvenation procedures have been shown to significantly improve a person’s outward appearance, studies suggest these types of cosmetic interventions also can have positive effects on how people feel and how they function. “When people feel more attractive and more confident in their appearance, they tend to perform better in other areas of their lives—in their work, family life, social life, and marriage or personal relation­ships,” explained Dr. Fried. “Under the right circumst­ances, cosmetic procedures can be a powerful ally, but it’s important for patients to understand that these procedures are not a panacea. Realistic expectations are the key to effectively delivered promises.” Currently, Dr. Fried is analysing data from a 2008 study designed to measure the positive ripple effects of botulinum toxin injections on other aspects of patients’ lives. In this study, 76 middle-aged patients were treated with one botulinum toxin injection and then asked to complete a questionnaire during their follow-up visit to gauge how they felt following the procedure. “The results of our study clearly showed that patients treated with botulinum toxin experienced substantial benefits,” said Dr. Fried. “In fact, 29% reported feeling less anxious, 36% said they feel more relaxed, and 49% were more optimistic. Even a portion of patients diagnosed with seasonal affective disorder, or SAD, prior to treatment reported they felt less sadness during the winter following botulinum toxin injection.” A previous study conducted by Dr. Fried evaluated the clinical and psychological effects of the use of alpha hydroxy acids (AHAs) in 32 patients. After 12 weeks, patients demonstrated significant improvements in facial skin tone and fine wrinkling, APJ 45

and reported satisfaction with their physical appearance and the quality of their interpersonal relation­ships. “The results of these two studies echo observations of recognised experts from around the world that cosmetic interventions can improve a patient’s self-image and help them feel better about themselves,” added Dr. Fried. “Feeling stressed, depressed or anxious is exhausting, and patients who report improvements in these negative feelings following a cosmetic procedure can use that redirected energy to pursue new interests that can enhance their lives.” AROMATHERAPY IN THE MANAGEMENT OF STRESS DISORDERS Aromatherapy is currently used worldwide in the management of chronic pain, depression, anxiety, some cognitive disorders, insomnia and stress-related disorders. Although essential oils have been used, reputedly effectively for centuries as a traditional medicine, they are now being investigated to provide verified science behind their use. As we know, essential oils are beneficial for both mental and physiological conditions because they have a unique capacity to penetrate the blood-brain barrier. The blood-brain barrier is like a sieve or filter through which only molecules of a certain size or smaller can penetrate. The molecules of essential oils are so small that most of them can pass through the blood-brain barrier. While much of the pharmacology of the essential oils and/or their single chemical constituents still remain undiscovered, accumulating evidence that inhaled, or dermally-applied essential oils enter the blood stream and, in relevant molecular, cellular or animal models, exert measurable psychological effects, indicates that the effects are primarily pharmacological.

Lemon aroma was found to cause an increase of heart rate whereas rose aroma led to a decrease of heart rate. This finding likely indicates that lemon aroma possesses a stimulating effect (an increase of heart rate), in contrast, rose aroma possesses a sedative effect (a decrease of heart rate). In a similar investigation of Kikuchi and co-worker (1991), lemon aroma enhanced the deceleration of the heart rate, indicating a stimulating effect. On the other hand, rose aroma suppressed it, which is likely represented a sedative effect. In the same year, Nagai et al. showed that sweet fennel oil suppressed the deceleration of heart rate as well. Brauchli et al. (1995) reported that a pleasant and an unpleasant odour presentation affected an autonomic variable, i.e. heart rate. Understanding these responses allows us to utilise lemon and citrus aromas for depression, while rose for anxiety. If you are keen in accessing further studies regarding how essential oils can be used therapeutically, I can highly recommend Robert Tisserand courses. Tisserand is considered a world expert and educator in aromatherapy and aromatic medicine. He is highly committed researcher into the therapeutic constituents of essential oils. If you would like to implement the use of essential oils in supporting your stressed clients, here are a brief list of essential oils that may be useful. ESSENTIAL OILS FOR CALMING ANXIETY • Lavender •

Damask Rose


Ylang Ylang




A recent study Aromatherapy in the Management of Psychiatric Disorders - Clinical and Neuropharmacological Perspectives was conducted. The review includes evidence from a number of clinical trials that have been published of ‘psycho-aromatherapy’ in relation to psychiatric disorders, together with evidence from mechanistic, neuropharmacological studies of the effects of essential oils in relevant in vitro and in vivo models. The study concluded that aromatherapy provides a potentially effective treatment for a range of psychiatric disorders. In addition, taking into account the available information on safety, aromatherapy appears to be without the adverse effects of many conventional psychotropic drugs. Investment in further clinical and scientific research is clearly warranted.

Chamomile Roman


THE PSYCHOLOGICAL EFFECT OF AROMATHERAPY Faster heart rate is often caused by stress, for example, our heart may race and pound when we are afraid. Other kinds of stress, such as depression, may result in lower heart rate. Generally, the heart is innervated by the autonomic nervous system. On the other hand the peripheral nervous system reduces the activities of the heart and particularly influences heart rate, whereas the somatic nervous system increases the activities of the heart and particularly affects the pumping function. A study conducted at Yale University (Schwartz et al., 1988) used changes of heart rate and blood pressure as indices for the measurement of the sedative effects of aromas. They found that the aroma of spiced apple possesses pronounced vasodepressor and stress reduction effects. Yamaguchi (1990) also used the changes of heart rate for the measurement of effects of lemon and rose aromas.





Rose Otto

Roman chamomile







You will note that some essential oils will work for both depression and anxiety, while others work more specifically for either anxiety or depression. COMBINING AROMATHERAPY WITH MINDFULNESS A novel and recently published study from Peru looked at essential oil inhalation compared to, or combined with mindfulness meditation. All interventions were effective, but the combination of aromatherapy and mindfulness was most effective. It would be fair to say that there is sufficient evidence to suggest that strategies that combine relaxing protocols including sounds and aromas can prove useful as part of your skin therapy arsenal. APJ

For a list of references, please contact the editor. APJ 46

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APJ 47


RAISING THE INDUSTRY’S CREDIBILITY THROUGH QUALITY GRADUATES AS AN INDUSTRY BODY APAN has various levels of membership and it’s always a joy to champion individuals and business owners and watch them grow, but it’s even more exciting to support and see a Registered Training Organisation raise the standard of the industry and provide through its graduates a skilled workforce we can be proud of. Ilse Taumberger is the principal of the Sydney Beauty and Dermal Institute. Together with Deborah Allen who is the senior trainer at the college (among other hats that she wears), are making waves as a highly reputable RTO, delivering a wide range of qualifications from Beauty right through to Graduate Certificates in laser and light therapies. The NAT10038 Graduate Certificate in Cosmetic Laser and Light Therapies, which was accredited a few years ago is considered one of the leading and most comprehensive nationally-approved post-graduate qualifications that includes skin rejuvenation, vascular, pigmentation and tattoo removal as part of its course competencies. It was a pleasure to approach these two dynamic and positive ladies to share their journey with our readers. Ilse and Deborah are a wonderful team. Through their mutual respect for each other they are forging ahead and developing a highly success college with an amazing reputation for developing confident and grateful graduates. APJ Q1: ILSE CAN YOU PLEASE SHARE WITH US YOUR JOURNEY AS A HIGHLY REPUTATABLE COLLEGE PRINCIPLE IN OUR INDUSTRY AND HOW DID YOU START OUT? My background is in nursing and beauty therapy however, APJ 48

I quickly developed a passion for dermal therapies and I began my career as a laser technician in 2001. It soon became apparent to me that there was a lack of quality training in Australia at that time and I did not feel comfortable working with equipment I didn’t fully understand. I realised that to succeed long-term as a leading laser practitioner I needed to seek more advanced training outside of Australia. This search led me to London where I undertook post-graduate training and later, I also attended additional training in Arizona in the US where I was trained by some of the leading world experts in laser technology. My knowledge allowed me to quickly gain experience in achieving great results and I soon realised I passionately wanted to train others to the some high-standard that I had gained and this eventuated in me purchasing of Fuss Beauty College in 2005. Fuss was a Registered Training Organisation and through this vehicle I was able to accredit the first courses in IPL and Laser for hair reduction and skin rejuvenation. APJ Q2: WHAT QUALIFICATION DO YOU OFFER POTENTIAL NEW STUDENTS WHO WANT TO ENTER THE INDUSTRY? As the college grew and started to also provide specialised training in IPL and Laser, Fuss underwent a name-change to a more appropriate name of Sydney Beauty and Dermal Institute (SBDI), which more accurately reflected who we are. Today, SBDI offers a broad range of courses to suit both the entry level student, right through to training for the more advanced student. Students who wish to enter the beauty


industry or become laser practitioners with no experience can start with short non-accredited courses, such as IPL and Laser for Hair Reduction, IPL and Laser for Skin Rejuvenation and Laser Safety Officer (LSO) training. For more advanced procedures, we also offer training Q-Switched laser courses for the treatment of tattoo removal, vascular, pigmentation conditions and skin rejuvenation. Our course, Introduction to Dermal Science is a valuable resource for any student enrolling from a non-beauty therapy background giving them the fundamental and underpinning knowledge of the skin prior to enrolling into our laser courses. APJ Q3:  YOU OFFER TWO ADVANCED COURSES IN IPL, LASER AND LIGHT-BASED THERAPIES. WHO ARE GOOD CANDIDATES FOR THESE QUALIFICATIONS? The SHB60118 Advanced Diploma of Intense Pulsed Light and Laser Hair Reduction and our course the NAT10038 Graduate Certificate in Cosmetic Laser and Light Therapies is currently undergoing re-accreditation with the addition of new units. These qualifications are for therapists who are currently working in the industry, and already have gained experience in the field of IPL and laser, but are now seeking to upgrade to a full, nationally-approved qualification. These qualifications are for therapists who wish to specialise as laser practitioners and offer their clients specialised treatments. APJ Q4:  DEBORAH, YOU AND ILSE MAKE A GREAT TEAM. WHAT IS YOUR ROLE IN THE COLLEGE AND WHAT ARE YOU MOST PASSIONATE ABOUT? I have worked with Ilse and the team for the past 12 years. During this time, I’ve been fortunate enough to have had the opportunity to take on the challenges of various roles within the RTO structure, most recently as the Head of Education


and Training. I have trained hundreds of students over the years and I feel the same passion and excitement for each one when I hear about the success of our graduates. My passion has always been to share my skills and knowledge in beauty and laser therapies and to empower our students to develop into successful therapists and business owners. APJ Q5: HOW DO YOU BOTH PERCEIVE THE EVOLUTION OF THE INDUSTRY AND WHAT CHANGES DO YOU ENVISAGE IN THE NEXT FEW YEARS? The impact of on-going advances with new innovations and technology is indeed impacting the industry, both in the scope of practice, as well as the depth of knowledge that is now needed to meet with consumer demands. Over the past five years our industry has and is still experiencing phenomenal growth, as we are seeing today’s client demanding quick nonsurgical fixes and visible results. However, with this rapid growth, we are also seeing the industry being exploited by unqualified individuals who are taking advantage of this demand. With the influx of substandard equipment entering the market, cost-cutting, APJ 49

price wars and minimal regulations requiring qualifications as a necessity to provide these services, all these factors are contributing to risks for consumers and challenging the reputation of the profession. As an RTO we endorse nationally-accredited qualifications that support safe practices and provide the appropriate level of training and competence for all therapists operating these devices. Qualifications equip graduates to operate not just with greater safety, but also to be able to deliver efficacious treatment outcomes with a high degree of confidence. To operate such devices, we believe we need nationally-uniform standards through appropriate regulations for the use of IPLs and Lasers in Australia. APJ Q6: FOR EXISTING BUSINESSES, IS THERE ANY FUNDING ASSISTANCE THAT WOULD ALLOW THEM TO TAKE ON FURTHER STUDIES? The State Government of NSW provides the RTO with an opportunity to offer part-qualifications that may benefit the industry, or for which there is a skills-gap, such as the laser industry is experiencing. Currently, we are taking expressions of interest in three units of competency from the SHB60118 Advanced Diploma of Intense Pulsed Light and Laser for Hair Reduction. These part qualifications are fully subsidised by the NSW State Government and upon graduating the student receives a Statement of Attainment, which they can use to enter into a full qualification, or to secure employment. This is a fantastic opportunity to get qualified at no cost to you or the business if you are an existing worker. APJ Q7:  CAN YOU SHARE WITH US A SUCCESS STORY OF A GRADUATE THAT HAS EXPERIENCED AMAZING GROWTH TO THEIR BUSINESS AS A RESULT OF STUDYING WITH YOU? We have had many success stories over the years, far too many to share with you here. However, one student that comes to mind was Kirsty-Anne Finlay who studied and APJ 50

graduated with a Diploma of Beauty Therapy. She went on to open a chain of exclusive spas in Bali. After graduating Kristy-Anne decided to move to Bali with her husband Greg. Her passion was to open up a nail spa and offer professional standard treatments. One nail spa went on to become many successful spas and is now one of my favourite places to relax while in Bali. Daniela Boerma trained with SBDI in 2010 and 2011and graduated with qualifications in IPL and Laser for Hair Reduction, Skin Rejuvenation and Tattoo Removal. In 2013 Daniela purchased Bliss Day Spa in Caringbah NSW and is the preferred spa for many VIP clients. We are so proud of the success she has achieved in her business over the years. She is hard working, has a real thirst for professional development and her dedication and passion have seen Daniela go on to graduate in 2015 with a NAT10038 Graduate Certificate in Cosmetic Laser and Light Therapy and win Australian Beauty Therapist of the Year 2015 and 2016 in the Australian Beauty Industry Awards. APJ Q8: HOW DO YOU VIEW YOUR RELATIONSHIP WITH APAN AND HOW HAS IT BENEFITED YOU? From our perspective as an RTO, APAN offers a consolidated approach to the wellbeing of our industry by providing many opportunities for professional development for our trainers, keeping the professional standards of our industry high, representing our industry to the Government and regulators and offering us clear sound advice. As an RTO and the provider of quality education it is critical to our success that we have a professional body working with us and for us to ensure we are kept up-to-date with the latest legislations and regulations that effect our RTO. APJ If you would like to speak to Ilse or Deborah please phone 02 9326 2211 or info@sbdi.com.au


or Upgrade existing qualifications using current skills and knowledge via RECOGNITION OF PRIOR LEARNING (RPL) Subsidised training available under Smart & Skilled Funding* • SHB60118 Advanced Diploma of Intense Pulsed Light and Laser for Hair Reduction

• Traineeships in SHB40115 Certificate IV in Beauty Therapy

• Part Qualifications in SHB60118 Advanced Diploma of Intense Pulsed Light and Laser for Hair Reduction

• Entry level courses in IPL & Laser for Hair Reduction, Skin Rejuvenation, Tattoo Removal

CONTACT TODAY FOR FURTHER DETAILS *Subsidised training available only for Part Qualifications in SHB60118

02 9326 2211 info@sbdi.com.au

Nat. Prov. No 91192 CRICOS No 02725B

APJ 51 www.sbdi.com.au


DISCOVER THE DEGREE THAT OFFERS ADDITIONALLY, FIVE YEARS OF EXCLUSIVE BENEFITS Australasian College of Health and Wellness HAVE YOU EVER considered gaining a Health Science degree to elevate your aesthetics career? With the rapid advancements in the aesthetics industry understanding the science behind skincare technologies and treatments is becoming increasingly important. A degree can help put you at the forefront of keeping up with this pace of change. However, being an excellent aesthetics practitioner takes more than understanding and applying science. It also requires soft skills, like communication and networking, and even business and management skills. With this in mind, the Australasian College of Health & Wellness (ACHW) now offers a GOLD CARD. This exclusive card unlocks 5-years of professional development opportunities for students in ACHW’s Applied Health Science degree programs. ENJOY EXCLUSIVE BENEFITS, EVEN AFTER YOU GRADUATE With the Gold Card, ACHW students can enjoy 5-years of benefits. From access to nationwide lounges, to over 70 free short courses from the Australian Institute of Management (AIM), these benefits last even after you graduate. LEARN IMPORTANT SOFT SKILLS TO BETTER MANAGER YOUR CLIENTS To stand out in business you need more than technical skills; you also need soft skills to be able to interact well with people. Through ACHW’s partnership with AIM, you can access free short courses to improve your communication techniques, time management skills and more. LEARN SKILLS YOU NEED TO RUN YOUR OWN BUSINESS With ACHW’s Gold Card you can be empowered to develop a diverse range of skills needed to start and run your own business effectively. Enjoy access to free courses in leadership, finance, sales, digital marketing and more.

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ACCESS LOUNGES AROUND AUSTRALIA With an ACHW Gold Card, you can access five lounges nationwide. Enjoy free wi-fi, comfortable study areas, coffee facilities, and access to meeting rooms. A DEDICATED SUCCESS COACH At ACHW, ensuring you get the most out of your degree is a priority. Be supported to achieve with a dedicated Success Coach. From getting into good habits from organising your time, to refining your academic skills and managing life challenges, a Success Coach will is available to help you reach your goals. STUDY FLEXIBLY FROM ANYWHERE IN AUSTRALIA Fit your degree around your life. With ACHW you can study a blend of online learning and advanced practical clinics with our experienced facilitators. As a full-time student you can expect to attend one week of face-to-face advanced clinical practice per semester (every six months). These sessions are conveniently run in capital cities around Australia. START YOUR DEGREE IN APRIL, JULY OR SEPTEMBER ACHW offers multiple intakes a year so students can commence their degrees at a suitable time for them. Start studying in April, and you could be halfway towards an Associate Degree by the end of 2019. To find out more, simply email admissions@tachw.edu. au asking for further information. You can also contact ACHW via Facebook Messenger using this link: https://m. me/TheAustralasianCollegeofHealthandWellness. An advisor will then be in touch with you shortly. Application forms are also available online from https:// www.tachw.edu.au/how-to-apply. Simply download the form, and return it to admissions@tachw.edu.au to apply.


Accelerate your Aesthetics career with a degree •

Gain an associate degree in two years

Exclusive professional development opportunities

Be supported by a dedicated success coach

Accredited & nationally recognised

FEE-HELP available

Flexible online study options

Visit tachw.edu.au to find out more APJ 53

Australasian College of Health & Wellness Pty Ltd; ABN 16 139036 721, TEQSA ID PRV13002; an approved FEE-HELP provider; Level 21, 580 George St. Sydney NSW





During the month of April Jane Iredale is launching the PurePressed Eye Shadow Kit: Solar Flare. This eye shadow kit consists of highly-pigmented, crease-resistant colours that stays put. The kit includes a mirrored compact with dual-ended wand for easy application. Containing a selection of botanical extracts to soothe, protect and nurture the skin, it is sure to be a popular seller. Here is what’s in the kit: Five richly pigmented, yet totally wearable, shimmery PurePressed® Eye Shadows to apply solo or layered: • Cosmic–metallic burgundy brown • Flash–metallic deep gold red • Corona–metallic deep taupe • Sunspot–metallic peachy beige • Aurora–metallic ivory Hypo-allergenic and Dermatologist tested. Contact 1300 850 008 or visit margifox.com.au





Maintaining effective hydration is imperative to skin health. Dr Anne-Marie’s Dermal Care has developed a carefully formulated Hydrating Moisturiser to both protect and improve the skin texture. It has been formulated with a selection of natural oils and purposely selected essential oils to help restore skin balance, leaving the skin with a matte, healthy appearance. Enriched with precious avocado oil, aloe vera leaf extract, shea butter, natural vitamin E and lavender oil, Hydrating Moisturiser comes in a generous 60ml pump for both hygienic and convenient delivery. For enquiries please contact Dr Anne-Marie’s Dermal Care info@dramdermalcare.com.au or www.dramdermalcare. com.au

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A holistic approach to skin management, an effective skin management plan and client engagement, are the essentials in achieving beautiful, healthy skin and client satisfaction. Clairderm’s Skin Analyser uses the latest technology to offer a comprehensive skin management system. It performs a detailed analysis of the epidermis and dermis, diagnoses 10 different skin conditions and recommends an effective customised treatment plan using your clinic’s products and services all in around 60 seconds. In addition, the comparative analysis shows clients that their treatment plan is really working, and we know that seeing is believing! Contact Clairderm Medical Aesthetics on 1300 781 239 or email office@clairderm.com or visit www.clairderm.com




Highly moisturising, yet lightweight Jane Iredale’s PureGloss Lip Gloss now includes three new shades to brighten up your day: Pink Glace, Spiced Peach and Blossom. Ultra-glossy never-tacky PureGloss Lip Gloss shades come in sheer tints of coral and pink that hydrate, condition and put the luxe on lips. Lusciously creamy with a light, fruit flavour, these beauties are vegan-friendly and free of wheat and petroleum. The new colours are: • Blossom–hot pink • Pink Glacé–sheer cool pink with shimmer • Spiced Peach–coral Once you try Jane Iredale’s lip colours you will not want to wear anything else. Contact 1300 850 008 or visit margifox.com.au

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There is no better way to achieve skin renewal than through the application of a mask that is enzyme-fortified to gently remove dead skin cells. REVITALISE ENZYME EXFOLIATING MASK by Dr Anne-Marie’s Dermal Care will gently dissolve cellular debris, thus preparing the skin to respond more favourably to further treatment protocols. This gentle mask can be used for even the most sensitive of skins due to its infusion of fruit enzymes that effectively remove dead and damaged skin cells. Revitalise Enzyme Mask contains colloidal oatmeal to help soothe and calm the skin, as well as coconut milk, white clay, pink clay, papaya and pineapple, as well as lavender oil. For enquiries please contact Dr AnneMarie’s Dermal Care info@dramdermalcare.com.au or www.dramdermalcare.com.au

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Dermatonics Clearskin® Forte

Are you looking for an answer for your clients to help clear up their skin? Dermatonics Clearskin® Forte is a highly innovative formula, packed with super-pure natural active ingredients that are known to be anti-inflammatory, help fight breakouts and also strengthen the skin. With key ingredients such as Niacinamide and Salicylic Acid as well as unique ingredients including Curcuma xanthorrhiza and N-acetyl cysteine, this unique formula achieves great results without drying the skin. The key to Dermatonics’ formulas is their proprietary technology to ensure each product is absorbed well into the skin to deliver its super-pure actives to ensure good bioavailability. See the difference that Dermatonics Clearskin® Forte can make for your clients’ skin. For further details contact Dr Donna Lee Marcal 0430 582 508 E: donna@sentryca.com.au




SKINFAKTOR exclusively distributes the patented Medilift delivery system with ‘Bloodless’ & ‘Anti-inflammatory’ design. Truly unique technology to offer fast results without the need for topical anaesthetics, trauma, downtime or pain. • Made in Europe, 2 years warranty • Polyabrasion, Shibata Skin Needling & Nutrient Infusion • All in the one compact system • EU & AU Registered Patents • In-clinic training & Launch event


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For further details contact SKINFAKTOR Australia (02) 8411 1681

clairderm medical aesthetics skin deep in technology

clairderm cosmeceuticals MOISTURISING DAILY DEFENCE SUNSCREEN LOTION Broad Spectrum UVA + UVB Protection

Protection To Help Keep Skin Healthy



A fast absorbing, extra light sunscreen that offers SPF50+ broad spectrum UVA and UVB protection. Suitable for all skin types, it helps to leave the skin feeling soft, supple and moisturised.

Proudly Australian Made

Specially formulated for every day use and pre- and post treatment care to protect the delicate new skin and optimise post treatment results. It offers invisible coverage and a matte finish, leaving no trace of oiliness, stickiness or ghosting. This makes it ideal to use under make up and over serums.

Every day Use + Pre- & Post Treatment Care Microdermabrasion • Hydrabrasion • LED Phototherapy Oxygen Infusion • Dermal Skin Needling • IPL • Laser • Peels

1300 781 239

office@clairderm.com APJ 57 www.clairderm.com


BARRIER REPAIR WITHOUT BREAKOUTS How to successfully reinforce the skin barrier of an acne skin Jacine Greenwood

THE MAINTENANCE OF skin barrier function is influenced by many factors. Day-to-day challenges, such as changes in humidity, temperature, and daily cleansing, can affect the skin’s barrier properties and its ability to hold water. When the skin is unable to hold onto moisture, skin dryness and flaking can occur. Acne skins have their own unique challenge with maintaining barrier function as the products often used to manage acne sometimes tend to be drying on the skin. Common ingredients such as BPO can cause surface dryness and irritation to the skin. The change of climate in winter exacerbates this even further, making it difficult for acne clients to maintain hydration. Correcting this deficit in barrier function can be challenging, as many common ingredients used for barrier repair also are comedogenic, examples include Isostearyl Isostearate, which has proven efficacy with barrier dysfunction. It is able to outperform Petrolatum with regards to reducing transepidermal water loss. However, it is known to be extremely comedogenic. As we know, comedogenic ingredients need to be avoided by acne skin types as they result in an increase in breakouts. There are few strategies that can be used to maintain hydration of acneic skin, particularly when it is barrier compromised: •

Avoid surfactants that remove the vital lipids from the stratum corneum

Use humectants that have a positive effect on the skin’s barrier

Use ingredients that act as precursors for ceramide production

Choose actives that are proven to reduce transepidermal water loss.

Let’s look at these in greater detail: AVOID SURFACTANTS THAT REMOVE LIPIDS FROM THE STRATUM CORNEUM Surfactants in skin cleansers interact with the skin in several manners. In addition to the desired benefit of providing skin

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hygiene, surfactants also extract skin components during cleansing and remain in the stratum corneum (SC) after rinsing. These side effects disrupt SC structure and degrade its barrier properties. Solubilisation of skin components such as lipids, enzymes, and natural moisturising factors weakens the skin-barrier function. Additionally, surfactants can also remain in the SC even after rinsing and lead to chronic surfactant exposure. While all surfactants tend to interact to some degree with lipids, their interaction with proteins can vary significantly, depending upon the nature of their functional head group. Studies have shown that surfactants that cause significant skin irritation interact strongly with skin proteins. Based on this understanding, several surfactants and surfactant mixtures have been identified as “less irritating” mild surfactants, because of their diminished interactions with skin proteins. Surfactants that interact minimally with both skin lipids and proteins are especially mild. Another factor that can aggravate surfactant-induced dryness and irritation is the pH of the cleanser. Harsh surfactants in cleansers can cause damage to skin lipids and proteins, leading to after-wash tightness, dryness, barrier damage, irritation, and even itch. Because surfactant binding reduces the skin’s ability to retain water, skin often returns to a state of lower hydration after washing. Anionic surfactants such as Sodium Lauryl Sulphate, Sodium Laureth Sulfate, Ammonium Lauryl Sulphate and Ammonium Laureth Sulfate have a greater tendency to cause protein denaturation. Surfactants that are non-ionic do not have this effect and do not interact with the lipid bilayer and proteins of the skin. Non-ionic surfactants have no charge on them. Most nonionic surfactants are in liquid form and they do not interact with the proteins of the skin. They are incredibly gentle and cause minimal irritation to the skin. Examples of the more safe, non-ionic surfactants include the following: •

Decyl Glucoside

Lauryl Glucoside

Caprylyl/Capryl Glucoside


These surfactants help to mitigate dryness and the skin by stopping the removal of lipids necessary for barrier function of the skin. They also tend to possess some hydration and humectant properties, leaving the skin feeling soft and dewy after use. USE HUMECTANTS THAT HAVE A POSITIVE EFFECT ON THE SKIN BARRIER Glycerine is a humectant that has been used traditionally in cosmetics for its hydrating properties. Often overlooked as an ingredient, glycerine mediates other functions beyond its spectacular humectant activity. Glycerine helps to keep the horny layer of the skin at a steady state of thickness during desquamation. It regulates the orderly shedding of corneocytes at the surface. It accomplishes this by enhancing proteolytic activity and promoting the dissolution of corneodesmosomes near the surface, which are responsible for the cohesion of corneocytes below the surface. Equally, glycerol also has effects on cornified envelopes - a previously unrecognised structural component of the horny layer that provides a new target for cutaneous therapeutics. Glycerine creates a stimulus for barrier repair and improves the stratum corneum hydration. Studies have shown it increases the key lipids necessary for barrier repair. Glycerine is an acne-safe ingredient and can alleviate surfactantinduced dryness and irritation. Glycerine functions differently in climates where the humidity is low, acting in the capacity of allowing the lipid bilayer to remain fluid. Fluidity of the lipid bilayer is important for maintaining the barrier function.

in this field relates to the alleviation of essential fatty acid deficiency in humans. Topical application of formulations containing linoleic acid in the form of natural oils leads to enhanced synthesis of Ceramide 1. Direct topical application of linoleic acid has also been shown to alleviate the symptoms of dry skin within five days of use. The topical application of Niacinamide has also been shown to stimulate de novo synthesis of ceramides. Niacinamide has been shown to upregulate fillagrin, a key protein involved in a healthy skin barrier. Many skin diseases occur from abnormalities in fillagrin production and processing. CHOOSE ACTIVES THAT ARE PROVEN TO REDUCE TRANSEPIDERMAL WATER LOSS Petrolatum has been around for centuries, however its ability to repair the skin barrier remains. Petrolatum while it is occlusive in nature, is not fully occlusive when applied to the skin and in fact it will result in a 90% reduction in transepidermal water loss. Studies have shown that Petrolatum significantly upregulates the antimicrobial peptide human β-defensin 2. This being of particular relevance for eczema clients. Clients who have eczema lack the necessary antimicrobial peptides to protect them from skin infections. Petrolatum has been shown to induce the expression of these peptides that are needed in their skin. Application of petrolatum also has been shown to induce the expression of key barrier differentiation markers (filaggrin and loricrin) and increases the thickness of the stratum corneum. It has also been shown to enhance the skin’s ability to maintain barrier function and hydration.

Normally the lipid bilayer is fluid and will move to fill in gaps in the stratum corneum, minimising moisture loss from the skin. In cold climates and where the humidity is low, it loses this ability to retain its liquid structure. Glycerine enables it to remain fluid and enhances the skin’s ability to retain moisture.

Managing barrier dysfunction with acne clients requires the therapist to have an understanding of the common cosmetic ingredients that are available on the market to manage this condition. The ingredients listed above are readily available in many products and can be used to successfully ensure that skin remains hydrated during times of climatic change and stress. APJ

USE INGREDIENTS THAT ACT AS PRECURSORS FOR CERAMIDE PRODUCTION Barrier function can be improved by the topical application of lipids, such as vegetable oils to the skin. The earliest work

Jacine Greenwood will be a speaker at the APAN Aesthetic Conference, Gold Coast. Attend for an opportunity to hear her live. www.apanconf.com

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E-sab Skin & Body Clinic

Delivering memorable skin treatment results LOCATED in the heart of the Gold Coast in the suburb of Bundall is a quaint little clinic that is making waves for its amazing skin treatment results. KATRINA PEACOCK is developing a reputation for herself as the go-to therapist that can transform just about any skin condition – even some of the most challenging. Her devotion and dedication to her work are legendary and it is these qualities that have contributed to her amazing success as an expert skin therapist. As a devoted APAN member, we caught up with her to explore her professional journey and to uncover what makes her so special to her client and to the reputation of the industry. APJ Q1: KATRINA HOW DID YOU GET STARTED IN THIS INDUSTRY? I entered this industry after graduating from the Diana Cameron Academy of Beauty Culture in 1983. It was Diana’s policy to employ her Dux graduate of each year and I worked hard to achieve high marks, so that get the opportunity to get into practice straight away. In 1983 there was a recession and jobs were hard to come by, so it was a wonderful opportunity for me to immediately gain employment and build my confidence and experience. APJ Q2: HOW WOULD YOU DEFINE YOUR PHILOSOPHY FOR MAINTAINING CLIENT RETENTION AND GROWTH? At the heart of everything we do is the wellbeing of the client, so our philosophy is to always focus on being client-centric on what is best for them. That is what most clients are looking for and it is also the ethical approach. In many instances this involves referrals to other specialists that further supports our ongoing treatments in skin management. For example, current research suggests APJ 60

that during the first five years of menopause, collagen loss will reach approximately 30%. Therefore, a client who is concerned, or presents with diminished skin density and depleting skin laxity, I refer to a doctor who specialises in anti-ageing medicine. While I will offer collagen-induction therapy, the doctor can examine the status of their hormones and address this deficiency from a medical and preventative perspective. I believe this collaborative approach offers my clients the very best results and is a more pragmatic approach that will benefit them on multiple levels. There are lots of other cases, such as investigating instances of polycystic ovarian syndrome that may be contributing to acne, allergens and gut dysbiosis in rosacea, insulin resistance when presented with skin tags etc. Yes, we provide skin treatments, but I am also looking for underlying causes. When you can establish causative factors that are impacting the condition and address those as well through an appropriate healthcare professional, you are halfway to a successful outcome. Interestingly enough, I never lose clients who I refer. APJ Q3: WHAT ARE YOU RENOWNED FOR AND IN WHAT ARE YOU MOST SUCCESSFUL IN TERMS OF TREATMENT OUTCOMES? I am renowned for my empathy, clinical assessment skills and management of skin conditions. In terms of successful outcomes, over the course of 15 years assessing, imaging and treating various skin conditions, I have amassed a lot of results and of course, some failures.  It is important to acknowledge the treatments that have not been so successful and investigate for further answers. It is something we sometimes don’t talk about enough.  When faced with a less than ideal outcome, it is what you don’t know, or have not considered that is important. This gives you an opportunity for further research and understanding of the condition.

We see and treat a lot of conditions ranging from the manifestations of sun damage to a variety of inflammatory skin conditions. I have had success with Lupus and most recently I am currently undertaking, under the guidance of Dr Des Fernandes from Environ, the management of a highly keloid scar due to a burns injury.   APJ Q4:  CAN YOU PLEASE SHARE WITH US A RECENT CLIENT SUCCESS STORY AND HOW YOU ACHIEVED THE RESULTS? I recently treated a gentleman with sun damage and pigmentation. The client was 50 years old and his skin type was Fitzpatrick II. His concerns were that he had sustained substantial sun damage that had contributed to skin laxity and wrinkles, as well as extensive pigmentation.

APJ Q5: DESPITE THE COMPETITION IN YOUR AREA, TO WHAT DO YOU ATTRIBUTE THE FACT THAT YOU ARE CONSTANTLY BOOKED OUT? I never worry about competition. I have always been of the opinion that there is room for everyone. My business comes from referrals. Women are usually wonderful, natural networkers, although sometimes it’s the husband I see first. Once they see what we’ve achieve form his skin, they reach out and want a little bit of that too... and so it goes. I have to say, I am always rewarded by the excitement of my clients after I have achieved positive results for them. I am currently developing a new treatment protocol utilising Radial Pressure wave therapy. Radial Pressure waves are

I prepared the skin for collagen induction therapy. I performed six CIT treatments using 1mm needle depths delivered at weekly intervals. For homecare I prescribed Environ AVST Moisturiser as well as Environ sunscreen. The results were recorded objectively by Siascope skin imaging as part of an objective review. The final image presented here shows the results six months after completion of the treatments. As you can see, there is substantial improvement in the pigmentation, as well as the texture of the skin.

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BEFORE TREATMENT acoustic waves that generate oscillations in the tissue. The wave hits the body at skin’s surface and from there travels radially into the body to a depth of around 20 centimetres. In the body, the pressure waves stimulate metabolic activity and the body’s intrinsic healing mechanism Recently, several of my clients received this free as a Christmas present. APJ Q6:  IF SOMEONE WAS STARTING A SKIN CLINIC WHAT ADVICE WOULD YOU GIVE THEM? My advice would be to identify what they love the most and enjoy doing and specialise in it. Look for a niche area that you can focus on. I think it is impossible to be everything to everybody. I would also advise to find a team of experts that can support the outcome you wish to achieve and establish collaborative relationships that will help you achieve the best possible outcomes for your client.

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AFTER TREATMENT APJ Q7: WHAT DOES YOUR APAN MEMBERSHIP MEAN TO YOU AND HOW HAS IT PROVIDED YOU WITH VALUE? I really appreciate APAN for their strong support of practitioners on so many levels. Their ongoing representation and involvement with government agencies and other regulatory bodies is truly invaluable for the reputation of the profession. They are truly dedicated to their members and in defending the reputation of the industry. Indeed, the reputation of a profession is enhanced through the dedication, passion and commitment to professional development of such practitioners as Katrina Peacock. We are so proud of Katrina’s achievements and it is a pleasure to support her in journey to on-going success. We do hope your story has inspired you. APJ E-sab Skin & Body Clinic 1C/95 Ashmore Rd, Bundall, Qld 4217 | 07 5538 1844

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ENHANCING AESTHETIC APPEAL for Face and Body supported by Wellness Benefits STATISTICS are confirming that while skin treatments will continue to experience consistent increase in consumer demand the new growth opportunity that is well-supported by research is body treatments. Not just Baby Boomers, but also Millennials are seeking to remove cellulite and improving body-shaping concerns. According to EurekaAlert – the global source for scientific news, the Body Contouring Market is now worth $1.1 billion and will continue to grow at an annual rate of 7.9%, while three of the top-five surgical procedures are focused on the body. On the other hand, the focus on wellness is also on the rise. The Health and Wellness Future Report unpacked the key trends, consumer shifts and new technologies that are shaping health and wellness, and looked ahead at the exciting possibilities for the future. The report inspired the need to build strategies that provide a clear path to tangible wellness-focused results. And considering ethical responsibilities, it delivers insights to help create wholesystem wellness. The report also combined rising trends, consumer insights and key technological innovations that can deliver credible wellness strategies.

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At Diamond Natural Beauty, we are embracing the best of both worlds by using technology in a beneficial way to work in harmony with the natural systems of the body, while at the same time honouring the ancient wisdom of natural treatments. Diamond embraces both science and nature with ground-breaking treatments that give both immediate and lasting results. They use natural non-invasive and nontoxic treatments to strengthen the natural systems of the body - the body responds by clearing toxins and other stagnation that lead to the build-up of wrinkles and fat. Diamond’s non-invasive innovative concepts have redefined face and body treatment results delivered through cutting-edge technologies that work holistically with the body’s function. Results are achieved quickly and without injury. There is no better, or easier way to grow your business and retain loyal clients than through introducing these amazing treatments. Diamond technology is backed by authentic, peer-reviewed scientific studies, published by Springer Nature, one of the world's leading scientific publishers. This same scientific publication is also recommended reading on the official Olympic International website. Results are visible within minutes of the treatment starting and are comfortable for the client. Contact Diamond Natural Beauty today and let us show you how you can establish leading strategies and secure business growth and on-going client loyalty. Diamond Natural Beauty 0406 279 889 rgreenberg888@gmail.com www.diamondnaturalbeauty.com


Leading the way in safe and effective technologies and treatment results

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BIOMESOSCULPTURE UNIQUE TREATMENTS Effectively target the epidermal extracellular matrix, improving the 1st stage of cellulite STAGNATION by oscillating pulses of dynamic energy. Targets 2nd stage CELLULITIS through an intensive non-invasive sub-dermal therapy. PURE SCULPT MATRIX THERAPY Moves the matrix dynamically to relieve stagnation through a unique cupping mechanism, stimulating the lymphatic systems to function at its peak. PURE SCULPT BIOMESOSCULPTURE CRÈME A luxurious chocolate-infused antioxidant crème, rich in botanicals, herbal homeopathic and plant extracts. Supports the removal of second stage Cellulitis, assisting in detoxification, inch-loss and rejuvenation. DIAMOND MEDILIFT Once the lymphatic system has been optimised, the Medi-lift technology further supports the body by working to improve the toning of the muscular system. Diamond devices are scientifically-proven to improve appearance and support wellbeing.

CONTACT DIAMOND NATURAL BEAUTY TODAY! 0406 278 889 www.diamondnaturalbeauty.com APJ 65



VERY OFTEN within our industry new innovations will enter the market, and in a bid to become competitive, we want to be first to provide our clients with the next-best-thing that promises a whole lot of appearance enhancing benefits. However, as professionals, we have a duty-of-care to investigate the science and possible safety issues in relation to these innovations before you introduce them. Additionally, we also need to be mindful of any regulatory restrictions within our own local jurisdiction in Australia. One such technology that has recent been introduced is the new BB Glow treatment. At the surface, it appears like a great treatment, promising to provide a more lasting result with a lovely health glow. However, on closer examination, there appears to be some risks that we should consider because of the way this treatment is delivered. Currently in Australia this procedure is being investigated by the authorities. Meanwhile DR LANCE SETTERFIELD, who is considered a global authority in skin treatments through microneedling, is presenting an article here that examines the risks and benefits of the BB Glow this procedure. We are very aware that sometimes advocating risks can be annoying to some, but as an industry body, APAN has a duty-of-care to YOU, to make sure you are presented with relevant information for your protection, especially with new innovations that have limited evidence of safety, or which are still being investigated. We trust you will find this article thoughtprovoking. It has been published with Dr Setterfield’s permission. To BB or Not to BB (Glow)? This article is in response to the many emails I have received requesting guidance on a new treatment taking the world by storm: “BB GLOW”. WHAT IS BB GLOW? BB Glow entails using a Microneedling device to tattoo BB Cream into the skin as a form of semi-permanent makeup to “hide blemishes and allow one to wake up looking radiant”. For the purpose of this discussion, while “BB Cream” is a marketing term used generically, I am referring to special ampoules of solutions that are sold for use with Microneedling and NOT the “BB Cream” from the local beauty store. My first reaction to this was, “why are we even talking APJ 66

about this?” It seems vanity and insanity know no bounds.  Instinctively, most of the enquirers suspect this is a bad idea, and, given the enthusiasm within the media from consumers and practitioners alike, the desire is now to counter this apparent wild abandonment with specific scientific data.  DISTURBING THE BALANCE OF NATURE The skin barrier has a physical, chemical, and immunological component. Disturb any of these complex components and the outcome may be problematic.  Disturb all three simultaneously and the risk of an adverse outcome skyrockets. Microneedling breaches the physical barrier by creating temporary channels that facilitate infusion of topically applied substances.  These ingredients interact with the chemical component of the skin, influencing change for good (or bad) via signalling systems.  Immunological reactions are mounted in response to environmental challenges (foreign material) via the innate and adaptive immune systems.  The former tends to be a poorly discriminating, rapid response without memory, while the latter is highly specific in response to previous exposure (memory) over time.   [Cells implicated in the innate response include phagocytes, eosinophils, mast cells, NK cells and keratinocytes.  Cells implicated in the adaptive response include dendritic cells, Langerhans cells and lymphocytes (B cells and T cells).] THE DISRUPTORS  Microneedling has been around for a while and is known to be relatively safe compared with other treatment modalities.  Why, then, are the risks higher with Microneedling (tattooing) BB Cream as opposed to any other cream used with a cosmetic device for home treatments? [As a side note: This gets a bit confusing on multiple levels due to definitions and differing recommendations within the industry. See following definitions: •

Cosmetic Needling: Industry classification of microneedling is according to needle length.  Less than 0.5 mm is considered “Cosmetic”, and therefore safe to use at home to infuse appropriate topical ingredients to support and maximise cell function. 

Medical Needling: Many companies encourage infusion of products after “Medical” needling, using needle depths exceeding 0.5 mm “in-clinic”.  This practice has more to do with “upselling”, and benefits the suppliers rather than the patient.  Improvements to the patient following one application of a product on a monthly basis are minimal compared to the risks of systemic infiltration of (mostly non-tested) ingredients.  These include allergic reactions, post-inflammatory hyperpigmentation (PIH), scarring, and granulomas.  Fortunately, these complications are less prevalent when compared to other treatments in the industry, but they are not insignificant and they are avoidable for the most part.  In view of this, I recommend “cosmetic” or home “infusion” instead, and daily application has a far greater benefit with less risk of an immune response.  (Consider going to the gym daily with low intensity, vs. once a month with high intensity.)

The above definitions clearly show that when one has an “inclinic” microneedling treatment, it is considered Medical, and involves a needle length of 0.5 mm or more.  Here is where the confusion arises.  BB Glow advocates are instead recommending an “in-clinic” treatment that is considered Cosmetic, using needle lengths of less than 0.5 mm. They do this because they mistakenly believe that confining ingredients to the epidermis renders this treatment safe.]  Permanent Makeup or cosmetic tattooing is also widely used with relative safety, leaving pigment implanted in the skin, so how is BB Glow any different?   The difference between creams infused for antiageing versus BB cream has everything to do with the type and number of ingredients.  With microneedling alone, the mechanical effects on the skin are of very short duration.  With anti-ageing creams, ingredients absorbed through the channels are mostly biodegradable, or are diluted, carried away, and excreted, so their chemical effects are limited.  In contrast, non-degradable substances in BB Cream accumulate over time and trigger an immune response which may end up being prolonged.  The quantity of non-degradable material deposited over an entire face (every few months) is also significantly more than, for example, brows or eye-liner.  Furthermore, the number of ingredients used for brows or lips tends to be in the single digits, as opposed to 40-plus ingredients in some BB Creams.

HOW DO WE KNOW WHEN WE ARE DOING HARM? As practitioners, we have a professional duty and responsibility to “First Do No Harm”.  Sometimes the answer is a ‘no brainer’ when we infuse something that causes an allergic reaction or contact dermatitis.  The greater challenge is when the adverse outcome is delayed or invisible to the naked eye.  In some cases, it may take years to show, e.g. cancer.  It is especially tempting to throw caution to the wind when “instant gratification” is involved.  If it looks great, why not?  Enter BB Cream Microneedling treatments, or semipermanent foundation, also known as BB Glow or MesoBB.   WHAT IS SEMI-PERMANENT BB CREAM AND WHAT PROMPTED THIS IDEA? The art of permanent makeup has also been around for a while.  The upside is always looking your best with little to no effort, and the downside is an irreversible blemish.  Two areas, eye-liner and lips, were initially most popular, but now brows are all the rage.  Microblading, in the right hands, enables depositing pigment in super fine lines, thus creating the impression of a real hair.  The natural progression of this thought process is, “if it is ok to put pigment into the lips or the brows, why not the entire face?”  The advent of microneedling devices has facilitated the ease of performing BB Glow treatments.  BB Cream became popular due to the appeal of “having it all” in one tube.  Variations include primer, foundation, concealer, moisturiser, skin treatment, and SPF all-in-one.  Given the popularity of Microneedling and BB Cream, it did not take long for someone to try combining the two and “tattooing” the pigment into the skin.  A mask is frequently applied after the treatment to enhance absorption of the ingredients.  Needling protocols vary, using depths from 0.1 to 1 mm, and results are quoted as lasting from weeks to years.  “Before” and “after” pictures can be remarkable.  Hence, the end justifies the means and we now have a runaway train on our hands. WHAT ARE THE BENEFITS OF BB GLOW? The allure in this case is waking up all year round with a naturally glowing, smooth complexion without having to apply foundation.  Immediate benefits are touted as saving time and money.  No more smudges or need for touch-up after a rough day in the world.  An added benefit from the microneedling aspect is collagen induction to smooth out wrinkles and tighten pores.   APJ 67

(I probably had your attention at “naturally glowing, smooth complexion”.) ARE THERE MARKETING RED FLAGS HERE? After reading about some of the benefits on websites and in beauty magazines, a few points caught my eye.  “EGF” (Epidermal Growth Factor) randomly thrown into the mix of the ingredient stack in some products makes no sense.  That is a huge can of worms all on its own, and you can read further here.  Statements like, “100% safe and natural ingredients”, and, “it’s so new that it is not yet approved by the FDA”, are automatic red flags. WHAT ARE THE RISKS OF BB GLOW? Many things are possible, but not all things are prudent. As with most things that are bad for us, we end up sacrificing “the permanent on the altar of the temporary”.  It may look good and feel good now, but we will pay a high price later.  Most of the risks of BB Glow are related to the ingredients infused.  These may include (but are not limited to) allergic reactions, contact dermatitis, infection, PIH, granulomas, scarring, organ toxicity, cell damage, and cancer. As a point of reference, here is a list of some of the ingredients found in BB Cream: Water, Glycerin, Niacinamide, Propylene Glycol, Mineral Oil, Ethanol, Titanium Dioxide(CI 77891), Aluminum Hydroxide, Triethoxycaprylylsilane, Caprylic/Capric Triglyceride, Cyclohexasiloxan, Cetyl Ethylhexanoate, Talc, Magnesium Aluminum Silicate, Polysorbate 80, Micro Crystaline Wax, Cetostearyl Alcohol, Stearic Acid, Glyceryl Stearate(se), Chlorphenesin,Dimethicone, Sorbitan Sesquioleate, Yellow Oxide Of Iron (CI 77492), Beeswax, Methyl Paraben, Fragrance, Disodium EDTA, Allantoin, Xanthan Gum, Red Oxide of Iron (CI 77491), Sodium PCA, Aloe Barbadensis Leaf Extract, Persea Gratissima (Avocado) Fruit Extract, PEG-60 Hydrogenated Castor Oil Tocopheryl Acetate, EGF, Propyl Paraben, Phenoxyethanol. (Keep in mind that virtually all safety studies on cosmetic ingredients are confined to application on intact skin.  They are also done in the context of a specific isolated ingredient, and evidence of safety is not necessarily applicable when combined with other ingredients due to interactions.  There are no safety studies pertaining to “injecting” a concoction like the above into the body because it is an insane thing to do for one, and impossible to cover all the variables when so many ingredients are included.) Here are some considerations: • Allergic Reactions You may recall the uproar years ago when “nanotechnology” was introduced into the cosmetic field.  It was feared that by miniaturising molecules, they would enter the body in larger quantities.  Nano-elements behave differently to their presence in bulk.  We know little of how quantum mechanics influence substances of nanoscale and how they may behave inside the body.  These molecules are charged, which is one mechanism facilitating surface reactivity with the surrounding tissue.  Non-degradable, or slowly degradable particles, may accumulate over time within organs with potential for toxicity. All of this previous uproar was in the context of “intact skin”, and yet here we are decades later breaking down the skin barrier with needling devices to permanently or semipermanently implant foreign material into the largest organ of the body. Reassurances: “But we are averting risk by only working in the epidermis.” Practitioners quoted in articles espousing this treatment discuss using a needle depth that “stops short of the

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dermis”, yet in their accompanying pictures, pin-point bleeding is sometimes visible. (Denotes evidence of dermal penetration.)  Can any practitioner guarantee they are only working in the epidermis?  Some say, “Yes!  One can be certain if nano-needles are used which treat only the upper layers of the epidermis.”  However, this is a moot point.  They mistakenly believe that by restricting deposition of material into the epidermis alone, the risks of an immune response are minimised.  While less absorption will occur using this technique (which means results will be very short-lived), allergic reactions are not necessarily “dose-dependent”, nor does it depend on the allergen (foreign material) entering the dermis.   There are many mechanisms that facilitate allergic reactions.  One way is via cells that migrate into the epidermis (Langerhans cells) to “capture” foreign substances and drag them back into the dermis and into the lymph nodes.  This migration of Langerhans cells depends on epidermal cytokines, e.g. TNF-α and IL-1β. Consider this for a moment.  One of the tests used to determine allergies is called a “scratch test”.  A small scratch is created in the epidermis and common allergy-provoking substances are applied to this tiny area.  After 20 minutes the skin is examined for a reaction in the form of redness, swelling, or a rash.  One of the BB formulas sent to me for my opinion contained 44 ingredients.  Forty-four!  Not only that, but it is to be applied over a LARGE area.  Whether it is BB Cream you are applying after Microneedling, or any other substance, remember in essence that you are doing a giant allergy test.  The higher the ingredient count, the higher the risk. Ingredients in BB Cream most likely associated with allergic reactions:  While any ingredient may be associated with allergy, the most likely are fragrance, methyl paraben, propyl paraben, mineral oil, sorbitan sesquioleate and phenoxyethanol. • Contact Dermatitis With irritant contact dermatitis, a certain minimum (dose) exposure to a substance is needed, whereas with allergic contact dermatitis (ACD), tiny quantities of allergens are sufficient to trigger a response. While symptoms may be similar, the underlying mechanisms differ. “Irritant contact dermatitis (ICD), evolves as a consequence of direct toxic effects of physical or chemical agents resulting in keratinocyte damage and local inflammation, while ACD critically depends on adaptive immunity.” Logically, underlying causes include anything that facilitates increased absorption of foreign material into the skin.  Impaired barrier defence results with friction, overexposure to water, chemicals (acids, alkalis, emulsifiers, detergents and solvents), and, of course, Microneedling (cosmetic and medical). Thus, allergic and irritant contact dermatitis may co-exist, especially in the context of Microneedling, both cosmetic and medical. Ingredients most likely associated with contact dermatitis:  Fragrance, methyl paraben, propyl paraben, propylene glycol, sorbitan sesquioleate, and phenoxyethanol.  Ingredients associated with depletion of bilayers include emulsifiers like cetostearyl alcohol, stearic acid, glyceryl stearate, polysorbate 80, and sorbitan sesquioleate. • Post-Inflammatory Hyperpigmentation Post-inflammatory hyperpigmentation (PIH) is perhaps the most commonly reported serious side effect with microneedling.  A common denominator in most cases is Microneedling PLUS something that amplified the inflammatory cascade.  There is nothing like a foreign body reaction to get inflammation going.  Try a sliver in your finger

for a week. The risk for PIH increases in higher Fitzpatrick skin types.  Sadly, the group at highest risk of harm are the target market for BB Glow treatment.  They are more prone to hyperpigmentation and uneven skin tone after sun exposure or acne, as examples.  (The treatment seems to have originated in Korea, and Asian skins are often associated with acne.) Ingredients most likely associated with PIH:  Fragrance, methyl paraben, propyl paraben propylene glycol, sorbitan sesquioleate, and phenoxyethanol. • Infections I would hope that all practitioners employ appropriate bloodborne pathogen prevention practices to avoid crosscontamination.  Hep B/C and HIV ought not to be a factor.  However, secondary infection after Microneedling, although rare, is a possibility.  Let’s not create the ideal environment to change this statistic.  If we look at the literature for infections related to “implants”, which includes dermal fillers, the introduction of material into the body raises the risk of infection considerably, even when adequate precautions of pre-surgical skin cleansing have occurred. In these studies, the implants were sterile (as opposed to BB Cream ampoules filled with preservatives).  Why is this the case if the implant is sterile and the skin is cleaned? The answer seems to be due to a phenomenon called “biofilms”.  Pathogenic bacteria (those that are harmful) can clump together and also stick to things (like foreign material) and become covered in a “film” that protects them from being detected by immune cells or antibiotics that would normally destroy them.  Staphylococcus aureus biofilm is a common offender. Interestingly, when it came to fillers in this particular study, infection was greater with lesser depths (1 mm vs. 3 mm).  Clinically visible infections with dermal fillers are rare in healthy individuals, but as high as 19% in patients with HIV, cancer, or diabetes[ Infections were more common, though perhaps delayed in onset, when minimally biodegradable fillers were used. The take-home lesson here is that tattooing foreign material into the skin affords “bad surface bacteria” an opportunity to enter and set up home on the “building blocks” you have laid down for them. • Granulomas Granulomas are a type of scar where the body tries to “wall off” foreign material that it is unable to eliminate.  Fortunately, granulomas caused by Microneedling alone are not that common, but the incidence is increasing as distributors promote topical products to apply during and after treatment with the express purpose of infusion.  Some of these patients present with systemic illness, some having required hospitalisation for intravenous antibiotics, steroids, and immunosuppressive drugs.  Presenting symptoms may include rash (erythematous papules coalescing into plaques), fever, arthralgia, and erythema nodosum. Ingredients most likely associated with Granulomas:  Titanium dioxide, dimethicone, Talc, iron oxide, aluminum hydroxide and triethoxycaprylylsilane. • Scarring Microneedling a patient with keloid has the potential to make things worse.  However, the scarring I am referring to here is different in that it may not be visible to the naked eye, but the fibrous tissue that results will reduce pliability of the skin.  Scarring is directly proportionate to the inflammatory cascade of any wound healing process.  Thus, where foreign material is implanted, we can expect a chronic, low grade inflammatory response which would lead to scar collagen over time.

• Cell Damage and Cancer Particles that are deposited into the body, particularly metals, initiate oxidative stress, inducing redox-sensitive transcription factors associated with inflammation. The skin’s susceptibility to UV radiation is well documented, and the combined effect of UVB and nanoparticles co-exposure is more significant than we realize. What are the possible effects of metals on keratinocytes – DNA damage and cell death. This is a vast topic which would overshadow the intention of this article, but just as a reminder, it is not only about environmental interactions with ingredients imbedded in the skin, but also how molecules may interact with each other.  For instance, “titanium dioxide” may cause bioaccumulation of copper (perhaps used in a topical cream on a daily basis after a BB Glow treatment) to the point of toxicity.[18] Ingredients most likely associated with cell damage and cancer:   Titanium dioxide, cyclohexasiloxan, mineral oil, iron oxide [IOG] and aluminum hydroxide [AG]. • MRI (Magnetic Resonance Imaging) You may recall from your childhood days the intrigue of moving a magnet beneath paper covered in iron filings.  Any metal with magnetic properties will be disturbed by an MRI.  Iron Oxide in particular may cause burns due to the magnetic field moving electrons to create a current that heats the skin.  The image may also contain a black spot due to the pigment, thus obscuring the structures from view beneath it. • Q-Switch Laser: As a side note, white inks containing iron oxides and titanium dioxide may turn irreversibly black after QS laser irradiation. In addition, standard universal precautions in the use of IPL and lasers for treatments other than tattoo removal need to be adhered to in patients with pre-existing (BB) tattoos to avoid burns. IN SUMMARY On the one hand, we have cosmetic Microneedling with the infusion of biodegradable (preferably native) material for homecare.  On the other hand, we have “in-clinic” cosmetic (or medical) Microneedling with the infusion/tattooing of BB Cream.  Why is one OK and not the other?  As you can see, it is not the needle depth that differentiates the two — it is mainly the non-degradable ingredients and the immune response that they cause.  This response may be delayed and/or prolonged.  The associated inflammation leads to complications, such as scarring, granulomas, PIH, organ toxicity, cellular damage, and even cancer.  Non-degradable substances also provide a habitat for biofilms that are associated with antibiotic resistance and chronic infection.  The vast quantity of ingredients, (40-plus in BB Cream), increases the risk of allergies and contact dermatitis, as well as the large surface area being treated when compared to permanent makeup of lips and brows.  Risk is not averted by simply confining the ingredients to the epidermis.  Given all the above, and in the absence of safety studies, the risks clearly outweigh the benefits. APJ For further reading, see The Concise Guide to Dermal Needling, Third Medical Edition – Revised & Expanded, pages 94-107. (Ingredients to avoid with Dermal Needling.) © Copyright 2019 Dr. Lance Setterfield. All Rights Reserved

For a list of references, please contact the editor.

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The Regulation of Aesthetic devices and products under Australia Law Dr Derrek Beech MSc, PhD, CChem, CSci, FRSC ON A REGULAR bases there are discussions on various social media platforms where the question arises as to when a device or a product is considered therapeutic and requires TGA registration. Often on social media there are individuals interacting that come from other countries and this is where the answers can be misleading, or at the very least, be conflicting. As a professional, it is important that you gain access to accurate information, particularly when there are regulations in place. To address these concerns, we approached DR DERREK BEECH to provide us with an up-to-date report on the current status of regulations in Australia when it comes to both devices, cosmetics and supplements. Dr Beech created and directed medical device regulation at the Therapeutic Goods Administration for over 10 years prior to becoming a consultant and was for a period, in charge of the entire TGA, so you can’t get a more qualified authority on the subject. WHAT IS COSMETIC AND WHAT IS MEDICAL? At the outset, it is important to understand the distinction between cosmetic procedures and therapeutic/medical procedures. Essentially, cosmetic procedures cover-up or change the appearance without actually doing anything to the body/skin, whereas therapeutic/medical procedures actually do something to make a change to the body. So, for example, changing the appearance of wrinkles by covering them up or filling the spaces between them is cosmetic, but actually doing something to change the wrinkles in the skin is medical. Anything that causes a change to body tissues such as pigmentation lightening, fat or wrinkle removal etc, is a medical product and must have regulatory approval from the Therapeutic Goods Administration (TGA). The APJ 70

TGA is Australia’s regulatory body for medical products in the same way that the FDA is for the USA. Other countries such as Canada, EU and Japan also have regulatory controls on medical products. AESTHETIC MEDICAL TECHNOLOGIES There is a variety of energy-producing modalities for ablative and non-ablative treatment of the skin’s surface (e.g., removal of pigmented lesions, acne, psoriasis, wrinkles, tattoos or hair). They include technologies such as intense pulsed light (IPL), lasers, together with dedicated applicators (hand-pieces) that are used to apply the different energies to the surface of the skin. Also, there are systems that result in skin tightening by subdermal radiofrequency heating, fat removal by ultrasound and other new technologies are continually being introduced. MEDICAL DEVICE REGULATION Anyone who imports into, or manufactures medical devices for supply in Australia must seek approval to do so from the TGA (see www.tga.gov.au). The TGA implements the Therapeutic Goods Act (1989) and its associated regulations. This legislation has provisions to prevent supply, recall products and pursue penalties for non-compliance. The regulatory system is harmonised with that of the EU, Canada and other countries utilising the globally-harmonised system. There is basically only one category of ‘included’ devices and all must have been subjected to ‘conformity assessment’ to enable registration. What this means in practice is that for imported products, conformity to the regulations can be established by the provision of a CE mark from an EU Notified Body (organisation’s approved by the

EU to provide regulatory approval (CE mark) for the EU). Until recently, if the device does not have CE marking, or is manufactured in Australia then the conformity assessment must be undertaken by TGA. Now it is possible to utilise FDA, Japan or Canadian registration to apply for TGA registration under certain circumstances. Please note that just because a device has FDA approval this does not mean it can make therapeutic claims in Australia. FDA only has jurisdiction in the US, not in Australia. For an imported CE marked device, there is an application process which takes a few weeks and involves submission of the CE certificate to TGA with associated information and a fee. Conformity assessment by TGA, on the other hand, can take many months and involve submission of substantial information and payment of substantial fees.If you import or manufacture a medical device for supply in Australia then you must have your product on the Australian Register of Therapeutic Goods (ARTG) via the TGA. The items on this Register can be found via the Internet at https://www.ebs.tga. gov.au/ SKIN CREAMS Cosmetic skin products cannot make claims to for example, calm irritation, fade pigmented areas, treat acne and stimulate collagen growth. Furthermore, products claiming to be primarily sunscreens must have TGA approval. There is generally no similar requirement overseas, therefore it is difficult to meet TGAâ&#x20AC;&#x2122;s requirements for imported sunscreens. Overseas, such as in the USA or EU, it is common for manufacturers of skin creams to make wide ranging therapeutic claims. In Australia, such claims are much

more vigorously and effectively policed by the TGA and by the National Industrial Chemicals Notification and Assessment Scheme (NICNAS). NICNAS (see www.NICNAS. gov.au) is the regulator for cosmetics, but TGA becomes involved if therapeutic claims are made.It is also important to ensure that ingredients are not in the Standard Uniform Schedule of Medicines and Poisons (SUSMP). For example, hydroquinone and its derivatives are scheduled for dermal use, so this means that arbutin, sometimes referred to as Bear Berry extract, is not permitted in retail skin creams as it is a derivative of hydroquinone. Arbutin is widely available overseas in cosmetics. SUPPLEMENTS If a supplement is classified as a food, it is subject to the rules of Food Standards Australia New Zealand (FSANZ) http:// www.foodstandards.gov.au. If it is classified as medicine, it is regulated by TGA. To be entered on the ARTG, among other requirements, it must be manufactured in a good manufacturing practice licensed facility in accordance with the requirements of the Pharmaceutical Inspection Convention. This would not normally be the case for cosmetics. RISKS If you do not comply with the regulatory requirements for medical products, you run a significant business and personal risk. The primary reason for the TGAâ&#x20AC;&#x2122;s regulatory system is to ensure that medical products supplied in Australia are safe and efficacious. Not only are you at risk of financial loss and legal penalties but if any harm is caused to the patient then your insurance may be void if you are supplying the product illegally.

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If you purchase treatment equipment from a company within Australia it is important that you seek confirmation that it is included on the ARTG by asking to see the ARTG entry certificate. If you import directly from overseas or manufacture in Australia, the responsibility for regulatory approval with TGA lies with you. The regulations are in place to protect the consumer. The use of unapproved medical devices that are applying high energy radiation to the patient may result in injury, as they may not have been properly checked to ensure that they operate safely. Importation of skin creams with banned ingredients or noncompliant labeling/brochures may result in prosecution and/ or a ban on importation. IN SUMMARY If you are using or supplying products that actually do, or claim to do, something to change the anatomy or physiology of a person then it is a medical product and requires approval by the TGA. APJ If you would like to find out what regulatory requirements might apply to your particular product please contact the author of this article on 0412 4459 03 or dbeech@medicaltechnology.com.au.

Dr Derrick R Beech MSc, PhD, CChem, CSci, FRSC has been a consultant in medical product regulatory affairs for over 20 years. He created and directed medical device regulation at the Therapeutic Goods Administration for over 10 years prior to becoming a consultant and was, for a period, in charge of the entire TGA. He has received several intentional awards for biomaterials research and for communication in medical product regulation. Please see www.medicaltechnology. com.au for further details.


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Call 1300 135 294 | www.skinfaktor.com.au


DermaplanePro Australia The new technology that delivers immediate and long-lasting skin improvement DERMAPLANING is a new innovation in skin treatments that has recently entered the Australian professional market creating quite-a-stir, so how does it work and what are its benefits?

CAN YOU CUSTOMISE THE LEVEL OF SCRAPING? Yes, you can. By moving the surgical blade on a given facial area back and forth you can determine how deep you want to exfoliate.  For example: 0 - 6 scraping movements remove superficial keratinised skin 6 - 12 scraping movements remove more and peel the skin layers on deeper levels

Riana Janse van Rensburg is the Director of DermaplanePro Australia. Here she answers a few key questions about this new technology.

CAN DERMAPLANING BE USED ON ALL FITZPATRICK SKIN TYPES? Yes, it is safe to use on all skin tones as the method doesn't interfere with the melanogenesis.

WHAT EXACTLY IS DERMAPLANING? In brief, dermaplaning is the controlled scraping of the skin using a sterile, surgical blade held at a 45-degree angle for the removal of keratinised cells on the stratum corneum as well as fine vellous hair. Dermaplaning immediately rejuvenates the skin and is highly effective in minimising the appearance of fine lines, wrinkles and acne scars, while leaving the skin smooth, supple and vibrant. It is a great treatment for prepping the skin prior to peels, enzyme treatments and to increase penetration of active ingredients, both for in-clinic treatments, as well as for better penetration of homecare products.  It creates the perfect canvas for makeup application and is the go-to treatment to prepare for high profile occasions. Basically, dermaplaning is a physical/mechanical exfoliation that is extremely safe when performed by a professionally-trained therapist utilising the appropriate tools for the service.  Clients love this treatment and will return monthly to have it done.

CAN DERMAPLANE BE USED ON ALL TYPES AND CONDITIONS? No, it is contraindicated for active acne. CAN DERMAPLANE BE USED ON ALL AGE GROUPS? Yes. Young adults love it for a smooth appearance and for a better make- up application.  On the other hand, ages between 30 - 40 love it for the rejuvenation benefits and clients between 50 - 70+ love it for the anti-ageing benefits.  When performed correctly dermaplaning delivers only beneficial effects to the skin. DOES DERMAPLANING STIMULATE HAIR GROWTH? No, as no hair is plucked from the dermal papillae. The 45-degree angle of the dermaplaning process ensures soft lengthening of the hair. CAN IT BE COMBINED WITH OTHER PROFESSIONAL TREATMENTS? Yes, it can be used before IPL hair removal, to remove hair from the surface of the skin, before skin peels to prep the skin and for preparing the skin for numerous other facial treatments. With DermaplanePro you are trained in specific protocols that you must adhere to, to achieve optimal results. DermaplanePro will be exhibiting at the APAN Aesthetics Conference on the Gold Coast and Riana Janse van Rensburg will also be presenting. DermaplanePro AustraliaTM Head Office Canberra 02 6166 2265 dermaplaneproaus@outlook.com www.dermaplanepro.com.au

QLD Trainer & Distributor DermaplanePro AustraliaTM Karen Geiszler 0416 169 130 klgeiszler@bigpond.com

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WITHOUT ENERGY our life is miserable. We are unable to complete some of our tasks, we can get depressed, irritable and we lose our joy for life. Yet, lack of energy is such a common factor for many. In this article Naturopath NICKY WOOD presents some of the biochemical contributing factors to poor energy and also discusses useful strategies to consider for improving energy levels. We are delighted that Nicky will also be one of our senior speakers at the upcoming APAN Aesthetics Conference on the Gold Coast. We trust you will enjoy her article and join us to meet her live at the conference. When was the last time you literally leapt out of your bed, with a clear head, a rested mind and a limber body? Have you EVER felt that you could literally bounce out of your skin because you felt that energetic? For many, an answer in the positive would be a distant memory at best. For some, if there was enough energy to recall a memory that far back it would be peppered with moments where the childhood version of yourself was most energy bound. Most of us remember being energetic young children, but few of us remember the moment that level of vitality drained out of us, never to return again. Arriving at an understanding that the plug may have been pulled on your vitality bath after a number of energy-draining moments, rather than just one, is the primary focus of this article. Complaints of prolonged fatigue constitute up to 25% of all clinical consultations, with approximately half of these being labelled as idiopathic, or ‘cause unknown’. DRAGGING THE BOTTOM OF THE ENERGY PIT ISN’T NORMAL If you are trudging through your days of every week, (as if you are wearing Wellington boots and your home and workplace were mud pits), with an all too familiar level of fatigue, brain fog, irritability and body aches, or other persistent health issues, you may find some clear and concise steps on how to harness more energy out of your day, by adopting some simple and healthy strategies highlighted in this article. APJ 74

If you acknowledge that this sounds like an everyday experience for you, alarm bells should be ringing that something has to change before you accept this as normal. I personally have a 48 hour rule for myself. If I am feeling anything adverse in my body, away from health and happiness that I aim to achieve daily, and this lasts for 48 hours or more, then something has to change in what I am eating, doing, thinking or drinking in order to return to my healthy homeostasis. In order for you to go from that level of fatigue to bouncing out of your skin may require a number of well-paced and grounded approaches to your healthcare, and certainly a detailed understanding on the timeline of events that lead you to that point. You may also find you have something in common with your clients’ as you uncover similar experiences during the course of your appointments. The danger in normalising low levels of vitality lies in accepting that this is just going to stay with you forever, and that your options are to give up expending the little energy you do have (exit stage left any exercise or physical activity), or to prop it up with stimulants to get you to the other end of the day (enter stage right coffee, chocolate, recreational substances and sugar laden snacks). Ironically, for some - the other end of the day is where your energy starts to annoyingly spike, preventing restful sleep, but more on that later in the article. HOW IS ENERGY PRODUCED IN OUR BODY? There are many ways to ‘create’ more energy to get you through a demanding time, a challenging workload, a draining emotional crisis or times of celebration, but it is commonly done through means that actually add more work for your body later on, and in the end it becomes a false economy. Some of the ways you can create this ‘false energetic economy’ may be through the use of stimulants such as

coffee, sugar, nicotine and some recreational or even some over the counter or prescriptive drugs. While in the moment they may seem like they are boosting your body and brain with a zip of dazzle, soon after, most of these substances will be using up important nutrients that would otherwise be used in your cells to produce Adenosine Di Phosphate (ADP) which is converted into Adenosine Tri Phosphate (ATP) – a chemical that your body uses to provide your body with energy. Alternatively, stimulants may also wire certain neural pathways that affect your mood and wellbeing, requiring more energetics to rewire later. Remember, your body is geared in default to find homeostasis. What goes up, must come down so to speak, but there are some inherent conditions that challenge that return to health balance. In the cells of your body are tiny power houses called mitochondria. It is in the mitochondria where energy (ATP) is produced from the Krebs cycle as a result of ingestion of food, especially carbohydrates and fats. Your body produces energy more efficiently from glucose with the presence of oxygen in the oxidative phosphorylation step of energy production, and it is possible to push the balance of carbohydrates/fats in and energy out, by not burning off enough of the potentially stored energy from these foods, through exercise or by increasing cortisol output through the stress response.

These tiny organelles have been identified not only in the manifestation of fatigue. Recent research into mitochondriamediated regulation of inflammation, reveals dangerassociated molecular patterns (DAMPs) signals released from mitochondria in response to stress and infection, promote the formation of inflammatory signalling mediators known as inflammasomes. These inflammasomes stimulate the secretion of potent proinflammatory cytokines. Mitchondrial dysfunction may not only be contributing to your fatigue, but also may be playing a role in activating chronic inflammation. What most chronically tired people may be overlooking is that the pathway back from mitochondrial dysfunction is not always as easy as a walk in the park. It may require a multifaceted and persistent approach to managing stress and infection related intermediates as well as frank dietary and movement deficiencies inside the lifestyle. COULD MY DIGESTIVE SYSTEM AFFECT MY ENERGY? The answer to the above question is “Absolutely!” Your digestive system and how well it functions is a huge player in the production of energy, following the ingestion of food and beverages.

A poor-quality diet, deficiency in B vitamins, magnesium, iron and manganese and some amino acids call slow-down your energy production cycle, and the final catalysing step that requires Co Enzyme Q10, which converts ADP to ATP, often results in chronically tired people.

In the last paragraph, I mentioned that ATP is produced after the breakdown of food, using a myriad of nutrients to help push along the Kreb cycle and oxidative phosphorylation. Your production of the end product ATP heavily relies on how well your digestive system actually breaks down your food higher up in the digestive tract. That can be dependent on the combination of foods it is breaking down and how efficient your small and large intestine are at absorbing nutrients.

WHEN THE POWER HOUSE IS FAULTY, THE LIGHTS DON’T GO ON Certain disease states render the mitochondria faulty, which means that the cellular energetics of the body are not optimised and therefore result in a tired, listless and fatigue ridden body.

Your digestive system relies on stomach produced hydrochloric acid and enzymes from your pancreas and small intestine, to be able to perform the digestive function efficiently. These are best produced when you eat raw fruits and vegetables as well as a good combination of protein, fats and carbohydrates – and slowly! APJ 75

OTHER WAYS FATIGUE CAN FIND YOU Aside from the energy in/energy out phenomenon of generating vitality there are some non-food related etiological causations for ongoing fatigue that may need to also be investigated and addressed. These are the places a naturopath would go looking if you presented with long term low energy.

1. Colon output - the more sluggish your energy, the possibility therein lies with your energy levels as well. 2. Post viral syndrome - commonly resulting in Chronic Fatigue Syndrome conditions 3. Chronic Inflammatory Response Syndrome (CIRS) as a result of exposure to biotoxins from mould and tick borne/like illnesses

Can you imagine for a moment how much sustained energy your body can generate if you are eating low nutrient dense foods day in and out, you eat them fast with little oxygenation through relaxed prandial breathing, while you breathe shallow breaths regularly due to stress and feeling rushed? Maybe now is a good time to take a long breath through your nose to digest that paragraph. The foods in the energy sapping list below can render the digestive function less effective in returning you to vitality, when consumed consistently over time. Whether it is for stress or celebration, you may want to review this list for yourself if you find yourself admitting you are tired for more than 48 hours at any one time. Energy Efficient/Assistant Foods: • Whole grain and gluten free breads and cakes •

Whole grain rice and pasta

Nuts and seeds

Raw or steamed vegetables, lean meats

Stevia/Xylitol (natural sweeteners)

Fruits (pawpaw, apples, kiwi, pineapple, berries)


Dark Chocolate (70% cocoa in small amounts!)

Filtered water, herbal tea, fresh juices

Lean meats

Legumes, beans

Maca Powder


Clean and adequate protein

Energy Sapping Foods: • White bread, cakes, and muffins •

White rice and pasta

Over cooked vegetables and fatty meats

Potato/hot chips


Muesli bards (some), lollies


Mild Chocolate

Alcohol, soft drinks, flavoured milk

Fatty or marbled meats

Deep fried food

High caffeine intake

“Energy” drinks

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4. Thyroid conditions - both under and overactive thyroid conditions can affect energy output 5. Haemachromatosis (genetic condition that hinders the removal of iron) 6. Candida albicans infections 7. Coeliac’s Disease 8. Emotional suppression 9. Cancer 10. Dehydration SEVEN SECRETS TO BOUNDING OUT OF YOUR SKIN 1. Avoid or reduce foods and beverages you are currently eating from the Energy Sapping Food list. 2. Increase the foods and beverages on the Energy Efficient Food list 3. Increase the amount of cardio exercise you are currently doing. 4. Breathing exercises found in disciplines like Yoga, Tai Chi and Qi Gong will help increase the oxygen intake, reduce the impact of stress and clarify your head for better decision making. 5. Investigate with a naturopath or nutritionist some ways to power up your digestive system, reduce unwanted bacterial overgrowth and address other causes of fatigue. 6. Consider a gentle and guided detoxification program to clean out old debris that may be a breeding ground for energy hungry bacteria. 7. Get to bed early and have a good night’s sleep, or if you are on the go with travel – learn the art of meditation – it will make up for lost sleep very effectively. There are also a number of supplements on the market that will add some efficiency to your energy producing systems. Some of the most important ones to consider are magnesium, carnitine, taurine, chromium, selenium, Co Enzyme Q10, B Complex Vitamins, Digestive Enzymes and a multi strain gut flora supplement. APJ Nicky Wood is a Conference Speaker and Naturopath practicing at Tweed Heads and offers remote appointments via online consultations. If you would like to personally assess and fine tune your health or the health of your team, contact Nicky through email, introducing yourself to nicky@wisehealthyliving.com.au

For a list of references, please contact the editor.

A+ OCEAN TATTOO REMOVAL SYSTEM CHANGING LIVES AND LEADING THE WAY TO A BOOMING MARKET MARK McCRINDLE is an award-winning social researcher, best-selling author and influential thought leader, who is a real expert in trends. This is what he recently said about tattoos. “Tattoos are part of the new symbolism as the markers of life’s milestones and Australians are getting tattoos in record numbers. Today, tattoos are being transformed from being a sign of rebellion and non-conformity to symbols of personal meaning and life-change. Their acceptance is now so mainstream that women are starting to lead the way in gaining tattoos.” While for men, they may be linked to an ideology, for women they are often emotively-connected to the love in their life, with their initials, or emblems of love. However, relationships today are not always permanent and the need

to move-on from a past relationship will often mean that they will seek to remove their tattoo and the memory to which it is attached. Tattoo removal is definitely a growth industry says CAROL DINIS, Distributor and Training of the renowned A+ Ocean hypertonic, saline tattoo removal system. Our method of tattoo removal is very popular because it is one of the safest and most natural ways of lightening and removing cosmetic and conventional tattoos. While laser tattoo removal using a Q-switched laser is considered a standard modality, sometimes the tattoo pigment can only be partially removed. A+ Ocean can safely and effectively remove tattoos and cosmetic tattoos in its own right. It can also be combined with a laser removal method to successfully remove any pigment that still remains. Tattoo removal is one of the fastest growing industries with new statistics confirming that one in five Australian will get a tattoo sometime in their life and 40% of those with tattoos at some stage will seek to remove them. Treatments range from $200 - $400 per treatment, so it is a profitable service with a great return. “I have conducted research on several companies and I can honestly say the A+Ocean saline tattoo removal system is the best option for safe and effective results,” Carol states emphatically. We offer excellent training to ensure that you can introduce this service with confidence. Call today on 0428 876 633 or email aplusoceanaustralasia@gmail.com


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www.aplusoceanaustralasia.com.au aplusoceanaustralasia@gmail.com APJ 77 0428 876 633

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Higher Education

Raising standards in beauty and dermal therapies

Through industry and Education partnerships There is an urgent need in our industry for employers and education providers to take mutual responsibility for supporting students to graduate career-ready. Together, we must drive for better standards and increase graduate skills and employability. For business owners, this means developing closer relationships with local education providers and creating partnerships that include workplace opportunities. In Australia, we need to rise to the challenge and keep up with global trends, in order to increase standards within our industry. “Lifelong learning” is now an integral part of our personal and professional development. For most practitioners, the starting point is a tertiary qualification as a Beauty Therapist or Dermal Therapist. This is a common pathway for school leavers, and adult learners looking for a career change or to up-skill to increase their employability. It’s not uncommon to hear industry complain about the standards of graduating students. We need graduates who can hit the ground running. Education providers driving positive change In response to industry demands for higher standards, education providers have introduced compulsory industry work placements for most practical units. For students, such partnerships increase career opportunities, help students develop high standards, set realistic expectations, build confidence, and cultivate good work ethics, preparing them for long-term career success. For employers, educational partnerships help to increase the skills set of future staff. They are an opportunity to enhance soft skills, set industry standards and manage the risk of a skills shortage.

What type of education partnership would suit you? •

Consultative partnerships: sharing industry input around change or ideas for policies

Contributory partnerships: benefitting an organisation or the industry community

Operational partnerships: work-sharing arrangements in which the components of a given task are delegated to specific industry parties

Collaborative partnerships: sharing resources, risks and decision-making

The power of collaboration Students are excited about the prospect of work placements in an industry they are heavily invested in. However, their requests are too often rejected. Some students report emailing more than 30 resumes and cover letters to local and national businesses, only to receive poor responses from our industry leaders. This can demoralise students, shatter their confidence and even cause them to fail subjects. Torrens delivers industry-ready graduates Torrens University Australia is at the forefront of industry partnerships to provide the best educational and career outcomes for their students. In turn, they deliver businesses high-calibre graduates who are ready, experienced and expertly equipped to work at the innovative edge of the industry. APJ 79

Breanna Woodman, a dermal therapist and student at Torrens, gains confidence from having her coursework closely aligned with real-world industry requirements. “I’ve learned so much already that I can put into practise while I’m at work,” she says. Amanda Malden-Browne, Senior Learning Facilitator at Torrens, has more than 30 years’ experience in the global Aesthetics industry. “Industry collaboration is the only way to ensure industry standards, graduate employability and a strong competitor presence in the global industry” says Amanda.

Here’s what industry can do:

There’s never been a more important time to work together If there is a lack of support from business at the education level, it can affect the entire Aesthetics industry, and with the recent reduction in training providers, fewer graduating therapists could lead to a skills shortage. That’s what makes Torrens University’s approach so essential. “Torrens University is meeting industry demands through its collaboration with industry, up-to-date learning platform, highly skilled lecturers, excellent course content and state-of-theart equipment that provides students with a solid foundation for meeting industry requirements, both nationally and internationally,” says Amanda.

Contact your local education provider and set up a meeting

As Breanna says, “With the industry I’m in, the best advice that I’ve received was ‘you never stop learning’.”

Be part of the Course Advisory committee and participate in forums to provide industry feedback

Invite training providers to your business

Discuss opportunities you can offer students and student placements

Participate in educational events, such as guest speaking at open days

Torrens University is one of Australia’s most dynamic universities. We have careers-focused and global perspective to higher education. We are committed to delivering the most relevant education, and the highest calibre of graduates to industry. We offer Bachelor of Health Science (Aesthetics) and Diploma of Beauty and Spa Practice: www.torrens.edu.au/beauty-courses We are looking for industry business partnerships. Please get in touch with our team in Brisbane on 1300 575 803, email industry@laureate.net.au or visit www.torrens.edu.au

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New findings on the SKIN’S MICROBIOME Gay Wardle

THE MOUNTING scientific evidence on the important role the microbiome plays in both our overall health, as well as the microbiome that reside topically on the exterior of the skin makes this subject worthy of thorough research. As new information comes to light you will find this topic featured regularly in this journal, as well as at the APAN Conference programs. This is indeed an inexhaustible topic so the information presented through the various articles and lectures will not be repetitive, but will cover different information as it comes to light. Gaining an understanding of the complexities of how the microbiome facilitates biological processes is critical and the on-going scientific findings continue to place an even greater importance on their role in both disease prevention and optimal health of the body and the skin. To enlighten you further on this subject GAY WARDLE addresses in this amazing article the specific characteristics of the microbiome of the skin and how to use this information in improving skin immunity and ultimately achieve better results with your skin treatments. Microbiome means that there is a collection of microorganisms found in one place. There is a lot of information surrounding gut health, gut bacteria, and the relationship between the brain and the gut, but we are also now understanding the relationship the gut bacteria has to skin bacteria. In this article I wish to draw your attention on understanding the microorganism habitat that lives on our skin and how to avoid possible prolonged inflammation from clinical treatments. Understanding the skin microbiome gives us insight into the bacterial involvement in the skin. Our skin barrier is critical for survival, it slows down moisture loss and very importantly it protects us from invasion by substances that are toxic. The skin is an eco-system where a whole world of millions of populations of bacteria live. Scientific studies have to-date identified, classified and compared more than 112,000 bacterial gene sequences in human skin. I am sure there will be more as research continues in the future. Bacteria live in a symbiotic and commensal relationship sharing a host, and that host is our skin. During birth the skin is colonised by microbes. which all begin to live in this symbiotic and commensal relationship and will continue to do so for the remainder of life. Because the skin has

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many different folds, different ranges of pH, variations of temperature, sebum content and moisture levels the colonisation of bacteria from region to region varies. Dry and moist skin had a broader variety of microbes than oily skin. Apart from the bacteria habitation on our skin, we also have fungi, viruses and mites that contribute to the biome of the skin all of which live in a symbiotic and commensal relationship. ECCRINE AND APOCRINE GLANDS There are both eccrine and apocrine glands that have totally different environments where their own unique microbiota colonises. Eccrine glands have a role to play with excreting water and electrolytes (salt) as well as creating acidification of the skin. This assists to prevent growth of microorganisms. The body has more eccrine glands than it does apocrine glands. Eccrine glands are found on all skin surfaces. Apocrine glands respond to levels of cortisol. When cortisol increases this also results in the increase of their secretion. These glands are found largely in the axillary, genital and regions of the upper body. The secretions create an environment that is very suitable to bacteria. Therefore, larger colonisations of bacteria increase in these areas of the body and feed off the sebum. The hydrophobic coating released by sebum in the sebaceous gland are anoxic and support the growth of bacteria such as Propioibacterium acnes (P.acnes) - this is a commensal bacteria. On the other hand, triglycerides that are found in sebum are hydrolysed by P.acnes bacterium and release free fatty acids. These free fatty acids contribute to the pH (4.5 – 5.5) of the skin creating an acidic environment. This acidic environment allows other bacteria such as Staphylococcus aureus and Streptococcus pyogenes (a species of Grampositive bacterium in the genus Streptococcus), to be controlled. Where the pH is more alkaline these bacteria will increase in numbers. WHAT FACTORS CONTRIBUT TO BEING A HOST? Foetal skin is sterile while in utero and as I have already mentioned, during birth, colonisation of bacteria will occur at this stage. This happens when the delivery is via the birth canal where the baby acquires healthy bacteria from the vagina. Caesarean births often allow unhealthy bacteria to colonise. Babies born through caesarean births are at risk of developing all types of skin rashes. Most babies born under caesarean section now, are swabbed with bacteria from the mother’s vagina.

cells that line the pilosebaceous unit and Propionibacterium acnes. FUNGI Malassezia spp. Have been found to constitute up to 80% of the total skin fungal population. It is not sure what percentage of population of other fungi groups such as Cryptococcus spp. are inhabitants of the skin. VIRUSES Studies are still continuing in identification of viruses and their role with the skin microbiome. I am sure it will not be too long in the future when we will have a greater understanding and further knowledge of viruses and the skin mocrobiome.

Changes occur during puberty where hormone changes increase the activation of sebum production which, in turn creates an environment for P.acnes bacteria to thrive. There are also huge differences in males and females in terms of sweat, sebum and hormone production during puberty. In most cases the male experiences a more aggressive change. Menopause will have impact on where bacteria colonise due to changes in lamellar production. Age has a huge impact on the survival and how bacteria colonise on the skin. We then need to consider the environment and how this will affect the host and the changes to the skin biome. This can be anything from hygiene, clinic treatments, products used on the skin, environment such as, humidity, heat, air-conditioning etc, to the clothing that are worn and how they are cleansed. Obsession with cleanliness can also have change to the delicate balance of the skin’s flora. BACTERIA The resident gram-positive bacteria include Staphylococcus, Micrococcus and Corynebacterium, Staphylococcus aureus and Streptococcus pyogenes. There are 15 different species of negative Staphylococci residing in the skin. Historically Staphylococcus epidermidis and other coagulasenegative staphylococci have been thought as the primary bacterial colonisers of the skin. Corynebacterium are very slow-growing organisms and tend to colonise in areas where there is moisture as does Staphylococci that use urea found in sweat as a source of nitrogen. Other bacteria that are major inhibitors of the skin include coryneform of the phylum Actinobacteria and Micrococcus. There are different strains of each of these bacteria. It would take an extremely high-powered microscope to see this incredible ecosystem, which comprises of approximately 1.9 square metres of colonies of microorganisms. MITES Demodex folliculorum and Demodex brevis are microscopic arthropods and are a huge part of the skin’s biome. These microscopic mites feed on sebum and are very prevalent at times of increased androgen hormone activation where the sebaceous gland is highly activated. They are also found in large numbers on rosacea patients. They are residents of the pilosebaceous unit where they are common on the facial area of the body. Other food sources for these mites are epithelial

STRESS Stress plays a huge role in the health of skin microbiome. It is also important to remember that when we are under stress there is a change to hormones that will have an affect to the lipid production to both keratinocyte cells and the sebaceous glands. This will cause a disruption to the host that will cause change in the skin microbiome. So, patients that also suffer from anxiety and depression will have changes to the skin microbiome. Medications such as antibiotics as well as highsugar foods cause gut inflammation and add to this stress causing a huge disruption to the skin’s microbiome. There are literally millions of our defence T-cells found in the skin and research is demonstrating that maybe these cells are being educated by the skin microbiome to identify microorganisms that might cause an infection in the skin. It’s amazing when you think about it. Everyday the skin is under constant assault where the microbiome is disrupted in many different ways - using antibacterial washes and wipes, stress, gut health, as well as in-clinic treatments we perform - the list is long.  A very good reason we need to ensure that homeostasis is maintained throughout clinic treatments. BRINGING IT ALL TOGETHER If you are healthy, have a good immune system and the correct balance of skin microbiota, your chances of keeping pathogens under control are high. But if you are sick, have a poor immune system, or the condition of your skin is compromised in any way, you have a portal of entry for disease. Our skin is an incredibly important organ for good health. It is the first line of defence in protecting us against bacteria. It is the first thing that comes in contact with the outside world that is full of bacteria, fungus and viruses. Microorganisms are potentially the problem for many skin disorders, some bacteria normally considered as commensals, can become pathogenic when they escape their original niche and start to colonise deeper tissues. Bacteria belonging to the microbiota, and therefore considered as commensals, can also become pathogenic if their growth rate rises allowing them to outcompete other bacteria. The importance of understanding and having respect for the skin’s microbiome is an understatement when it comes to today’s clinical treatments that we provide to our client population. APJ To further enhance your knowledge and understanding of the skin and the various factors that contribute to skin health we recommend you undertake Gay Wardle’s Advanced Skin Analysis training. Visit http://gaywardle. com.au/courses/

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ORTHOREXIA – the unhealthy side of healthy eating Tina Viney

THERE IS NO DOUBT that investigating and applying the principles of healthy eating is of benefit to us for disease prevention, healthy skin and body, as well as longevity.

You feel healthy, pure and clean. You haven’t touched chocolate or anything you deem ‘unhealthy’ for weeks and feel completely in control.

But what happens when the desire to eat healthily turns into an obsession? And what are the potential consequences?

However, after a few months you are starting to find it hard. At first, you felt full of energy, but now you struggle to make it through the day without feeling tired. And you have had to turn down a few social events because you don’t feel comfortable eating any food you haven’t prepared yourself. In fact, you notice yourself becoming anxious around meal times. You seem to be spending most of your day planning your next meal and are constantly concerned about eating the ‘right’ foods.

Orthorexia Nervosa is a condition where an individual is driven to eat in a way they see as perfect or pure, often involving strict and inflexible eating behaviours. The word orthorexia is Greek, with ‘orthos’, meaning ‘correct or right’. The term has actually been around for some time, Steven Bratman, MD, MPH, a California physician, coined the term in 1996. It means “fixation on righteous eating.” Since then, many medical professionals have accepted the concept and while orthorexia is yet to be officially recognised as an eating disorder, health professionals are recognising the eating behaviours as being part of the eating disorder spectrum. Orthorexia usually starts out as a true intention to eat healthy foods, but over time, an obsession starts to develop around eating as healthily as possible. The person might strive for a perfectly ‘clean’ diet, shunning all food they have not made themselves, cutting out food groups, or only eating specific foods in the belief they are superior. They experience psychological distress when they cannot fulfil the set rules they have created around their diet. Let’s look at a potential scenario on how this can happen: You’ve cut out the Friday night take-aways, the wine sipped with dinner, your morning mochas and you are feeling great! You have lost a bit of weight, your skin is glowing and you are full of energy. You feel so good that you wonder about making a few more changes. You might try out some of the health trends that are appearing on your social media feeds. You always see glutenfree, raw or vegan creations popping up on your Instagram and Facebook. Gluten is the first to go, a few weeks later, you cut out all dairy, finally you decide to stop eating any animal products.

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WHAT ARE THE SIGNS OF ORTHOREXIA? Most responsible people who wish to support their health will follow a sensible eating plan. In fact, experts encourage people to be enthusiastic and well-informed about healthy food choices, but when can eating health cross over to something more dangerous? Changes in your diet should be made gradually, and eating healthily should have a sustained, positive effect on health. When coining the term “Orthorexia”, Dr Steve Bratman devised a 10-question checklist to help individuals and practitioners identify if someone falls into this category. If someone answer yes to four or more of the questions, they may benefit from seeking support around your eating behaviours.

1. Do you spend more than three hours a day thinking about your diet? 2. Do you plan your meals several days ahead? 3. Is the nutritional value of your meal more important than the pleasure of eating it? 4. Has the quality of your life decreased as the quality of your diet has increased? 5. Have you become stricter with yourself lately? 6. Does eating healthy gives your self-esteem a boost?

7. Have you given up foods you used to enjoy in order to eat the ‘right’ foods 8. Does your diet make it difficult for you to eat out, distancing you from family and friends? 9. Do you feel guilty when you stray from your diet? 10. Do you feel at peace with yourself and in total control when you eat healthily? If you, or anyone you know is experiencing signs of orthorexia, seek advice from a health professional. While at this stage orthorexia nervosa is not an official disorder it can lead to that. This is because people who deliberately develop eating habits that reject a variety of foods for not being “pure” enough eventually begin to avoid whole meals that don’t meet their standards, or that they don’t make themselves. This obsession can ultimately lead to health issues. In fact, some experts believe there are similarities between the constant worry about food seen in orthorexia as in eating disorders like bulimia and anorexia nervosa. All are about food and control. Here are a few other common habits that can lead to orthorexia: •

Bury themselves in food research. It’s one thing to spend a few minutes scanning a product label or surfing the web for more information on ingredients. But with orthorexia they may spend hours thinking about food and planning meals.

Refuse to eat a broad range of foods. It’s normal to pass on some foods because you don’t like the way they taste or the way they make you feel. But with orthorexia they might decide to drop whole categories of foods from their diet - grains, for example, or any foods with preservatives, or all foods that just don’t seem “healthy,” or all of the above.

Fear of losing control. They feel that they are doing the right thing by eating healthy. But they may also be afraid that eating even one meal they didn’t prepare - including dinner at a restaurant - can be disastrous.

Be overly critical of their friends’ food choices. At the same time, you may have no rational explanation for your own.

Find themselves in a vicious circle. Your preoccupation with food causes you to bounce between self-love and guilt as you change and restrict your diet.

The downside to this obsession is that due to fear of unhealthy food, they cut out whole food groups altogether and this can ultimately contribute to malnutrition, weakness and in some cases, illness. In this age of social media so much information is available on various platforms and forums and this can sometimes become overwhelming, as a result bringing information to a balanced conclusion can sometimes evade us. This is where the help of a caring professional can offer valuable guidance. When performing you client assessment you will be able to identify if a “healthy eater” is going overboard. Look out for on-going low energy levels and fatigue, or a fuzzy head. If you identify any of the above symptoms, draw their attention to the need to review their diet for the purpose of achieving correct balance that will not compromise their energy levels. HOW TO GET HELP As with bulimia and anorexia, a nutritionist or naturopath may be able to help with orthorexia. Because of the emotional aspects of the condition, they may also consider seeing a mental health professional. The key is to recognise that one’s fixation on food may be bad for them, so they may need to be trained to think differently about it. By bringing that mind set into balance they will be on their way to eating right for real. APJ Ref: WebMD Medical Reference Reviewed by Joseph Goldberg, MD on February 07, 2017

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What do Clients Buy when they come into your Clinic? Phillip Fernandez

THERE HAS NEVER been a time when the market was more flooded with business coaches who all promise that without their strategies and cool tools you will not succeed or grow your business. So how is Phillip Fernandez different? What we love about Phillip is that he is incredibly knowledgeable and experienced, however, he delivers his information in a calm, confident and sophisticated manner that allows you to truly grasp and gain a more profound understanding of the principles he teaches. He is not only competent in business strategies, he is also a human strategist. This means he will connect with you on a uniquely personal level and bring out the very best in you. His skills will teach you how to articulate who you are in a confident and meaningful manner that can resonate with others, whether they are staff or clients. These skills will allow you to become a people-magnet and enable you to achieve powerful engagements with others, which is the prelude to any successful interaction, both personal and in business success. In this article PHILLIP FERNANDEZ discusses some of the principles that are important for a business to succeed and how to incorporate them in developing a brand that stands out. Have you ever asked yourself when a client comes into your clinic what are they really buying? This is a very interesting question indeed. Isn’t it obvious one might say that they are purchasing your products and or services? Yes, to a degree this is true, but what they are really buying are your values. Don’t values belong to people? Yes, they do, so what they are also really buying is the values that you and your staff reflect. Well what about the skills and knowledge? Yes, you do need them as well, but what the client is buying is the total experience and values are a big portion of that total experience. Let’s ask ourselves where do our values come from. Values come from our parents, schools and institutions, close friends as you grow up and the environment that we have APJ 86

experienced from birth to now. These values are also part of the sub-conscious and so we exercise them and live with them in their “Unconsciously Competent” state. In other words, we exercise these values spontaneously without thought. These ingrained values also equip us to decipher what is right and what is wrong. To take it one step further, values come from your self-belief, which in turn comes from four main areas: •




Professional ethics


Values are an integral part of every culture. Along with worldview and personality, they generate behaviour. Being part of a culture that shares a common core set of values creates expectations and predictability without which a culture would disintegrate and its members would lose their personal identity and sense of worth. Values tell people what is good, beneficial, important, useful, beautiful, desirable, constructive, etc. They answer the question of why people do what they do. Values help people solve common human problems for survival. Over time, they become the roots of traditions that people groups find important in their day-to-day lives. Values are related to the ‘norms’ of a culture, but they are more global and abstract than norms. Norms are rules for behaviour in specific situations, while values identify what should be judged as good or evil. Flying the national flag on a holiday is a norm. Different cultures reflect different values. As you can see these values are pretty difficult to hide and your clients can feel and experience these values when they are in conversation with you. This comes out in what you say,

feel and do unconsciously. I am often asked the question if values are different at work, or are they always consistent, even when you are outside the work environment? Some believe that they are different, but they really are one and the same. You cannot switch your values on and off like a light switch.


Let me give you an example; if integrity and caring are two values you have, how can you switch them off when you leave your work? They are ingrained in you because that is who you are. You can choose not to exercise them, but if they are important to you, and you ignore them you will not feel too good about yourself.

Following the APAN Conference in Mebourne, Phillip will be conducting a one-day BUSINESS LEADERSHIP WORKSHOP on Tuesday 14th August.

MISSION STATEMENTS Values are seen in Mission Statements of businesses. Mission Statements have been abused over the decades and so many businesses do no place importance in them, or even understand the underlying implications that they bring to a business. Your Mission Statement is what your client experiences that embody the characteristics and values of the business owner and the staff. It also embraces the ambience, music, décor, colour of the salon, how the coffee is served, the smiles, the caring and the little things that are delivered above standard expectations. It also includes the “Wow” factors and lastly, the quality, technical expertise and skill level of the staff. Further details on the importance and how to structure a Mission Statement check out the article in this journal. LEADERSHIP SKILLS The next step is to look at systemising your business. It starts at the top with your leadership. Your staff will buy into what systems you put in place. These should include accountability, ensuring the salon brand and culture is in sync. You should include effective communication in the workplace and above all a Policy and Procedure manual that is staff friendly and easy to follow. One of my favourite sayings is “The fish rots from the head first”. This is so relevant in any organisation and involves any leader or manager in any business. The characteristics of a great leader are many and I will not be going through each and every one of them here, but one of the most important characteristics is the ability to know that no matter how good a manager or business owner is, they do not know everything. It is therefore, not a sign of weakness to say, “I do not know the answer to the problem or question right now”. This will not only show a humble and courageous leader, but one that is humane and this simple gesture will gain them immense respect from the staff. This manager would go on to say, “let’s work on this together and come up with a solution”. SALON BRAND AND CULTURE ARE IN SYNC How sure are you about what the client sees from the outside of the salon, to when they come into the salon? Does the feeling about the facade, the website, the social media marketing and the advertising coincide with what the client experiences when they enter the salon? EFFECTIVE COMMUNICATION IN THE WORKPLACE This is extremely critical in any work environment. Are we asking the intelligent questions to find out what the client really needs and to also get to know what your clients’ like and dislike? Do we really show empathy and does the client perceive this? Are we really listening to the clients and what they are trying to communicate to us? As the saying goes, “A good listener is a good conversationalist”. Equally important is the communication between peers, from manager to staff and vice versa. This should be genuine, caring and clear.

To register for one or both of these events please visit www.apanconf.com or 07 5593 0360 for further details.

POLICY AND PROCEDURE Do you have one of these? This is all about systemising the business. It’s about having everything written down so that there is no ambiguity, particular with new staff. This manual should cover: •

Mission Statement

Salon Culture

Profile of the perfect employee

Recruitment and Induction

Induction Framework

Training and Development

Assessment and Appraisals

Presentation and Dress-code

Occupational Health and safety

Remuneration and Incentive

In-Salon Policy

Retail Policy

Empowerment Policy

Confidential Clause and Restrain of Trade

Harassment Policy

Holiday and Leave Policy

and probably not too much more.

This manual should also be staff-friendly and so must be laid out in plain English and be kept to the bare facts and business expectation. Keeping it simple will allow staff to understand the document and so foster buy-in and ownership of company policies and procedures. Now let’s reconsider the questions I raised at the beginning of this article - what do clients buy when they visit your clinic? The answer is they buy the values that you reflect. These values start at the top from the business owner and work down through the staff who demonstrate the clinic’s culture through their communication in the workplace and by carrying out the policy and procedures that the client sees, which is ultimately reflected in the Mission Statement. Finetuning all these elements to come together in synergy is how success is achieved. APJ APJ 87


SVIATOSLAV OTCHENASH COSMETIC TATTOOING MASTER CLASS A Vietnamese Adventure Katherine McCann ALWAYS PASSIONATE about education our editor, KATHERINE McCANN wears many hats. As a skilled and competent journalist and a highly intelligent strategist, she always brings new ideas to the table on how the industry can improve. Added to this, she is also renowned for her artistic flair as a qualified, and skilled cosmetic tattooists.

Otchenash’s is a world-recognised and renowned specialist in permanent makeup and artistic tattooing. His threeday masterclass focused on learning his specific advanced tattooing techniques for eyeliner, eyebrows and lips. The attendees were also assisted by the host Nhung Phan and Academy S craft-master trainer Lynn Nguyen of Luxury Beauty Academy in the USA.

Each year, she invests in furthering her education and techniques. Whether this is locally, or it takes her to other shores, Katherine is always passionate about constantly refining her skillsets and mastering the latest advances in her work. So, at the end of last year she announced in her usually, enthusiastic manner that Vietnam was on the cards as she had enrolled to attend Sviatoslav Otchenash Mater Class Training hosted by the also highly renowned cosmetic tattoo master, Nhung Phan. Here is an account of her experience.

Having multiple trainers, I found was helpful when learning new techniques, as they all had a slightly different way of explaining how to do the same skill. Although this sounds fairly straight forward, it was incredibly valuable especially as the class was taught in Russian, translated to Vietnamese and then translated into English – another first for me, so making sure things weren’t lost in translation was also a challenge and kept me on the alert.

As a cosmetic tattooist Sviatoslav Otchenash has been on my bucket list of trainers with whom I have wanted to train for some time, so when I saw he was being hosted in Vietnam by Nhung Phan, I thought it would not only provide a fabulous opportunity to attend his three-day Master Class, but I could combine a few extra days either side and have an adventure on the same trip exploring the region. Owner of Academy S and its main developer, Sviatoslav APJ 88

NEW SKILLS AND TECHNIQUES Here in Australia, we are more and more becoming a multicultural society, with racial diversity. Cosmetic tattooing is relatively permanent, so an understanding of what techniques would best work with the various ethnic groups is so valuable. Also, as our industry is constantly evolving, I believe it’s imperative that we remain well-informed and up-to-date with the latest developments, techniques and education in whatever we practice. Cosmetic tattooing has

come a long way since even a decade ago. The techniques have become much more refined and we can now achieve amazingly natural finishes that integrate beautifully to enhance the individual, whether male or female and still look totally natural, while achieving the desired correction or improvement. To become a master at what we do the key is to never stop learning. As I am actively involved with both APAN and the ACT, I am fortunate to attend multiple cosmetic tattoo training events throughout the year. However, due to attending in an official capacity as opposed to being a student of the class, I often miss bits or I am unable to work on models myself, or practice the skills on the day. Because of these limitations I try to ensure that I personally take at least one to two advanced classes, (either nationally or internationally) each year to ensure I continue to expand my skillset and refine my technique. You can never stop learning and being-hands on right in the thick of it is the only way to put yourself to the test and grow as an artist! GAINING A GREATER UNDERSTANDING OF ASIAN FEATURES AND NEEDS This was the first time I had attended an â&#x20AC;&#x153;interpretedâ&#x20AC;? masterclass â&#x20AC;&#x201C; very different to a translated segment in a conference or workshop, as there is a great skill in being able

to learn a practical technique, apply it precisely and not lose anything in translation at the same time, especially when things begin to move along quite quickly. Second, because the class was held in Vietnam, the majority of the attendees were all Vietnamese and I was one of only three Caucasians. It was really quite interesting to see how the class was balanced between both Asian and Caucasian attendees. I raise this point because there are so many varying factors and unique differences when it comes to executing the very same practical skill on a person, simply due to their ethnic orientation. For example, tattooing a hairstoke eyebrow sounds fairly easy, however, in order for this to be successful, there are many factors that must be adjusted, amended, or even changed to ensure the end result suits the orientation, skin, face, hair patterns and so on of the person receiving the tattoo. This class delivered amazing techniques and I can say I left feeling that I truly gained valuable knowledge on how I can improve my current skillset. I left Vietnam feeling very content. The knowledge I gained was incredible and the adventure of exploring another part of the world was indeed memorable. APJ APJ 89



An updated report on safety Dr Zac Turner

THE MOST DAMAGING environmental factor that wreaks havoc on our skin comes from the sun. Sun exposure causes wrinkles and age spots throughout the skin, with the ones that we notice the most occurring on our faces. As most of the world glorifies that glowing complexion we get from a nice day in the sun, people still continue to ignore the fact that this exposure is actually ageing the skin and increasing their risk for developing skin cancer. Over periods of time the sun’s harmful ultraviolet light damages the elastin fibres within the skin. As we know, the breaking down of elastin causes the skin to sag, stretch and loses its ability to be ‘elastic’, hence the name. Additionally, exposure to the sun causes freckles, elastosis, benign tumours, precancerous and cancerous skin lesions. The sun’s damage on the skin may not be apparent at younger ages, but it will indefinitely begin to become noticeable as you age. When choosing sunscreens, here are some key points to consider. SPRAY-ON SUNSCREENS Spray sunscreens, yes are handy and easy to apply, however there is a concern about their safety. In the US, the FDA is concerned about their safety and effectiveness, but has not yet banned them from the shelves. Most studies involving spray-on sunscreens have been tested for their effectiveness when applied on the skin, however, they have yet to be tested on their effect when inhaled. This is an area of concern that should be taken into consideration when looking for sunscreen especially if using on or around children. HIGH SPF FACTOR Another consideration is the issue of high SPFs. This SPF as we know, stands for sun protection factor, but note that the term is referring to the protection against UVB rays - those

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rays that burn the surface of the skin and not the protection against those UVA rays, those which penetrate deep into the body and accelerate skin ageing and may even repress immune system functions and cause skin cancers. Just because a sunscreen has a high SPF does not necessarily mean that you are being protected from damaging UVA rays. SPF is only a measure of how well a sunscreen protects you from sunburn, which you get only from UVB rays. UVA (ultraviolet-A) is a longer wavelength of sunlight that makes up 95% of all UV light reaching the earth's surface. It passes right through clouds and glass, and it is pretty much the same strength throughout the day and the year. This false sense of security gives the consumer the idea that they can stay in the sun for longer amounts of time when in actuality this is far from the truth. The FDA within the United States is even considering banning the SPF rating claiming that high SPF that are 50+ alone is not enough to protect the skin. A LOOK AT THE HISTORY Early civilisations have used a large spectrum of different naturally-occurring products to protect their skin from the harmful rays of the sun. From olive oil used by the ancient Greeks to the people of southeast Asia that use a plant-based paste called burak, but it was not until 1928 that the first synthetic sunscreens were being used that later evolved into today’s water-resistant sunscreens in 1977. ENSURE BOTH UVA AND UVB PROTECTION  As we all know, the use of sunscreen can help prevent certain types of skin cancer – the most evidence – backed preventative types are both melanoma and squamous cell carcinoma. Aside from helping to prevent certain types of skin cancer the primary objective (for us) in sunscreen, is to reflect

or absorb some of the sun’s ultraviolet (UV) radiation and prevent us from having a nasty sunburn or worse, blistering of the skin. This UV radiation damages the skin after prolonged periods of time and damages DNA in our skin, which then causes genetic mutations that ultimately lead to skin cancers. There are two types of ultraviolet radiation that damage the skin both UVA and UVB. UVB is the primary radiation that sunscreen protects us against sunburns on the surface of the skin. On the other hand, UVA rays penetrate much deeper into the skin and are associated with wrinkles, sagging, and other types of photo-ageing. With the massive variety of sunscreens available to us today make sure your clients are using a broad- spectrum sunscreen as some common sunscreens prevent burns but not ageing. A good sunscreen should prevent both. A study released in 2013 produced evidence that applying a sunscreen to the face every day will slow fine lines and wrinkles of the face that come with age. (To no surprise the study was conducted in Australia. Hughes, MCB; Williams, GM; Baker, P; Green, AC (June 4, 2013). "Sunscreen and Prevention of Skin Aging". Annals of Internal Medicine. 158 (11): 781– 790. doi:10.7326/0003-4819-158-11-201306040-00002. )   MEASURING HOW THE SPF WORKS Sunscreens are commonly labelled and rated by its sun protection factor or SPF. The SPF measures the fraction of those ultraviolet rays that reach the skin.  Here is how to try to conceptualise this SPF rating: If you have a sunscreen that has an SPF rating of 15 this means that 1/15 of the burning radiation coming from the sun will reach the skin. The higher SPF rating the better protection it will provide. For some it’s really all about how tanned you want to be aka slightly burnt. However, note the importance of reapplying as described, because as a topical it loses its effectiveness as it is battling against those harmful rays. Using percentage SPF 15 filters out about 93 per cent of incoming UVB rays, SPF about 97

per cent, and SPF about 98 per cent (no sunscreen can block 100 percent of the sun’s harmful rays). These percentages are more important to those individuals that are light-sensitive or have a history of skin cancer. There are two types of sunscreens organic and inorganic. Inorganic compounds such as zinc oxide and titanium dioxide physically scatter or absorb the sun’s harmful rays. Both protecting against UVA and UVB radiation. They are reflecting the UV rays just as colours do, but at a higher magnitude. Organic compounds act as a UV absorber and does so using its bond strength. There are a variety of chemical UV blockers each having its specific property in what type of UV light it protects against: UVA, UVB, or both. Some include: UVA blockers - avobenzone, menthyl anthranilate, and ecsamsule. UVB blockers – octly methoxycinnamate, homosalate, and PABA. BOTH blockers – oxybenzone, sulisobenzone, and Mexoryl XL. The safest ‘go-to’ sunscreen right now is zinc oxide.  INGREDIENT SAFETY  When choosing a type of sunscreen look on the back of the bottle and find the ingredients section. The manufacturer is required by law to state all the active ingredients and the inactive ingredients. You are looking for the active ingredients that could possibly be wreaking havoc on your skin. Look out for high concentrations of ‘OXYBENZONE’. This compound has shown evidence in that is can cause significant photo allergenic and allergenic effects in certain individuals. As the allergenic reactions where low in numbers it is still something to consider especially when looking for sunscreens for young children as it is found in many children’s products. Once oxybenzone is applied to the skin, like all skincare products, once it passes through the phospholipid bilayer and reaches the blood stream it has been shown to be associated with endocrine disruption. Lab testing showed that once in the blood stream it acts like an oestrogen in the body and is

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linked to abnormal sperm function and endometriosis in studies of women. The EWG’s Skin Deep Cosmetic Database classifies this as an 8 on the 1-10 hazard score. It has even been detected in mother’s milk. Another chemical to be on the lookout for is ‘AVOBENZONE’. This ingredient has been classified by the Environment Canada Domestic Substance List as a weak endocrine disruptor, expected to be toxic and harmful, and is suspected to be an environmental toxin (being bioaccumulative). Japan’s Standard for Cosmetics restrictions the concentration of the compound in all its cosmetics as it has been shown to break down sunlight into harmful byproducts. These by-products sitting onto of the skin later make their way into the blood stream. Lastly, at all costs avoid the compound ‘RETINYL PALMITATE’. This is beginning to become a popular additive as it helps reduce the signs of ageing, but note that is derived from vitamin A and does NOT filter UV light making it not an essential sunscreen ingredient! The conflict over the ingredient varies from doctor to doctor, but in some lab experiments the ingredient, at high concentrations, developed skin cancer in mice subjects. Regardless of its possible link to skin cancer the FDA label this as a known human reproductive toxicant. In Germany the compound has been banned in cosmetic products as it violates government restrictions and was found unsafe in the use of cosmetics. Laboratories in Asia found that it produces excess reactive oxygen species that can interfere with cellular signalling, causing mutations and leading to cell death and may even be implicated in cardiovascular disease. Last, to add the National Toxicology Program found that even at low doses in animals tumour formation was evident. All this data was given when the compounds were applied in exposure to the sun’s rays. This doesn't mean that you should avoid the sun at all costs. The sun rays provide you with adequate levels of vitamin D which your body needs. So those of you who avoid the sun at all costs watch your vitamin D levels. While avoiding the list of ingredients above here is list of ingredients to look for in your next sunscreen purchase. Nanoparticles in sunscreen are proving to be extremely effective in protecting one’s skin against the sun. These nanoparticles are zinc oxide, and titanium dioxide. They are raising few health concerns, while providing ultimate protection as they don't break down into harmful by-products in the sun. These are both mineral derived sunscreens, coming from the earth therefore are much safer than those active chemical ingredients. These particles are very small, hence the name nano, and the smaller the particle the better the SPF protection. The more effective zinc oxide nanoparticle has shown evidence that it cannot cross the skin in significant amounts and that the studies could not determine if the zinc in the bloodstream was insoluble nanoparticles therefore it is now universally declared to not pose any health risk. Studies showed that the two ingredients when exposed to the sun’s harmful rays produced free radicals that did damage surrounding cells. However, they were not a concern for human safety as the free radicals that were generated by the nanoparticles on the skin were quenched by the skin’s own antioxidant protections.  SUNSCREENS AND THEIR EFFECT ON THE ENVIRONMENT  There are currently two types of sunscreen that have been banned for their harmful effect on coral reefs. Sunscreens that contain either oxybenzone and octyl methoxycinnamate will be banned from use in Hawaii starting 2021. As research has proven that it is disrupting the ecology of the reefs surrounding its beaches. 

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SUNSCREEN FOUND IN NATURE As far as the most natural alternative to protecting your skin. Going back to using plant-based spreads, and even mud was used throughout human history and to this day, is still used by many. This is especially seen in populations that live near the equator. To no surprise there are some types of foods that will help protect you from the sun’s harmful rays. The use of sunscreen while being in the sun for long, or even short periods of time, is highly advised. Therefore, do not think of this as a guideline of what to eat so that you can tan throughout the weekend. Here is a list of food that you should incorporate into your diet, if not already, so that you are better prepared to combat the sun’s unavoidable damage. First, I would like to point out that a study recently undergone at the UT Southwestern Medical Centre, has found a very interesting factor to consider before getting your tan. An experiment using mice found that eating late into the night before a day out in the sun will in fact decrease the skin’s ability to combat the sun’s rays the following day. Eating late into the night, at abnormal times, disrupts the biological clock of the skin, this includes the daytime potency of an enzyme that helps protect against the sun’s harmful ultraviolet radiation. Just something to consider the day before you get out in the sun. Back to our list of foods to eat to help your skin combat those harmful rays: Citrus fruits: These are high in vitamin C, research has shown that long-term intake in conjunction with vitamin E can reduce the potential for sunburn. Not to mention that citrus fruits have been associated with an astounding 34% lower risk of skin cancer as they contain antioxidants the work to protect cells from free-radical damage. Carrots: Carrots aren't just for the eyes! Carrots contain beta-carotene which help protect against free radical damage. Strawberries: Contain antioxidants and vitamin C, both protect you against sun damage. On a side note strawberries contain tannins. Tannins help reduce that sting felt from sunburn, so next time you get the burn mash up some strawberries and apply them to your skin, let them sit for about ten minutes and rinse off. Green tea: Studies show that green tea contains catechins, which have disease- preventing properties and protect against sunburn inflammation and long-term UV damage. It also contains tannic acid that help calm sunburn pain and even more astounding it contains antioxidants called EGCGs. - A University of Wisconsin study found that EGCG’s stopped genetic damage in human skin cells exposed to UV light.  Pomegranates:  This is an amazing super-fruit across the board. Pomegranates contain ellagic acid that helps protect skin from cell-damages induced from both UVA and UVB rays. Some studies have shown that the extract when used in conjunction with sunscreen increased its efficiency.  The standard preventative measures you should exercise and advise your client are that if you plan on being in the sun frequently this summer try to remember to bring a hat to cover you face, the right sunscreen, and try to avoid being in the direct path of the sun’s rays during those most vulnerable time of the day (usually 12-2). The sun is a vital part of earth’s ecosystem and a great way to get an adequate amount of vitamin D. Always remember that with the glorified glow, comes with a price. APJ


EXPANDING YOUR CLIENT REACH WHETHER you are a cosmetic tattooist, laser practitioner or dermal therapist, adding a new modality to your services is another way of expanding your clientreach and attracting a new type of client with a different need. Additionally, it can not only increase your revenue, it can also give your business a point of difference to your competition. One such modality is tattoo removal. So why should you introduce tattoo removal? Apart from the above reasons there is also another consideration. People with tattoos also have skincare needs, so here is your opportunity to provide them with face and body solutions as an additional way of servicing them. WHY IS TATTOO REMOVAL A GROWTH INDUSTRY? If it seems like there are more Australians with tattoos currently, that’s because there are. Australia is experiencing growth in the proportion of the nation opting to be “inked”. Interestingly enough in previous years the percentage of men who had tattoos were 15.4% with the women who had

tattoos 13.6%. However, the latest figures indicated that women who are now having tattoos are exceeding that of men. According to industry figures 15.5% of Australians are having tattoos and they spend in excess of $93 million each year to get them and this figure is growing every year. NOT WITHOUT REGRETS More than 1-in-4 (27%) of Australians with tattoos say they regret, to some extent in getting a tattoo and seek for options to remove them. They may have had a relationship bust-up and find that as the tattoo had integrated images, names or statements that relate to a past experience or individuals, and the tattoo is now a painful memory and something they no longer wish to associate with. Achieving a tattoo removal for these individuals can be very liberating, as well as a rewarding experience for the practitioner. SKINIAL is an effective non-laser method of tattoo removal using a substance the body recognizes – lactic acid. SKINIAL has a long-standing history and reputation in Europe. It is renowned for its safety and effectiveness and this makes it an attractive tattoo removal option. The company offered great support and comprehensive training and it is also a very cost-effect method with an excellent return on investment. Deanne Carney has worked extensively with the SKINIAL method and was so impressed that she is now the national trainer for the company. With a background as a qualified teacher, Deanne delivers comprehensive training ensuring that practitioners can achieve exceptional treatment results with this revolutionary system. “The obvious health benefits of non-laser tattoo removal are becoming more widely recognised to the community and the SKINIAL brand is growing rapidly, clients looking for an alternative to laser are so relieved to find us,” Deanne says.

SKINIAL method of non-laser tattoo removal We need more practitioners to help us cope with the demand SKINIAL achieves great results using a completely natural product - Lactic acid, the most widespread acid in nature and part of energy production in the body. Expand your scope of practice by introducing the SKINIAL non-laser tattoo removal services. Take advantage of the consumer demand. It is the safer and healthier option of removing the pigment externally, rather than releasing it internally through the lymphatic system as with laser tattoo removal.

Become a certified SKINIAL practitioner full training is available Deanne Carney 0423 621 764 australia@skinial.com

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Cosmetic Tattooing and the AGEING FACE The new techniques and working collaboratively with injectable procedures for optimal treatment outcomes Katherine McCann AS WE AGE it is inevitable that facial features shift and alter. These usually involve changes in bone structure, fat distribution, muscle ptosis and skin wrinkling. So, when it comes to cosmetic tattooing procedures, which are usually considered long-lasting and sometimes even permanent, how can we ensure that these changes do not negatively impact the procedures we have performed as one ages? In this article, I want to discuss how cosmetic tattooing techniques are evolving and some of the technical considerations that I have found to be helpful in ensuring that procedures delivered to the three key areas – eyebrows, lips and eyeliner, remain age-appropriate and continue to fulfil their purpose of enhancing the client’s appearance. I also want to address in my experience which is the best sequence when combining injectables with cosmetic tattooing to optimise the end result. Here are some common questions that I am sometimes asked: APJ 94

DOES THE CONCEPT “LESS IS MORE APPLY TO THE NEW TECHNIQUES AND TRENDS IN COSMETIC TATTOOING? I would say most definitely! With respect to the less is more concept, this falls in line with the current trend towards ‘natural beauty’, whereby clients seek that subtle yet enhanced look. Many are seeking tattooing that ‘enhances’ their features as opposed to making them stand out. This is because as more people are having these procedures, it is now evident what happens as people age - cosmetic tattooing procedures that were on the heavy side, when people were younger will start to look quite ‘made up or even harsh’. Consumers are mindful of this and this has contributed to the evolution of the more refined and sophisticated techniques, that can suit a wide variety of individuals and age groups. The new cosmetic tattooing techniques today are so much

softer, sophisticated and able to provide a truly enhanced, but natural look. These advances have broadened the appeal to a much wider age demographic. Getting beautiful brows for example that can look natural are so much easier these days to perform with the new feather-stroke and powder ombre techniques. These allow us to achieve a lovely 3D effect of simulated hairs rather than the old block techniques. Today the new techniques can allow us to create a beautiful shape that can give the illusion of a more youthful slightly lifted eyebrow to flatter the eyes and enhance the features without looking artificial and one which can suit any age. Another major factor with the natural look and “less is more factor” is the ability to adjust and change a client’s look as they continue to age – this not only sets you both up for a long and trusting client/practitioner relationship, but also enables you to keep them looking fresh and age-appropriate over the years. Personally, I’ve always found that through the provision of contextual understanding and consultation, clients are happier to tattoo more conservatively and retain the ability to modify their look every couple of years as the pigments fade out when they return for their biannual colour refresher appointments. IF SOMEONE IS HAVING INJECTABLE FILLERS, WHEN SHOULD THEY HAVE THEIR COSMETIC TATTOO PROCEDURE AND WHAT ARE THE CONSIDERATIONS FOR THE COSMETIC TATTOOISTS? The advice as to when they should have their injectables will depend on the procedure they are having. Here are some examples: LIPS: With regards to lip-filler, I personally advise the client to have this done before a cosmetic tattooing procedure and

to let any bruising, or discomfort subside, as well as allow the filler to settle a minimum of 14 days before having lip cosmetic tattooing. Another reason behind this is due to the amount of ‘room’ in the lip tissue and the fact that filler and pigment tends to go into the same area. So, my rationale is that if filler is added to the lips first with the client gaining the desired lip size and volume, this will often even-out many of the small creases within the lips – this minimises the risk of missing any part of the lips when tattooing should the two procedures be done in reverse. Another consideration when working with lips that have filler is the issue of swelling, so I tend to work very lightly and superficially, which allows me to layer the pigment while carefully watching the saturation levels – this not only ensures pigment is placed evenly, but also gives me the opportunity to add contour and volume and reduce the chance of bleeding, bruising or residual swelling. Another tip for cosmetic tattooists when working on lips with filler is using your primary topical anaesthetic (ideally a glycerine-based one) for the vast majority of the procedure ‘as-you-go’, as it aids with any wiping of pigment and helps to maintain client comfort throughout the procedure without thickening the skin. Then before your last pass, use a topical with a vascular restrictor that will then allow you to watch the skin changes and see if there are any areas within the lips that require any additional pigment to be added. Also, check your work ensuring it is both even and symmetrical. (APAN’s online Topical Anaesthetic course will also give you invaluable knowledge to get tyhis right https://apanetwork.com/onlineanaesthetics-course/). By working with a very light hand, you will find the lips will very rarely swell, but you do need to understand the basic contraindications and protocols. Also, note that if the lips are ‘too full’ or ‘tight’ then you also need to have the discretion to APJ 95

natural and age-appropriate. On the other hand, injectables are a great addition to assisting with the ageing face and maintaining the ability to keep things ‘symmetrical’ – this goes for both Botox and fillers. EYELINER: Eyeliners are another story when it comes to cosmetic tattooing and injectables because it depends on the type of eyeliner the client is wanting to have done. Many of the smaller liners or lash enhancements are no problem to do before, or after a client has had injectables or filler, as their shape or size isn’t really affected. However, if we are talking ‘wings or wedges’ then I try and advise clients to have the tattooing done when they are in their most natural state. Additionally, should the need for injectables be required to adjust eyelid shape, or temporal lobe volume, etc, then again use your discretion around whether they would be a suitable candidate for the bigger liners taking into consideration the way their eyelids are shaped and how the peripheral skin around the area is aged, or ageing.

refuse to perform a procedure, especially if it risks splitting the lips or that there is no room left for pigment due to excessive volume. EYEBROWS: When it comes to eyebrows, I always ask clients if they get injectables on a regular basis, or if they are prepared to have them – this opens up the opportunity to chat about expectations of symmetry and muscle function, or dysfunction. As a cosmetic tattooist, I very rarely tattoo outside the general hairline, and while we can always vary a brow and modify its appearance and shape, we must remain vigilant to the shape and the impact of future ageing of a person’s face and skin. Ideally, I would recommend that a client has their eyebrows tattooed BEFORE having any injectables, as this will allow me to see what their facial muscles do, and how the brows look in their natural resting state. If a person is due for their injectable top up, try and have this done after the eyebrow tattoo is completed (both initial appointment and the touchup). Should there be any issues with one side of the face dropping, or one brow being stronger than another, these can be safely adjusted by the injector during that appointment. The other consideration is that if you tattoo too far outside of the hair - extending an eyebrow tail, or take an arch too high or low, simply to ‘fix’ an eyebrow, you need to make the client aware that should any thing happen to them in the future and they are unable to maintain their brows, that there is a strong possibility of having ‘two eyebrow tones’. This information is in many cases enough for them to opt to remain a bit more conservative having a clearer understanding of the long-term consequences should they wish to go down that route. I always remind people that it’s easier to add to brows than to take away. So, if the trend is for big, heavy brows, it is sometimes better to add a little powder or pencil to enhance the look. This will allow them to enjoy the trend without “permanent” heavy eyebrows that will look odd when they are not wearing makeup. Less is more when it comes to keeping it APJ 96

IT IS A COMMON UNDERSTANDING THAT THE MOST HATED PROCEDURE FOR COSMETIC TATTOISTS IS THE LIPS. WHY ARE LIPS A CHALLENGE AS THEY AGE AND WHAT ARE THE KEY CONSIDERATIONS WHEN DOING A COSMETIC TATTOO PROCEDURE ON THE LIPS? I’ve heard of this very often. However, regardless of the tattooing procedure – whether its lips, eyeliner, or eyebrows for that matter, there is always a particular process, issue or challenge that the person saying they hate doing the particular procedure is actually encountering. Whether it’s mapping eyebrows and achieving symmetry, getting eyeliner retention spot on, or maintaining client comfort for lip tattooing, there are always going to be challenges and exceptions. However, with respect to challenges and key considerations

can all cause issues when attempting to successfully tackle a lip tattoo. Discretion should be used to determine the skill required to either correct, or bypass a potential client who presents with any of the latter factors, as achieving a nice, even lip colour, can require a more advanced skillset. Keep in mind that although these are common considerations, there are numerous others that you could encounter. However, I can assure you achieving a successful lip procedure can be one of the most satisfying experiences for many clients and also extremely rewarding for the practitioner, knowing they have improved a feature through colour-tone and shape that allows them to create amazingly natural and beautiful lips. IN CONCLUSION Working on an ageing client definitely requires more skill and technique than working on a young face that only requires slight enhancement. However, the Baby Boomer population is constantly growing and with your skills, you can potentially take years off their appearance and refresh their look. In fact, they can be some of the most grateful clients you will ever have. for tattooing lips as they age, I would advise as much as possible to stick to the vermillion line, or only 1-1.5mm maximum outside of this if you have to modify the lip shape. The reason for this is due to the fact that different types of skin retains pigment differently and this means that achieving the correct colour can also become a lot trickier from the outset. Another challenge is how the tattoo will look as it ages and in retaining colour over time. A tattoo that has been placed outside of the vermillion line is on different skin textures and colour retention can therefore heal and age differently. Another factor that contributes to tattooing of lips is loss of volume around the mouth, jaw and face. Also, changes to teeth position can also cause a challenge to perfecting a lip procedure and these changes can also contribute to fine lines and wrinkles.

As cosmetic tattooing is a constantly advancing industry there are always new trends and education emerging. I cannot overemphasise the importance of ensuring we stay on top of these developments and we continually update both our skillset and the contextual understanding of why we’re doing what we’re doing. This is so important, as clients are also becoming more and more savvy and often seek out the latest trends or techniques. Updated knowledge will allow you to confidently answer their questions and provide them with the specific outcome they are looking for. Successful procedures will create happy clients and this will help build your reputation, while referrals that you are the ‘go to’ professional in your area will only grow. APJ

When tackling lips that have significant lines, it’s important to design the lip shape while the client is sitting up, as due to gravity, this can differ dramatically if the client is laying down. Also, the way the facial muscles move or retract, or even the way the lips move over the shape of a person’s teeth can create a further challenge. The tattooist must also be aware that sometimes it’s better to tattoo the lips without stretching them, especially in the wrinkle areas. You can gently hold the skin taught, but not stretch it, that way the lips will remain in their natural state. Tattooing them in that way will allow you to avoid the pitfall of an inverted line once the skin retracts back from being stretched. Thickened skin and dry lips are also common and prior to tattooing advice should be provided to the prospective client to gently exfoliate the skin for a week or so leading up to the tattooing procedure – this helps to thin the skin and makes the lips in general, easier to tattoo. Finally, one of the last but most common concerns, is existing tattooing. Dark spots or titanium residual – these factors APJ 97

GAIN NATIONAL RECOGNITION FOR YOUR COSMETIC TATTOO QUALIFICATION Paving the way for national standards-recognition for qualified Cosmetic Tattooists APAN has established CTARP - a national registration process that allows qualified Cosmetic Tattoo practitioners to gain national recognition, differentiating them from unqualified technicians. CTARP REGISTRATION CTARP - Cosmetic Tattoo APAN Registered Practitioner is Australia’s leading recognition symbol for best practice in Cosmetic Tattooing. CTARP PREREQUISITE REQUIREMENTS • Must provide evidence of a nationallyapproved qualification • Must provide evidence of SHBBINF001 Maintain Infection Control.

Be recognised as the best For further details visit apanetwork.com/ctarp

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07 5593 0360| info@apanetwork.com| www.apanetwork.com



COSMETIC TATTOOING COSMETIC TATTOOING is now becoming an in-demand service, as well as a highly competitive profession. However, there are many practitioners who have trained several years ago and have gained experience, while perfecting their techniques and becoming true masters of their trade. The only thing they possibly lack is the ability to state that their credentials are GovernmentAccredited and nationally-approved as part of the competitive advantage.

You can apply for the RPL process for just $1500. It is easy as A, B, C:

If you believe you are highly skilled and proud of your standards why not apply to have your competencies measured through a “recognition of prior learning” process and apply to gain the government-accredited course SHBBSKS003 Design and provide Cosmetic Tattooing. This unit of competency is the highest level of training that you can receive.

If you wish to undertake any course in Microblading or Scalp Micropigmentation, in fact any course that entails skin penetration, we recommend that you undertake this on-line course. The cost is just $350.

The Australian Cosmetic Tattoo College is a Registered Training Organisation RTO No. 445214.

If you are already a cosmetic tattooist without nationally-accredited credentials, please contact us to upgrade.

Complete the on-line theory

Demonstrate via video or photographic evidence your skills and experience and attach copies of your previous training

If you meet with the current competencies you will receive the upgrade to SHBBSKS003 Design and Provide Cosmetic Tattooing.

As a cosmetic tattooist you should also hold the accredited SHBBINF001 Course Maintain Infection Control Standards. This online course is a pre-requisite to Design and Provide Cosmetic Tattooing.

As an RTO the AUSTRALIAN COSMETIC TATTOO COLLEGE offers quality training through highly-experienced practitioners. We deliver training one-on-one so you can be assured that you will gain the very best from your training. Our courses are nationally-accredited and meet with the highest standard. If you are interested in expanding your scope of practice and add cosmetic tattooing to your service please contact us. We can assure you that you will gain quality training.

DESIGN AND PROVIDE COSMETIC TATTOOING SHBBSKS003 Upgrade your credentials through Recognition of Prior Learn process (RPL). The Australian Cosmetic Tattoo College only offers one-on-one training in every State – no classrooms. Ensure your course is an accredited course DESIGN AND PROVIDE COSMETIC TATTOOING SHBBSKS003, or SHBBINF001 Course Maintain Infection Control Standards.

TRAIN OR UPSKILL NOW • Microblading • Scalp Micropigmentation • Skin Needling NO. 45214

“One on One” Private Training

1800 024 050 APJ 99



INSTAGRAM STORIES Why you should be doing them Trish Hammond - Plastic Surgery Hub INSTAGRAM. Whether you like it or not, it’s the most popular social media platform of the younger generations. Even the Baby Boomers and Generation X’s are embracing it. As Facebook becomes more and more difficult to navigate through all the advertisements and random posts, more and more people are moving to Instagram as their main social media platform. And one of the fastest growing and most popular aspects of Instagram is Instagram Stories. WHY INSTRAGRAM STORIES? Besides the fact that over 200 million people use Instagram Stories EVERY DAY (enough of a reason on its own!), Instagram Stories are what’s called “discoverable”. That means they can also be seen and appear to people who don’t follow you! Just like random stories appear on your Instagram feed (that Instagram has identified might be of interest to you), so your stories appear on other people’s feeds and you don’t even have to pay for it! This creates a whole new way of “advertising” and reaching out to those potential clients who might not have found you otherwise. Instagram Stories allow you to engage with not only your followers but an additional audience that you wish you had (and actually do have through Instagram Stories!). Additionally, you can #hashtag your stories which means anyone searching for that particular topic will see your Instagram Story. I also recommend tagging other Instagram users in your post where possible - that will also allow you to reach an even wider audience of the followers of those you tagged. Creating unique insights into your life, business, clients and the like through Instagram Stories allows you to connect directly with your followers and potential patients in a less formal way. Spontaneous, behind the scenes glimpses into your clients not only makes viewers feel special but makes them more likely to use your services, recommend you, talk about you and feel like a part of your “family”. They kind of get to know you before even stepping foot into your clinic. One of the distinctive things about Instagram Stories is that they only last 24 hours so they give a feeling of exclusivity to your followers. That’s why a more personalised approach to what APJ 100

you post in your stories will generally see a higher audience engagement. Make the stories fun, positive and not too “heavy”. There are several “fun features” of Instagram Stories that allow you to play with filters, stickers, doodles (draw over the top of your image), add music and more to make your posts more attractive, personal and appealing to viewers. There is also no “best time” to post, so you just upload an update and add it to your story as you go. Easy! Quick! No stress! Instagram Stories have several other features making them super attractive to businesses. You can “hide” your posts from some users, allowing you to target only those you want to target; and, you can download or save your stories to create normal Instagram posts that can be seen for longer than the 24 hours when Stories are seen. So again, why Instagram Stories? Let me wrap it up: •

Instagram has 4.2 billion daily likes!! Grab some of them for your clinic and grow brand awareness for FREE through the fastest growing social media platform today.

Allow your followers to get more familiar with your staff, clinic and services through your stories.

Figures show that 75% of Instagram users get engaged with a company or business after seeing their post and more than 80% of Instagram accounts are following businesses on their network, it’s a source of free advertising and promotion that just can’t be overlooked.

Keeping up with social media can be tricky - it changes from year-to-year, month-to-month and even week-to-week. But if you just want to choose one way to make yourself seen in 2019, personally, I’d go with Instagram Stories. APJ For more info, get in touch with Trish at trish@plasticsurgeryhub.com.au

Happy, Productive Staff are the Backbone of a SUCCESSFUL BUSINESS Let us help you find them and keep them. • • • •

Wage Rates Staff Conflict Issues Employment & Industrial Relations Staffing Contracts plus access to over 35 documents



APAN - Aesthetics Practitioners Advisory Network (07) 5593 0360 info@apanetwork.com www.apanetwork.com

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New Amendment to mitigate against “double-dipping” outcomes for employees Authors: Michael Bishop, Amelita Hensman and Ben Drysdale Pointon Partner Lawyers IN THE SUMMER issue of APJ an article entitled “REVIEW OF CASUAL EMPLOYMENT ARRANGEMENTS – When is a casual worker not considered a casual worker by law” was presented by a legal team at Pointon Partner Lawyers – APAN preferred legal advisors.

is awarded their accrued permanent benefits and also retain their casual loading payments over the same period in dispute, then it could amount to a double-dipping of the mutually exclusive entitlements available under the Fair Work Act 2009 (Cth).

Since then there has been an amendment to the Act, which is presented below. This information is relevant both for staff who are hired as casual workers, as well as for employees.

The Federal government has responded by amending the Fair Work Regulations 2009 (Cth) to include regulation 2.03A, which specifically deals with the above circumstances. The new regulation permits an employer to claim that they should be allowed to offset value of casual loading payments retained by the employee when estimating the permanent benefits owed to the employee over the relevant period.

Employers have recently received some legislative support with regards to casual employees who successfully claim for accrued annual leave and other permanent benefits. As discussed in our recent article on the decision of WorkPac Pty Ltd v Skene [2018] FCAFC 131, an employee may successfully claim that they have been miscategorised as a casual rather than as a permanent employee by their employer. Following the Skene decision, employers have voiced their concerns that such court or Fair Work Commission decisions may result in an unfair ‘double dipping’ in favour of the employee. The reasoning is that casual loading payments are meant to compensate the employee for their lack of accrued paid annual leave and other permanent benefits. If an employee APJ 102

As Australian businesses are becoming increasingly reliant on casual employment arrangements, disputes from employees over being miscategorised as casual are likely to increase. It is therefore important for employers to seek professional legal advice when such disputes arise, as well as regularly reviewing their current arrangements in order to limit their exposure to such claims. APJ If you would like your particular casual employment arrangements reviewed, please feel free to contact Michael Bishop, Amelita Hensman or Ben Drysdale for advice. 03 96 14 7707

Authors FAIR WORK REGULATIONS 2009 - REG 2.03A Claims to offset certain amounts This regulation applies if:  (a)  a person is employed by an employer on the basis that the person is a casual employee; and (b)  the employer pays the person an amount (the loading amount) that is clearly identifiable as an amount paid to compensate the person for not having one or more relevant NES entitlements during a period (the employment period); and (c)  during all or some of the employment period, the person was in fact an employee other than a casual employee for the purposes of the National Employment Standards; and (d)  the person makes a claim to be paid an amount in lieu of one or more of the relevant NES NOTE 1: This regulation is intended to apply if the person has been mistakenly classified as a casual employee during all or some of the employment period NOTE 2: For the purposes of paragraph (b), examples of where it may be clearly identifiable that an amount is paid to compensate the person for not having one or more relevant NES entitlements included in correspondence, pay slips, contracts and relevant industrial instruments. (2)  To avoid doubt, the employer may make a claim to have the loading amount taken into account in determining any amount payable by the employer to the person in lieu of one or more relevant NES entitlements. (3)  This regulation does not affect the matters to which a court may otherwise have regard, at law or in equity, in determining an employer’s claim to have the loading amount taken into account. (4)  A reference in this regulation to a relevant NES entitlement is a reference to an entitlement under the National Employment Standards that casual employees do not have.

POINTON PARTNER LAWYERS Pointon Partners offers the expertise and experience of a top tier law firm, coupled with the personal service and attention that can only be offered by an expert, smaller firm. Our lawyers are technically excellent in their areas of expertise, but more importantly for our clients, they are genuinely concerned with the application of the law in the ‘real world’ to achieve results. We are outcome-focused and commercially-minded, helping clients achieve their goals or solve their problems in the most effective and efficient manner is our key objective. “More than a law firm, we’re your legal partner. An extension of your team. Your success is our success. That’s what drives us to be the best.” Services include: •

Employment Law





Intellectual Properties


Wills and Estates

Restructuring and Insolvency

For legal advice and services Ph: 03 9614 7707 or email Michael Bishop mjb@pointonpartners.com.au APJ 103


BAKUCHIOL the natural ingredient that is challenging RETINOL as the king of anti-ageing ingredients Eva Boyd WHETHER you are a doctor, dermal therapist or aesthetician one thing we can all agree on is that retinol is a trusted ingredient in fighting fine lines and wrinkles. Retinol would have to be one of the most researched ingredients with extensive validated evidence of its efficacy in improving the skin. As we know, retinol is a vitamin A derivative, which stimulates cell turnover and prevents the breakdown of collagen, keeping skin fresher and more youthful-looking. But, as we all know, there are noted concerns around the potency of this active ingredient – namely, that it can result in irritation, flakiness and redness in some skins – particularly those that are on the sensitive side. This is the reason why there is a spike of interest in a new, natural product called bakuchiol, as it offers a gentler alternative in skin improvement, claiming similar results to retinol without the potential irritation. WHAT IS BAKUCHIOL? Pronounced 'back-ooh-chee-all,' this is a plant-based skincare ingredient that's said to stand up to retinol in the efficacy stakes. Derived from the Indian babchi plant, which is used extensively in Ayurvedic medicine, it's said to work on fine lines, brighten the skin, reduce the appearance of pores and strengthen collagen, just like retinol.

hyperpigmentation, with no statistical difference between the compounds,' noting that: 'The retinol users reported more facial skin scaling and stinging.' Their conclusion was that 'bakuchiol is comparable with retinol in its ability to improve photo-ageing and is better tolerated than retinol. It is promising as a more tolerable alternative to retinol - this is the premature ageing of the skin as a result of UV radiation’. As we know, retinol and the sun are not friends and rays undermine the solution. Basically, because retinol contributes to an increase in cell turnover, it views that as its primary job and fighting UVs as a secondary task. Thus, retinol can allow rays to damage your skin, if worn in the day time. To further investigate the effectiveness of bakuchiol on the skin, it was formulated into a finished skin care product and was tested in clinical case study by twice-a-day facial application. The results showed that after 12 weeks treatment, significant improvement in lines and wrinkles, pigmentation, elasticity, firmness and overall reduction in photo-damage was observed, without usual retinol therapyassociated undesirable effects.

WHAT ARE THE STUDIES INDICATING? A study undertaken in 2018 and published in the British Journal of Dermatology was conducted on 44 volunteers, to compare the effects of 0.5% solutions of the two ingredients.

When comparing bakuchiol to retinol, research identified that bakuchiol caused less scaling and peeling than retinol, however, bakuchiol appears to cause more redness over time. So, it isn't necessarily a ‘golden bullet' even though it is gentler on the skin than retinol.

The study's authors found that: 'Bakuchiol and retinol both significantly decreased wrinkle surface area and

So what compound is responsible for the effectiveness of bakuchiol? Studies reveal that the higher percentage of

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terpenophenol compound attributes to its incredible skin benefits. It is this compound that is responsible for the following: Provides anti-ageing properties: Stimulating collagen production similar to retinol, leaving the skin looking plum and firmer. This was confirmed in a 2014 study that was published in the International Journal of Cosmetic Science. Bakuchiol is an antioxidant that helps with oxidative stress. It regulates the cells’ mitochondria, which limits cell damage from free radicals. Hydrating and healing: The plant extract is packed with vitamin E, so it's moisturising and reparative. Acne-fighting: It also has antibacterial properties, so it can protect the skin from acne-causing bacteria and from breakouts. FURTHER STUDIES Another randomised, double-blind study conducted as recently as 2018 compared the skincare related activities of retinol and bakuchiol, looking closely at their gene expression. Retinol is a pivotal regulator of differentiation and growth of developing as well as adult skin. Retinoic acid is the major physiologically active metabolite of retinol regulating gene expression through retinoic acid receptor - dependant and independent pathways. The study reviewed the comparative gene expression profiling of both substances in the EpiDerm FT full thickness skin substitute model. Furthermore, type I, III and IV collagen, as well as aquaporin three expression was analysed by ELISA and/or histochemistry in human dermal fibroblasts and/or Epiderm FT skin substitutes.

The results of the study concluded the following: Bakuchiol is a meroterpene phenol abundant in seeds and leaves of the plant Psoralea corylifolia. While the study confirmed evidence that bakuchiol has no structural resemblance to retinoids, however, it can perform as a functional analogue of retinol. The studies further showed great overall similarity of retinol and bakuchiol effects on the gene expression profile. This similarity was confirmed by the side-by-side comparison of the modulation of individual genes, as well as on the protein level by ELISA and histochemistry. (ELISA diagnostic assay – is an enzymelinked immunosorbent assay commonly used for analytical biochemistry analysis. The assay uses a solid-phase enzyme immunoassay to detect the presence of a ligand in a liquid sample using antibodies directed against the protein to be measured). It was also confirmed that bakuchiol showed retinol-like functionality for the upregulation of types I and IV collagen in DNA micro-array study. It also showed stimulation of type III collagen in the mature fibroblast model. WHAT IS THE VERDICT? The conclusion of several studies confirmed that bakuchiol can effectively function as an anti-ageing compound through retinol-like regulation of gene expression. Even though bakuchiol is a natural, gentler alternative to retinol, it doesn’t mean it's not a powerhouse ingredient. APJ

For a list of references, please contact the editor.


DERMATITIS and its Complex Systemic Connection Pia Kynoch DERMATITIS is a very common condition that any skin or dermal therapist will encounter in their practice. Reviewing its origin can be both associated to external factors, as well as internal. In this scholarly article PIA KYNOCH reviews the complex connection between the Nervous System, Gastrointestinal tract, Immune system and the Skin. Pia Kynoch, a holistic skin therapist at Verve Skin Beauty Wellness in Kew. She has over 20 years of industry experience and specialises in advanced skin treatments. Pia is also currently completing her final semester of Bachelor Health Science Naturopathy degree at the Southern School of Natural Therapies. You may, at some stage, have heard the epidermis called the ectoderm. The ectoderm is the outermost of the three primary germ layers which appear very early on in embryonic development. I want to give you a quick ‘helicopter’ view of this process as there are some pretty fascinating correlations you can begin to draw between our stress response and the way the epidermis looks, feels and acts. During embryonic development of the nervous system the ectoderm differentiates into two parts. The first is the surface ectoderm, which gives rise to the outer tissues such as epidermis, hair and nails. The second is the neuroectoderm, forming the nervous system of the embryo, which further divides into the neural tube (the beginnings of our central nervous system (CNS)), and the neural crest. In a nutshell, our nervous system and our skin function come from the same ‘master’ cell line, and are intrinsically and powerfully linked. The neural crest is actually a collection of transient cells shed from the margin of the newly created neural tube. The neural crest form melanocytes, connective tissue, cartilage, craniofacial bones, smooth muscle cells of the cardiovascular system (interesting to keep this in mind also with the connection between asthma and atopy), and most of the peripheral nervous system (PNS). Important to note - it is neural crest cells (that have divided from APJ 106

epidermal cells!) that form the entire enteric nervous system of the gastrointestinal tract. So now it is a triad - our gut health, our nervous system and skin health that are intrinsically and powerfully linked. The PNS is all of the nerves that branch out from the brain and spinal cord, connecting our CNS to the sensory organs, such as the eye and ear, and to other organs of the body, muscles, blood vessels, glands, and the skin. The PNS is divided up into two parts: The somatic nervous system has sensory neurons that carry information from/to the nerves from/to the CNS, and also motor neurons that carry information from/to the muscle fibres from/to the CNS. This is what gives us voluntary skeletal muscle control of body movements. 
 The autonomic nervous system (ANS) regulates all involuntary body functions (eg blood flow, heartbeat, digestion, secretions, breathing). It is divided into two branches - the sympathetic nervous system (SNS) and the parasympathetic nervous system (PSNS). The SNS regulates our ‘flight-or-fight’ stress responses, and the PSNS ki is our ‘rest and digest’ mode. So how much does our brain (what we think), and our nervous systems, affect our skin? What our brain perceives, remembers, thinks, loves and hates will coordinate both conscious and unconscious bodily processes. Acute psychological stress (PS) due to ANY perceived or real external or internal threat or stimuli (ie. physical, environmental, mental and/or emotional) will trigger a cascade of stress hormones that produce well-orchestrated physiological changes. Studies have clearly established that PS and the ensuing cortisol release reduces both the innate and adaptive immunity of the epidermis, increases production of reactive oxygen species (ROS), nitrogen oxygen species (NOS) and the local expression of pro-inflammatory cytokines and chemokines that promote tissue inflammation. The epidermal permeability barrier homeostasis and stratum corneum (SC) integrity are impaired, with noted increases in cell layers with

The GIT mucosal immune system is in constant communication with the vast diversity of microbes present on all our body surfaces. A plethora of immune cells and cytokines can be influenced by the microbiome, and the microbiota can also synthesise histamine to maintain their required intracellular pH (pathogenic and commensal prefer different pH environments). Altered HPA axis, vagal nerve and SNS function can modulate mucosal immune function, and the resulting dysbiosis and hyperpermeability can increase histamine production, and systemic inflammatory and immune system dysregulation effects can be noted throughout the body. Histamineâ&#x20AC;&#x2122;s effects on the skin are numerous, elevating physiologic and pathologic processes such as vascular leak, redness, hyperresponsiveness, inflammation, and itching.

hyperkeratosis, parakeratosis and dyskeratosis. This all happens because PS rapidly increase our endogenous glucocorticoid (GC) levels and activates our ANS. It is the hypothalamic pituitary adrenal (HPA) axis that is our central stress response system, orchestrating our neuro-endocrine (nerve and hormone) stress adaptation. WHAT HAPPENS WHEN STRESS RESPONSE IS TRIGGERED? When any type of stress response is triggered, the hypothalamus releases corticotrophin-releasing factor (CRF) to stimulate the pituitary gland, which then releases growth hormones (gonadotropin) and adrenocorticotropic hormone (ACTH) to stimulate the adrenal glands. GC stress hormones such as epinephrine, cortisol, and aldosterone are then released by the adrenal glands. Cortisol synthesis in keratinocytes can be stimulated by ACTH, and UVB will also stimulate epidermal cortisol production. Interestingly, psoariatic skin has inhibited glucocorticoidogenesis and reduced expression of glucocorticoid receptors, and recent research suggests that defective skin GC signalling can play a major role in the pathogenesis of various inflammatory skin conditions. Glucocorticoids are actually a class of steroid hormones, and have numerous effects including modifying carbohydrate, protein and fat metabolism, as well as complex immune modulation and suppression actions. Changes to motility and secretions occur throughout the gastrointestinal tract (GIT) as ANS activation specifically affects microbial populations, increases permeability of the epithelium and causes immune activation. Studies have unequivocally shown that exposure to stressful stimuli results in GIT barrier hyperpermeability, and the resulting antigen exposure will stimulate a mucosal immune response and mast cell degranulation (histamine levels elevate), which in turns alters the microbiome and increases production of inflammatory cytokines. A 2002 study found that elevated stress hormone production can cause a 10,000-fold increase in both pathogenic and commensal bacteria populations while simultaneously enhancing pathogenic virulence. â&#x20AC;¨So now all four systems are activated. Our gut health, our nervous system, immune function and skin health are intrinsically and powerfully linked, and activity in one will provoke activity in another.

Basically, stressful thoughts running through our brain can directly affect the composition of the microbiota via release of signalling molecules through enterochromaffin cells, neurons and immune cells. Continued HPA activation will cause inhibition of gastric acid secretion and secretory motor function, change intestinal transit times, increase intestinal permeability, and also visceral hypersensitivity and at the same time reduce digestion and absorption of nutrients from food and supplements, which further adds to the cascade of inflammation as nutrient resources become more limited. Histamine, as a regulator of both the innate and adaptive immune responses, is a major mediator in these inflammatory activities. Activated immune cells can, under certain circumstances, also secrete histamine, which then directs effector cells into tissue sites and changes their function, leading to localised proinflammatory responses. This can occur in skin. Repeated exposure to stressors of any type causes habituated repeated and sustained HPA axis activation, although it is important to note that there is considerable variation in the type and amount of hormones released, and in response to different stressors, by each of us. Obviously the HPA axis plays the major role in cortisol secretion although a peripheral HPA axis exists in various organs, including the skin. Keratinocytes can produce equivalents of all the major components of the HPA axis. Thus, the skin is acting as an endocrine organ. Histamine H1R is expressed in various cell types (that include a mix of ectoderm cells!), such as neurons, endothelial cells, adrenal medulla, muscle cells, hepatocytes, chondrocytes, monocytes, neutrophils, eosinophils, DCs, T cells, and B cells, many of which are also activated by the HPA axis. IN CONCLUSION Maintaining the integrity of the epidermal barrier is a key factor in preventing the symptoms of dermatitis, and in alleviating its exacerbation. And, hopefully obviously now, so is controlling stress, and improving GIT function! Our skin is such an incredible entity, operating in many complex realms - mechanical, functional, immunologic and/ or microbiological. There are so many different pathways that can initiate stress and activate the HPA pathway, and there are also so many ways in which we can inhibit, or markedly reduce the cascade of nervous system, immune, gastrointestinal and skin effects. APJ

For a list of references, please contact the editor.

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JANE IREDALE CELEBRATES 25TH ANNIVERSARY “My commitment to giving you beautiful makeup without compromise hasn’t wavered since I launched my first product 25 years ago!” Jane Iredale JANE IREDALE is the president and founder of Iredale Mineral Cosmetics, a company she founded in 1994, which brought the mineral makeup line jane iredale to the aesthetics industry. She was the first to supply this industry with a line of makeup that had skin care benefits.  Jane was inspired to develop a makeup that was good for the skin by her career in the entertainment industry where she saw actresses and models struggling with the illeffects of the many kinds of makeup they wore. Jane has always thought of makeup as an essential part of a woman's sense of well-being and she wanted to make that easy to achieve. In May this year will mark the 25th Anniversary since the Jan Iredale skincare makeup was launched. To celebrate this milestone, MargiFox Distributors are finalising some amazing promotions. Contact MargiFox Distributors for further details 1300 850 008. APJ

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MARK THESE TRAINING DATES IN YOUR CALENDAR CLINICAL THERAPIES LASER INSTITUTE PASSING ON 30+ years of clinical experience Clinical Therapies Laser Institute is conducting post-graduate training in a variety of modalities. These include Nationally-Accredited and non-accredited courses and training. If you are seeking to update your skills please review the courses below and enrol today. With extensive industry experience Clinical Therapies Laser Institute offers leading education that will enable you to raise the level of your treatment results and grow your business with greater ease. Check these dates: APRIL • 10-11 Apply Skin Tightening and Body Contouring Using HIFU, Ultrasound and Cryolipolysis •

18-20 Design Cosmetic Tattooing and Microblading

23-24 Provide Cosmetic Tattoo Removal and Pigmentation Treatments with Q-Switched Laser

MAY • 4 Perform Cosmetic Light-Based Therapies for Pigmentation and Vascular Irregularities •

11 Infection Control Practicals

14 Provide Dermal Needling to Treat Skin Irregularities

15 Perform Enzyme and Chemical Peels in a Clinical Setting

21-22 LSO Course for Various Laser and IPL Treatments

JUNE • 14-17 Non-Surgical Symposium Gold Coast Qld National Laser Workshop • 1pm-5pm Pigmentation and Laser Workshop •

5pm-6pm Non-Invasive Skin Lesion Removal

18 Brisbane, Qld

19 Sydney, NSW

20 Melbourne, Vic

24 Adelaide, SA

Book today Ph: 1800 628 999 E: laserinstititue.edu.au APJ

This section presents the latest news, training dates and other Aesthetic Industry information

The move in Australia now brings it in line with a number of other countries that have ended these cruel, wasteful and outdated tests that are unjustifiably being used for nothing more than to test cosmetics and other personal care products, and will hopefully soon be followed by other nations. According to Humane Society International, which estimates that around 500,000 animals are used in cosmetics testing around the world every year, a number of other countries including Brazil, Canada, Chile, Mexico, South Africa, Sri Lanka, Taiwan, the ASEAN region of southeast Asia, and the U.S. are all currently discussing passing similar measures. APJ

LAWMAKERS IN AUSTRALIAN MOVE TO END ANIMAL TESTING FOR COSMETICS WHILE ANIMAL advocates are continuing to work towards a world where beauty and personal care products don’t cause needless suffering, there’s more reason to be optimistic that it will become a reality with Australia taking action to ban animal testing for cosmetics. The Australian Senate recently passed the Industrial Chemical Charges Bill 2017, which bans using data for new chemicals and ingredients that come from tests conducted on animals. It includes 11 measures to ensure that all ingredients will be covered, in addition to funding that will support the development of alternative test methods that don’t involve animals. According to Cruelty Free International, it’s part of a package of bills introduced to regulate industrial chemicals, and although it had been delayed while campaigners worked to make it stronger, and in line with the wishes of the majority of Australians who oppose this type of testing, a final agreement was reached when the government

committed to reinforcing measures to further restrict using animal test data for the use in chemical ingredients. “We congratulate the Australian Government, parliamentarians from across the country’s political parties, citizens and consumers who have campaigned hard and the animal protection organisations that worked tirelessly to achieve this result. This is great news for animals, great news for Australia and great news for moves to bring this cruel, outdated and unnecessary practice to an end globally, everywhere and forever,” said Cruelty Free International’s Director of Public Affairs Kerry Postlewhite. Thankfully for the animals who are victims of this industry, our attitudes towards the practice are changing for the better. Not only have dozens of nations passed bans like this, but hundreds of companies have pledged not to test their products on animals and have successfully proven we truly can have beauty without cruelty. It also makes good economic sense for companies that won’t otherwise be able to compete in global marketplaces where doors continue to close on products that have been tested on animals.

CONSUMER BRANDS ADOPT PAUX SKIN ANALYSIS APPROACH THE TREND for customised skincare continues to grow and now department store brands like Neutrogena, Atolla, Skinsei and Proven are capitalising on this trend. Although each brand is very different, their goals remain the same – providing skincare for each person’s individual skin needs. They are doing this by asking consumers to answer a series of

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AESTHETICS INDUSTRY BULLETIN questions surrounding their skin e.g. needs and concerns, your daily routine, along with lifestyle-related questions, such as workout regimen, are you mainly an indoor or outdoor person, pollution levels in your environment etc. They then plug this into a “scientific-looking” program where an algorithm then configures the best and most effective regime for you. The objective is to make the consumer feel that the choice of product was customised to their specific needs. The trends is also followed up by smaller, niche brands who want to capture consumers with their promise of customised skincare solutions. APJ

PARIS LAUNCHES INAUGURAL GLOBAL BEAUTY DAY ON THE 3RD APRIL HISTORICALLY, CREATING a diverse culture in the beauty sector has been complex, with the industry dominated by brands that appealed to the masses, but were less agile and able to encompass mass individuality. Today, better connected millennials are pushing for more inclusive beauty, encouraging challenger and indie

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brands to shake the market up and forcing the major players to move towards product ranges that are fully representative of the world’s population.

Beauty series social campaign will run. It will highlight brands and professionals who are challenging traditional beauty standards and promoting beauty for all within the industry.

In the UK alone, 70% of Black and Asian women feel that high street stores don’t cater for their beauty needs, and they end up having to pay up to 70% more for products from specialist ranges. However, the opportunity is there. Black women invest more than £4.8 billion on products and services each year worldwide and spend twice as much as other consumers on skincare. Indeed, when international musician Rihanna launched her Pro-Filter Foundation line, which carries 40

Exhibitors who are focused on aligning their strategy with diversity and inclusivity will be highlighted to visitors, helping R&D professionals identify brands making their mark within the sector. Global Beauty Day will also see a trio of roundtables with a host of experts from across the industry – from formulators, trend analysts and brand representatives – gathering to discuss some of the most pertinent issues impacting the beauty industry in relation to diversity.

tones, the darkest sold out fastest. Just as some races may feel ignored by the mainstream beauty industry, so too do older women and men, where the choice is even more limited. It is no secret that men have long used skincare lines traditionally aimed at females, and there is a burgeoning market for cosmetics particularly among younger men. So, 2019 promises to deliver a greater focus on ethnicities, gender, and different skin types, making it the perfect time to celebrate diversity.  As part of Global Beauty Day, which will recur annually on the second day of in-cosmetics Global, a Diversity in

A number of Marketing Trends sessions will also follow this theme, such as ‘Challenging beauty norms – inclusivity in beauty’. This will be delivered by Jamie Mills, Senior Analyst at GlobalData, who will discuss challenges from developing make-up for men to appealing to a broader range of skin tones. Sam Farmer, Owner of Samuel Farmer & Co Ltd, will also later take to the stage to discuss how to cater for the sea-change in the way young people identify with sexuality and gender and what this means for NPD in the beauty industry. Roziani Zulkifli, Exhibition Manager of in-cosmetics Global, commented: “As a leading show in the global beauty

This section presents the latest news, training dates and other Aesthetic Industry information

industry, we wanted to celebrate diversity in this fast-paced sector and provide a platform for the debate. 2019 is shaping up to be an exciting year in the industry with diversity and inclusion high on suppliers’ agendas. Our programme of activity ahead of the show will culminate on 3 April, representing the united voice of consumers and demonstrate that inclusivity is a growing trend that should be recognised by brands large and small. We aim to challenge brands to evolve to meet these new industry standards and give practical advice on. For more information on the latest updates visit www.in-cosmetics. APJ

CURRENT MARKET OFFERING IN SKIN MICROBIOME AT THE MOMENT, the market is generally focused on offering prebiotic and probiotic solutions. Consumers are likely to be familiar with probiotics in relation to gut health and live dairy products, although it should be emphasised that when it comes to cosmetics, products contain extracts made from bacteria rather than live cultures. Some brands take a scientific stance with products designed to address specific concerns and benefits, such as reducing wrinkles, while others place the emphasis on nature, overall skin health, holistic lifestyles and green beauty.

From skin microbiome-friendly cleansers and moisturisers, to skin microbiome-enhancing probiotic mists and serums, there is plenty of opportunity to innovate and also to redefine or reposition established products. If you wish to learn more about skin microbiome, attend the APAN AESTHETICS CONFERENCE 27TH May 2019. Dr Tiina Meder from Switzerland will be a keynote speaker address this topic from a clinical and treatment perspective.

inner arm for 5-15 minutes (until the two centre dots change colour) and then photographs it using the My Skin Track pH app on their smart phone. The app reads the pH measurement as well as the wearer’s rate of perspiration “to assess skin health”, provide an accurate pH reading and recommend suitable La Roche-Posay products. Although the sensor only recommends the French brand’s products its core function – pH reading – could be a ‘game changer’ for people around the world with


skin issues such as eczema and atopic dermatitis that often require regular pH testing for effective treatment.

THE WORLD’S first wearable sensor that measure the skin’s pH level was unveiled by L’Oréal at the 2019 Consumer Electronics Show in Las Vegas.

Currently such testing is typically carried out in medical clinics as it requires electronic equipment and large sweat samples, but the new sensor would mean such testing could be done almost anywhere with “imperceptible quantities of sweat”.

Developed by L’Oréal’s Technology Incubator and La Roche-Posay, My Skin Track pH uses “microfluidic technology” to capture trace amounts of sweat through a network of microchannels. The wearer places the sensor on their

L’Oréal Technology Incubator global vice president Guive Balooch says “the scientific and medical communities have long known the link between skin pH levels and

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common skin concerns that millions of people experience every day”. “Our goal is to use this advanced technology to empower consumers with meaningful information about their skin, so that they can find the products that are right for their individual needs.”

solutions to our consumers,” says Balooch. APJ

My Skin Track pH will initially be introduced in 2019 through select La Roche-Posay dermatologists in the US with the goal of amassing new research and ultimately launching a direct-to-consumer product.

THE QUEST to remove plastic containers, that are proven to pollute waterways and the environment is recognised as a global pursuit.

The unveiling of My Skin Track pH follows the company’s launch of My UV Patch (the first stretchable skin sensor designed to monitor UV exposure) and My Skin Track UV (the first battery-free wearable electronic UV sensor) at the same show in 2016 and 2018. “At L’Oréal we know that health is the future of beauty and we are committed to leveraging technology to bring powerful insights and

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Now a new innovating material is set to provide a workable solution. PAPTIC® is a revolutionary new material replacing plastics that is made of sustainable wood fibre suitable for uses where plastic films have previously been the only alternative. The versatility of PAPTIC®, along with its exceptionally-pleasing haptic properties, make the material a powerful tool for environmentally conscious brands. Forging a category of its own, Paptic®

combines the best features of existing materials, for instance high print quality like paper, durability like non-wovens and versatility of textiles. Easy shift to sustainable and reusable also for cosmetic products for retailers and brand owners. PAPTIC® is a 60–85% bio-based, recyclable, next generation packaging material; it offers an unseen combination of paper and plastics’ qualities. PAPTIC® can be converted similarly to paper or plastic, i.e. existing production units can be used. The product is biodegradable or compostable. It is based on up to 80% biodegradable raw materials, with a view to this becoming 100% in the forthcoming product generations and is available in a range of thicknesses, from 30 – 200 micrometres. Furthermore, it is foodcontact approved as it is made of raw materials that are considered safe also for packaging food. For further information visit www.patic.com. APJ









CONTINUING PROFESSIONAL DEVELOPMENT (CPD) PROGRAM Is your professional title trademarked? AS A NATIONAL STANDARDS BODY APAN provides membership opportunity for a diverse range of practitioners and business owners in aesthetics, dermal therapies, cosmetic tattooists, cosmetic nurses and cosmetic doctors. Members are provided with support in a variety of areas including business advice, industrial relations and wage concerns, regulatory compliance, discounted services, access to best practice documents as well as discounts for APAN sponsored conferences and professional development courses.




However, when it comes to assessing your qualifications and confirming and recognising your credentials that activity comes under a separate banner known as ARAP (for dermal therapists and aestheticians) and CTARP (for cosmetic tattooists). This is the formal APAN registration program and it is protected by a national trademark, which means that only those who have successful met the merit criteria will be allowed to use the acronym ARAP (APAN REGISTERED AESTHETIC PRACTITIONER), or CTARP (COSMETIC TATTOO APAN REGISTERED PRACTITIONER). Applicants are required to submit their credentials for assessment and if their qualifications meet with the necessary requirements, they will be awarded the appropriate status, which they can promote in their advertising. APAN will also promote them on the NATIONAL REGISTRY for consumers to access their details on their website.

There is a great deal of unrest among qualified practitioners who have worked hard to gain qualifications for the modalities they are performing, meanwhile there are others who are practicing as dermal therapists, laser and IPL practitioners, or cosmetic tattooists with no qualifications. This is because there is no regulatory instrument to prohibit them from doing do. ARAP and CTRP registration is an industry initiative that objectively assesses practitioner qualifications allowing them to gain recognition from an independent industry peak body acknowledging that they are indeed qualified to perform their professional responsibilities. This recognition sets them apart with an additional level of credibility that they can advertise and promote.

ARAP and CTARP practitioners are now required to provide evidence of their ongoing CONTINUING PROFESSIONAL DEVELOPMENT (commonly abbreviated as CPD). The new CPD program was launched in July this year and full details are now available on the APAN website. The CPD program refers to the process of tracking and documenting the skills, knowledge and experience that you gain, both formally and informally as you work, beyond your initial training. It is a formal record of what you experience, learn and then apply. Professionals who are registered through the ARAP or CTARP programs must complete mandatory CPD requirements in order to maintain their registration.

MAINTAINING YOUR ARAP OR CTARP REGISTRATION To maintain your ARAP or CTARP registration you must complete and provide evidence of your investment in your on-going education and professional development to the accrued value of 15 points per year through educational activities and educational providers that are approved by APAN. You can access this information from the APAN website www.apanetwork.com.

PROFESSIONALISM REQUIRED OBJECTIVE VALIDATION AND EVIDENCE OF ON-GOING COMMITMENT TO CURRENCY OF SKILLS AND KNOWLEDGE. APAN extends an invitation to all qualified professional to submit their qualifications and gain ARAP or CTARP registration. Gain validation of your credentials by a peak industry body that will vouch for your integrity. For further details Ph: 07 5593 0360 or www.apanetwork.com

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SCIENTIFIC NEWS In each issue of the journal, Terry Everitt conveys a few items of scientific interest. In italics are his thoughts on the subject matter of the research study.

FIBROBLASTS – MAKING LIPIDS NOT FIBRE A GROUP from University of California (UC) San Diego School of Medicine wrote a paper discussing how skin ageing deals with fibroblasts developing into fat cells in the skin. Some dermal fibroblasts can convert into fat cells that reside under the dermis The authors uncovered how a protein called transforming growth factor beta (TGF-β) can stop dermal fibroblasts from converting into fat cells, thus providing the possibility of how the skin loses the ability to form fat during ageing. Inhibition of the TGF-β receptor restored the adipogenic and antimicrobial function of the dermal fibroblasts in culture. Zhang, L., Chen, S., GuerreroJuarez, C., ..., Zheng, Y., Plikus, M., &. Gallo, R. (2019). AgeRelated Loss of Innate Immune Antimicrobial Function of Dermal Fat Is Mediated by Transforming Growth Factor Beta. Immunity, 50, 121–136. Doi.org/10.1016/j. immuni.2018.11.003 This misrepresented study has been doing the Facebook rounds implying

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that fibroblasts can make you fat and being part of the immune system. It is known that Dermal fibroblasts do help to resist infection by local

differentiation – some tuning into adipocytes and producing a cathelicidin antimicrobial peptide. This study helps in understanding how this occurs with the TGF-β showing upstream inhibition of this process as the body ages. The study was undertaken on mice in laboratory conditions, so it does not have immediate effect on humans. More study is required as usually is the case to test this theory on human fibroblasts and a long way off before anything is developed that will help modify the process. APJ

HOW SHOULD SUNLESS TANING BE USED? AN AMERICAN study of 2018, of 27,353 men and women 18 years or older found that sunless tanning was most common among young, white, collegeeducated women. It also found that sunless tanners were more likely to indoor tan and report recent sunburn and less likely to use sun protection methods. Study showed that sunless tanning is associated with risky skin cancer–related behaviours. The sunless tanners are used as a tanning supplement to regular sun-based tanning practices, which were not changed. The study showed the use of fake tanning increased the risk of sun damage as sunless tanning products could inadvertently reinforce desires to achieve tanned skin. Dodds, M., Arron, S., Linos, E. (2018). Characteristics and Skin Cancer Risk Behaviors of Adult Sunless Tanners in the United States, JAMA Dermatology, 154(9), 1066-1071. doi:10.1001/ jamadermatol.2018.2054 Not exactly new information yet reminds us that we cannot think that if a client is using a sunless tanning product that they will not get into UVR to increase their tan. Many clients still think that if they have a

Research and Scientific New Developments

little skin protection applied then they are safe in the sun. Sunless ‘fake’ tans are not sun protection. Also do not be complacent in thinking that your client is not going to the suntanning place (thankfully illegal in Australia) however ‘sun beds’ are still being sold in Australia for home use. APJ

AGEING OF THE UPPER LIP THIS MAY not be of major interest for some, but plastic and cosmetic surgeons have long debated the mechanisms that create ageing-related changes in the face: is it ‘deflation’ or ‘sagging’? A new study helps settle the debate, showing significant loss of volume in the upper lip in older adults. This study showed that ageing perioral area is affected with a combination of soft tissue lengthening, thinning, and volume loss. Using magnetic resonance imaging (MRI) scans of 200 adults: 100 women and 100 men; divided into a younger group aged 20 to 30 and an older group aged 65 to 80. Significant lengthening of the upper lip in older adults was found about 19 per cent longer in women and 18 per cent longer in men, compared to the younger group. The older group also had decreased soft tissue thickness of the upper lip: by about 41 per cent in women and 33 per cent in men. Most of the reduction in tissue thickness occurred at the

“alar nasolabial fold” (the area from the lines running from the base of the nose to the upper lip and to the corners of the lips). Ramaut, L., Tonnard, P., Verpaele, A., Verstraete, K., Blondee, P. (2019). Aging of the Upper Lip Part I A

Retrospective Analysis of Metric Changes in Soft Tissue on Magnetic Resonance Imaging. Plastic and Reconstructive Surgery, 143 (2), 440-446. DOI: 10.1097/ PRS.0000000000005190 Ageing of the centrofacial area of the face has been poorly understood with many assumptions of causative factors rather than true knowledge. While it may seem a bit simple, it is the combination of lengthening, thinning, and volume loss, all of which contribute to ageing of the area around the mouth, rather than just one of these factors. This is partly why some dermal filers are not so successful in the area between the upper lip and nose. It is not only about volume as previously thought. These specifics will help to improve evidence-based approaches to facial rejuvenation as different methodologies need to be employed to successfully treat the area. APJ

EXPOSURE STUDY SUPPORTS THE USE OF ZINC OXIDE NANOPARTICLE SUNSCREENS AN IMPORTANT new study from Australia provides the first direct evidence that intact zinc oxide nanoparticles neither penetrate the human skin barrier, nor cause cellular toxicity after repeated application to human volunteers under in-use conditions. This confirms that the known benefits of using ZnO nanoparticles in sunscreens clearly outweigh the perceived risks. Multiphoton images of human skin at a depth of 15-20 nm below the skin surface in volunteers after application of uncoated and siliconecoated zinc oxide nanoparticles suspended in a commercial sunscreen base compared with no

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SCIENTIFIC NEWS product (untreated control). Red and yellow pseudo-colour indicates the presence of zinc oxide nanoparticles in skin furrows. The blue-green colour shows autofluorescence from living epidermal cells, with no evidence of zinc oxide nanoparticle penetration. “The terrible consequences of skin cancer and photo-ageing are much greater than any toxicity risk posed by approved sunscreens,” stated lead investigator Michael S. Roberts, PhD, of the Therapeutics Research Centre, The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, and School of Pharmacy and Medical Sciences, University of South Australia, Sansom Institute, Adelaide, QLD, Australia. Mohammed, Y., Holmes, A., Haridass, I., Sanchez, W., Studier, H., Grice, J., Benson, H., Roberts. M. (2019). Support for the Safe Use of Zinc Oxide Nanoparticle Sunscreens: Lack of Skin Penetration or Cellular Toxicity after Repeated Application in Volunteers.  Journal of Investigative Dermatology, 139, 308-315. DOI: 10.1016/j. jid.2018.08.024 This study reinforces the important public health message that the known benefits of using ZnO nano-sunscreens clearly outweigh the perceived risks of using nano-sunscreens that are not supported by the scientific evidence. Some public advocacy groups have voiced concerns that penetration of the upper layer of the skin by sunscreens containing ZnO nanoparticles could gain access to the living cells in the viable epidermis with toxic consequences, including DNA damage. This has no scientific validity as they use a couple of badly constructed animal studies as their proof. It is true that previous animal exposure studies found much higher skin absorption of zinc from application of ZnO sunscreens to the skin than in human studies and this present study simply reconfirms that Zinc oxide is a very safe ingredient - not totally scientific, yet interesting. APJ

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LEGAL ACTION AGAINST CLINICS SELLING PEPTIDES DIRECT TO THE PUBLIC A REPORT in the Australian Doctor published online December 18th, 2018, by Sarah Wiedersehn, states that the TGA has launched legal action against a clinic for allegedly selling dangerous, prescription-only medicines directly to the public. The Secretary of the Department of Health filed a case against Peptide Clinics Australia in the Federal Court in November, The TGA said the Sydney clinic was breaching the Therapeutic Goods Act by advertising substances, or goods containing substances, included in schedule 4. Peptide Clinics Australia is alleged to have advertised compounded prescription-only therapeutic goods, including ‘peptides’, on its website and other social media platforms, which are both accessible to registered customers and the public, stating that the products were completely safe and would not cause harm. The Court will hear this case early this year. APJ

REMEMBER THAT HEALTH REBATES CHANGES IN APRIL The following natural therapies will no longer receive a private health insurance rebate as part of a general treatment policy:

Research and Scientific New Developments

Alexander technique

Western herbalism


Bowen therapy











Tai chi


This follows the Australian Government’s Natural Therapies review, undertaken by the NHMRC, that found ’no clear evidence’ demonstrating their efficacy. APJ http://www.health.gov.au/internet/ main/publishing.nsf/Content/privatehealth-insurance-reforms-fact-sheetremoving-coverage-for-some-naturaltherapies

FORCASTING WHAT WILL BE NEW IN 2019 COSMETIC MEDICAL TRENDS THIS MIGHT not be my best idea, however, here is a few thoughts on what I think will be the trends in aesthetics this year. LIPS: While not completely new, the surgical lip-lift is getting new life among aesthetic patients, primarily as many are becoming a little disenchanted with fillers, as despite the hype, sometimes, they don’t always work the way you want them to. A more permanent pout is coming. THREADS: Thread lifting will make a return in popularity with new refined materials being available and the techniques have also improved allowing subtle contouring. NEUROTOXINS: USA will see a few new neurotoxins on the market, so Australia will not be far behind. This will be the fourth generation of such products and into the realm of daxibotulinumtoxin A.

DERMAL FILLERS: Dermal fillers will continue to evolve with more becoming available in a very competitive market already. BIOLOGICALLY-ACTIVE INGREDIENTS: What will be different is biologically-active ingredients. I still hope the biggest change will be even more focus on safety. Not only as a result of the Brazilian butt lift and the mesh problems in the surgical area, but in the cosmetic medicine area also. I think a greater response from regulators will help educate the public about potential dangers of going to inexperienced, or unqualified providers for cosmetic treatments, no matter what their qualification may be or supposed to be. Manufacturer and supplier training will remain paramount and essential, yet will not be enough for more and more educated consumers. Ever increasing products and equipment will continue to confuse in the anti-ageing armamentarium.


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WINNING STRATEGIES FOR BOOSTING SALES IN A SALON ENVIRONMENT REGARDLESS of your budget, there are always ways to increase your sales and grow your business. But one of the trickiest aspects is increasing your sales when your budget is tight. However, with a few innovative ideas you can increase sales without the need for expensive advertising. One of the best ways to achieve this is through existing clients who already trust you. Below are seven ways you can boost your small business sales figures: 1. Talk to Your Current Clients Your current clients are one of your best resources for increased revenue. It’s much easier to upsell a client who already is familiar with your work, the quality of your product and services, and has an understanding of what to expect from you and your business. If you’ve built a relationship with

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your clients, and they consider you a trusted partner, then they are more likely willing to share with you and further needs they may have. By listening, you will be able to identify and provide them with solutions. Often a client will come to you about their skin, but they may also be concerned with losing weight or improving their body shape. Look at ways that you can address other concerns they may also have. This can be a wonderful way to grow your relationship with them while also increasing your revenue. So, find creative ways to promote a new service or product to your existing clients. Study their needs and wants and expand your offerings by introducing a new treatment or product with a special offer component - just because they are a VIP client. 2. Bundle Your Products and Services Many salons or clinics either sell a product or a service to their clients, however, be innovative and bundle products and services as a package

rather than individual offerings. Many salons are finding this strategy very successful. Clients equate a bundle of services with savings, even if the savings are nominal, making it a much easier sell for you. If possible, try to keep your bundles somewhat flexible; a potential client may seek to gain value by adding something else to the mix. If you can stay flexible enough to swap out different products or services to align with multiple needs, you’ll find success. 3. Ask for Referrals Your current clients are also a great asset in providing you with client referrals. If you know that a client is satisfied and happy with your products, ask them if they mind providing you with a quote that you can use in your marketing. The key is to ask for this as soon as someone is extremely happy with a service you have provide them. This is also a great time to ask them if they mind referring a friend or colleague and offer them an incentive by way of a gift voucher if you can secure an appointment from their referral.

Business & Legislation, New Tools and Research Outcome

4. Have a Limited-Time Sale or Promotion In our industry it is not considered a good ideal to discount services, however, products are a different matter. Create a seasonal theme package and give it a creative idea e.g. Pre-Winter Skin Tonic Package. Approach your supplier and ask them to help you by providing you with a special package price. Make sure to clearly define the parameters of the sale, including start and end dates. Also include an end date for special promotions to create urgency in purchasing. 5. Listen This is perhaps the simplest and most overlooked tactic when trying to boost your sales. Listening to your clients or potential clients is the best way to understand and address their needs. Without open communication, the chances for misunderstandings and frustrations arise. Make sure that you and your team understand how to actively listen, ask leading questions to get more information and gently brainstorm solutions with clients. 6. Staff feedback Your staff are constantly interacting with your clients. Create a feedback reward program with your staff. Each month at a staff meeting the staff member that comes up with a best marketing idea based on their experience from client feedback will win a reward. It could be a couple of tickets to a movie, or a gift of your choice – the key issue is to engage your staff to come up with ideas that they believe will work. 7. Use Social Media to Your Advantage If you have even a small following on Twitter or Facebook, using social media to promote and tout your product offerings is a great way to raise customer awareness and quite possibly get the phone to ring. Additionally, don’t just view social media as a sales tool, but as an open line of communication. Use it to disseminate interesting industry information, retweet or repost articles of particular significance or further illustrate how your business works, perhaps with behind-the-scenes photos or videos. Social media is first and foremost social; use it as a personal touch point to your audience. APJ

TO RAISE OR NOT TO RAISE YOUR PRICES? IT IS NOT uncommon in our industry for salons to have had the same prices year-in, year-out. Each year you should review your prices and consider your costs and expenses. You will not survive if you are no longer making a profit, or worst still, not making ends meet. If after a close examination it becomes imperative to you to increase your prices then there is a right and a wrong way to do it. Raising prices is not something that should be taken lightly. Be sure to analyse the pros and cons of increasing your prices for both the short-and long-term. Here’s an idea: Announce the increase to your current clients. Give them the chance to purchase products and services before the increase takes place. This will not only give you an opportunity to increase your sales, but it will make your clients feel that you are looking after them giving them a chance to invest in your services prior to the increase. It will also allow them to appreciate the value of your services. APJ

BUILDING BRAND LOYALTY IN A DISCOUNT OBSESSED MARKET THERE IS NO doubt that the Internet enables people to be as leisurely or proactive about researching a purchase as they want before actually making the decision. Countless websites offer hard-to-turn-down time sensitive discounts to drive sales, while price comparisons are at consumer fingertips, "flash sales" perpetuate an on-line shopping trend encourage fickle consumer buying behaviour in today's market. According to a recent study at Rice University 40 per cent of businesses would not offer another Groupon deal again and many companies have noticed that this new wave of online shopping does nothing to encourage brand loyalty. For companies and brands looking to attract a large number of new customers, Groupon and similar flash sales may seem like a tremendous value, but how a company converts those dealseeking clients into brand loyal

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TIPS FOR BETTER BUSINESS customers is critical. The online shopping trend conditions consumers to only make a purchase if there is a deep discount. The result is a value-obsessed economy where consumers have no incentive to be loyal to any particular brand.

that you are listening to their concerns and constantly looking at ways of improving. A business that appears to be proud of constantly evolving for the better is one that will never become mundane, or boring to visit and engage with.

Consumers are expecting the same value from brick and mortar establishments that they can find online, even though that deal online was exactly as it was advertised - a short lived, first-come-first-served, and sometimes offered within a frustrating window of opportunity. Whether businesses like it or not, these shopping experiences are setting the bar for how people perceive value. The mindset is becoming “If I found it once, sooner or later, I’ll find it again at or below the same price.”

Make sure that your clients know that you respond to their demands. If you want your clients to come back, give them what they want!

Brand research experts are identifying ways to navigate this issue everyday so they can build brand loyalty, while increasing revenue as well. Here are a few tips to keep in mind:

Give them a reason to come back Provide incentives for clients to return to your salon or clinic instead of the competition. Create programs that reward loyalty to your brand. Consider giving insider access, special status and other non-monetary driven incentives. Everyone wants something that cannot simply be purchased, provide some privileges and create some cache! Stay relevant Are you up-to-date in your services with new advances? Keep a close eye

Provide Value How much does the first repeat purchase mean to you, how much do you value the third transaction and is it worth losing the fourth potential purchase to a competitor? The answer is that client loyalty is invaluable and no, you don’t want to lose them to the competition. Create a plan to give a percentage of loyal clients’ cumulative spending back to the client in some way. Whether it is through phased in discounts, complimentary shipping, gifts with purchase, or if a bonus service, always find a way to create added value. Show your appreciation This is one of the most important of all. If you forget to say a simple Thank You this could be a deal breaker. Wish your clients Happy Birthday, Celebrate their achievements with them. Wish them Merry Christmas and a Happy New Year. It may sound unnecessary, but studies reveal that it is the accumulation of these little interactions that can make a client feel appreciated and continue their transactions with you. APJ

Keep your quality high Depending on the price of your products or services there is an expectation for a certain level of quality from the marketplace. Stay consistent in the quality of your goods or services. People will go back to what they know they can count on, don’t let them down. Engage your clients Keep in touch with your target market on a frequent and consistent basis. Let them know about the new and exciting developments within the company and what to expect next, build momentum through communication and let your clients feel involved in the happenings of your business. Solicit your client’s feedback Stay in touch and engage with your clients. Ask their opinion of your business, did they like their most recent experience with you, were they satisfied with the client service, did the product or service meet their expectations? Let them know that you care about their experience and

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on new developments in your industry and explore current trends on both services as well as client approach. If your marketing and communications strategy isn’t relevant to what your clients are now looking for, then your message provides little or no value and falls on deaf ears.

HOW TO MAKE YOUR BUSINESS’S HOMEPAGE STAND OUT RECENTLY, THE government released the top eight mast-have items for every homepage to make your website a success.

Business & Legislation, New Tools and Research Outcome

The homepage is the most important page of your business’s website. It is the virtual shop front to your business, providing your clients a first impression of what you have to offer. You only have seconds to grab your client’s attention so it is key to make sure that they can find what they’re looking for quickly and easily. Here are the eight essential items and design features to include on your homepage. While you’re free to be creative with the design of your homepage, there are some standard items that a user will expect to see when they arrive at your website. Branding Branding can be in a name, sign, symbol, slogan, words or design, or a combination of these elements, that identify the products or services of your business and help you stand out from your competitors. •

Site Search function • Add a search function on your homepage to help users find information on your website. •

Place the site search box in the middle or to the right of the header where users are more likely to find it. Colours and borders can help the site search box stand out on the page.

Call to action (CTAs) A call to action is an image or text that prompts your user to take some form of action. •

What do you want your users to do on your site? Do you want them to place an order, subscribe to a newsletter, register for an event or request a quote? You can use CTAs to direct your audience to areas of your website where they can perform an action, whether it is to sign up, register or subscribe.

Ensure your brand is easy to see on your homepage and include your business logo and headline at the top of the page. A headline tells your visitors what your business has to offer.

Create a great headline for your business by writing down the key points you want to communicate about your brand. Keep the message clear and simple. Don’t forget, your brand is your promise to your customers so make sure you can deliver what you promise.

Site Navigation A good site navigation will help clients to find the different areas in your website.

In order to keep your brand consistent, make sure that the look and feel of your website is similar to the look and feel of your printed materials and branding (e.g. brochures, menus, advertisements, letterheads).

Contact Information • Make sure your customers can find you or get in touch with you by having your contact number, address, email address and/or contact us form easily accessible and visible on your website’s homepage. •

provide an online map directing customers to your business.

If you have a physical shopfront, make sure you include the hours and days of the week you are open, and

Ensure the CTA stands out from the other content on the page. You can have it in a colour that makes it stand out from the colour scheme of your homepage.

Include a clear and simple site navigation bar to link to the different pages on your website. If your website is very detailed, you may just link to the primary pages.

Place your site navigation bar either at the top of the page or down the side of the page so it’s easy for customers to find.

If your site contains a large number of pages, you may look into using a drop- down menu for your navigation bar.

Images • An image or short video on your homepage that clearly shows what you offer can make your site more attractive to your audience,

enhance the user experience and help with the overall branding of your business. •

Don’t use images just to fill white space, make sure the image matches the content on the page. Users pay close attention to images that are relevant.

Make sure your images and videos are of high standard as the quality of the images can affect how your users perceive your website.

Typography Typography is the visual component of the written word, the art and technique of arranging print. •

Use a couple of fonts that are consistent with your brand’s voice and tone. Too many different fonts and sizes can make your website look cluttered causing confusion.

Be consistent and use the same font and typeface in both your digital and printed material so customers immediately recognise your brand.

Make sure there is a strong contrast between the colour of your text and the colour of the background, so the text is easy and comfortable to read and meets accessibility standards.

Making your text in italics or bold can also cause your content to be difficult to read on some screens.

Content • As website users generally scan pages, your content needs to be easy to read and direct. •

Use short paragraphs on your homepage and try to bring your message across with as little words as possible. A short paragraph on your homepage summarising your business and products and services can help grab your customers’ attention.

Make sure your content is relevant, and speaks the language of your customers.

Keep the important content near the top of the page so

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TIPS FOR BETTER BUSINESS information isn’t lost on smaller screens. Build a great first impression Make your first impression count! A clean and appealing web design, which is easy to navigate and highlights the key points of your business, can better attract customers than a website full of irrelevant information. If your audience can’t identify what it is your business can offer, they won’t stick around. APJ Ref: www.business.gov.au

ARE YOU PAYING YOUR STAFF THE CORRECT RATE? THERE ARE several business owners that may start out as a sole practitioner, but as their business picks-up they decide to employ staff. Many may not have gone through this process and they need guidance in making sure they are paying their staff correctly. There are several owners that choose to engage professionals on a contractual basis. The problem with this option is that there is criteria that they must abide by. But why are contractors so popular?

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As businesses look for lower overheads and greater flexibility, contracting appears to be a great solution. In theory, employers can hire the resources they need, when they need them, without taking on the associated infrastructure and taxation overheads required for permanent employees. In Australia, that means employers of contract workers don’t need to meet pay-as-you-go (PAYG) tax, payroll tax, fringe benefits tax, workers’ compensation insurance or the superannuation guarantee. 

It sounds like a no-brainer, but there’s much more to consider than just whether a contractor should be issued an invitation to the staff Christmas party. Nick Ruskin, partner at K&L Gates and employment law and labour relations specialist, says the so-called “gig” and “sharing economies” are legal minefields that need to be carefully navigated. “We have noted a greater proportion of people are being placed into [agreements] which are not employeremployee arrangements,” Ruskin says. “I don’t think the law properly accommodates the changing nature of

work in Australia or, indeed, overseas.” As the number of independent contractors continues to rise, so too does close scrutiny of it by watchdog agencies such as the Fair Work Ombudsman and the Australian Taxation Office. APAN CAN HELP As part of member services, APAN offers Gold and Platinum Members full Human Resource Services. This includes advice on Wage Awards and assistance with the interpretation of a wage classification. With the support of Pointon Partner Lawyers, APAN can provide you with

accurate and timely advice to ensure that you are not in any breach in this area of your business. Additionally, we also have over 40 resource documents and templates to help you run your business efficiently. These areas are highly specialised and they are governed by Fair Work so it is important that you ensure that you are operating within the appropriate guidelines. If you need any assistance in this area please contact APAN. This service is available to you for free if you are a Gold or Platinum Member. APJ

APAN’s standards recognition program now linked to continuing PROFESSIONAL DEVELOPMENT (CPD) PROGRAM As of July 2018, the CTARP and ARAP programs are now linked to a more comprehensive Continuing Professional Development (CPD) Program.

‘Let your credibility be your competitive advantage’



Practitioner Clinical Associate Educator Master Educator

Who can apply: • • • •

Aesthetic practitioners Dermal therapists Dermal Clinicians Educators




• • • • •



For further information visit www.apanetwork.com/arap and complete an online Application Form.

There are five ARAP registration classifications:

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APAN AESTHETICS CONFERENCE 2019 We believe the new format will provide you with a stronger two-pronged approach:


123 Collins St, Melbourne VIC

16 DYNAMIC LECTURES ‘Exciting New Conference Program’

• Global education on the latest scientific and industry advances • Practice-based solutions • • • • • •

Latest scientific research Regulations Technology Consumer Trends Leading business Strategies Industry advances

MELBOURNE Monday August 12 07 5593 0360 info@apanetwork.com www.apanetwork.com APJ 124


@apan.page #apanconf

Profile for APAN - Aesthetics Practitioners Advisory Network

APJ Vol 40 2019  

Aesthetics Practitioners Journal Volume 40 Autumn 2019 - The official publication of the Aesthetics Practitioners Advisory Network (APAN)

APJ Vol 40 2019  

Aesthetics Practitioners Journal Volume 40 Autumn 2019 - The official publication of the Aesthetics Practitioners Advisory Network (APAN)