CYBER LADY SKINCARE WITH AN ATTITUDE The face of our brand, Cyber Lady, is a persona created by the fabulous contemporary artist Sasha Frolova. We are honoured to have her as our ambassador and to support her creative efforts any way we can. Cyber Lady represents everything we stand for: intelligence, confidence, creativity, technology, and vision. She is also a creature without age or race. We do not believe in ageism, objectification, exclusion and peer pressure, so common in the cosmetic industry. Instead, we embrace beauty that comes in all shapes and colours and in each and every age. Meder Beauty Science can say with confidence that our products, without exception, are suitable for all genders, all skin types and all age groups. No compromise in quality standards also means no discrimination in market strategy. We don’t care if its unconventional. Meder Beauty Science is proud to be different - in every way.
MEDER BEAUTY SCIENCE THE TRUSTED BRAND FOR PROFESSIONAL, ADVANCED AND TARGETED SKIN THERAPY RESULTS Manufactured in Switzerland under the highest qualityassured standards.
CLINICALLY PROVEN PRE & PROBIOTIC FORMULATIONS Meder Beauty Science offers 6 easily marketable professional treatments to provide solutions for the most widespread, aesthetic problems. The combination of organic plant extracts and the latest biotech ingredients make Meder Beauty Science one of the few truly effective clinically proven cosmeceutical brands in the global market.
MEDER BEAUTY SCIENCE guarantees you excellence in treatment outcomes.
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IN THIS ISSUE AUTUMN VOLUME 46. 2021 REGULATIONS, STANDARDS AND EDUCATION
CAN MY EMPLOYER REQUIRE ME TO GET A COVID-19 VACCINE
GLUTATHIONE: ITS ROLE IN SKIN, HEALTH AND IMMUNITY
DERMAL NEEDLING IN COMBINATION WITH RADIOFREQUENCY
PANDEMIC INFECTION CONTROL COURSE
SCIENTIFIC RESEARCH, TREATMENTS AND TECHNOLOGY 14-15
COSMETIC MEDICINE & BEAUTY TRENDS FOR 2021
ACTIVATING THE VAGUS NERVE WITH ESSENTIAL OILS
22-24 HIDRADENITIS SUPPURATIVA
32-33 THE MAGIC OF SKIN MISTING
LIVE APAN AESTHETICS CONFERENCE
96-97 CLINICAL STUDY POINTS TO OXYTOCIN’S ANTIAGEING BENEFITS
76-78 WHY ELECTROLOYSIS IS BECOMING CENTRESTAGED IN PERMANENT HAIR REDUCTION
THE OZONE PARADOX
HOW DOES EXERCISE IMPACT THE SKIN?
HYALURONIC ACID INTERNAL AND TOPICAL USES
BUSINESS, PERSONAL AND PROFESSIONAL DEVELOPMENT 30
THE SCOOP ON FACEBOOK AND INSTAGRAM STORIES
COFFEE AND ITS AFFECTS ON THE SKIN
58-60 PSORIASIS - A COMMON AFFLICTION
MOTHER’S DAY COMPETITION
IS YOUR BRANDING ACCURATELY COMMUNICATING IN THE MARKETPLACE
TIPS FOR BETTER BUSINESS
INDUSTRY REPORTS, NEWS, PRODUCTS AND COSMETIC MEDICINE 18-20
THE POTENTIAL COMPLICATIONS OF FILLERS WITH THE COVID19 VACCINE
SKIN ENERGY CELEBRATES ITS FIRST ANNIVERSARY
26-28 A LIFE DEDICATED TO COSMETIC TATTOOING
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102-105 SCIENTIFIC NEWS
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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.
Dr Giulia D’Anna
EDITOR’S LETTER I am super excited about 2021. We have so much to look forward to now that the diabolical year of 2020 has passed us by. We have the COVID-19 vaccine rolling out across the world, and I truly hope that the world becomes a more predictable and “normal” place to be. During the ups and downs, I have loved seeing our industry band together to help each other through the tough time, particularly in Victoria, where I am also based. The support has been truly humbling to witness and I applaud all of you. Some great initiatives were put together by APAN, including the Salon Hub Australia Directory, where you can list your business for FREE. If you haven’t registered yet please do so, it is very easy www.salonhubaustralia.com you can also update your registration as you wish. Please include your business as we are planning some media activity to promote this site to the public.
The Pandemic Infection control course is a world-class education program that really sets you apart. Written by leading authority in immunopathology, Professor Laurie Walsh, this course allows you to gain amazing new information about the behaviour of pandemics and why and how to ensure your full compliance to safety during this unprecedented time. I look at 2021 as a year of opportunity. Having missed out on almost nine months of treatments, our clients are hungry for skin correction and preventive treatments once again. Zoom-phobia and Maskne are real and as we all head back into our workplaces to take care of our clients who want to look their best. In my practice, I have had many clients that are looking for subtle tweaks to improve their skin health and proportions, I am sure that you have all seen this too. In 2021, APAN is planning a brilliant conference on June 28-30. There are some inspiring speakers that will be presenting information that is cutting-edge, and of-the-moment. Taking off from the very successful 2020 conference, this year looks to be even better, and I am looking forward to seeing you virtually for this one. There are further exciting announcements yet to be made, and I cannot wait to see them unfold as we prepare the launch of another website totally dedicated to an amazing library of articles for you to access. And don’t forget, as an APAN member you have the opportunity to have your clinic featured on the APAN socials as well as in this journal. Reach out to Lauren and let her know you would like to be featured. We love hearing about our members, your niche and clinic vibe. It is so inspiring to hear your unique story and achievements, and going by the feedback, so do our readers. Please check these out in this issue of APJ as well as the amazing educational articles that you will only find in APJ Journal.
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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.
Katherine McCann has moved to her new dual position within APAN. Her new title will now be Regulations and Standards Advisor and Press and Media Liaison. Additionally, Katherine will continue to contribute to APJ through articles on Cosmetic Tattooing as this is an area in which she is truly an expert.
Gay Wardle is a well-known multiawarding 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.
Jacine GreenwoodDrummond 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.
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We are delighted to welcome Deb Farnworth-Wood as our new business expert. Deb will be sharing her wealth of knowledge in each issue of APJ.Her column - Wisdom in Business will present valuable, business-boosting tips. Deb is a leading figurehead and business development expert with amazing achievements, also within our industry. She has an incredible reputation as a serial entrepreneur. Expect to gain winning strategies from this amazing woman.
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.
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Tina Viney APAN CEO
Dear colleagues and friends, THE PAST FEW MONTHS have seen several positive changes as we are starting to see the industry settle down as businesses are starting to identify their direction. The level of resilience that we are seeing in so many of you has been truly inspirational, as you go beyond survival to finding new ways to adapt and move forward. In the previous two issue of APJ we featured just a few of these women who are making a difference within their communities. They are moving beyond fear and uncertainty and stepping up to provide a new level of care and service that is creating positive change even with their most demanding clients. It has been so inspiring to see how they are responding positively to their challenges and focusing on new solutions that will best serve the new environment that they have found themselves thrust into. REDEFINED STANDARDS It is interesting, but when businesses renew their values, and redefine their position in the market, they also see the need and seek the support of an independent industry body for guidance and help. They want their values to be benchmarked against professional standards that reflect integrity and best practice at the highest level. While they seek to be different, they also see the need to be part of a stronger umbrella that defines and gives acknowledgement and recognition to standards, as well as offer on-going support to them. This is the role of industry bodies that have in place clearly defined code of ethics, code of practice and best practice standards. We are so mindful of both immediate and long-term industry need. As a result APAN is constantly updating our documents, reviewing our Code of Ethics and Code of Practice, and providing recognition for standards and qualifications. Our ARAP and CTARP Registration programs have been popular, while the demand for our resource documents has been consistent, helping businesses step up their back end and refine their operations in line with industry best practice and mandatory regulations. Our latest addition to our resource documents has been two Sole Practitioner Contracts – one for renting a room and the other for engaging a practitioner to deliver services under their own ABN. There are laws that govern both these arrangements, and it is important that you are fully compliant with these when contracting someone to engage with you or in your premises.
NATIONAL AND INTERNATIONAL ALLIANCES No-one is exempt from the need to constantly grow and continue to improve and even more so, industry representative bodies. I have always been a strong collaborator especially with bodies that reflect our ethos and values and from whom we can both learn and benefit from the exchange of resources, knowledge, and experiences. Recently, we have established some strong industry alliances that I am excited about and would like to share with you: New Zealand Board of Professional Skin Therapists (NZBPST) On the international front, I am pleased to report that several weeks ago, we have been approached by the NEW ZEALAND BOARD OF PROFESSIONAL SKIN THERAPISTS (NZBPST) with a view to establish a strategic alliance and share education, strategies, and resources. We are impressed with the ethics and values of this industry body and their commitment to advocacy for their members’ needs with their government, as well as in defining and establishing industry standards, improving education, and supporting best practice through the introduction of appropraite documentation. APAN and NZBPST have established a strategic alliance and we plan to share our knowledge and resources and support each other. Their members will also be encouraged to attend our ONLINE AESTHETIC CONFERENCE and we look forward to introducing some of their advances within our organisation. International Professional Standards Network (IPSN) Another professional body is the INTERNATIONAL PROFESSIONAL STANDARDS NETWORK (IPSN) for which we have been appointed as their Australian agent. This body is a little different. Its purpose is to review formal qualifications from various countries and benchmark them against set criteria, to determine if they meet with the internationally agreed standards. Australian qualifications that have met their criteria are for Beauty Therapy and Hairdressing, however they are also, looking at other professions. Those who meet the set criteria will be allowed to be awarded IPSN international qualifications recognition across the nations that are IPSN accredited. At this stage for beauty, the Australian Diploma of Beauty Therapy Level V has been mapped and approved. This will mean that graduates who hold this qualification as well as meet additional IPSN requirements can apply for International Certification. IPSN has also invited me as a
“The secret to change is to focus all of your energy, not on fighting the old, but on building the new” - Socrates guest on their board, and it will be my honour to learn and provide my support with strategies to help the organisation gain further global recognition. Australian Society of Dermal Clinicians (ASDC) On the home front, I can confirm that we have established a professional alliance with the Australian Society of Dermal Clinicians (ASDC) and we are working collaboratively with them to support the recognition of qualifications and standards in dermal therapies and for degree qualified clinicians, as this sector of the industry moves forward towards being formally recognised under the umbrella of allied health. Additionally, we are working together in the regulatory space as our industry fights for more stringent guidelines especially, in the practice of laser and IPL for cosmetic purposes. Cosmetic Nurses Association (CNA) The other body that we have been approached to collaborate with is the Cosmetic Nurses Association (CNA) as they seek to define and establish standards of best practice for their profession sector. Aesthetics and Beauty Industry Council (ABIC) There is also another body that is about to be launched in Australian, the Aesthetics and Beauty Industry Council (ABIC). While still not launched at the time of writing this report, representatives of this organisation have held several discussions with APAN to review potential collaboration once they are established. We will investigate ways that we can work together to strength the industry’s voice for positive changes. THE POWER OF ETHICAL CODES The shift toward the recognition of industry bodies in recent times is becoming centre-stage. This is an important move and professionals should seek to belong to the body they believe will best serve them. However, membership should not be just about paying a fee and getting a certificate. They need to also take on board and pledge to the ethics and values that define an industry and that aim to bring harmony and order in a chaotic world. I am sure that many in the industry do not fully understand the power of a Code of Ethics. The APAN’s Code has been carefully researched and defines conduct against five specific areas, supported by articles of required conduct:
Education and Compliance
Business and Financial Dealings
This code, when adhered to, has the potential to minimise misunderstandings, conflicts, insurance claims, staff/ management disputes and client disputes, as well as legal and regulatory violations. How important are these areas to a business? If you are not already a member of APAN please seriously consider joining. You can access further information from our website. By joining our professional community of practice and standing by our values and ethics, you are helping to strengthen our industry voice, as well as promote yourself to the public as a committed professional who complies with industry and regulatory standards. AESTHETICS CONFERENCE EVENT WITH A DIFFERENCE The time is coming close to the launch of our next online aesthetic conference. If you haven’t registered yet, I urge you to please do so now. The feedback last year was incredible, as so many of you stated that you enjoyed the option to revisit a session of interest and take further notes, something that you cannot do with a live event. The aim this year is for 35 speakers. We are carefully selecting them for their knowledge and experience on a diverse range of topics. What is totally unique, and of great value about this event is that all 35 lecture sessions will be available on our website for you to revisit and access specific information that you need for a full month. This is a very costly exercise for us, but we are about empowering you with quality education and it is the best way for us to ensure we also provide you with a level of flexibility in being able to revisit the session and gain maximum benefit from this event. Please note APAN needs your support to survive. Please join us and take advantage of the many benefits that are design not for our benefit, but for yours. United we stand. Tina Viney
A Woman With a Vision Vita Catanzariti, owner of Dolce Vita Skin TWENTY-FIVE YEARS AFTER STARTING HER CAREER in skin and dermal therapies, VITA CATANZARITI is delivering a blend of amazing procedures that offer more than a touch of La Dolce Vita to clients at her luxurious medi-clinic on NSW's Central Coast. Vita opened the doors to DOLCE VITA SKIN, a premium destination specialising in holistic and medically supported treatments, just three years ago, but has already attracted a loyal clientele due to her ability to deliver complete and highly customised treatment plans for premium results for every client's skin. Indeed, Vita and her team (cosmetic injector Dr Nik Davies, dermal therapist Kylie Alexander, nutrition, and wellness consultant Chiza Westcarr, registered nurse Rhianna Catanzariti and front-of-house team, Kaitlin and Tiarne, are committed to offering clients not just a quick fix, but a lifetime of beautiful skin. “What we offer our clients is a comprehensive treatment approach that does not just focus on one thing, but incorporates, skin, nutrition, health, and wellness strategies, as well as injectables and hair restoration through a multi-disciplinary holistic approach. "Every DOLCE VITA SKIN client is treated as a whole person from the moment they step into the medi-clinic," she says. "At the initial consultation we spend a lot of time getting to know our clients. This allows us to gain a comprehensive understanding of the factors that have impacted and contributed to their skin health concerns such as, diet, lifestyle, health, stress, etc. By gleaning this information, we can then devise a customised skincare plan that will deliver the results they are seeking. "I'm never going to tell a client that they need to have a series of a
particular treatment just because it is available, instead, I aim to create a realistic plan for them that will work within their specific concerns, lifestyle and budget." Locally renowned as the skin whisperer, Vita is convinced that getting to know her clients and their needs before performing any treatments ultimately benefits them, as it also helps them make sense of the treatment options we recommend. "There are so many different skin treatments available nowadays that most people are overwhelmed and don't know what option, or combination of options, is best for them. “We take the guesswork out of those decisions and give them a professionally-devised treatment plan for their skin journey that will allow them to achieve the optimal results that they are seeking. Vita also believes the planning process is where she develops trust between her clients and and her. “From the initial consultation I want them to know I am genuinely interested in helping to improve their skin's health and that I view and value them as an individual." And, according to Vita, forming a relationship is important if trust is to be established in her professional recommendation. “From there on, it is our commitment to the personalised service that is consistently delivered by our expert team that ultimately drives our client loyalty,” Vita stresses. VITA’S PROFESSIONAL JOURNEY Vita's own commitment to skincare began when, as a teenager, she
And so DOLCE VITA SKIN was launched. It was this confidence in being able to effectively transform clients’ skin that is the critical factor behind DOLCE VITA SKIN’s success story. "While it is important for us to gain the education and the skills needed to achieve results, this must be combined with a personalised care program for each client. In that way we can foster and ensure the loyalty of our clients as they come to value, appreciate, and trust in our ability to deliver the outcomes they are looking for. From there on, you are on your way to success,” she says.
Venus Versa™ TRIBELLA An exceptionally versatile nextgeneration system for today's top aesthetic treatments offering a selection from up to 10 different applications in one multi-treatment workstation. Vita Catanzariti, owner of DOLCE VITA SKIN attributes many of the beautiful skin treatments results that she can achieve to the amazing technology. Of Venus Versa™ Tribella. Distributed by Venus Concept Australia, the Venus Versa™ Tribella will allow you to raise your skin treatment outcomes to the next level. Here is what it offers: TECHNOLOGY Venus Versa™ combines three unique, highly effective technologies in one workstation for true versatility. The device can be customised to grow with your practice—start with one set of applicators and add more as you grow to maximise the treatments you can offer at your practice. Venus Versa™ can also be easily moved between treatment rooms, making it the ideal system for locations with limited space. underwent treatments for her own skin problems. This experience led her to undertake studies as a beauty therapist. After completing her education, her career in the industry began at the Panacea in Wahroonga. Following this, she moved to the Crowne Plaza day spa in Terrigal where she was hired as a beauty therapist before leaving to set up a skincare service at Dr Gazi Hussain's plastic surgery clinic. “I continued my education and undertook further studies in cosmetic dermal science including pre-and post-operative care and laser treatments. These studies and working within a surgical environment, expanded my knowledge and experience on how to strengthen the skin's integrity before surgery and then help it heal post-surgery. "I very much enjoyed the 13 years I spent working alongside Dr Hussain and other plastic surgeons, as it gave me the opportunity to witness an array of skin procedures and ultimately, I gained the knowledge and skills to effectively manage a multitude of skin concerns," she recalls. "There is no doubt that this experience taught me a lot. It also helped me develop a clear vision for my professional direction and what sort of services I wanted to provide clients, but the only way I could make this a reality was to establish my own clinic. I was now confident in my ability to step out and make this happen."
INTENSE PULSED LIGHT (IPL) WITH SMARTPULSE™ Photorejuvenation/photofacial, acne treatment, hair reduction •
All IPL applicators include innovative SmartPulse™ technology to ensure precise and consistent energy delivery through advanced pulse optimisation.
Pulses of broad-spectrum light are selectively filtered and delivered into the skin, where it’s absorbed by target chromophores and transformed into therapeutic heat.
For photorejuvenation/photofacial, target chromophores are oxyhaemoglobin for vascular lesions and melanin for pigmented lesions in the skin.
For hair reduction, target chromophore is melanin in the hair shaft.
For dual-light acne treatment, blue light targets the porphyrin produced by Propionibacterium Acne bacteria, leading to destruction of the bacteria, while the longer wavelength of red light controls inflammation and promotes faster healing.
Real-time cooling system monitors the light guide temperature 1,000 times a second for unparalleled patient safety and comfort.
NANOFRACTIONAL RADIO FREQUENCY (RF) WITH SMARTSCAN™ Skin resurfacing •
Designed to resurface the skin, which helps reduce the appearance of acne scars, traumatic scars, striae, rosacea, dyschromia, deep wrinkles, enlarged pores, and uneven skin texture and pigmentation.
Tip is one of the largest spot sizes in the industry and delivers up to 700 pulses.
Energy is distributed through small footprint per pin (160 x 38 µm2) at variable energy densities in a single tip, reducing the risk of post-inflammatory hyperpigmentation (PIH)1 and leaving sufficient intact tissue in between, for faster wound healing, uniform post-treatment tissue appearance, and low downtime.
SmartScan™ uses a unique algorithm and pattern selection technology that enables the operator to generate customised patterns for greater flexibility and control during the treatment.
(MP)2 TECHNOLOGY Body contouring via cellulite reduction, skin tightening, and wrinkle reduction. •
Unique combination of Multi-Polar Radio Frequency (RF) and Pulsed Electro Magnetic Fields (PEMF).
Multi-Polar RF uses a complex algorithm to deliver homogeneous energy and volumetric heating to multiple tissue depths, allowing for quick and safe build-up of heat and easy maintenance of therapeutic temperature throughout the treatment.
Effect of Multi-Polar RF is enhanced by PEMF, a non-thermal mechanism emitted through the applicator’s electrodes.
Through synergistic (MP)2, RF heats and directly stimulates fibroblasts, while PEMF is known to promote angiogenesis and induce fibroblast proliferation through release of the growth factor FGF-2, resulting in increased collagen synthesis2.
(MP)2 is therefore effective in collagen-remodeling for body contouring via skin tightening, cellulite reduction, and wrinkle reduction*, and the creation of new capillaries for renewal of blood supply.
The three technologies can each be used separately, but when combined, they can achieve exceptional results for several treatment objectives, including anti-ageing skin rejuvenation, acne, hair removal, skin resurfacing, body contouring, circumferential reduction, skin lightening and wrinkle reduction treatments. This workstation is best renowned for its 3-in-1 treatment, which allows you to step-up your results in enhancing skin tightness and tone, while also improving skin texture. Vita, who only purchased the workstation a year ago, has already achieved amazing skin transformations on numerous happy clients. "I love the Tribella treatments,” Vita said, “as through its amazing multi-faceted capabilities, is able to deliver exceptional results in a fast and efficient manner. This also appeals to my clients, who are often time poor, but still seek incredible results. “The beauty of this tri-phase technology is that it can target the various layers of the skin in the one treatment. There is no need to tell your client, “we can do IPL photo-rejuvenation in one appointment, you then must return in three weeks for a DiamondPolar treatment and after another three weeks you will need to return for the NanoFractional RF,” Vita said.
After “Additionally, clients also really appreciate that the Tribella treatment does not require much downtime. “If their skin is wellprepped, through the use of active ingredients for a period of time, most can still go to work the next day,” Vita confirmed. Although Venus Concept Australia recommends a series of three Tribella treatments followed by a maintenance treatment every six months for optimal results, Vita has performed the treatment as a "one-off" on clients who just wanted the wow factor for a particular occasion, or as a simple boost in their normal skincare routine. In fact, you can still achieve wonderful boost to your results with a single treatment. "I had a gentleman who just wanted me to treat some spots on the side of his face," she recalls. "I told him he would probably need three treatments, but he came back after just one treatment to show me that the spots had gone. He was impressed." Vita also often uses the device for its single modalities (photorejuvenation, wrinkle reduction, or skin resurfacing treatments) on clients who have a limited budget.
workstation would be able to make a massive difference to the results I could achieve for my clients. "I didn't struggle with the decision to buy it at all. I just thought that if I loved the treatment and the results it gave me, my clients would love it too – and they do. Vita confirmed.” RETURN ON INVESTMENT Venus Versa™ includes various features that enable a higher return on ownership, such as multiple treatment options and a combination of unique technologies, making it the most adaptable to the needs and growth of your business. Venus Concept's industry-unique business model is designed to increase the success of your practice even further. APJ
VENUS CONCEPT AUSTRALIA +61 416 022 096 firstname.lastname@example.org www.venusconcept.com @venusconceptaustralia
"The Tribella Venus Versa™ gives you a high level of flexibility, making it easy to meet a diverse range of clients' needs, and this makes it easy (and profitable) for us too. "As soon as I saw and tested the Venus Versa™ I knew the
COSMETIC MEDICINE AND BEAUTY TRENDS FOR 2021 Dr. Giulia D’Anna
AS CLIENTS ARE RETURNING FROM THEIR TIME IN lockdowns or isolation they are once again seeking to enjoy the feel-good experience of refreshing their appearance in ways that only a skilled and profession treatment plan can deliver. More and more we are seeing a blend of skin treatments that extend to cosmetic medicine enhancement for optimal results. We are delighted that our editor Dr Giulia D’Anna is a qualified dentist, cosmetic injector, and dermal therapists. Her expansive knowledge allows her to achieve amazing results across several modalities. In this article she highlights some of the most popular procedures that are in demand this year. SKIN BOOSTERS Not your typical beauty treatment, but these are all about improving skin quality and structure. Using minute needles, super hydrating hyaluronic acid is injected just under the skin. This creates a super hydrated skin layer, that functions better and looks radiant. Skin boosters work in two ways. The first is via hydration. When cells are super-hydrated, they function much better as nutrients can get to the cells, and by-products and waste can also be drained away by the lymphatic system. The second function of skin boosters is via the skin needling process. The controlled stimulation of the needles entering the skin, creates an improvement to collagen levels. Skin boosters are perfect for the tear trough area, and fine lines and wrinkles. PROBIOTIC SKINCARE Given the new mask rules have created their share of skin problems (acne, oily skin, and breakouts), introducing “good” bacteria to the skin is so important. Much like probiotics in our diet, probiotic skincare is important as it focusses on improving the natural skin’s microbiome. Good bacteria are required to keep the “bad” bacteria under control. Kind of like the goodies winning over the baddies in a movie, except when the goodies win in skin, you experience skin improvement without the on-going breakouts.
PROTECTION AGAINST BLUE-LIGHT Spending all our time in front of a device, has created its own level of skin damage. Our devices emit energy rays, known as blue light, which can accelerate the ageing process, as UV rays do. This can result in pigmentation, or age spots and collagen breakdown. This will become increasingly more important to all of us, because the amount of time we are spending in front of computer screens is unprecedented. A really good habit is to wear sunscreen when using your device, and to also turn down the brightness of your screen. Both these strategies will help shield our skin from the unwanted effects of this light energy. Some good advice also for your clients. NIACINAMIDE This one is not new, but Niacinamide (otherwise known as vitamin B3) is here to stay. Niacinamide has an incredible effect on the skin by improving hydration and moisture retention, reducing inflammation and improve the radiance of the skin. Used morning and night, niacin amide is perfect for all skin types. HAND REPAIR Hand sanitiser is the new handshake. We all use it multiple times a day to help reduce the spread of bacteria and viruses. Whilst it is perfect for this purpose, what hand sanitiser also does is to dry the
skin. With frequent use of sanitisers, the skin can become sensitive, red and even peel. We will see a rise in hand repair lotions, that can be used to reduce the skin damage that hand sanitiser has caused. Look for hand repair creams that are fragrance free, one of the biggest irritants in all skincare. When taking care of your client’s face, why not also inspect their hands for the signs of any damage due to frequent use of sanitisers. THE FOX EYE I have seen this trend really starting to emerge now thanks to the likes of Kendall Jenner and other celebrities. Dissolvable threads (or surgical stitches) are placed under the skin in a non-surgical procedure to re-drape the skin around the eye and temple upwards. This is also known as a thread lift. This creates an eyebrow shape that is flattened and creates a sleek eye shape too. Just be careful of the results, as the Fox Eye may not be as long lasting as you hope. Some people only notice a change for 2-3 months, and I am not sure that the cost, effort, and invasiveness of the thread lift procedure is warranted for such a short period of time. BUCCAL FAT REMOVAL (CHEEK REDUCTION) Made famous (or infamous) by Demi Moore recently, this surgical procedure is performed by oral surgeons and plastic surgeons. AN incision is made at the back of the mouth, and the natural fat pads in the lower part of the cheek are removed. This gives more definition to the cheekbone, but also a “sucked-on” contoured look to the face. This is a surgical procedure and can be associated with some discomfort and plenty of risks. Take care on this one in researching your chosen practitioner and be aware of the outcome. Demi took this to the extreme, but most people will experience a beautiful, contoured appearance.
THE 8-POINT LIFT Zoom has made us look at ourselves more than we ever have, and sometimes the way we look on Zoom is not very flattering. I have had many people that have consulted with me about improving their confidence. The 8-point lift is a non-surgical enhancement of the face, where we focus on improving the cheekbones, temple, under-eye, lips, chin, and jawline using eight different points, thus the name. The 8-point lift is perfect in taking a natural approach to age-management, and overall improvement in proportion and face shape. THE GOLD FACIAL Gold has long been admired for its anti-inflammatory properties, so it makes perfect sense that gold powder might be introduced and used into facial treatments. After cleansing the face, and a deep exfoliation, a gold-infused mask is applied to the skin. Not only does it look absolutely sensational but the skin will also look clearer and more radiant after just one mask application. TWEAKMENTS I have always found that my patients prefer to fly under the radar when they undertake cosmetic procedures. So, when performing enhancements, I am generally looking for recommendations that are not dramatic, do not take a lot of time to produce and appear naturally beautiful. A perfect example is the Muscle relaxant Nefertiti lift. This is where we use botulinum toxin (Botox, Dysport or Xeomin) to produce a relaxation of the facial muscles. This creates a super sharp jaw line, jowl reduction and beautiful facial contour as the lower depressor (the muscles that pull the face towards the floor) are reduced. This results in the face gaining a natural lift in response. APJ
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THE POTENTIAL IMPLICATIONS OF FILLERS WITH THE COVID-19 VACCINE Dr Giulia D’Anna
AS AESTHETICS AND DERMAL PROFESSIONALS it is important that we arm ourselves with the most up-to-date and scientific information that we can. In the headlines over the past year, it has been inescapable to read about COVID-19. The virus has been devastating on those infected and the world community have taken steps like social distancing, lockdowns, and other drastic measures to try to keep the population, safe. It is only natural that scientists would work on a vaccine to try and normalise the way we function. A successful vaccination worldwide program is necessary if we are to return to some level of normality, in the near future. And science has seemingly produced multiple vaccines that are being released. Like all new medicines, there are going to be reports of unexpected complications. Recently there have been multiple reports of delayed hypersensitivity reactions in patients that have undertaken dermal filler treatments. But are these reports true and should we be worried? In this article I would like to address this subject as there are growing concerns both with practitioners and also with consumers who have had these procedures. WHAT ARE DERMAL FILLERS? Dermal fillers are the most common non-surgical procedure undertaken in the world with the aim of facial rejuvenation. They are a soft, gel-like substances that are injected under the skin to revolumise and redraw the skin where there has been volume loss as a result of ageing. Fillers can address a number of common problems, including reducing the appearance of under-eye circles, improving the contours and structure of the cheekbones, volumisation of the lips, smoothing of fine lines and wrinkles, and nasolabial folds, as well as many other deflations and deficient areas. Dermal fillers made from hyaluronic acid (HA) are called nonanimal stabilised hyaluronic acid (NASHA) dermal fillers, and have been used in the United States since 2003. NASHAs have always been described as temporary fillers, as they are thought to completely dissolve over time. Yet any injector who works routinely with NASHAs, like me can attest to patients that have received multiple treatments of filler requiring less filler volume over time, as there tends to be a retention of previous filler, or at least the effects that the filler has on the skin tend to persist. This may be due to the
infiltration of collagen and elastin through the filler, and those components being retained even when the filler is long-gone. SO WHERE DOES THE HA COME FROM? HA is derived from the bacteria Streptococcus Equi. This bacterium produces a HA capsule to enable it to survive the immune response of its host. The bacteria are grown in a laboratory, the capsules are fermented, and the HA is captured and processed into the HA dermal filler injectable gels used all around the world. HA coming from bacteria may sound terrible, but let’s not forget that Penicillin comes from mould, and it is the pharmaceutical that changed modern medicine most significantly in history. Although dermal fillers can be composed of a variety of different substances, the most used is hyaluronic acid (HA). HA is a naturally occurring polysaccharide sugar complex found in our skin, and it plays a major role in keeping skin hydrated, structurally resilient and volumised. HA fillers vary in longevity based on their structure. In our body, our innate HA turns over every 24-48 hours. So, the manufacturers of HA need to modify the basic polysaccharide complex to produce much longer-lasting
results. Some HA filler last up to 18 months, due to the complexity of the cross-linking that the manufacturers establish to achieve resilience, volume, torsional strength, and longevity. WHAT ARE THE RISKS WITH HA DERMAL FILLERS? One of the main benefits of HA fillers, aside from their natural appearance when injected, is that they can be dissolved in the case of a complication or unwanted visual appearance at any time. This is by introduction of the enzyme Hyaluronidase which also occurs naturally in our body. By injecting this enzyme in a concentrated area, the HA filler is quickly dissipated, and so are any complications that may be associated with it. There are several possible complications. The most common and least serious are discomfort, redness, bruising and localised swelling. More serious, but less common side-effects are infection and allergy. Even more serious and rare side effects are vascular occlusion (blocked blood vessels) which can involve the retinal artery which supplies the eye. This can cause the partial or complete loss of vision where the blockage is not immediately and completely resolved. While this is exceedingly rare, it is a very serious side-effect that needs to be discussed with all patients prior to treatment. DELAYED HYPERSENSITIVITY REACTION Adequate time needs to be given for the patient to understand the risks, the experience of the injector and the expected results of treatment. A less common side effect that is not as widely known is called Delayed Hypersensitivity reactions. This is a Type IV hypersensitivity reaction, where the reaction may occur days, weeks, or months after the initial treatment. This is therefore not recognised as an allergy, but rather an immune system reaction that occurs when there is another challenge in the body. That challenge raises the level of T-lymphocytes circularising and in susceptible individuals, they settle into the injected filler and create a reaction. This has been a long-established possible sideeffect or risk of dermal filler reactions, with reports dating back to 1985 in some of the first papers. So, this is not new, but occurs so seldom that there is generally little thought about it. Let’s look at the data here. There have been many published studies over the years of Delayed hypersensitivity, but to get a sense of where this occurs, to whom, and how to prevent and treat it, we need to look at the data. In the published reports, largely the treating practitioners are ophthalmologists, plastic surgeons, or dermatologists. These are all highly experienced medical experts. To deliver the dermal filler to the patients that experience DH reactions, the practitioners use a variety of injection methods, including needle and cannula. No one delivery method determined whether a hypersensitivity reaction would occur or not. Prior to
treatment, the patients all appeared to be generally well without any relevant or significant medical history. A variety of dermal filler brands are represented in the patients that later present with delayed hypersensitivity reaction. WHAT ARE THE MANIFESTATIONS OF DELAYED HYPERSENSITIVITY REACTION? Delayed hypersensitivity reaction appears like an allergy, a delayed reaction occurs week to months after the injection of filler. The dermal filler is usually completely without any concerns or complications at the time of placement, so when the hypersensitivity reaction occurs weeks to months later, it is completely spontaneous and unexpected. The reaction appears to be mediated by T-lymphocytes. There usually appears to be influenza-like symptoms that precede the reaction. It is suggested that the HA molecules in all fillers act as a foreign implant. Since HA molecules are a polysaccharide that is naturally found in the skin, the HA is not though to be the focus of the delayed hypersensitivity. Instead, all the filler manufacturers need to modify the HA so that it is resistant to breakdown by our body. This provides longevity, structure, and predictability to the filler. The manufacturing process of the HA is where the filler differs from out innate HA, and it is hypothesised that this processing of the filler creates the seed for delayed hypersensitivity as the T-lymphocytes see these structural chains as foreign when the immune system is triggered by the influenza. A delayed hypersensitivity reaction is characterised by induration (localised hardening), erythema (redness) and oedema (swelling). It is also very important to remember that more than 2 million of these procedures are performed in the US alone every single year, and many millions more worldwide, but these reactions only occur in an extremely small group of people that develop influenza-like symptoms, and not every time they are sick. All case reports of delayed hypersensitivity reactions contain a very small cohort of patients, and there is variation in the filler brand, position of the filler, treatment undertaken. Ideally there would be a histological study done, but most patients are understandably resistant to this as they prefer quick and noninvasive resolution. The delayed hypersensitivity rate is believed to be around 0.42% (https:// www.sciencedirect.com/science/article/ pii/S2352647521000083_) of all patients treated. Treatment varied in each study, which also makes it difficult to evaluate. Some practitioners will use the Hyaluronidase enzyme to dissolve the filler, thereby removing the allergen potential. Others use steroids to reduce the reaction. Others that have patients with milder symptoms simply wait for the immune system to settle down, and the hypersensitivity reaction appears to resolve
spontaneously without treatment. HOW DO VACCINES WORK? Now, let’s look at how vaccines work and their potential implications with individuals who have had fillers. A pathogen is a bacterium, virus, parasite, or fungus that can cause disease within the body. Each pathogen is made up of several smaller parts, usually unique to that specific pathogen and the disease it causes. These sub-parts of a pathogen cause our body to produce antibodies in response. This is how we fight disease. Each new pathogen produces a new antibody. The reason COVID-19 has been so deadly, is that our bodies have never been exposed to anything like it. No one has. All of a sudden, our bodies are exposed to pathogens with no antibodies to fight it. Vaccines contain weakened or inactive parts of a particular pathogen, and this will trigger an immune response within the body. So, before you are ever exposed to the actual pathogen, your body has prepared antibodies that are on standby for the real assault. Some vaccines, such as the Pfizer vaccine, require multiple doses so that the antibodies develop and are long-lived. Occasionally, some vaccines have a more widespread effect in susceptible people. Those people react as though they are ill. I am sure that we have all heard people complain that they got the flu after a flu vaccine, and maybe they did. This is their immune system putting up a strong fight to being inoculated with a foreign antigen. COVID-19 VACCINE It makes sense that any challenge to the immune system, will raise the level of activity in our immune system, this is an expected and desired sequela to vaccination. This can lead to “chills”, feeling generally unwell and so on. What has been reported after COVID-19 vaccines have been delivered is that a very small cohort of patients that have previously had dermal filler, may have experienced a delayed hypersensitivity reaction in the treated areas. Why do I say, may have experienced a reaction? Because the data at this stage is poor. There are no statistics behind how many people that have had the vaccine have had fillers, and those with delayed hypersensitivity type reactions did not have a biopsy. At present, the presentation of the delayed hypersensitivity reactions following the COVID-19 vaccine appears to be consistent with the presentation of other virus-initiated hypersensitivity reactions. Those that have had influenza-like symptoms in the past and those with post-COVID-19 vaccination hypersensitivity appear the same. This is not a new phenomenon. THE AUSTRALIAN SITUATION In Australia, we are in the position of being able to see both the Pfizer and Moderna vaccines being delivered to overseas populations before it is rolled out here. Again, the data that we are seeing in terms of the rollout, delayed hypersensitivity and dermal filler injections is very sporadic and limited. None of the patients that have been inoculated were asked on the medical history forms whether they had dermal filler. These questions were asked once the hypersensitivity reaction occurred. I am sure that there will be
more data that will be disclosed as more of the population overseas and eventually in Australia are treated. There is some suggestion to wait 4-8 weeks between filler treatment and vaccination so that as the immune system reacts to the vaccine, there is no further challenge from dermal filler being injected, and vice versa. Additionally, in the extremely small cohort of patients that have had the COVID-19 vaccine and sexperienced dermal filler delayed hypersensitivity reactions, the vaccine appears to be effective at the same level as in those that have had no reaction. SHOULD YOU GET THE COVID-19 VACCINE IF YOU HAVE HAD FILLERS? As the vaccination program continues to roll out, I am sure that this will be an expanding area of reporting as more and more patients are vaccinated. However, in the early stages, the vaccine appears to have the same low reports of delayed hypersensitivity as in the general population that might experience these concerns when confronted with influenza. I have had dermal filler treatment, and I treat patients every single day in my practice. Will I still give and receive HA dermal filler? Definitely. Will the risk of Delayed hypersensitivity change our usual treatment protocol? Maybe a little. We recommend delaying treatment if you have received the vaccine for a couple of weeks so that your immune system is settled. Will COVID-19 vaccines change the world? I hope so. Will I get the COVID-19 vaccine? For me personally, yes, I will. APJ
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An often-misdiagnosed dermatological condition Hidradenitis Suppurativa Jacine Greenwood-Drummond IN OUR INDUSTRY WE ARE OFTEN PRESENTED with lesions that may be mild, acute, or chronic. While accurately diagnosing may be outside of your scope of practice, ignorance is also not necessary. In this article Jacine Greenwood-Drummond discusses an often-misunderstood disorder known as hidradenitis suppurativa, which is sometimes thought to be a sebaceous gland disorder. This article will help shed some light on the origin and potential treatment option of this condition. Hidradenitis suppurativa (HS) is a chronic dermatological condition that results in painful bumps under the skin and in the hair roots near sweat glands. It is also commonly known as acne inversa. The early stages of Hidradenitis suppurativa are often misdiagnosed, due to the beginning stages often just looking like an ingrown hair or a minor skin infection. Hidradenitis Suppurativa is an inflammatory disease which is characterised by the formation of nodules. These recurrent lesions can appear in the armpits, the groin, between the buttocks, palms of the hands, and under the breasts. The nodules may spontaneously rupture with a foul-smelling discharge, or they may coalesce, forming painful, deep dermal abscesses. In extreme cases scarring and sinus tracts can form. Hidradenitis suppurativa is graded on a system called the Hurley Grading System that has several stages. STAGE 1: The first stage of HS is usually solitary or multiple lesions (boil like or abscesses). These are typically located in the armpit, groin, thighs, buttocks and under the breasts. At this stage, the lesions are usually small bumps, which can become swollen and sore. They will frequently burst and drain, but often recur in the same location. The recurrence of the lesions is a strong indicator of HS. This stage is often misdiagnosed and mistaken for a boil, ingrown hair or just a skin infection. There is no scarring or sinus tracts present in Stage 1. Stage 2: In Stage 2 the abscesses are recurring with sinus tract formation,
scarring and tunnelling. The recurring lesions occur where the old lesions have been and subsequently healed over. As the lesions heal, they can scar. The repeated scarring results in tunnelling or sinus tracts occurring in the skin. The sinus tracts form under the skin. The tunnel contains a lot of pus and drain constantly, leading to a foul smell. At this stage Hidradenitis Suppurativa can be diagnosed by a medical professional. Due to the scars and tunnelling, doctors can recognise the condition. Stage 3: This stage is severe and is characterised by diffuse or near-diffuse involvement of multiple interconnected tracts and abscesses across an entire area. The abscesses occur in multiple sites and there are sinus tracts from repeated scarring, which are interconnected. There is no healthy skin between the lesions. It is painful and the wounds don’t heal and stay open. There is currently no cure for this condition and the aetiology of how it forms is not fully elucidated. The medical treatment of the condition includes long-term antibiotics and anti-androgens. Surgery is sometimes performed to remove the sinuses and drain the lesions, but it only partially successful at controlling the symptoms. POTENTIAL CANDIDATES Women are more likely to have this condition than men, and young African American women and biracial individuals are at greatest risk, with a two to threefold higher prevalence. The age group with the highest number of sufferers is 30-39 years of age. Early diagnosis is usually missed, with many taking 7 years to get a diagnosis of their condition. Smoking has been shown to worsen the condition and research has shown that those with hidradenitis suppurativa tend to have a higher rate of smoking than the general population. The condition is characterised by hyperkeratosis, and smoking is known to aggravate and cause further hyperkeratosis and follicular occlusion.
Originally Hidradenitis Suppurativa was thought to be caused by a defect of the sweat gland, but it is now recognised as a problem with the hair follicle itself. The hair follicle develops a buildup of keratin within it, which eventually plugs the hair follicle, causing the cells to build up and eventually the rupture of the hair follicle, causing an inflammatory response and infection. What is amazing about this condition is that despite the use of antibiotics as a treatment, bacterial involvement is not always a component of the condition, with bacterial swabs and cultures showing no bacteria in some lesions and other lesions containing anaerobic bacteria, staphylococcus aureus and coagulase-negative staphylococci. The discovery of biofilms being involved in the condition is a new finding. Biofilms are a polysaccharide that is secreted by bacteria which is sticky and binds to the surface of the skin. Bacteria when enclosed in a biofilm become resistant to antibiotic treatment. Chronic lesions of hidradenitis suppurativa (HS) exhibit several characteristics that are compatible with well-known biofilm infections. Studies have shown that biofilms were seen in 67% of the samples of chronic lesions and in 75% of the perilesional samples. The larger biofilms were found in sinus tracts (63%) and in the infundibulum (37%). Most of the sinus tract samples (73%) contained active bacterial cells, which were associated with inflammation. BACTERIAL ACTIVITY Immune dysregulation has been implicated in HS, with a range of associated cytokines identified, including interleukin (IL)-1β and tumour necrosis factor (TNF)-α and anti-inflammatory cytokine IL10 in lesions and perilesional skin. The increase in cytokines is directly correlated to the severity of the disease. In another study, enhanced expression of cytokines IL-17, IL1β, IL18, and TNF-α were found in lesioned HS skin. In normal and perilesional skin, there was enhanced expression of IL-17A and IL1β, suggesting the presence of subclinical inflammation preceding the formation of active HS lesion. T helper (Th) type 17 cells also
appear to play a role in the pathogenesis of HS, as the presence of elevated levels of them have been established. Additionally, the role of other pro-inflammatory cytokines such as IL-36 and IL-32 continues to be defined. In a study comparing the cytokine profiles of skin specimens from healthy donors, patients with HS, and patients with psoriasis increased expression of IL-36β, IL-36γ, and slightly increased expression of IL-36α and IL-36RA in lesioned HS skin were identified. The primary occurrence with hidradenitis suppurativa is follicular hyperkeratosis, which plugs and causes dilatation of the hair follicle. This results in inflammation of abscess and sinus tract formation. Involvement of the sweat glands is a secondary factor resulting from the diffusion of inflammation into the deeper structures of the skin. One of the factors that has been overlooked however, is the fact that the skin produces antimicrobial peptides, and these can have both an inflammatory and anti-inflammatory effect. Antimicrobial peptides are part of the innate immune response of the skin and play a role in immune dysregulation in HS. These peptides are produced by mature keratinocytes, as well as in the eccrine or sweat glands, which is the same areas that hidradenitis suppurativa ironically occurs, or the areas where sweating occurs. One of the antimicrobial peptides psoriasin is produced in the sweat glands, and studies have shown that it is directly regulated by antibiotics, which would explain why antibiotics can be successful with treating hidradenitis suppurativa. One study showed a nine-fold increase in the expression of S100A7 (psoriasin) expression in hidradenitis suppurativa and is directly correlated to the severity of this condition. There was also a three-fold reduction in human β defensin-1, which is a molecule that protects against infection. IL32 has also been found to be present in higher amounts in inflamed lesioned skin, and has been shown to upregulate antimicrobial peptides and cathelicidins. IL-32 in contrast, is nearly absent in healthy skin. Studies have shown that HS lesioned skin is also deficient in sphingolipids such as ceramides. These membrane lipids are present in the skin and appendages, acting as biologically active signaling molecules. In lesions of HS, ceramide synthases and
enzymes that create ceramides de novo are downregulated, and enzymes that metabolise ceramide are upregulated. A decrease in ceramides has been shown to cause sebum to solidify, leading to blockages of the hair duct. GENETIC LINK Is there a genetic component? Initially a genetic component was suspected due to the positive family history. Up to 40% of patients have a positive history of HS with a first-degree relative. It was not until 2006 when the first genetic locus thought to be responsible for HS was identified. The gene responsible was mapped to chromosome 1p21.1–1q25.3. THE ROLE OF NUTRITION Nutrition plays a critical role in the management of inflammatory diseases, especially of the pilosebaceous duct. Both acne vulgaris and hidradenitis suppurativa are affected by diet-modulating pathogenic pathways. The Western diet influences hidradenitis suppurativa by increasing insulin and modulating the FOX01m/ mTOR pathway. This results in the overexpression of various keratins, and the hyper-cornification of the follicular wall. Reduction in simple carbohydrates and sugar will be beneficial in reducing the incidence of hidradenitis suppurativa. MEDICAL TREATMENT Antibiotics are the first line therapy for mild to moderate HS. While the condition is not driven entirely by bacterial infection; however, antibiotics have shown to reduce the inflammation associated with the condition. Antibiotic efficacy is likely due to a combination of antibacterial and anti-inflammatory actions. Antibiotics have been the mainstay of treatment since early randomised controlled trials demonstrated that both topical and oral antibiotics are effective for HS lesions. In 1983, Clemmensen et al. discovered that topical clindamycin 1% solution significantly improved HS lesions compared to placebo. Then in 1998, Jemec et al. compared topical clindamycin 1% solution twice daily with oral tetracycline 500 mg twice daily. Both treatments were found to be effective against HS without significant difference between the topical and oral medications. Treatment of Stages 1 and II, the recommendation is to begin with topical clindamycin 1% solution and switching to an oral tetracycline antibiotic such as doxycycline 100 mg up to twice daily, minocycline 100 mg up to twice daily, or tetracycline up to 500 mg
twice daily if there is no response. More extensive and complex cases of HS require the combination of clindamycin and rifampin. A 2006 study with 14 HS patients treated with clindamycin 300 mg BID and rifampin 300 mg BID for 10 weeks found 8 patients achieved complete remission. Rifampin is considered a good choice for HS because of its anti-inflammatory properties and its ability to penetrate bacterial biofilms. In extensive cases surgery may be necessary. Surgery involves excision, of the lesions. Wide excision removes both affected skin and the tissue around it. The aim of wide excision is to prevent the disease from spreading. A person who undergoes wide excision may also need a skin graft to replace the tissue removed. Tissuesparing excision removes only the affected tissue. And local excision removes individual lesions. LASER TREATMENTS An alternative to surgery is laser treatment. Recent studies have also investigated the efficacy of laser surgery on HS. Benefits of laser surgery include less invasive, less expensive procedures that produce well-healing lesions. Laser surgery is thought to be effective because it destroys the hair shaft and clears debris from the follicular unit. Options for laser surgery include carbon dioxide laser, IPL laser, and Nd:YAG laser. Other less invasive therapeutic measures that have been studied are the use of photodynamic therapy (PDT) with intralesional 5aminolevulinic acid or methylene blue followed by 630–635 nm light treatment. Both these methods produced high remission rates in small studies. Further, the combination of surgery followed by treatment with PDT may have added benefit, with advantages of faster healing and less extensive scarring. CONCLUSION The treatment of hidradenitis suppurativa needs to be commenced from the earliest stages to minimise the occurrence of the condition and scarring. There are many options to medically manage the condition including dietary modification, antibiotics, and laser. Skin therapists can encourage the conversation for conservative management, by being observant of any indications of potential disease in their clients. Many clients are unaware that they have the condition, and just assume it is an ingrown hair in many instances. When identifying similar manifestations please also seek a medical diagnosis to rule out the condition. APJ
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A LIFE OF DEDICATION TO COSMETIC TATTOOING JUNIE YE IS A PASSIONATE aesthetician and cosmetic tattooist. Throughout her 30 years in the industry, she has travelled the world on numerous occasions seeking to perfect her knowledge and craft with some of the world’s greatest experts. Within Australia Junie completed the WRB50105 Diploma in Beauty Therapy at TAFE. In 2015 Junie also upgraded her qualifications in Cosmetic Tattooing gaining the government approved SHBBSKS003 Design and Perform Cosmetic Tattooing and the SHBBINF001 Maintain Infection Control Standards through the Sydney Beauty and Dermal Institute. She also was part of a training faculty with a Registered Training Organisation for several years and more recently Junie has been an ABIA Award finalist for Tattooist of the Year in 2018, 2019 and 2020. As a valued member of APAN it is our privilege to interview Junie and capture her professional journey as well as her passion to see aspiring Cosmetic Tattooist gain quality education. APJ Q 1: Junie when did your journey start with cosmetic tattooing and what was your background? I have been working in the beauty industry for 30 years as a beauty therapist in several spas, salons, and slimming centres. I also worked for nine months with Royal Caribbean cruise lines as a highly trained aesthetician which was a career highlight. I started my journey as a cosmetic tattoo
artist in 1996 after my eyebrows were tattooed in China with the traditional bamboo technique. I was lucky enough to have a great artist give me the shape and finish that really suited me. This inspired me to learn both the bamboo method and rotary machine in China with further training in 1997 in Hong Kong with the 'soft tap system’. From 1997, I have travelled annually to Cosmoprof Hong Kong to ensure I continued to perfect my techniques. I was privileged to be taught by global masters, renowned for their unique techniques who helped me expand my knowledge and refine my skills. I am also grateful to have worked with many global leading brands of both products and equipment. Over the years I have been trained to master techniques using a diverse range of machines from rotary to digital, as well as in the use of various high quality needles that allow me to deliver exceptional work ensuring the best results for each client. These experiences have all helped fuel my passion for cosmetic tattooing and over the years I have worked on thousands of clients. As I come from a Chinese background, I studied Chinese meridians in my late 30s allowing me to also give my clients a unique and memorable Geisha facial massage, which feels amazing and offers many benefits. As I am a spiritual person, I learned crystal healing, skincare formulation, colour therapy, and ancient Chinese face reading methods all of which I’ve incorporated in my cosmetic tattooing treatments to help balance the energy and harmony of the face. I have worked with the Australian Cosmetic Tattoo College as their senior qualified trainer for the past seven years and I have trained many incredible students, some of whom are now successful celebrity artists and trainers. I also have an excellent partnership with Nathan at Parlour B, Paddington, and last year I established my own clinic and training academy in Leichardt offering cosmetic tattooing services, training, and other beauty services. It is a rewarding feeling, knowing that with our skills and knowledge we can make a difference in people's lives. APJ Q. 2. Over the years how do you believe that the techniques have changed in cosmetic tattooing compared to say 20 years ago? Over the past 10 years the changes are incredible. Cosmetic tattooing is constantly experiencing innovative developments - new machines, pigments, needles, and techniques. I believe that the need to up-skill has never been more relevant than now. The trends in cosmetic tattooing have made an enormous leap forward, with artists needing to use multiple skills to achieve the best results.
One example is the old filling-in technique replaced by the fine hair strokes technique which delivered through “fence-like” stiff strokes performed in a single row. Since it was first introduced, this technique continues to improve over time. Then it progressed to the modern hair stroke pattern which was more artistic and combined with a soft powder finish, or a combination of both. This technique is immensely popular, because it has the capacity to deliver a more realistic, 3D natural results as well as makes provision for better maintenance as the procedure ages. I have noticed that some artists are a little heavy-handed with their hair strokes, which over time, contribute to a solid block brow. This points to the importance that as artists we continually update our knowledge and skill, while also giving consideration as to how a procedure will age over time. We can always learn more about the skin and its response to pigments, improve on our colour theory and stroke techniques, such as spacing and direction of eyebrow strokes. It is important that education should be constantly updated. We now can use advanced skills to create the illusion of natural ‘fluffy’ hair implemented using multiple pigments, various shading techniques, and pigments. Skillful brow placement and shape can create a lifting, youthful effect that balances the face. I now also teach Scalp Micropigmentation, both with microblading and machine techniques, with excellent hair stroke results on my alopecia and cancer patients. When it comes to eyeliner, we have progressed from solid and moving from blue/green eyeliner to many more natural options, from lash enhancement eyeliner to designer eyeliner and ombre eye-shadow liner. These new innovative techniques certainly give hope for clients who have had the old-style eyeliner tattoos by correcting unwanted tattoos with artistic new designs. These amazing possibilities bring much joy back to many clients.
Let us now talk about lip tattooing. The dark strong lip line is now replaced by modern softer borderless lip blush and natural lip contour pigment implanted through a new technique that delivers less pigment. This technique gives greater flexibility to a potential client who previously was contraindicated due to having lip-enhancing injections. However, careful colour selection is paramount as the trend towards more natural, softer colours means that consideration must be given to how your colour selection will look over time. Therefore, I strongly believe that every artist should learn the pigment characteristics and be able to explain this to their clients. Paramedical tattooing in 3D nipple areola has also made big advances – it’s more than just colouring in. Now we can create every detail in the areas such as blood vessels, layering colours to create the illusion of the nipple – it is fascinating and inspiring what we can achieve today. Scar camouflage is another technique used for imperfections in the skin and even
These days there is now also a stronger focus on improving communication with our clients and determining their expectations, reviewing medical history, lifestyle, skin tone, and understanding how the skin and pigment will change over time.
I would also like to challenge artists to consider the length of the tail when performing an eyeliner because as we age, our eyelids will droop, and the original placement will change as the face changes and these results are permanent. I have seen so many cases in the past year that had these tails that eventually migrated to the wrong place after 10 years. When performing an eyeliner I like to start with a softer colour, then apply a darker shade that blends in with the primary colour, and end with applying black eyeliner just at the roots of the eyelashes.
minimising the appearance of scars and vitiligo. Again, knowing your pigments and providing honest information to your client on the changes that will happen over time and the necessity for colour adjustments every two years is very important. I believe it is our mission to make people look and feel good with our honest professional advice. Especially with tattoo correction. APJ Q3: What are the three most important things that consumers are looking for today when considering cosmetic tattooing? Natural results: Most clients are now seeking to enhance their appearance with a natural finish. While microblading was all the rage over the past seven years, there is now a greater interest also in traditional tattooing methods.
Colour accuracy: There is a lot of anxiety over the issue of colour results especially with changes to blue, green, or orange. These concerns are based on witnessing old tattoos, especially eyebrows changing colour on family members and friends that make them look dated. Shape: Fashion trends come and go. In the 90’s thin arched brows were popular, while the current trend is for fuller, thick and more ‘fluffy-looking’ natural brows. As cosmetic tattoo artists, we need to explain this to our clients and be mindful of not following extreme fashion trends that may date in future years. APJ Q4: You are brow specialist, do you believe in microblading for eyebrows or do you prefer working with a machine? This is a controversial topic and I feel it’s very personal to each artist. Microblading can achieve beautiful crispy lines with very natural results. However, this technique needs the right candidate, it is not for everyone. I have found that most microblading artists are not using this technique correctly. They often apply too much pressure and have the wrong angle.
the artist who has been working with machines for many years – it will be difficult to adjust to microblading movements. Practice is needed to strengthen the little finger and achieve greater dexterity and flexibility. With machine-delivered hairstrokes, it is essential to master a different hair stroke end-result. I have no preference in working with a machine or with microblading. The determining factor is the end result must meet with each client’s individual needs. The powder finish technique can be done by a hand tool with multiple needles which can deliver different shades by layering through a technique called pointillism, or a machine technique called pendulum or pixel . This technique leaves swift dot impressions in a line that requires a layering effect with light and even hand movements. These techniques can be utilised for eyebrow/lip/eyeliner or for camouflage purposes. APJ Q5: You also conduct training - what are some of the key errors that you see artists making who have undergone poor training? I believe that cosmetic tattoo training in Australian is out-ofcontrol. It is desperately lacking in regulations. Many training providers run big classes with insufficient hands-on practical training and in reviewing different case studies that one will encounter when they start their practice. I think face-to-face follow-up workshops should be integrated into all training as it is vital to ensure artists are practising correctly and have an environment to follow up with questions and concerns. Mastering cosmetic tattooing is not solely about learning techniques, it is a combination of beauty, art, and science. Artists must have knowledge on facial anatomy, have experience with different live case studies, and be able to understand a client’s facial proportions and symmetry, skin type, age-appropriate shapes for eyebrows, as well as consideration of the client’s personality.
This can cause more trauma to the skin. Thus, additional training is often vital to supplement one’s introductory course because no artist can achieve mastery with just one course. Microblading is easy to learn, but not easy to master. In some cases, the perfect end-result cannot be achieved by microblading alone. Working with a machine for a microblading-trained artist entails a different technique and different hand and muscle movements. It is much the same for
I have been an instructor for the past seven years I have developed a training system that I teach in my academy - Junie’s Master Hand International Academy of Cosmetic Tattooing in Leichhardt - which caters to small groups or one-on-one training. I am proud of the skills and knowledge I have acquired over decades of practise and it’s my mission to support every artist’s career journey. I believe training should be comprehensive. Artists need to understand colour theory, pigment characteristics and how they are influenced by the individual’s skin tone, health, and facial structure. It is important that a candidate must have an eye for design and detail. While this skill can be learned, it cannot be mastered in a week. Additionally, training for ‘Face Mapping’ should be considered as a guide rather than a rule. And finally, it is essential to understand considerations beyond the skin’s surface, such as medication, overall health, and lifestyle issues. APJ Junie Ye can be accessed by email email@example.com
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The Scoop on Facebook & Instagram Stories How to Maximise your Reach and Grow your Influence Trish Hammond
ANY BUSINESS TODAY WOULD AGREE ON THE POWER OF SOCIAL MEDIA FOR MAINTAINING CLIENT ENGAGEMENT AND ATTRACTING NEW ONES. As the various social media platforms grow in popularity so new features are introduced to expand and ensure that the information shared is more visual and fun. Trish Hammond is considered an industry authority on social media for business acquisition and optimising engagement with consumers. In this article she discusses some of the new Facebook and Instagram features that have recently been introduced. I am sure that most of us have viewed social media stories from a variety of social media platforms, including Facebook and Instagram. These stories allow us to share our daily lives, interests, humour, or simply things that will influence our emotions. When I think of the relationship between Facebook and Instagram, I can only explain it as sibling rivalry. So, let’s start with a little background information. Both Facebook and Instagram are owned by the same company. Facebook is the big brother and has a bigger audience, while Instagram is arguably more likeable on social networks, especially by younger followers. Instagram launched its first story feature in 2016 and noticing its popularity, Facebook followed in 2017. Facebook Stories is another news feeds feature of Facebook and is basically a more visual way of sharing cool videos and photos. When you create a story on Facebook, just go to your profile, and click Create Story. With the Facebook Story feature, either you want it live to record, or you simply want to add your best photo or video. You can add text, location or poll, and there are also some awesome features such as Normal, Video, Boomerang, Super-zoom and Layout that will suit your preference. Filters are also available and there are a lot to choose from! Be reminded that Facebook Stories only last for 24 hours, but you can revisit the stories you have shared in your Story Archive feature.
On the other hand, Instagram Stories describes sharing the moments of your day in a slideshow format. In terms of posting, simply tap the camera button in the top left of your profile or swipe right anywhere from your Instagram Feed. This allows you to share multiple photos and videos. Instagram also offers a wide array of features such as Boomerang, Lay-out, Level, Super-zoom, Handsfree, Multi-capture, and the newest feature, which is really cool known as Photo booth. Either way, once done, just tap the doodle, text, or sticker icons to add the effects. Stickers include location, poll, and music. FILTERS, FILTERS, FILTERS Did I say filters? Yes! Instagram offers a lot of awesome filters that are seriously great. You can browse filters on your effect gallery, choose filters depending on your mood, selfies, colour and light, funny surroundings, and many more! But, of course, these photos and videos will also disappear after 24 hours. By now, marketers have also become quite ‘story-savvy’. From any social media platform, you can find several brands using stories to publish content related to their industry, entertaining videos showcasing their services, how-to clips related to their products, or display clients' testimonials. Since social media provides strong marketing opportunities it is a great way for businesses to post stories. With that said, Facebook has the most active and bigger audience, meanwhile Instagram can drive tons of engagement and value whether you are sharing a story from your brand account or your personal account. I would also add that Instagram is the most visual of the two platforms, so if your business and story is supported by great images, do not underestimate the pull for the influence of Instagram, especially with younger people. APJ Don’t forget if you need help, reach out to me at firstname.lastname@example.org
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The Magic of Skin Misting Tina Viney
IT WAS 1972 AND I WAS ATTENDING A CIDESCO International Congress in Athens, Greece. There were numerous lectures and demonstrations presenting the diverse and incredible advances that were happening to our industry at that time. After several days of being immersed in this environment I left feeling a deep sense of excitement and enriched with much knowledge and take-home messages, but there was one “experience” that left a lasting impression on me that I will never forget. It was a video presented by the French delegation. We were greeted to the gentle sound of violins that ushered in a magnificent view of a breathtaking rose garden. The close-up views captured the velvet-like petals bursting with glorious colours of red, peach, pink, white and variations of these colours. The early morning sun was just starting to emerge and suddenly a gentle shower released a mist of water that danced on the flowers. Each petal swayed as the delicate mist was released in the atmosphere around them. As the droplets touched the petals they gently moved almost as if they wanted to reach out and capture the mist’s hydration. The narrator went on to say that while the rose bushes can be watered at their root, the true beauty of their blossoms are best enhanced by amazing moisture benefit from the morning’s gentle shower mist. The video’s ultimate objective was about communicating the hydration benefits of skin misting. The analogy was so poignant that it truly impacted me. In this article I would like to look at how misting, or spritzers can benefit the skin when used both within our treatment strategies, as well as a valuable part of our client’s home routine. The question is, while facial misting feels refreshing, does it really benefit the skin and what are the elements that make it work best? WHY MISTING? It is a well-established fact that disturbing the skin’s surface hydration and the biofilm is one of the fastest ways to age the appearance of the skin, as well as make it more susceptible to
infections. This can happen because of environmental factors – excessive heat, lack of atmospheric moisture, excessive sweating, pollution that disturb the skin’s barrier function, lack of skin protection, or using incorrect product, as well internal health issues. Even if we apply a moisturiser in the morning, the skin loses water throughout the day and how rapidly this occurs depends on numerous factors. When the skin reaches parched status, it will feel tight and look dull. Skin misting can be a valuable tool in both protecting, as well as restoring the skin’s health. Here are a few skin misting tips for both salon and home use and how they can benefit the skin: 1. SKIN WAKEUP: In my own morning ritual, as soon as I wake up I go to the kitchen to make my morning coffee. My first move, however, is to reach out for a toning mist – I keep several of them in the fridge and have a variety, all of which are alcoholfree. Some combine Witch Hazel and other herbs, plant extracts and other actives such as vitamin C, Retinol and curcumin. Others are pure floral hydrosols such as rose water, chamomile water, lavender water etc. Spraying my skin first thing in the morning with a chilled bust of mist not only awakens my senses, but it also refreshes and rehydrates my skin. It is important to note that facial mists are much more than just water. Spraying the skin with just cool water may be refreshing but it will not hydrate the skin. Formulas must contain moisture-binding ingredients like glycerine or hyaluronic acid, thermal waters that are rich in minerals, as well as other boosters, such as sweet orange, bergamot, or vanilla to fight off infection and inflammation, as well as promote relaxation and calmness. For obvious reasons avoid those that contain alcohol as they will further dry the skin. 2. USE AS A TONER: Following cleansing the skin, why not spray your toner prior to applying your serum and moisturiser. It is
so much more pleasant to spray a toner on the face than applying it with a cotton ball. Additionally, it will enhance the penetration and effectiveness of your serum and moisturiser. 3. RIVIVE YOUR MAKEUP: Spritzing the skin before applying your make-up will help it adhere better, set it and last longer. On the other hand, if you are working in airconditioning, you may find that throughout the day a quick spray will also help refresh both you and your makeup, so it remains fresh and dewy. 4. THE MENTAL FACTOR: While these elixirs are meant to rehydrate and strengthen skin cells, they can also help recharge your mind. The act of closing your eyes and gently misting feels spa-like, plus many of the scents have therapeutic notes, such as citrus to pep you up, or rose to calm you down. There is something therapeutic about closing your eyes and inhaling the gentle aroma of a high-quality spritzer to boost your energy levels through the day. 5. IDEAL FOR ALL SKIN TYPES: No matter the condition of the skin on any given day, a facial mist has its benefits. These mists are balancing and keep skin oils in check, while simultaneously preventing dryness and irritation. They infuse the skin with protective elements that slow the ageing process, while also providing it with a refreshing dewy glow. 6. USED WITHIN A TREATMENT REGIME: Following microdermabrasion, skin needling, skin peels or even after removing a mask, skin misting with an appropriate mineral-rich solution will help restore the skin’s pH balance. 7. SUPPORT ON-GOING HYDRATION DURING A PROCEDURE: Some equipment procedures require on-going hydration, such as ultrasound, or high frequency that require water-based hydration, or for the removal of debris. Misting is an appropriate solution during these procedures, and will also
help maintain the client’s relaxation. Many skin treatment routines have multiple steps that require application and removal of the product. This is where spritzers can help, such as for the removal of masks or various products, without the need for excessive rubbing of the skin, while also providing it with additional health benefits. 8. ENHANCE ABSORBTION OF ACTIVES: In general, you can think of face mists as a toner or a fluid that is packed with nutrients and help lock in moisture in the skin, as well as enhance the absorption of your serums and moisturisers. These factors alone, make them valuable. 9. BODY HYDRATION: It is a proven fact that spritzing the skin prior to applying a body lotion will help adhere the moisturiser to the skin and make it last longer, which is great, particularly in the summer months when the skin is more exposed and prone to dehydration. 10. GREAT FOR THE HAIR: Not just the face and body, hair that is exposed to the elements can also become dry. A quick spray with a plant infused spritzer that harnesses hydration elements can help restore and tame dry and dehydrated hair. 11. THE BENEFIT OF AROMATHERAPY: Hydrosols can also support overall mood, calm, and restore emotional equilibrium. Many alternative health practitioners recommend essential oil spritzers prior to flying, travelling, or during stressful meetings and long-days at work. Lavender, which has anti-inflammatory properties can help soothe and calm, Neroli is excellent in combatting depression and anxiety and many of the citrus oils, mandarin and orange are uplifting and relaxing. Additionally, many of these oils also have antibacterial properties offering an additional layer of protection. As a treatment ritual the use of face and body mists are experiencing a come-back in popularity. Additionally, a change in routine is always a welcoming experience. APJ APJ 33
Written from both sides of the fence
CHOOSING YOUR SKINCARE SUPPLIER Deb Farnworth-Wood I WAS INSPIRED TO WRITE this article by the sudden departure of several skincare companies from supplying the salon’s market and choosing direct retail as their core business. Social media then went into overdrive as stockists sought out recommendations for alternative suppliers and expressed their dismay at being abandoned in this way. As a long-time clinic owner, and now also a skincare and makeup supplier I would really like to share my thoughts from both sides of the fence - so to speak! Like you, as a clinic owner, I’m acutely aware of the importance of a good retail offering to top up profits. At the same time, it’s easy to feel resentful that the product I stock is also available locally in many other businesses. Yet, there is no doubt that it is easier to sell a brand that people know and recognise than one they don’t - In fact 80% of women prefer to buy from a brand they know, like and trust. The irony is therefore, that wider the availability of products, the greater the recognition of the brand and the more people that buy them. Similarly, it is also easy to resent
manufacturers selling their products in their own webstore and to fear the possibility that they are stealing customers away from you. However, don’t panic! Once again, it’s a twoway street. With my supplier hat on, I know from experience that more people visit our “locate a stockist” page than purchase our products online. Think about it - It’s a more enjoyable experience to stroll down to the local salon, where I can touch and try products, sage advice and interact with the friendly staff that I know and recognise than order online. Of course, there’s nothing worse than taking that stroll to find that my local salon is out of stock of my products, or infer only a partial range for me to choose from. WHAT TO LOOK FOR IN A SUPPLIER So, on what should we judge suppliers? From my experience, I look for service, training, support and profit margins as my pre-requisites to purchasing. If the company’s rep/ business development manager is friendly they will of course get my time. But what truly piques my interest is the value they bring in terms of product knowledge, training and assistance in driving my business. Similarly, I would avoid manufacturers that under-cut their own stockists or supply discount webstores that make their profits based on high volume sales at low margins - the exact reverse of the salon environment. The supplier/stockist relationship is important and should be seen as a partnership where both sides understand the other’s point of view and work to mutual benefit. APJ Please direct any question you would like Deb to answer to email@example.com
Fixing uneven skin tone and pigmenation Deb Farnworth Wood, Issada Cosmetics ONE OF THE MOST EVIDENT SIGNS of ageing is uneven skin tone and pigmentation. Those days of letting the sun kiss your skin and working on an even, bronzed tan with sexy tanned legs, eventually become a distant memory. Instead, that glorious, bronzed tan is replaced by uneven skin tone, pigmented lesions, over-kill of freckles and even solar keratosis and liver spots. In Australia, even the small amounts of incidental sun exposure, such as walking to the car without sunscreen, can have a devastating effect, especially from the age of 25 when our body begins to age faster. Luckily, at Issada we provide clean cosmeceutical solutions to these complexion challenges that are free from toxic nasties. But more importantly, they work! Sun damage and pigmentation require several lines of attack. We recommend starting with a good cleansing routine. Dry, dead skin cells on the surface of the skin inhibit absorption of skincare products. Using our Daily Gentle Cleansing Gel followed by 14% Glycolic Polishing Scrub will help shed those dry and damaged skin cells and help the skin absorb more of the precious serums it needs. Following cleansing, begin your routine with Even Tone de-pigmenting serum applied morning and night. This serum
contains Licquorice Root, Bearberry Rumex and other active ingredients in a combination that is more effective than hydroquinone. Additionally, these ingredients are powerful tyrosinase inhibitors, which impede the skin’s production of melanin, fade age spots, sundamage and melasma. Melasma, also known as chloasma, is a hormonal condition characterised by darker brown patches commonly found on the upper cheeks, nose, upper lips, and forehead. Chloasma is also known as “mask of pregnancy” as it is caused by elevated levels of oestrogen and progesterone during pregnancy. Layering products is key to achieving the best results when targeting specific skin concerns such as pigmentation. Issada’s Vitamin C 25% serum supports collagen synthesis and assists in antioxidant protection against UV-induced photodamage. Vitamin C should be applied in the morning, followed by Issada’s Enzyme Moisturiser, which is a multi-tasking daily active formula that uses enzymes to gently exfoliate and buff away dead skin cells leaving the skin smooth, radiant, and hydrated. In the evening, Retinol is absolutely essential to increase cell turnover and target sun damage, fine lines and wrinkles, acne and enlarged pores. We offer this in two strengths – 0.5% for the Retinol rookie and 1% for the hard-core Retinol lovers. 0.5% is a great introduction to using Retinol products to build the skin’s tolerance to high-strength Retinol formula - works like a little sister to Retinol 1%. However, no skin routine is going to reduce the effects of sun damage if the skin continues to be exposed to the harsh sun! The number one product to help reduce the signs of ageing and sun damage is Issada’s Sheer Defence SPF 50+. A silky, lightweight SPF 50+ formula designed to protect against UVB/UVA rays. It can be worn beneath makeup and works in combination with your skincare products or alone. Finally, while the products are working their magic to fade pigmentation and sun-damage, you can camouflage your pigmentation with Issada Mineral Prostick. The above “before and after” photo demonstrates how well the Mineral Prostick covers Melasma. Mineral Prostick offers instant pro-strength all day long coverage. The cream-gel, semi-matte studio formula leaves the complexion smooth and even, plus it's enriched with Vitamins A, C and E as well as Aloe and Coconut Oil and is available in 13 shades. ISSADA Skincare and Makeup 07 3904 2288 issada.com/partners
REVIEWING THE GOOD AND THE BAD
How Does Exercise Impact the Skin? Tina Viney
WE ALL KNOW THAT EXERCISE IS SO IMPORTANT for overall health, it stimulates blood flow, strengths the heart and increase blood and lymphatic circulation. But what about the skin, is it always good, or can it also impact the skin negatively? I have often looked at gym junkies, particularly women and I have to say that many times their skin is not the best. While their body may be youthful-looking and strong the face has not kept up and it often looks older than their chronological age. So, I decided to do a bit of research and here is what some of the experts are saying. According to dermatologist Dr Corey Hartman exercise has innumerable benefits for the body overall and especially for our skin. Most of that good has to do with the way your workout gets your heart pumping. During exercise, the heart rate increases and improves blood circulation, which helps to deliver oxygen and nutrients to the skin. This rush of oxygen and nutrients promotes the development of collagen to prevent skin sagging and regenerates new skin cells to keep the skin glowing and youthful-looking. However, the verdict is still out on just how much exercise can improve the visual appearance of the skin. While Dr. Jordan V. Wang, a dermatologist from New York agrees with Dr Hartman, he also points out that even though the benefits of exercise may play a positive role, too much inflammation can contribute to damaging key proteins in our body, this may extend to the skin too, although Wang was clear that more research is needed to determine exactly to what extent. However, the chair of dermatology at the
Univesity of Cincinnati College of Medicine, Dr Brian B. Adams and director of sports dermatology was less enthusiastic when asked about the particular benefits that exercise might have for skin. “People always ask me this question,” he said. “There are no direct beneficial effects on the skin from exercise. People who have recently worked out might have an erythematous glow and some people think that that looks good.”
If you are working out outside, make sure to wear SPF to prevent sun damage. Dr Wang even suggests wearing a product with antioxidants, especially if you are in a city, to protect against pollution. Runners in particularly, are often so focused on extending their distance that they regularly suffer from sun-damage due to the extended time outdoors, or due to their perspiration their sunscreen is not holding up in protecting them against sun damage.
HOW EXERCISE CAN NEGATIVELY AFFECT THE SKIN As with everything, extremes can backfire. Without appropriate precautions, your workouts can cause new skin problems and exacerbate existing conditions. This is because exercise can increase sweat, and that can cause certain skin conditions to flare according to Dr Hartman. These may include acne, eczema and folliculitis, an inflammation of hair follicles. “Moist conditions on our skin can encourage the normal bacteria that live on our skin and function positively to suddenly overgrow, clogging pores and leading to pus bumps and painful acne nodules,” he stresses. And not just the face, there are also concerns for areas of the body. The combination of sweat, tight-fighting clothing and high friction can also bring problems. “For example, rashes in folded areas, such as the inner thighs, knees and elbows, can worsen with chronic rubbing from running or weight-lifting routines.
What about the face? After exercise, washing your face can remove the build-up of sweat, oil and environmental pollutants that may lead to acne, but getting out of your clothes and into a shower is even better.
HOW TO MITIGATE THESE ISSUES WHILE STILL GETTING YOUR WORKOUT Fortunately, there are ways to minimise the bad so you can reap more of the good. If you suffer from body rashes, experts advise to apply an emollient or thick cream to provide a barrier and protect the areas of high friction during exercise. Areas such as thighs, knees, and elbows.
“The best way to control the negative effects of exercise on the skin is to remove all sweaty workout clothes as quickly as possible after a workout, especially those that are tight-fitting. Taking a shower promptly after a workout also helps to keep bacteria numbers manageable,” Hartman said. Shedding those compression pants can be helpful in preventing folliculitis, which often shows up as red, pimple-like bumps on your arms or backside. If you’re noticing drier skin, that may be due to sodium-rich sweat. While a shower will help rinse the sweat off, make sure to replenish the skin by applying a moisturiser to help rehydrate the skin. Adams goes one step further and suggests skipping soap when it comes to your arms, legs, back and chest. “Only water needs to hit these areas to keep you clean,” he shared, adding that you should still make sure you are soaping up your face, underarms and groin with a mild soap. For more insidious problems, like infections, foot fungus and warts, all the
experts advise that you should always wear foot protection in locker room showers and surrounding areas, where viruses and fungi can hide. For more extreme cases, take some time off from working out and call your doctor. These days, your skin may develop an additional irritation: mascne (that’s inflammation caused by wearing a mask). Safely exercising outside your home now often means that a mask is needed, which does not make skin happy. “Masks function much like tight-fitting workout clothes and keep all the oil, bacteria and sweat in place where they can band together to clog pores and cause acne,” Hartman said.
Mascne can be mitigated by always wearing a clean mask and by cleaning your skin soon after a workout.
the heat and increased circulation. Those prone to rosacea should try to reduce overheating when they can.
Most dermatologist are confirming that they are seeing an increase in cases of rosacea over the past year, too. They attribute this to the increase in heat while wearing masks. Heat is one of the major triggers of rosacea and one’s breath is nearly 38 degrees Celsius, so when someone constantly exposes their face to 38 degree heat because the mask contains that temperature, they risk flaring the number of bumps and degree of redness on their cheeks, chin and nose. Even without a mask, exercise can worsen rosacea due to
While exercise’s list of potential negatives for the skin may be long, we should not be discouraged from keeping up our workout. The benefits of exercise on the body are clear, and the outlook is good that some of those positives may extend to the skin. With some extra care (and a good shower), you will reap the benefits of the postworkout glow a little longer. Encourage your clients to do the same. APJ
Can my employer require me to get a COVID-19 vaccine? Michael Bishop – Senior Partner Pointon Partner Lawyers
WHEN IT COMES TO COVID-19 we know that governments around the world are arduously working towards a solution through appropriate vaccines. We recognise that this is a controversial subject and highly debated throughout businesses, individuals and professional communities. To present a scientific update of what the studies are saying we are delighted that Professor Laurence J. Walsh will be addressing this subject in depth through a 60-minute presentation at the upcoming ONLINE AESTHETIC CONFERENCE. In this article, our legal strategic partners Pointon Partner Lawyers are presenting another consideration – the legal position of enforcing employee vaccination in the workplace. With the roll out of vaccines having commenced in Australia many employers are querying whether they can require their employees to be vaccinated as a condition of employment. In short, the answer is - it depends. There would be a stronger case for employers dealing with vulnerable people, for example, those in aged care facilities to require their employees be subject to mandatory vaccinations. It is well established law that employers have a right to issue lawful and reasonable directions to employees. Whether a direction is lawful will usually be decided by confirming that the direction does not breach the terms of any agreement governing the employment relationship or other employment law. What a reasonable direction constitutes will be largely dependent on the facts of each case and will usually encompass a wide range of factors including the type of employment, established precedents and practices in the workplace, the terms of agreements governing the employment relationship and the impact of the direction on the employee and the employer’s business. Courts have long accepted that employers are able to issue directions to comply with their obligations under occupational health and safety laws. An employer may take the view that to ensure, as far as reasonably practicable, the health and safety of their employees they will require their employees to get vaccinated to protect the workplace. The difficulty with this approach is that to date there is uncertainty about the effect of the COVID-19 vaccines to stop APJ 38
transmission of COVID-19 as distinct from good evidence of the efficacy of the vaccines in preventing disease symptoms such as death and serious illness. Until such time as there is more definitive evidence that the vaccines prevent or reduce transmission of the COVID-19 virus in the workplace the fact that the vaccine may benefit the health of an individual employee is not considered an adequate foundation to require an employee to take the vaccine. It is akin to requiring employees do not smoke on their lunch break if there is no impact of that behaviour on the workplace and would not be a direction that could be made under existing workplace laws. Until scientific data becomes available to establish reasonably that transmission of COVID-19 is reduced in the workplace requiring employees to receive the vaccine is not recommended. As noted above, we consider this would be different for employees in industries exposed to vulnerable people such as the elderly or persons with disabilities or who are unwell. The higher risks for vulnerable people who become exposed to the virus is likely to substantiate a more cautious approach by employers. If State Governments decided to regulate in this space by for example issuing Public Health Orders mandating vaccines in certain workplaces, then that would provide more certainty for those employers. It is clear that these are complex issues and considerations of how to balance the rights of the community and those of the individual in a public health emergency need careful thought. Whilst most employers may not be able to require an employee to receive a vaccine, employers can encourage employees to get the COVID-19 vaccine as many do for the flu vaccine as part of employee welfare initiatives. APJ If this article has raised any specific queries about your business, please feel free to contact Pointon Partner Lawyers to discuss your situation. 03 9614 7707.
MYO-FIX MF5 MASK Rejuvenating and Mimic Wrinkle Smoothing Mask that defies gravity.
THE MYO-FIX MASK, SUBTLY REDUCES THE EXCESSIVELY ACTIVE facial expressions correcting mimic wrinkles and rejuvenating the face. Myo-Fix Mask contains innovative biotechnological peptides reducing the mobility of facial mimic muscles, filling in the existing fine lines and wrinkles, making the face look effortlessly serene.
MYO-FIX ACTIVE INGREDIENTS
Personality is mirrored in the facial expressions more and more with age: our emotions create a mimic mask of sorts. Anxiety, stress, and other negative emotions are most often reflected in the wrinkles on one’s forehead and the bridge of the nose, drooping corners of the mouth and narrowed unhappy eyes.
Palmitoyl Tripeptide-1 Palmitoyl Tripeptide-1 helps restore the thickness of the dermis, hydrates the skin and enhances the syntheses of collagen, elastin and hyaluronic acid quickly filling in the wrinkles. It is one of the most potent rejuvenating ingredients in beauty industry today.
The peptides in Myo-Fix mask reduce the skin’s mobility by limiting the contraction of the mimic muscles’ ends intertwined with the skin. The muscles themselves remain mobile, but their ends stretch the skin less, reducing the depth of wrinkles and leaving the face looking calmer. All the mask’s peptides are minute small molecules that easily penetrate into the skin. Studies show that the first application reduces the mobility of mimic muscles by 20–30 per cent and with the regular use the muscles of the upper third of the face may become 50–60 per cent less active in their surface parts. The neuromuscular blocking (myorelaxant) peptide-based cosmetics is commonly nicknamed ‘serene face solutions’.
Acetyl Hexapeptide-3 Acetyl Hexapeptide-3, a neuromyorelaxing peptide, reduces the mobility of the facial muscles and decreases the contractions of the mimic muscles in the part that is intertwined with the skin. It is the most thoroughly researched neuromuscular blocking peptide; its effect has been confirmed by numerous scientific research studies. Acetyl Hexapeptide-3 affects the upper and upper-medium thirds of the face the most, working on the forehead, bridge of the nose, eye area and upper cheeks.
Palmitoyl Tetrapeptide-7 A cell messenger, Palmitoyl Tetrapeptide-7 restores the communication and metabolic processes in the mature skin. It stimulates the syntheses of collagen and elastin, tones up and moisturises the skin, restoring its elasticity and resilience, and helps fill in the wrinkles. SH Oligopeptide-1 Biopeptide nonapeptide 1, Human epidermis growth factor earned its creators, neurobiologists Rita Levi-Montalcini and Stanley Cohen, the 1986 Nobel Prize in Physiology. Epidermis growth factor is a peptide able to restart the decelerated or stopped with age processes of collagen, elastin, and hyaluronic acid’s syntheses in the skin. Growth factor enhances the healing of injuries, tones up the skin and slows down the ageing process. Growth factor is such a powerful ingredient, that the recommended doze should be applied no more than twice a week to allow the skin to fulfil its stimulating potential. All Meder Beauty Science formulations can be used by both men and women at any stage of life. The company advises aesthetic professionals to recommend the masks to their clients both as part of a course of treatments, and for before and after any traumatic procedures including facial surgery, as well as for the clients’ regular use at home to maintain the skin’s health. MEDER Beauty Science 0466 338 844 | firstname.lastname@example.org mederbeautyscience.com.au
Winning human resource strategies for strengthening your brand’s identity
Is Your Brand Accurately Communicated in the Marketplace? Tina Viney
AS A BUSINESS OWNER YOU DETERMINE how you show up in the marketplace, what your products and services can promise, and what they will deliver. You research your product options, treatment options and carefully select three specific areas: Treatment options You determine what services you will be providing for your clients and what the treatment objectives and results you are aiming to deliver will be, and ultimate what you can promise and guarantee your clients, for example, skin corrective treatments, grooming services, injectables, inner-health, and wellness support, etc. Skincare products In view of the above objectives, you will need to determine the best products you will work with to achieve these results. You will research and establish the criteria on which to base your choices. Will the products just address facial needs, or also extend to include body and grooming needs, and what about products that can support overall wellbeing? Techniques and technologies To ensure the treatment outcomes you are aiming, you will need to carefully research and select credible technologies with the appropriate capabilities to deliver consistent, quality results that will meet with your expectations. Putting it all together Once these decisions are made, your next step will be to determine and define the policies, procedures, and protocols on how all this will come together in a seamless way so that you can not only deliver a result for your clients, but also a memorable experience that will leave them longing to return to you for more. The techniques and protocols of how your services and products will be delivered will ultimately define your brand’s identity and this will
attract the kind of clients that you believe you are targeting. Many businesses believe that once they have these steps in place, they just need qualified staff, and they are on their way. In my experience when mentoring business owners, many of the problems they encounter are often attributed to their lack of fully understanding the importance of the staff orientation process into the brand’s identify, not just as a one-off process, but also when it should be updated? WHAT IS ORIENTATION? Orientation is the process of introducing new employees to the business and assimilating them with its policies, benefits, and culture. It is the first step in an employee's continuous socialisation process. This step must be performed with great care, connecting to your employee’s ability to comprehend and develop the behaviour, conduct and processes that will be expected of them. It requires that you measure their competence and give them feedback when they have achieved the right behaviour, but also identify any deficiencies that they may be struggling with that may require further attention. Orientation is also the process of bringing employees up to speed on organisational policies, job roles and responsibilities and other organisational attributes and concepts that may have changed since you employed them. While most astute business owners achieve the first part of the orientation process, they often fail to recognise when this process may need to be repeated and why. This failure may erode the impact of the positive changes that you wish to evolve your business into. For example, your business may have offered traditional treatments and products, however, your brand may wish to change direction and is evolving, with a stronger emphasis on a more
environmentally-sustainable approach with a new focus on “green and clean” products and treatment options that aim to provide a higher emphasis of health and safety. At this stage, the brand is taking on a new “expression” if you will, that may be subtle, but also of important significance to your clients. Any time that a business shifts its brand direction or modifies it, staff will need to be re-orientated on how these changes will need to be expressed and communicated to the clients. If you fail to introduce this step, any improvement may go unnoticed. I know that much can be done to communicate these changes through other branding exercises such as, new statements on your website, social media, changes in logo, new colours, and mission statements, however, your staff must also flow cohesively in adopting, adapting and subtly communicating these changes to your clients, bringing them to their attention so that they can appreciate them. I do understand that many businesses are often working in the business due to financial limitations. However, many of these strategies require that they act more on a managerial level working on the business and its direction. Here are some strategies that might be helpful: 1. Introduce a staff newsletter: If you enjoy writing, you may wish to implement a brief newsletter specifically for your staff: You could call it - STAFF NEWS AND POLICY UPDATES. This could be introduced once a month. Here is what you can include: •
News about a new technology that may be introduced into the business, how these technologies will impact the business and the way things are done. You may also give them 3-4 simple promotional statements that they can use to introduce the services to their clients. Give them the statement and the language they need to use.
Validate why something new is being introduced. For example, if you are introducing a new “green and clean” product line you may state that market research is confirming this is a major shift in consumer expectations. Introduce a new mission statement to accommodate this and give this to your staff asking them to memorise them. Request feedback from your staff with their suggestions.
Promote a positive testimonial from a client, or when staff have reached the financial target for the month. Take this opportunity to thank them and show your appreciation, while fostering a team spirit.
knowledge, plus an emotional response. 4. Use originality and fun during the orientation process: If you are to engage the heart you may wish to bring a fun creative element to the process. Invite the staff to join you for coffee one afternoon, present your information to them and ask them to share their views and how best to successfully communicate these changes to their clients. Get their feedback but make it fun. Then at the end of the brainstorming, take them out to see a movie or visit a garden centre together, do something fun and memorable as a team. We live in a constantly changing world and as business leaders we need to look at ways that we are constantly evolving and improving in a way that demonstrates to our clients that they can regularly expect to be surprised with something fresh and new. This could be something simple, such as a shift towards a more environmentally conscious offering, expanding the services you provide to include something new that they have never tried before, modernising your work environment, improving your newsletter or message to include a motivational quote and something to cheer their day. It shouldn’t be only about getting them to spend money with you. Another major brand enhancer is to demonstrate a commitment to giving back – supporting a charity and being part of a community for making the world a better place. They say that a change is a good as a holiday. This will not only be appreciated by your clients, it can also boost staff morale and help make a more enjoyable and happier work environment for all concerned. IN CONCLUSION In today’s marketplace when thousands of products and services, all of which are being rapidly commoditised, your business brand needs to make a clear statement. It must reflect integrity, quality care, safety, compassion and leadership in excellence and best practice that consumers can immediately recognise and are invited to trust. This will require investing and refining, not just the offerings, but also the human factors. Achieving this will guarantee you loyal clients and allow your brand to stand out from the clutter of competition. APJ
2. Cue cards: Sometimes some of the easiest ways to change behaviour it to include 3-4 simple statements on a 5” x 4” card (you can pick these up at a newsagency) and get your staff to include key phrases that they can be reminded to communicate with all their clients. This is a simple strategy that is easy to implement, but it really works! 3. Staff training: While introducing a new procedure to your business may require staff training that you can get from your supplier or distribution company, this does not constitute orientation. The objective of orientation is something more: it is the ability to embrace, believe and be passionate about what is on offer and for the staff member to feel the urge to share and recommend the service or product in a caring and genuine way that is believable, inviting and enticing their clients to respond with interest and engagement. I am sorry to say that does not happen instantly, or by just teaching staff how to use a product or a device. It requires training that engages the heart and stimulates faith and excitement in what is on offer –
Photos by Pask Media & Good Vibes Co
A SHINING DIAMOND SHANNEN SIMMONS IS AN AMAZING YOUNG WOMAN who is making positive waves in her community. As an APAN member and a member of our professional community we are immensely proud of her and her achievements. We dedicate this report to Shannen as we give you a glimpse into some of her recent achievements. A devoted wife and mother of four, Shannen, together with her husband Mathew Simmons established their own business Aesthetically You Rejuvenation Clinic on the Gold Coast in Queensland, which she operates, while studying to finalise her bachelor’s degree in applied health science (Clinical Aesthetics). Shannen juggles many roles in her life and does so with grace and poise. Her infectious smile lights up the room when she enters. She possesses an incredible zest for life and has an insatiable passion to contribute to a good cause in her community. In 2020 Shannen entered the Miss Diamond International and succeeded in reaching as a Grand Finalist. As a past domestic violence victim Shannen chose to support the charity – the Sanctuary Women, Children and Pet’s Refuge which is dedicated to helping women and their children fleeing domestic violence and gaining refuge, support, and counselling. On Friday 19th March Shannen hosted a Night for the Sanctuary in order to fundraise for her charity. The night was filled with fun and inspirational activities including a APJ 42
presentation from Shannen, who shared her person experience with domestic violence. She was also joined by published author of the Perfect Stranger and Domestic Violence Ambassador, Kay Schubach, who also shared her experiences. “There was not a dry eye in the place,” Shannen said. Simone Patterson the founder of the Sanctuary for women, children and pets on the Gold Coast also spoke of the struggles she faces being a non-government funded organisation that is dedicated to helping the community. While the financial requirement for keeping the shelter open needs over $3,000 per week there are times when they have to manage with less than $200 which puts a great deal of pressure on them. Guest were entertained by the powerhouse voice and Gold Coast local talent Taylah Little, singer with Good Vibes. “We all had so much fun with their interactive photo booth,” Shannen said. Tasman Star Seafood provided a scrumptious seafood bonanza filled with oysters, prawns, crab, and sashimi. Served with love, they created a three-meter long spread of grazing goodness with an array of cheeses, fruit, wraps etc. Crumbed GC supplied mouth-watering chocolate brownies and cookies. Drinks were provided by local companies, Witch’s Fall Winery, Wildflower Gin, and Burleigh Brewery. And of course, Roger, (the real macaw) mascot of the Sanctuary logo, causing much laughter in the room. Hosts for the evening were Tania Meli (General Manager of Audi) and Moyra Major (Hot Tomato radio station) who both did an incredible job. The evening was supported with over $7,000 in prizes to raffle off including a pink sapphire from Deer Honey Jewellery. The event was a great success and raised over $12,000 for the Sanctuary. Shannen, plans to continue this fundraising event annually, in support of the Sanctuary as she is committed to its cause. From here, Shannen will be competing for the title of Miss Diamond, a grand affair that will be hosted over two days 16 and 17 April in Brisbane, where contestants will be judged on five areas: Fashion Competition, Community Activities, People’s Choice Award, Charity and Evening wear. APJ We wish Shannen every success for this and all her future endeavours. Shannen Simmons can be contacted at email@example.com
Lateral learning and APAN’s Conference point of difference ONE OF THE FASCINATING NEW SHIFTS IN EFFECTIVE BUSINESS GROWTH IS THE CONCEPT OF LATERAL THINKING.
WHAT IS LATERAL LEARNING? What is unique about our industry is that it covers an extensive array of modalities. A quick look at our conference program and you will identify numerous areas of specialisation.
This new approach of thinking and determining your business’s direction warrants investigation, as it can potentially empower you to make more creative and powerful decisions. The research on this is extensive. To learn more, a lecture on Lateral thinking and how it can transform your business will be dedicated to this subject and presented by Tina Viney at the upcoming APAN Online Aesthetic Conference.
Many within our industry consider themselves as specialists. They may be cosmetic injectors, cosmetic tattooist, laser practitioners, etc. Oftentimes their only interest is in lectures that help them perfect what they are currently doing, but in doing so they neglect to look “over the fence” at other modalities that may well interface with those they perform. This can result in missed opportunities to evolve their practice or business and move with the times.
As the whole conference program is based on this principle, this article will present an introduction to the concept and how it can help you gain the most benefit from attending this online event. Please note that the conference program has been carefully designed to not only give you knowledge and education on your current modalities, it will also empower you with skills to think in new ways that will support you to remain strong in your business and profession endeavours. Studies confirm the importance of lateral thinking and lateral learning, which are now both necessitated for survival in our rapidly changing world. So, here is a brief introduction to this concept.
Lateral learning is about solving problems through an indirect and creative approach. It means “taking my education into my own hands, through an exploratory and creative avenue.” Lateral thinking is solving problems through an indirect and creative approach, using reasoning that is not immediately obvious, involving ideas that may not be obtainable by using only traditional step-by-step logic. We know that new advances are entering our industry at phenomenal speed. Keeping up with them requires that we constantly remain flexible to change. If we fail to change and adapt, we will progressively become less relevant and ultimately lose our influence in the marketplace, while others who have moved with the times will pass as by and take over the market. However, change is not for the fainthearted. This is because it carries risk, as often it leads us to unfamiliar, or even unproven territories. Understanding the principles of lateral thinking will allow you to gain the skills to make this process safer and to minimise those risks. There is a skill and an art to this way of thinking and gaining this information will help you move forward with greater wisdom and understanding as you navigate within a constantly changing world. APJ Please register today and join us for a rich educational experience that promises to inspire and provide you with incredible new possibilities available to you. We also promise you that you will gain new tools to think with a winning mindset and elevate your confidence to lead as an expert within a fiercely competitive market. www.apanconf.com
A comparative review of the two modalities
Dermal needling in combination with radiofrequency versus traditional dermal needling Gay Wardle
THERE ARE SO MANY OPTIONS WHEN it comes to treating a variety of skin conditions and disorders such as, ageing skin, acne, scarring, pigmentation, and rosacea, just to name a few. The choice of equipment for treating these conditions is truly endless and with the on-going advancement in new technologies those options are never-ending. SKIN NEEDLING Skin needling is considered a a minimally invasive, non-surgical and safe treatment that can be delivered to all areas of the body. The devices have very fine needles attached to the applicator, which penetrate the skin leaving the smallest puncture holes. These holes are known as micro-channels that create controlled inflammation to the surrounding tissue. As a modality, skin needling provides effective results for most skin conditions and for most skin types. The claims that results are achieved for scarring, stretchmarks, collagen induction, pigmentation, acne, skin texture and minimising lines and wrinkles are pretty much true, although there is no miracle cure with just one treatment for any of these conditions. The treatment itself has many different names – dermal rolling, micro-needling, collagen induction therapy and skin needling, even though these are all performed with a needling device. However, they come in three options: •
Electric or battery-operated pin
HOW IT WORKS The superficial injury created by this device increases the release of platelet-derived growth factors transforming growth factoralpha and TGF B-3, fibroblast growth factor, and stimulate the production of collagen and elastin. APJ 44
The clinical advantages of skin needling primarily are two-fold: •
Superficial skin needling .25mm predominantly assist in increasing the penetration and aiding in absorption of active substances applied to the skin during and after the procedure.
With needle depth of .50mm and above, the result is collagen induction therapy (CIT).
Immediately post-treatment there will be erythema and oedema and the degree of trauma will depend on the needle depth, skin density and the overall health of the skin. It is important the patient follows all post-care advice given. The results are not immediate and can take weeks and months to see the optimal outcome. Most of the time 3-4 treatments are required delivered four to six weeks apart - this greatly depends on the skin condition being treated. Skin needling is a popular procedure that is considered safe and effective for treating many skin disorders. Now let’s look at what happens when we add it to Radiofrequency? RADIOFREQUENCY NEEDLING Radiofrequency (RF) is a modality that is used to tighten lax skin. Energy, which is measured in frequency, is at the lowest frequency range when used as a skin tightening-treatment. RF works by heating the deeper layers of tissue which stimulates the growth of collagen and elastin. Over time the skin becomes firmer and tighter, the skin texture improves. Radiofrequency on its own will not treat scar tissue or stretch marks. It mainly works on skin tightening. New technologies are now combining skin needling with radiofrequency in one procedure. In this way the RF energy is delivered through the small needles to the tissue. In some cases, this method allows the energy to be delivered deeper to the dermis of the skin. By heating and targeting the tissue in the dermis which
causes constriction and further tightening of the skin, while also more effectively stimulating the production of collagen and elastin. RF devices have a handheld piece that hold the tips containing the needles, these needles penetrate the skin backwards and forwards and at the same time deliver the radiofrequency energy to the deeper layers of the dermis in a controlled manner. Most RF devices allow you to adjust the needle depth and the energy that is being delivered to the tissue. The outcomes that you can expect from an RF needling treatment are quite impressive: •
Reduction in fine lines
The skin becomes considerably firmer and toned
Pore size is considerable reduced
Scar tissue is reduced
Pigmentation is minimised
Rosacea is also improved.
RF needling is also excellent for tightening the skin on the neck and jowls. The big plus is that is safe to use on all skins. Most RF needling treatments require the application of a numbing cream. Post treatment the skin will have signs of erythema, swelling, warmth, and there could be visible signs of where the needles penetrated the skin, these are usually gone by the next day. The patient might also note that their skin is feeling dry, this is due to the heat and slight evaporation of water. The down time can be anywhere from three to seven days. As a general rule, the patient will need to have three treatments, six weeks apart, depending on the skin condition.
WHICH IS BETTER? Both methods will increase collagen and elastin, reduce scar tissue, reduce pigmentation, and reduce wrinkles and fine lines. However, because the energy in RF is delivered deeper into the tissue, this usually achieves faster and more dramatic result. Radiofrequency is delivered past the tip of each needle to the dermis, which usually provides more efficient collagen and elastin stimulation. Now, let us consider the treatment of scar tissue. While needling alone is effective in breaking down scar tissue, RF needling is more likely to provide better results, this is because scars consist of a tough patch of thick, damaged skin that needs to be broken down. RF needling is therefore the preferred option. When it comes to pigmentation, the preferred option would be traditional needling, as with RF there is a risk for further pigment stimulation, however that risk is not high. Skin needling treats the surface layer of the skin for fine lines, pigmentation, and very superficial scarring. RF needling treats both the dermis and the epidermis for deeper scar tissue and deeper wrinkles. Skin needling is a procedure that uses very fine sterile needles that penetrate the skin causing micro-wounds that stimulate and create inflammation. With RF needling, where micro-needling is combined with radiofrequency heat energy, the production of collagen and elastin is amplified. Both procedures will achieve results although it is important to note that both will need multiple treatments to achieve optimal outcome. APJ
GET READY FOR A KNOWLEDGE UPGRADE!
The Leading Certified Professional Development Event in 2021 28 - 30 JUNE (available until 20 July)
LEARN FROM LEADING LOCAL AND GLOBAL EXPERTS. Gain insight into new advances, new techniques, and regulatory updates. Expand and embrace the winning mindset and return to your business or practice energised with new ideas, greater boldness and confidence. While many conference programs run for just 2-3 days, this full program will be featured on the conference website www.apanconf.com for 30 days allowing you to revisit at your own convenience. The APAN ONLINE AESTHETIC CONFERENCE is a fully certified professional development program and delegates will receive a Certificate of Attendance and they will be awarded 10 CPD points. Here is a brief preview of just some of the speakers that will be featured at this event. TOPIC: USING THREADS IN CONJUNCTION WITH YOUR CURRENT INJECTABLES SPEAKER: Rebecca Habersbeger, RN TIME: 30 minutes Today’s consumers are seeking a youthful enhancement of their appearance in a way that is beautifying, but undetectable that a procedure has been performed. The skillful blend of fillers, botulinum injections and new advanced collagen stimulating threads can provide an amazing combination of volume enhancing, as well as strengthening the skin’s architecture for a more natural and youthful end-result. Rebecca Habersbeger is a cosmetic nurse with over 30 years of experience. She has extensive knowledge in leading techniques and is a respected cosmetic medicine educator. TOPIC: HEAT SHOCK PROTEIN STIMULATION SPEAKER: Gay Wardle TIME: 30 Minutes With so many new technologies based on heat to stimulate collagen production, what are the risks and limitations? Can you have too much of a good thing and can excessive exposure to on-going heat-based treatments have an adverse effect, or even be counterproductive? New research is identifying risk factors that should be taken into consideration when determining suitability and frequency of these procedures within a treatment plan. Gay Wardle is a degree qualified dermal clinician
with extensive experience and knowledge in advanced procedures, as well as in light and heat-based technologies. TOPIC: THE EVOLUTION OF CLEAN, GREEN COSMECEUTICALS AND THEIR ROLE IN WELLNESS SPEAKER: Michelle Reeve TIME: 30 Minutes What do consumers really want from their spa or salon treatments and at-home skin rituals? Studies confirm the growing trend for expect treatments that provide a synergistic blend of safe, highquality results, as well as a wellness experience that goes beyond the superficial. New and exciting advances in clean and green cosmeceuticals allows businesses to provide tailored solutions to meet client expectations. Michelle Reeve is a passionate educator in high-quality formulations and their effective application within the spa and aesthetic environment. TOPIC: HOW TO BLEND COSMETIC INJECTABLES AND DENTISTRY FOR PREDICTABLE BEAUTIFUL RESULTS SPEAKER: DR. Giulia D’Anna TIME: 30 Minutes As we age the skin loses tone and elasticity, while the internal structure of the face, such as bones, gums and teeth can deteriorate contributing to the ageing appearance of the face. As a qualified dentist, cosmetic injector, and dermal therapist Dr. D’Anna has in-
depth knowledge across three disciplines allowing her to integrate and blend different procedures to achieve amazing treatment results. TOPIC: WOUND HEALING AND AESTHETIC TREATMENTS SPEAKER: Danielle Hughes TIME: 30 Minutes The wound healing model underpins a vast majority of aesthetic treatments – from laser to radiofrequency, skin needling to plasma pen, chemical peels, and microdermabrasion – the key to the results we seek is to match the treatments to the limits of our clients’ ability to repair and heal. Renowned as a leading researcher and educator Danielle Hughes will share important information on how to appropriate the theory of wound healing as it relates to the various procedures. TOPIC: ESSENTIALISM – UNDERSTANDING THE NEW BLACK OF AUDIENCE BEHAVIOUR SPEAKER: Gillian Fish TIME: 30 Minutes Essentialism is the new frontier principle of audience behaviour borne out of the seismic shift in the way we live, work and play, brought about by COVID-19. Communities have needed to dramatically adapt to the unfolding pandemic and finding a new rhythm in all facets of life, albeit still with a dose of uncertainty of what lies ahead. Most have needed to pare back to the absolute essentials in life – people, time spent and consumption, either out of necessity or a desire to take the opportunity to reset, in this once-in-one-hundred-year great reset moment. Join leading branding and business development expert Gillian Fish, as she unfolds what is Essentialism and how it impacts your brand. This information will help you leverage the principles for better client engagement and business growth.
TOPIC: ACHIEVEMENT AND HOW TO ACTIVATE YOUR DOPAMINE SPEAKER: Dr Andrew Huberman (USA) Time: 14 minutes Neuroscience is now uncovering how we can have more control over our performance by utilising specific yet simple protocols that will help us optimise our path to achievement. In this lecture you will learn how to use appropriate light to affect your cognitive behaviour through the secretion of specific hormones. Learning how small changes to our behaviour can allow us to gain control of our life on so many levels is so exciting. Dr Andrew Huberman is a highly accomplished and world-renowned neuroscientist an an expert in human behavioural science. TOPIC: TRANSEPIDERMAL DELIVERY SYSTEMS THAT PROVIDE GREAT RESULTS SPEAKER: Dr Donna Marcal TIME: 30 Minutes With the advent of ingredient permeability and micronisation of active ingredients in skincare, the common belief is that serums are our only topically applied options for optimal penetration of actives. However, new studies confirm that the key factor to skin penetration is the chemistry of the delivery system. Dr Donna Marcal holds a PhD in biochemistry and is a passionate educator in cosmetic ingredients and biotechnology. TOPIC: THE RENAISSANCE OF ELECTROLYSIS SPEAKER: Mr. Clement Beaumont (Canada) TIME: 30 Minutes While in the past electrolysis was the only means to achieve permanent hair removal, the advent of light-based technologies, such as laser and IPL brought a new era of swift hair removal. Over the past 15 years IPL and laser have become the go-to technology, despite the results not being permanent, particularly with recurring white hair. In recent times, we are seeing a comeback in the popularity of electrolysis, but with more sophisticated technology providing not just permanent hair
removal but also additional capabilities in aesthetic care. In this lecture world-renowned educator Mr. Clement Beaumont will update you on how electrolysis is being re-introduced into the new era and what you can expect from the new technological advances. TOPIC: COSMETIC INJECTABLES FOR THE LOWER THIRD OF THE FACE SPEAKER: Dr. Giulia D’Anna TIME: 30 Minutes One more lecture from Dr Giulia D’Anna … There are many challenges in rejuvenating the lower face as it is the most compromised by gravity and other anatomical factors. For this reason, injectable solutions are often short of being truly effective if they are delivered with insufficient knowledge of the lower facial area. Dr Giulia D’Anna is a renowned dentist, experienced cosmetic injector, and dermal therapist with unique expertise for dealing with these more challenging cases for facial rejuvenation. TOPIC: CLINICAL APPLICATION OF ENZYME PEELS FOR ENHANCED TREATMENT RESULTS SPEAKER: Metro-Dora Clifford TIME: 30 Minutes The popularity of enzymatic peels is constantly on the increase and for good reason as they provide additional benefits to chemical peels, while still delivering amazing skin renewal and effective exfoliation in a more skin-friendly manner. Fruit and vegetable based, enzyme peels (depending on their origin), come in different chemical compositions, strengths and efficacy, depending on your treatment objectives. Additionally, they offer antioxidant benefits to support various skincare needs. Metro-Dora Clifford holds numerous qualifications and extensive experience in skincare formulations and advanced equipment technologies. TOPIC: TREATING TRAUMATISED SKIN CONDITIONS WITH MEDICAL COSMETIC TATTOOING SPEAKER: Kelly Forshaw (UK) TIME: 30 Minutes The evolving modality of Cosmetic Tattooing is not just about improving features, such as eyebrows, lips and providing a perfect eyeliner. As a constantly advancing profession cosmetic tattooing is far-reaching in providing solutions for traumatised skin and medical conditions, allowing practitioners to support a patient’s quality of life through more permanent cosmetic solutions. In this lecture world-renowned educator Kelly Forshaw will take you into the specialised area of medical cosmetic tattooing with evidence of amazing outcomes that can be achieved through advanced techniques. TOPIC: HOW TO ACHIEVE AN ENTREPRENEURIAL MINDSET SPEAKER: Deb Farnworth-Wood TIME: 30 Minutes Every business owner starts with a dream – a vision of what they would like to achieve in stepping out in the world of business. However, the reality of competition, financial limitations, accessing recruiting and developing a winning team, not to mention conceptualising the vision into a leading brand, requires mustering multiple skills. Deb Farnworth-Wood is not only a highly gifted serial entrepreneur, she is also exceptionally successful in everything she undertakes. Deb will share proven strategies that are essential in creating on-going business growth even through challenging economic times.
TOPIC: LASER PHYSICS AND NEW ADVANCES IN IPL TECHNOLOGIES SPEAKER: Phil Schramm TIME: 30 Minutes Despite new technologies constantly on the rise, IPLs and Lasers are still considered the leading and in-demand technologies, both by practitioners and their clients and patients. While there is a plethora of devices, new, exciting advances are stepping up the capabilities of these devices by delivering quicker, safer, and more efficient results. Phil Schramm has a reputation for his knowledge in all-thinks-laser and as a leading educator of medical aesthetic devices for over 15 years. TOPIC: METAFLAMMATION, INFLAMMAGEING AND NUTRITION FOR THE SKIN SPEAKER: Fiona Tuck TIME: 45 Minutes This session looks at the role of nutrition, the gut microbiota, and the connection to skin health and inflammageing. Fiona Tuck is an author, nutritional medicine practitioner and skincare expert. She is also known as the “myth buster” of the health and beauty world. At this presentation Fiona will discuss how diet and the gut microbiota is involved in both metaflammation and inflammageing and how this affects crosstalk with skin cells. TOPIC: GLYCATION: A NEW UNDERSTANDING AND EFFECTIVE TREATMENTS SPEAKER: Jacine Greenwood-Drummond TIME: 30 Minutes Skin glycation is not just about cross-linked collagen. In fact, research is uncovering a new understanding of both the origin and treatment options for this condition. Glycation impairs the epidermal barrier from repairing properly, disassembling the dermal matrix, and causing an inflammatory cascade. It has also been shown to be involved in pigmentary changes, that are unrelated to melanin. Jacine Greenwood-Drummond is a qualified cosmetic chemist and beauty therapist and internationally recognised ingredient expert who will discuss this topic.
TOPIC: YOU WILL NEVER BE STRESSED AGAIN SPEAKER: Dr Andrew Huberman (USA) Time: 14 minutes Another amazing and powerful presentation by renowned neuroscientist Dr Andrew Huberman on how to successfully take control of your own stress levels. Learn how to trigger your brain’s ability to gain optimal sharpness and alertness and how to activate your ability to calm your brain and nervous system so that you gain more control of your life and make productive, rather than reactive decisions. TOPIC: SECURITY AND CYBER PROTECTION SPEAKER: Professor Terry Everitt TIME 30 Minutes As the reliance on the computerised flow of information continues to increase, so is the risk to that flow. Many make it easy for sensitive and private information to be hacked by a lack of appropriate administration and security policies around the transfer and handling of information. It has been said there are two types of organisations: those who know they have been hacked and those who have been hacked, but do not know it. Almost, every day there is news about a hacked company, regardless of size. You take on additional responsibilities when
handling the health information of your clients. Known for his unwavering commitment to educational excellence professor Everitt will address this topic.
TOPIC: INSTAGRAM ON STEROIDS SPEAKER: Trish Hammond TIME: 30 Minutes Every astute business owner knows that business growth requires a two-fold approach – retain existing clients, while continually reaching out to gain new ones and grow your database. As a business owner, to achieve these objectives you will need to maintain a consistent and effective communication strategy, profiling how your services and products will deliver incredible benefits and provide solutions to your clients’ needs. Instagram is one of the most powerful tools for this purpose, however, it must be used correctly to gain optimal results. Trish Hammond is a dedicated social media marketing expert who has developed many brands through her award-winning skills and knowledge. TOPIC: FROM GOOD TO GREAT PERFECTING YOUR COSMETIC TATTOOING TECHNIQUES SPEAKER: Katherine McCann TIME: 30 Minutes Cosmetic tattooing now has many tools and techniques that can deliver amazingly beautiful and natural end results. This is great news for the artist because it means endless possibilities that will suit a much broader and more astute client demographic than in previous years. This session will present visual evidence of how small changes can totally transform an ordinary procedure to an extraordinary one. Katherine McCann is a specialist cosmetic tattooist and educator. TOPIC: AUSTRALIAN REGULATIONS FOR IPLS AND LASERS – AN INDUSTRY UPDATE SPEAKER: Dr Stephen Newbery TIME: 30 Minutes Within our industry, there is so much talk on the need for regulation for Laser and IPL services. While there have been several attempts to achieve regulated mandatory standards, an appropriate outcome has not been reached, despite two extensive efforts over several years involving comprehensive work undertaken by several industry leading bodies under the auspices of the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA). Meanwhile, the incidents of burns continue to escalate, and industry bodies are once-again pressing for the issue of regulations to be revisited. Dr Stephen Newbery is Principal Health Physicist, Department of Health for Tasmania. Dr Newbery was responsible for setting up the Tasmanian regulations. TOPIC: COLOUR PRINCIPLES FOR SUCCESSFUL COSMETIC TATTOOING OUTCOMES SPEAKER: Maja Ercegovac TIME: 30 Minutes The success of a cosmetic tattoo procedures lies not just in the shape, but also in the effective colour that can transform a feature, enhance it, or make it more youthful. Colour success is not just about colour selection, but also about the method of application, technique, as well as understanding the condition of the skin as the recipient organ in which the pigment will be introduced. Maja Ercegovac is a principal trainer and educator. In this lecture she will share her wealth of knowledge, as well as her technical secrets on how to avoid problems in colour stability.
TOPIC: 2021 COVID-19 UPDATE: THE GLOBAL VACCINATION EFFORT SPEAKER: Professor Laurence J. Walsh AO TIME: 50 Minutes Moving forward from last year, it is time to gain a comprehensive understanding of the issue of “vaccines”. This has been a highly controversial topic that has brought uncertainties and confusion to many. Professor Walsh is a respected academic who will provide an update on this topic.
PRINCIPLES AND TECHNIQUES FOR POST-CANCER NIPPLE AREOLA SIMULATION WITH COSMETIC TATTOOING SPEAKER: Paola Gateno (Chile) TIME: 30 minutes In 2020 female breast cancer increased globally by an estimated 2.3 million new cases (11.7%). This affliction is devastating for many women and their families, stripping at their dignity, and contributing to ongoing stress, potential divorce and in some cases even death. The role of the medical cosmetic tattooist is an extremely important one postmastectomy in helping restore confidence and a level of normality through skilfully crafted nipple areola simulation. Paola Gateno has extensive qualifications and knowledge in medical cosmetic tattooing and specialises in cancer patients. She also holds qualifications in Oncological Aesthetics and Restorative and Integrative Aesthetics and lectures internationally on these subjects. TOPIC: BEYOND INGREDIENTS - NEW ADVANCES AND CONCEPTS IN COSMECEUTICAL APPLICATIONS SPEAKER: Dr. Tiina Meder – Dermatologist (Switzerland) TIME: 30 minutes As delivery systems are becoming more sophisticated aiming to instigate positive changes and more advanced treatment outcomes, they pose another consideration – what is the most effective sequence of application to ensure advanced clinical results? New clinical studies are uncovering interesting data on why, when and in what order skincare layering should be applied. Dr Tiina Meder is a renowned and award-winning formulator and cosmetic dermatologist and educator, she will provide the latest scientific evidence on this topic.
TOPIC: LATERAL THINKING AND HOW IT CAN TRANSFORM YOUR BUSINESS SPEAKER: Tina Viney TIME: 30 Minutes As a rule, we usually make business decision based on the analysis of information we possess through specific, logical criteria. This information is often obtained through education we have completed, or supplier training through companies we engage with. This process usually directs us to a predicable outcome on how we think and operate our business. The problem with this approach is that it is most likely duplicated by our competitors. Studies are identifying a new way of thinking and processing information known as lateral thinking. This approach allows us to reach outcomes that are more creative, original, and less predictable allowing us to carve our niche though a more unique business model that can provide us with a strong competitive advantage. Tina Viney is the CEO of APAN and an avid researcher of cutting-edge advances in both business and scientific studies that will best serve the aesthetics industry.
TOPIC: SKIN CANCER AND COSMETIC MEDICINE PRESENTER: Dr Lucas De Siqueira Time: 30 minutes Skin cancer can sometimes be deceptive or can be misdiagnosed. Furthermore, removal of lesions, pre-cancerous or cancerous, can warrant further skin treatments for corrective purposes. This lecture will provide an update on various lesions, their origin, and manifestations, as well as potential treatment options, surgical and non-surgical. It will present ways that skin and dermal therapists can work collaboratively with a cosmetic physician to support the skin’s recovery and in the treatment of scarring for the best possible patient treatment outcome. Dr Lucas De Siqueira is a RACGP fellow general practitioners who specialised in skin cancers and cosmetic medicine.
TOPIC: THE ROLE OF GLUTATHIONE IN IMMUNITY AND SKIN HEALTH SPEAKER: Dr Stephanie Tan TIME: 30 Minutes In an era of pandemics optimising immunity is so important. However, so is the need to ensure we are implementing this though evidence-based solutions. Glutathione is renowned as the “master antioxidant” with impressive research backing its incredible ability to reduce oxidative stress, fight free radical damage and boost the utilisation and recycling of vitamin C and Vitamin E as well as CoQ10 and Alpha Lipoic acid. In addition, Glutathione is a powerful detoxifier and plays a major role in immune function. Not only does it protect against viruses, but also known to support the body against many ageing diseases such as heart disease, dementia, cancer, chronic fatigue syndrome, asthma, high cholesterol, and many others including skin disorders. Dr Stephanie Tan is the associate medical director of iXBiopharma and a clinical trial expert. TOPIC: TOPIC: PROFESSIONAL TIPS FOR PERFECTING EYEBROW MICROBLADING SPEAKER: Junie Ye TIME: 30 Minutes Eyebrow microblading is one of the most popular and in-demand procedures, however, as currently there is no formal qualifications for this procedure in Australia, the level of training is inconsistent, with errors and poor-quality work a common concern. Junie Ye is a highly qualified practitioner and trainer in Australian and has also completed extensive international training in all facets of cosmetic tattooing. Julie is an innovator of leading techniques.
TOPIC: ASSOCIATION LEADERSHIP IN THE NEW DECADE (Panel Discussion) PRESENTERS: Jacinta King (President) – Cosmetic Nurses Association (CNA), Tina Viney (CEO) – Aesthetics Practitioners Advisory Network (APAN), Julie Martin (Chair) – New Zealand Board of Professional Skin Therapists (NZBPST), Jennifer Byrne (President) – Australian Society of Dermal Clinicians (ASDC) Moderator: Professor Terry Everitt TIME: 60 Minutes Over the past 24 months the world has experienced incredible changes due to the global pandemic and beyond. These challenges have brought about a new focus on the important role that industry peek bodies play in providing meaningful support to their members and constituents. This panel discussion will explore the current industry changes that industry bodies have identified and the role, responsibilities and focus of each body.. TOPIC: DEVELOPING AND MONITORING CONSISTENCY IN BUSINESS GROWTH SPEAKER: Daniel Dickson TIME: 45 minutes So many businesses struggle to maintain consistency in reaching their monthly targets and business growth. Is this stagnation due to outdated marketing and promotional methodologies, or is it the human factor of staff performance, particularly during more challenging economic times. With extensive experience, knowledge in both staff and business development Daniel Dickson, together with his wife Debbie, have developed one of the most successful brands in the highly competitive aesthetics professional skincare market. In this lecture Daniel, in his usual creative style, will present a step-bystep approach on the most effective strategies in increasing sales and achieving consistent business growth.
TOPIC: THE REDEFINITION OF BEAUTY SPEAKER: Dr Adam TIME: 30 Minutes As cosmetic medicine becomes more mainstream so are the evolving techniques that feature “natural-looking youthfulness” where any enhancement is undetectable. These advances allow for a broader age demographic to embrace cosmetic enhancement. However, achieving these outcomes requires a very different protocol approach to previous years. Today, a cosmetic injector has incredible options in both product choice and techniques that offer exciting possibilities. Dr Adam hold a Bachelor of Medicine and a Bachelor or Surgery and holds extensive training and experience in cosmetic medicine. He is renowned for having a good eye for what beauty is and means in 2021. TOPIC: SUCCESSFUL STAFF RECRUITMENT AND MANAGEMENT SPEAKER: FRANCESCA WEBSTER TIME: 30 Minutes Every business owner knows how important it is to find the right staff and orientate them to effectively reflect the values and standards that will serve the business model they have carefully developed. However, even with highly gifted staff the potential for changing attitudes and a shift away from consistent and reliable high-performance is always a risk. Francesca Webster is a highly skilled and experienced business owner who has managed over 200 staff throughout her successful salons. She is renowned for her incredible passion for empowering women regardless as to whether they are her staff or her clients . Prepare to learn from the best.
28 - 30 June REGISTRATION APAN MEMBERS $249 Staff $12ea NON-MEMBERS $299 Staff $14ea
The Master Aesthetics Educational Event of the Year! Featuring 35 global impacting educational presentations. It will be screened on 28-30 June, and available for viewing on apanconf.com for 30 days so it can access all segments at your convenience.
This is a certified professional development event and will secure delegates 15 CPD Points.
WHO SHOULD ATTEND: Aestheticians Dermal therapists & clinicians Cosmetic Medicine practitioners Cosmetic nurses & tattooists Trainers & Educators College principals and staff Students Industry suppliers
firstname.lastname@example.org APJ 51 www.apanconf.com
Coffee and its affect on
Adrenals and the Skin Tina Viney
WHILE TRADITIONALLY, AUSTRALIANS WERE CONSIDERED TEA-DRINKERS, our coffee consumption over the years is constantly on the rise. Perhaps this is because Australian coffee baristas are considered to rival some of the world’s best. Who does not love the smell of coffee when passing by a coffee shop, even if they you don’t drink it, the aroma is tantalising?
IS COFFEE A DIURETIC? There is no surprise that coffee contains caffeine - that's the main reason people drink it in the morning and rely on it for a midday pick-me-up. You might have also heard that caffeine, although a lifesaver when you are tired, is a diuretic that can cause dehydration. But is it really?
The annual domestic coffee consumption in Australia reached almost 1.87 million 60-kilogram bags. On average, Australians consumed around 1.91 kilograms of coffee per person in 2019, out of which 1.39 kilograms were roasted coffee and around 0.53 kilograms were instant coffee. While instant coffee still exists, roasted coffee is almost three times as popular.
Many recent studies have found that caffeine is a very mild diuretic at most; a review of 10 studies at the University of Connecticut found that 12 out of 15 cases showed that people went to the bathroom the same amount of time, regardless as to whether the water they drank had caffeine in it or not. This study therefore claimed that there was no difference between those who consumed coffee versus water. It is all still up for debate, but there is an easy solution for those worried their coffee habit is dehydrating their skin - just drink more water.
There is no doubt coffee is an efficient way to get the day started strong, but does the temporary energy boost lead to an energy loss in the long run? And what about the skin? In the past, Terry Everitt tackled a lengthy article on the cons and mainly pros of coffee. However, as an update, I found some interesting recent information to share with you. This is because, there is often misinformation communicated about coffee, so it is good to known what the studies are showing. APJ 52
Coffee also contains antioxidants. We all know that eating a diet rich in antioxidants can help improve your skin health, but research into the actual process of how antioxidants are absorbed and utilised in the body is still ongoing. However, we do know this: free radicals cause signs of ageing, like fine lines, wrinkles, and
brown spots. Antioxidants (whether consumed orally or applied topically) fight free radicals, and thus, help to fight signs of ageing. THE BENEFITS OF COFFEE Dr. Justin Marchegiani is a functional medicine doctor based in Massachesetts. He is an amazing educator and I often view his educational programs which are incredible. When it comes to coffee here is a brief summary of some of his observations: Our brains have an inhibitory neurotransmitter called adenosine, which helps to calm and relax. Coffee decreases adenosine–the compound that decreases energy and alertness–thereby increasing energy! This adenosine-dampening effect helps boost energy and focus and can be particularly useful for burning fat. Taken before a workout, caffeinated coffee (averaging between 150-300 mg of caffeine per cup) helps increase lipolysis - fat burning. There are also many people who opt to swap coffee for breakfast to remain in ketosis: a cup of coffee with healthy fats (grass-fed butter, coconut oil, MCT oil, pastured egg yolk) can be a fat-burning yet quite satiating meal replacement that helps you stay in ketosis while keeping you full and alert. High quality coffee is quite nutrient-packed. B vitamins, a lot of alkaloids, and antioxidants are especially abundant in coffee. There are also several studies which indicate coffee may be neuroprotective, providing protection from neurological diseases like Alzheimer’s, Parkinson’s, and dementia. COFFEE’S DOWNFALLS If you suffer from adrenal or thyroid issues such as adrenal fatigue or hypothyroidism, take note of how caffeine affects your condition and pay attention to how you feel in the hours and days after its consumption. Coffee stimulates adrenaline and the adrenals–if you have healthy adrenal function, this is similar to getting a little cortisol or adrenaline push, which may boost your energy and performance. If you have adrenal fatigue, however, you may want to exert a little caution when it comes to caffeinated coffee. The science is somewhat contradictory: some studies show caffeine affects cortisol levels, some studies say it does not affect cortisol levels, and others have shown that habitual coffee drinkers have a reduced cortisol secretion response. Clearly, we need more research on this topic. Ultimately, research seems to indicate that there are a wide range of responses to caffeine intake. If you have adrenal fatigue or other adrenal/thyroid issues, it is wise to consult a professional who can help you test and track caffeine’s effect on your unique biology. COFFEE AND SLEEP Cortisol rises and falls with your body’s internal clock– cortisol rhythm should be aligned with your circadian rhythm, rising in the morning, and lowering in the evening. However, those with hormone imbalances may have cortisol issues. If you feel fatigued during the day but get a burst of energy at night (making it hard to fall asleep), you may have a hormonal imbalance, adrenal fatigue, or thyroid issues. This can be exacerbated by coffee, particularly if you are drinking it too late in the day. Studies confirm that coffee can keep you ramped up even six hours after drinking it, so it is recommended to have your last cup no later than 2pm. HOW TO USE COFFEE TO YOUR BENEFIT Coffee is an incredibly useful substance which provides us with energy and alertness when used correctly. To avoid the downfalls of this caffeinated beverage, here are some tips from Dr. Justin Marchegiani to get the most out of every sip.
HYDRATION AND NUTRIENTS Coffee can put your body in a sympathetic state, reducing appetite. If you are doing a keto coffee with added fat (like butter), you may feel like you can go for hours without eating. While this may work great for a healthy individual, if you have compromised adrenals or thyroid, it is important to eat regularly to prevent putting extra stress on your body. A combination of adrenal fatigue or hypothyroidism, caffeine, and fasting can cause undue stress. Be sure to eat meals at good intervals of every three hours or so, depending on your body: grass-fed meats, healthy fats, and organic veggies. It is also beneficial to add a high-quality source of protein or a collagen powder to your coffee. COFFEE QUALITY AND DECAFFEINATED COFFEE Decaffeinated coffee can be beneficial for those with adrenal fatigue or thyroid issues who want to avoid the burden of consuming caffeine. Be aware, caffeine is a natural pesticide, and decaffeinated coffee is sprayed more heavily to compensate. Organic coffee grown without pesticides will help you avoid this common downfall of decaf coffee. Just be sure the coffee is decaffeinated via a Swiss water process, not the toxic and carcinogenic benzene or methyl chloride process. Ultimately, every individual has unique biochemistry and whether coffee is helpful or harmful will depend on the state of your health, the quality of the coffee you buy, and how you use it. Choose a high-quality coffee grown without pesticides and checked for mould. If you have autoimmune issues, it might be best to cut caffeine for a little bit to see how it affects how you feel. Unless you are in ketosis, a great way to prepare coffee is by adding healthy fats like grass-fed butter or coconut oil, along with a protein powder. This combination turns coffee into more of a ‘meal’ which supports your thyroid and adrenals. SAFETY ISSUES AND THE SKIN According, Dr Gary Goldenberg, a cosmetic dermatologist from New York and an assistant clinical professor of dermatology at Mount Sinai Hospital drinking more than four cups of coffee can be detrimental to your health. But he adds that when consumed in moderation, not only is coffee safe, but it has also been shown to be beneficial to the skin, thanks to its anti-inflammatory and antioxidant properties. If you are prone to post-coffee anxiety, you may want to document how you feel after each cup of coffee you drink. If coffee is the culprit, trying decaf is an option since you still get the antioxidant benefits, even with the removal of 97% caffeine from the beans. CAN COFFEE MAKE YOUR ACNE WORSE? In short, Goldenberg says, "Caffeine doesn’t cause acne. However, over-consumption of caffeine has been associated with stress, which is associated with acne." In one study, researchers found that those who drank a cup of coffee before going through a stressful event saw a 211% increase in cortisol levels, versus those who didn’t drink coffee. In other words, coffee can heighten your stress levels, which in turn can cause your body to overproduce insulin, which is bad news if you are already struggling with acne. Additionally, the way that you take your coffee could play a huge role in your breakouts. There are studies linking skim milk and dairy milk with acne. Whey and casein are the two proteins found in dairy that have been associated with inflammation in the skin, and in particular, acne. But it's not only coffee creamer to blame. Goldenberg adds, "Inorganic milk can adversely affect your hormones and cause acne, so can white sugar and syrup. So, if you already struggle with acne, you might want to cut back on the milk and sweetener and start drinking your coffee black. APJ
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GLUTATHIONE Its role in skin health and immunity Tina Viney
IN THIS DAY AND AGE WITH THE CHALLENGES OF COVID-19, the issue of strengthening our immunity has become a hot topic. While there are numerous ways to achieve this, we are committed to providing you with the most researched and evidence-based data as it comes to hand, enabling you to stay informed with credible information. While we are aware of the benefits of vitamin D for immunity another master antioxidant that is worth investigating is glutathione. The research on glutathione is not only extensive, but on-going. We are thrilled to say that at our upcoming ONLINE AESTHETIC CONFERENCE we will have the privilege to present to you a leading expert who will bring you up-to-date with some exciting information and the latest research on glutathione and how to optimise your levels. Dr Stephanie Tan is the associate medical director of iXBiopharma and a dedicated academic in clinical trials. However, in this article, I would like to share some highlights of what we know about this amazing antioxidant.
Structurally, glutathione is a tripeptide consisting of three specific amino acids: Glycine, Glutamic acid, and Cysteine. It is found and synthesised naturally in both plants, and animals. Glutathione is an excellent antioxidising agent and acts as a very effective skin whitening agent, if available in sufficient dosages. It is the most abundant antioxidant in our bodies. In fact, virtually every organism on earth has some glutathione in its cells. Without adequate levels of glutathione, you are at risk of dangerous medical conditions, including stroke, Alzheimer’s, heart disease, susceptibility to viruses and even cancer. But when glutathione levels are healthy, that is when the magic happens. You can not only prevent health problems, but possibly experience amazing energy, glowing skin, a strong heart, and a sharp brain. WHY IS GLUTATHIONE IMPORTANT TO HEALTH? The role of glutathione in your bodily function cannot be underestimated. Healthy levels of glutathione possess some potent and important health benefits, these health benefits largely relate to glutathione’s role in these vital bodily processes:
WHAT IS GLUTATHIONE? Who would not like to get their hands on a naturally occurring substance that acts as an antioxidant, an immune system booster, and a detoxifier? Something that can help your body repair damage caused by stress, pollution, radiation, infection, drugs, poor diet, ageing, injury, trauma, burns as well as improve the skin?
Cell differentiation, signalling and proliferation
Glutathione, also known as GSH, is an antioxidant naturally found in human cells that neutralise free radicals, boost the immune system and detoxifies the body. It can also contribute to skin lightening by converting melanin to a lighter colour and deactivating the enzyme tyrosinase, when taken in sufficient quantities.
But the most powerful functions glutathione offers your system are its antioxidant properties. Glutathione fights free radicals and the oxidative damage that cause disease. So how does this work?
Many of us know the chef’s trick of sprinkling a little lemon juice over fruit to keep it from turning brown. Antioxidants are like that lemon juice. By consistently “sprinkling” your body with
antioxidants like glutathione, you can prevent your body from “browning” or “oxidising” which causes damage and ageing of cells. Antioxidants are the anti-agers of the nutrient world, working to protect your body from free radicals, and the oxidative damage they cause. Every time you eat, breathe, or move, your body uses fuel created from the food you eat to produce energy. Just as a car releases harmful by-product as exhaust, so too does your own body’s energy-producing efforts produce a dangerous by-product in the form of free radicals. Free radicals are highly reactive forms of oxygen that are missing an electron. When they come into contact with normal molecules, they steal an electron, damaging the healthy cell and its DNA. In fact, research confirms that your DNA takes 10,000 oxidative hits daily. Antioxidants work to counteract the damage caused by free radicals. Glutathione is the “master” antioxidant, directly binding to oxidative compounds that damage cell membranes, DNA, and energy production. It directly neutralises a wide range of oxidants, including superoxide, nitric oxide, carbon radicals, hydroperoxides, peroxynitrites, and lipid peroxides. Glutathione offers the allimportant antioxidant defence like few others can. GLUTATHIONE AND DETOXIFICATION The role of glutathione in your body’s detoxification system is vital. But your natural processes sometimes require a boost from increased glutathione from your diet or supplements. The detoxification system works, in three phases: PHASE 1: During Phase 1 detoxification, all sorts of toxins and xenobiotics are partially processed by specialised proteins inside mitochondria called cytochromes. Unfortunately, Phase 1 is an incomplete process and can turn toxins into dangerous free radicals. These are not only damaging, but they can single-handedly deplete glutathione, creating an imbalance between Phase 1 and Phase 2 activity. PHASE 2: In Phase 2 detoxification, various enzymes act directly on the toxins partially degraded and processed in Phase 1. These enzymes use glutathione to neutralise the toxins. PHASE 3: Detoxification is the elimination of toxins and xenobiotics. Toxins are removed from your body, mainly by the kidneys (urine) and liver (bile).
Without glutathione, your body would not be able to neutralise and eliminate toxins effectively. GLUTATHIONE AND ENERGY Energy production occurs within all cells (except red blood cells) via the mitochondria. Glutathione protects mitochondria from free radicals and the oxidative damage they cause supporting its function and in this way glutathione is paramount to energy production. If mitochondria are damaged, they slow down and start to make less energy. The affected diseased mitochondria lead to decreased bodily function and efficiency as well as premature ageing. To make things worse, damaged mitochondria output more free radicals. In turn, these free radicals cause further mitochondrial damage and create a vicious cycle of less energy and more damage. Glutathione binds these free radicals and relieves oxidative stress — not just on the mitochondria, but on the rest of the cell. GLUTATHIONE AND SKIN BENEFITS Whether you are concerned with acne, wrinkles, dryness, eczema, or puffy eyes, or seeking to achieve flawless, youthful skin, science confirms that glutathione is an effective answer. Glutathione not only decreases the melanin (pigmentation) in your skin, it also has been found to decrease wrinkles and increase skin elasticity as it helps cells heal and regenerate themselves. Glutathione works on the skin pigment production by inhibiting tyrosinase, an enzyme involved in melanin production that is responsible for our skin colour, but also for pigmentation. In one study, glutathione achieved a skin lightening effect over a course of a few weeks. The effect on pigmentation is transient, so you would need to continue using glutathione to maintain the skin-whitening effect. There are multiple studies that confirm the effectiveness of glutathione is achieving skin lightening benefits. A recent study confirmed that glutathione has also been shown to decrease psoriasis. The glutathione levels in this clinical trial were increased by consumption of whey protein, which contains glutamyl cysteine, a precursor to glutathione. The same studies also show that glutathione does not just lighten the skin, but it improves skin elasticity and decreases wrinkles. WHAT CAUSES GLUTATHIONE DEFICIENCY? Age is the most natural reducer of glutathione levels. However, there are a number of environmental factors and medical conditions that increase your risk.
• Cystic fibrosis • Stroke • Heart disease • Infertility GLUTATHIONE AND BRAIN HEALTH How do low levels of glutathione affect brain and mental health? Studies confirm that there is a clear link between low glutathione levels and decreased brain health. As we age, it is not uncommon to experience a bit of forgetfulness or difficulty concentrating. These are just two examples of neurodegeneration, a process by which the neurons in our brains become damaged and may even die. This leaves us with a “shrinking” brain which does not function to its full capacity. While this process is unavoidable as we age, it can be slowed, or even reversed, and glutathione plays an important role in preventing this to happen. Accelerated neurodegenerative diseases, such as Parkinson’s disease and Alzheimer’s exhibit high levels of oxidative stress damage to the brain, as well as low active glutathione levels. Glutathione has been proven to ease the decrease the rate of damage to brain tissue. Other neurological illnesses like Lyme disease have been shown to weaken when your body experiences higher levels of glutathione.
Environmental risk factors of glutathione deficiency include: • Exposure to chemical toxins (including pollution) •
UV radiation exposure
Excessive alcohol use
Certain medications (like Tylenol)
Certain illnesses are known to decrease glutathione levels. Researchers are still determining whether low glutathione causes some of these diseases, or the other way around. The most common low glutathione-related diseases are: • AIDS/HIV •
Sickle cell anaemia
GLUTATHIONE AND HEART HEALTH The number one health related cause of death in Australian is still heart attack. A lesser-known fact is that glutathione may prevent heart attack and other heart disease, thanks to its ability to neutralise the “lipid oxidation” (fat oxidation) process. Virtually all heart disease starts with the accumulation of arterial plaque inside the artery walls. Bad cholesterol (LDL) is lipid oxidised and damages the lining of the blood vessels, forming plaque contributing to atherosclerosis. When these plaques eventually rupture and break off, they can clog your blood vessels and block blood flow that contribute to heart attacks or strokes. With the help of the enzyme glutathione peroxidase, glutathione stops the superoxides, free radicals, hydrogen peroxides, lipid peroxides, and peroxynitrites that cause this lipid oxidation and wreak havoc on your health. In this way, glutathione helps to prevent damage and lowers the risk of heart attacks. In a study of 643 cardiac patients who underwent coronary angiography in Germany, those who died of heart attacks had much lower levels of glutathione peroxidase than those who survived. If we don’t have enough glutathione to neutralise damage to our arteries, we are at increased risk of heart disease and cardiovascular events. GLUTATHIONE FIGHTS INFLAMMATION Inflammation has been a hot topic in the natural health world for the past decade; however, many people still don’t fully understand exactly why inflammation lies at the root of most of the health concerns. High levels of inflammation are present in virtually every chronic illness, like diabetes, heart disease, and cancer. However, inflammation is also healthy and necessary (in short bursts) to fight infectious invaders. Injury can also incite an inflammatory response. Whether you are talking about trauma, infection, toxins, or allergies, your immune system answers the same. First, the blood vessels in the injured area begin to expand and open wide to allow your body’s natural
healing compounds to get to the injured site as quickly as possible. Because of the increased blood flow, fluid and immune cells flood the area often in overwhelming amounts. This increase in permeability of the blood and lymph vessels is what causes the physical manifestations of acute inflammation, namely redness, pain, stiffness, and swelling. After the infection or injury is repaired the acute inflammatory response normally subsides and goes away. The inflammatory response comes to your rescue when its needed and cools itself off once the healing is complete. But we don’t live in an ideal world. In the real world, environmental toxins, diet, stress, and other lifestyle issues, have disabled the checks and balances of this system and inflammation doesn’t subside and go away as it is meant to. As a result, many people suffer from chronic, systemic inflammation, this is where glutathione can help. Glutathione controls when inflammation increases or decreases as needed by instructing and influencing our immune white cells. This is a completely separate mechanism from its antioxidant properties. Rebalancing glutathione levels reduces chronic inflammation and restores immune function. GLUTATHIONE AND THE IMMUNE SYSTEM Glutathione helps your immune system stay strong and ready to fight infections. While vitamin C seems to get all the accolades when it comes to immunity, glutathione is the under-recognised supporting actor who deserves the starring role. Research shows that active glutathione primes white cells such as natural killer (NK) and T cells, your body’s front-line infection fighters. Glutathione-enhanced T cells are able to produce more infection-fighting substances, controlling both bacterial and viral infections. One clinical trial found that glutathione doubled NK cells’ ability to be cytotoxic (kill invaders) after just six months of use. Glutathione actually has a potent antibacterial effect as it helps the immune cells called macrophages fight the bacterium that causes tuberculosis, Mycobacterium tuberculosis. In another study, researchers found that glutathione modulates the behaviour of many immune system cells, affecting adaptive immunity and protecting against microbial, viral and parasitic infections. There are many chronic infections such as EBV, hepatitis, herpes viruses and Lyme, to name a few, which can deregulate and suppress the immune system. Glutathione can modulate and reverse this suppression. Autoimmune diseases also appear to be hallmarked by imbalanced glutathione levels. GLUTATHIONE AND VITAMIN D Vitamin D3 - the most active form of vitamin D, has been a hot topic in medicine because it controls and modulates the immune system. And when glutathione levels are low, vitamin D3 doesn’t work as efficiently. Initially thought to play a role in calcium metabolism and bone formation only, we now know that low vitamin D3 levels can increase your risk of: •
High blood pressure
Decreased brain function
The association of vitamin D3 deficiency has been correlated with simultaneous glutathione deficiency. Observing animals deficient in vitamin D3, researchers found that supplementing vitamin D3 and cysteine (a glutathione precursor) restored glutathione levels,
increased the bioavailability of vitamin D3, and lowered inflammation. Researchers noted that the vitamin D supplements widely consumed by the public are unlikely to be successful unless the glutathione status is also corrected. In other words, simply taking vitamin D isn’t enough. You need to be sure you have adequate glutathione levels to make sure that your vitamin D3 is working as it should. *GLUTATHIONE AND COVID-19 A recent study identified that endogenous glutathione deficiency appears to be a crucial factor enhancing SARS-CoV-2-induced oxidative damage of the lungs and, as a result, leads to serious manifestations, such as acute respiratory distress syndrome, multiorgan failure, and death in COVID-19 patients. When the antiviral activity of GSH is considered, individuals with glutathione deficiency seem to have a higher susceptibility for uncontrolled replication of SARS-CoV-2 virus and thereby suffer from an increasing viral load. The severity of clinical manifestations in COVID-19 patients is apparently determined by the degree of impaired redox homoeostasis attributable to the deficiency of reduced glutathione and increased ROS production. This assumption was supported by the research findings. In particular, COVID-19 patients with moderate and severe illness had lower levels of glutathione, higher ROS levels, and greater redox status (ROS/GSH ratio) than COVID19 patients with a mild illness. Long-term and severe manifestations of COVID-19 infection in one of the patients with marked glutathione deficiency suggests that the degree of glutathione decrease correlates negatively with viral replication rate and that an increasing viral load exacerbates oxidative damage of the lung. This finding suggests that the virus cannot actively replicate at higher levels of cellular glutathione, and therefore, milder clinical symptoms are observed with lower viral loads. Glutathione deficiency is an acquired condition attributable to decreased biosynthesis and/or increased depletion of the endogenous glutathione pool influenced by risk factors such as ageing, male sex, co-morbidity, and smoking alone or in combinations. Glutathione deficiency in COVID-19 patients with serious illness may also be a result of decreased consumption of fresh vegetables and fruits (especially during winter and spring seasons), which contributes to over 50% of dietary glutathione intake. The hypothesis suggests that SARS-CoV-2 virus poses a danger only for people with endogenous glutathione deficiency, regardless which of the factors of ageing, chronic disease co-morbidity, smoking or some others were responsible for this deficit. The hypothesis of this study provides novel insights into the causes and mechanisms responsible for serious manifestations of COVID-19 infection and justified promising opportunities for effective treatment and prevention of the illness through glutathione recovering with N-acetylcysteine and reduced glutathione. Since the antiviral effect of glutathione is nonspecific, there is reason to believe that glutathione is also active against SARS-CoV2. Therefore, restoration of glutathione levels in COVID-19 patients would be a promising approach for the management of the novel coronavirus SARS-CoV-2. Notably, long-term oral administration of N-acetylcysteine has already been tested as an effective preventive measure against respiratory viral infections. N-Acetylcysteine is widely available, safe, and cheap and could be used in an “off-label” manner. The studies confirm that both glutathion and N-Acetylcysteine offer promise in supporting the body against COVID-19. APJ
For a list of references, please contact the editor.
Psoriasis – a Common Affliction Gaining an understanding of this condition and simple strategies to offer support Eva Boyd I AM SURE FROM TIME TO TIME YOU HAVE SEEN ON OUR CLIENTS, SILVERY DRY SCALES on elbows, knees or even around the nose, which are the tell-tail signs of psoriasis, and while you may not be qualified to treat this condition, there are certainly safe and effective ways to help provide relief, alleviate itchiness, and condition the skin to help soothe and calm the inflammation. Psoriasis is a chronic, noncontagious skin condition that causes skin cells to build up and form red, inflamed patches. Following decades of research, doctors remain unclear as to the exact causes of psoriasis. However, over time studies are gaining a greater understanding on how the immune system, genetics, and environmental factors can play a key role. This article will look at psoriasis and the immune system and how to boost immunity. It will then explore possible complications of psoriasis, as well as triggers and potential treatments. PSORIASIS AND THE IMMUNE SYSTEM Many experts classify psoriasis as an autoimmune disorder, although others disagree. One alternative theory is that psoriasis occurs because the immune system reacts irregularly to bacteria on the skin due to genetics. In an autoimmune disease, specific triggers cause the immune system to malfunction. These triggers vary between individuals. But in the case of psoriasis, they can include stress and skin trauma, such as insect bites, sunburn, and scratches. In psoriasis, the activated immune system mistakenly launches an inflammatory response. It begins to attack healthy cells as though they were harmful invading pathogens. White blood cells called T helper lymphocytes, or T cells, become irregularly active and produce excess signalling molecules.
These cytokine molecules cause the blood vessels in the skin to widen. In turn, this causes white blood cells to accumulate, and keratinocytes, which make up the outer layer of the skin, to multiply much faster than usual. In psoriasis, the process of a cell dividing, maturing, migrating to the skin’s surface, and sloughing off is complete in as little as just three to seven days, compared with 3–4 weeks in a person without psoriasis. The result of this skin build-up is thickened, flushed, and scaly skin plaques. CAUSES OF PSORIASIS There are many different types of psoriasis. Researchers believe that a combination of factors can cause an individual to develop psoriasis. In some cases, genetics can be a cause, as the condition often runs in families. If a child has one affected parent, they have a 16 per cent chance of developing psoriasis. With both parents, the chance jumps to 50%. However, it is not uncommon for individuals with no family history to also develop psoriasis. This finding of one study highlighted that environmental factors such as stress, smoking, and diet may contribute to the development of psoriasis. DOES PSORIASIS RESULT IN IMMUNOCOMPROMISE? Having psoriasis does not necessarily mean a person is immunocompromised. But some individual who are taking immunosuppressant drugs, such as Adalimumad, can experience psoriasis, as a result of the reduces immune function. HOW TO REGULATE THE IMMUNE SYSTEM TO FIGHT PSORIASIS Having a properly functioning immune system is essential to health. There are various ways that individuals with psoriasis can
regulate their immune systems through diet and exercise. Here are proven recommendations that support the immune system and benefit individual who suffer from psoriasis. MEDITERRANEAN DIET According to a 2018 study, following a Mediterranean diet can slow the progression of psoriasis since it reduces inflammation. The Mediterranean diet consists of the following: High consumption of
Low consumption of
Olive Oil (Extra-virgin) According to a 2017 paper, curcumin was found to lower inflammation levels in psoriasis sufferers. This was attributed to the antioxidant and anti-inflammatory effects of turmeric. In another 2014 study garlic was also shown to have an immunemodulating effect that was also found to benefit psoriasis conditions. EXERCISE We know that regular exercise is important to overall health and in improving the function of the immune system. Studies also confirm that a 30-60 minutes of brisk walking can help improve the body’s immunity and that regular exercise can improve the inflammation of psoriasis. It can also reduce the risk of other complications, such as high blood pressure or diabetes. OTHER COMPLICATIONS Psoriasis appears not just on the skin, but also can inflect the nails. Additionally, psoriatic arthritis can occur and contribute to inflammation of the joints. It can occur in approximately 30 per cent of patients with psoriasis. This condition can be painful and can contribute to an inflammatory type of arthritis, however, symptoms can be reduced with treatment.
TYPES OF PSORIASIS
Psoriasis can also contribute to a potential higher risk of developing cardiovascular diseases such as: •
Peripheral artery disease
This is possibly due to the inflammation that occurs with all the conditions. IMPACT ON PSYCHOLOGICAL DISORDERS People with psoriasis may feel emotional distress that disrupts their regular social interactions or working life. According to a 2018 study, people with psoriasis have an increased risk of experiencing depression and anxiety. CAUSES AND TRIGGERS Individuals with psoriasis may have different triggers, and the
condition may run in families. Common triggers that can cause flare-ups in people with psoriasis include: •
injuries to the skin, including tattoos or shaving cuts
dry, cold weather
sunburn and hot weather
MEDICINAL TREATMENT If psoriasis is mild, treatment with a skin moisturiser, medicated shampoo, and exposure to sunlight may be enough to alleviate symptoms. However, severe cases require medical therapies to manage the condition. The most common are Corticosteroid ointments, gels, and lotions of varying strengths. These can reduce inflammation and itching. However, long-term use of potent topical corticosteroids can cause skin thinning and damage. So, doctors may recommend forms of vitamin D and vitamin A instead of, or in conjunction with, steroid use. They may also prescribe corticosteroid-free, immunemodulating topicals for delicate areas instead. PHOTOTHERAPY In some cases, medically supervised UV radiation is used to treat moderate to severe psoriasis. Doctors may also prescribe UVB in combination with other topical medications and reserve UVA for psoriasis that does not respond to other treatments. NATURAL THERAPIES One of the best ways to support someone with psoriasis is to help them lower their stress levels with any modality that you are qualified to assist them with. Here are few recommendations that can also help provide relief. Coconut oil for psoriasis Coconut oil is an emollient oil that has anti-inflammatory
properties that may help ease psoriasis pain. It’s widely regarded as a gentle ingredient, and often recommended as a treatment for scalp psoriasis as well as in moisturising the skin. A massage using coconut oil can also help to lower stress levels, while also conditioning the skin. Tea tree oil for psoriasis Tea tree oil is native to Australia. If fact, Australian tea tree oil and eucalyptus oil are considers some of the highest quality oils in the world with excellent therapeutic profiles of antibacterial, antiviral, and antifungal properties. Tea tree is an excellent choice for psoriasis, especially if there is evidence of scratches and inflammation. It will not only ease the pain, it will also help to minimise inflammation. You will only need to use a small quantity of the oil, preferably diluted within a carrier oil at 4-5 per cent. Castor oil for psoriasis Castor oil is also an excellent oil for psoriasis and can be used as a carrier oil when used in conjunction with essential oils. Castor oil is an excellent natural emollient which also helps to soften and heal the skin, treat dry, flaky skin when used daily as well as support the skin’s immunity. You can access organic castor oil from the local chemist or health shop. It is an amazing oil with many uses. Lavender oil for psoriasis Lavender oil is one of the most studied essential oils. It is frequently used for a variety of conditions, including abrasions, headaches, and muscle pain. Lavender oil has even been shown to have successful antibacterial and antifungal properties against different bacteria when traditional medicines have failed. Lavender oils diluted can help lower stress levels and alleviate certain emotional triggers associated with psoriasis. It can also help lessen itching on the skin when blended with a carrier oil. CONCLUSION The latest statistics indicate that up to 6.6 per cent of Australians could be suffering from psoriasis. There are many instances when this condition is only mild, however, psoriasis does contribute to stress, itchiness and often result in psychological conditions. While treating psoriasis would be outside of your scope of practice, there are several simple solutions that you can offer to support and alleviate some of the discomfort and offer relieve to individuals with this affliction. APJ
APAN is launching a SPECIAL MOTHER’S DAY COMPETITION You could win $300 worth of ISSADA product.
WHO CAN PARTICIPATE? The competition is open to all therapists in our industry regardless as to whether they are APAN Members or not. WHAT YOU NEED TO SUBMIT? Write a story on a client who received a Mother’s Day gift of a treatment experience in your establishment and tell us how it touched them and what it meant to them.
Your story should not be more than 500 words, photos can also be included. SUBISSIONS WILL CLOSE MAY 30. All applications will be reviewed by a panel of experts who will select the winning story. To find an Application form go to www.apanetwork.com
You can also submit it via our social accounts Facebook and Instagram. The winner will also be featured in the next issue of APJ and will receive the $300 product pack from ISSADA. ANOTHER REASON TO CELLEBRATE ALL THE LOVELY MOTHERS IN OUR COMMUNITY. APJ 61
AESTHETICS INDUSTRY BULLETIN data on Covid-19 skin symptoms with 375 cases. The study identified one of the key characteristics was skin irritation, dermatitis, and dryness with people who previously had healthy skin. Furthermore, the study identified and classified five clinical cutaneous patterns as COVID-10 skin symptoms as follows: 1. Acral areas of erythema (pseudochilblain) 2. Urticarial lesions 3. Maculopapular eruptions 4. Vesicular eruptions 5. Livedo
IT’S OFFICIAL – REGENERATIVE EYE ENHANCEMENT IS THE 2021 FASTEST GROWING SKIN TREND IT IS PROPOSED THAT AS A RESULT OF MASK-WEARING the focus on the eyes is driving the trend for eye-enhancement treatments. Dermatologist Tess Mauricio, agrees. “We are seeing eye-area rejuvenation as one of the top trends in 2021,” she says. “As we are using masks for an indefinite amount of time and our eyes are front and centre when the face is covered, it stands to reason that this area of the face that is becoming the main focus. She recommends two regenerative treatments featuring growth factors for the eye region, noting, "As people look for more natural alternatives to fillers, these regenerative products will become all the rave in 2021." For example, the Sublimax Eye Opener is a plasma treatment that removes the extra tissue (i.e., loose skin and wrinkles) around the eye area by converting it to a gas, without making any incisions. Platelet Rich Fibrin Matrix (PRFM) utilises your body's own growth factor serum to create what they call "Plasma Filler," which can be injected into the hollows
beneath the eyes to treat a sunken appearance, dark circles, eye bags, and loose under-eye skin. Meder Beauty Science also confirmed that their MYO-FIX eye treatment is experiencing great popularity, as it can achieve great results for the upper third of the face through the application of a specific three-point protocol to enhance penetration using a unique blend of peptides (see full article in this journal). APJ
CAN YOU IDENTIFY COVID19 RELATED SKIN CONDITIONS? WHILE WE KNOW THAT THE MAIN SYMPTOMS OF COVID-19 ARE high temperature, a new continuous cough and loss of change in one’s sense of smell and taste, more extensive studies are examining the tell-tail signs of COVID-19 through skin manifestations. A key epidemiological paper was published in June 2020, from a group of Spanish doctors, who carried out a nationwide case collection survey of images and clinical
The most common skin symptoms identified from the Spanish nationwide consensus was maculopapular eruption, accounting for 47% of documented skin signs. The next most common was acral erythema and urticarial lesions (both 19%). Vesicular eruptions (9%) were reported to appear early in the course of COVID-19; conversely, acral erythema appeared later in the course of the disease (59% after other symptoms). Urticarial lesions, maculopapular eruptions and livedo appeared at the same time as other symptoms of COVID-19. A group of dermatologists from Kings College Hospital, London, an area with
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high infection rates suggests that vascular is a more appropriate clinical classification to include both acral and livedo. A French study identified several vascular skin symptoms, including livedo, violaceous macules, purpura, chilblains, Raynaud’s phenomenon and eruptive cherry angiomas. 1. Acral area of erythema
(flat discoloured areas) and papules (raised bumps), it can be a generalised eruption. In the Spanish consensus study, 475 COVID-19 patients have maculopapular eruptions, with half the patients also experiencing pruritus (itching). This skin sign is uncommon in children and more likely to be seen in adults with severe COVID-19 infection, with an average course of nine days. 4. Vesicular eruptions These eruptions consist of vesicles, which are small itch blisters, less than 5mm, and described as chickenpox-like. In the reported cases, this eruption was either
multiforme-like eruptions, unspecified erythematous facial eruptions and androgenic alopecia. It is wise to consider any unusual or unexpected skin eruption to be considered as a possible COVID-19 sign, even in the absence of other coronavirus symptoms. The British Association of Dermatologists has set up a website, which it is constantly updating, with images of possible skin signs of COVID-19. https:// APJ covidskinsigns.com/
NEW PUSH FOR IPL AND LASER TO BE REGULATED FOLLOWING EXTENSIVE MEDIA COVERAGE by A Current Affair in late January of several burns and incidents of trauma instigated by unqualified practitioners, the Cosmetic Physicians College of Australia (CPCA) indicated that it is lobbying for national laser regulations after growing reports of misuse among unqualified therapists resulting in patient disfiguration.
‘COVID toes’ These are chilblain-like eruptions, which usually appear in milder cases of COVID19, particularly children and young adults. The term ‘acral’ refers to distal extremities of peripheral body parts, such as fingers and toes. The most commonly affected site is the toes – hence the real term ‘COVID-toes’. There have been many documented case studies, which describe generally asymptomatic skin changes, which can commence with blisters, pain, and erythema (redness), progressing to purplish discolouration. In around 25% of reported cases the discoloured areas are itchy. The development of skin conditions generally happens days or weeks following the onset of COVID-19 symptoms. Some children may have been asymptomatic – so COVID-toes are considered a late manifestation. 2. Urticarial lesions Urticaria, (‘hives’), and refers to itchy white or red lumps (wheals) that spontaneously appear on the skin, often randomly distributed over the body, in acute urticarial, they often subside within 24 hours. COVID-19, should be considered when urticarial lesions, appear as a rash over the body, together with pyrexia. This skin sign is an early sign of infection. 3. Maculopapular eruptions A maculopapular eruption is described as a skin rash that contains both macules
localised (a common area was submammary or trunk) or generalised and reported early in the course of COVID-19 infection. 5. Livedo Livedo refers to mottling of the skin, caused by underlying vascular changes. Livedo is more likely to be localised with the trunk and acral areas of the body most affected. Since the publication of the Spanish consensus study, other COVID-19 skin signs and symptoms have been reported, so the cutaneous list is dynamic and constantly being added too. Other skin symptoms include: acro-isccaemia and necrosis, petechiae and purpuris erurtions, intertriginous and flexural (skin fold) exanthemas (viral rashes), pityriasis rosacea-like eruptions, erythema-
Two A Current Affairs reports exclusively committed to airing these incidents, reporting three women who had received seconddegree burns from the abuse of laser devices. The segment showed graphic pictures demonising firsthand what can happen when things go wrong. They included HIFU skin tightening treatment that appeared to be performed on a Fitzpatrick Type V skin. Another woman who undertook a fat freezing treatment in preparation for her upcoming wedding, receive extensive burns and a third 29-year-old who had received cryotherapy nearly lost her legs through severe burns, after she was allegedly left in a chamber for too long. According to ACA, these incidents are not isolated. In fact, they reported that “not a day goes by, when we don’t receive calls and reports from viewers who have and similar experiences from IPL and laser treatment devices”. “Consumers are lured into dangerous clinics with low prices for laser treatments, unbeknown to the lack of
AESTHETICS INDUSTRY BULLETIN medical supervision and experience,” they confirmed.
Environmental Health, a final decision has yet to be finalised.
1. Trend for digital shopping only is forecast to dwindle.
APAN in collaboration with Australian Society of Dermal Clinicians ASDC contacted ARPANSA and several regulatory experts urgent for the reopening of the case for regulation of IPLs and Lasers use for cosmetic purposes.
We can confirm that the processes of regulation are involved and complex, however, the matter is currently under investigation for another regulatory review. Meanwhile, we encourage all responsible professionals to please comply by existing industry guidelines and ensure that you do not operate any device without seeking appropriate training and preferably qualifications wherever available. This is your duty-of-care to your clients and your ethical responsibility in upholding your industry’s code of ethics.
Give somebody too much of a good thing and, eventually, they will tire of it. This principle applies to virtual experiences.
While we agree with the CPCA that technically, all energy devices (known as non-ionising radiation) used to improve or maintain appearance must be compliant with the TGA listing, we do not agree that all operators need to be medical doctors. Our position is that the issue should be “scope of practice” and in ensuring that any practitioner – medical or non-medical - should gain a qualification and training before undertaking to deliver any IPL or laser treatments. Qualifications should include laser and light physics, laser safety, skin classifications, as well as technical training on the correct setting and protocols for treating a variety of skin conditions and concerns including hair reduction.
Please note that all societies, as well as APAN are advising the public that before undertaking any laser or IPL treatment that they should ask the operator if they have completed a recognised ‘Laser Safety Officer Certificate Course’ and if they have not, then we suggest they walk away. We will keep you informed of developments. APJ
Currently, there are now several certificates, diplomas and advanced diplomas that include laser and IPL modalities, both at VET level as well as through tertiary qualifications. There are also several state licensing requirements for the use of IPL and Laser. These include:
Action: While your business will continue to require an on-line presence, salons and clinics are advised to emphasise the best of what in-location experiences offers:
Queensland, Tasmania, and WA. All three require licences that are supported with varying hours of practical training. While the other states do not have any compulsory licence requirements APAN urges ALL practitioners, regardless as to whether your state requires for you to hold a licence, to undertake as a minimum, a laser safety officer’s course as a matter of best practice. It is the professional thing to do, and we guarantee that you will gain important knowledge to enable you to protect your clients from potential incidents. Furthermore, your clients will appreciate it. You can access several on the APAN website through this link https:/ /apanetwork.com/courses. While there are current discussions as to who will undertake the review of regulation – ARPANSA or possible
Shopping online, or having a Zoom session have their benefits, namely convenience and safety. These alternatives will serve as a substitute for in-location shopping for a time. However, new data reveals that online experiences are not permanent substitutes for in-person experiences as 46% of respondents in the study said they still prefer to shop in person rather than online. Those who prefer in-location experiences cited that they enjoyed the ability to hold and directly view products and the unique experience that a physical business provides. We also found that even those who prefer online shopping do not necessarily prefer online shopping all the time. Consumers have had more than their fair share of online shopping. They have gone without inlocation entertainment for far too long and are generally anxious to get back to some kind of normalcy.
NEW STUDY CONFIRMS THAT CLIENTS WILL TIRE OF DIGITAL SHOPPING SHORCOMINGS A LEADING GLOBAL RESEARCH CONDUCTED BY FORBES on consumer behaviour has uncovered some interesting consumer behaviour treats. The report provided five key consumer behavioural changes we should anticipate in the forthcoming years. Here are just a couple that we thought were noteworthy:
Direct interaction and an opportunity to sample our products.
Meet our staff and allow you to get to know them .
We would like to introduce you to an educational experience. (Use your premises introduce a guest speaker, or if space is limited, why not provide an educational video segment, while offering refreshments).
We have a special offer just for you. (Introduce special offers that are exclusively available only when booked with a treatment).
Let us show you how we assure your safety. (Promote your quality assurance, safety measures and qualifications you have in place and why your client should have peace of mind that they are in safe hands).
Something special awaits you at your next visit. ( Add tactile services that support stress management,
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COOL KHAKIS Switch out your beloved blacks, whites, and navys for a new neutral colour palette this season—khakis, beiges, and tans. Beige-hued cotton pieces will seamlessly integrate into your existing wardrobe (just add denim), while khaki pieces will shake off any unwanted Tropic Thunder overtones with the addition of slickly tailored blazers and sleek ribbed knits. With new season pieces from Bally, Viktoria & Woods (David Jones), and Witchery—you’ll find yourself a khaki convert for life.
immunity, better sleep, and wellbeing. Let them know that at their
next visit you will incorporate lymphatic drainage, scalp massage or an extended facial stress management massage procedure to support their well-being). 2. There will always be a certain percentage that have indicated that the online only shopping works for them. So, how can you get them back in? When interviewed, customers who were asked what will it take to get them back to a live store rather than settling to only purchase online, 90% of the respondents said what they will consider returning to a live shopping experience if they were promised a positive or worthwhile and phenomenal experience. Action: Many businesses have resigned to the fact that with COVID they have permanently lost some clients. However, the research points to one thing that will get them back – offer them an extraordinary experience that they cannot resist. All forward-thinking businesses should look at investing in unique ways to lure all their clients back and drive revenue. By combining convenience, safety, an alluring atmosphere, efficiency and great client service, those who gain an understanding of their clients’ needs, and design a phenomenal client experiences can continue to differentiate themselves and achieve success. APJ
AUSTRALIAN AUTUMN/ WINTER TREND REPORT – THE NEXT BEST THING WHILE THE NORTHERN HEMISPHERE IS MOVING INTO SPRING, AUSTRALIA HAS ENTERED AUTUMN. Here is a sneak preview of the Autumn/Winter that will dominate as we enter the cooler months. On the eve of a new fashion season, Chadstone offers a comprehensive breakdown of the five trends that will dominate the Australian autumn and winter. This is an opportunity to freshen up and rejuvenate our look. Statement-making knits, keep-for-life outerwear, and dreamy boots are just a few of the delights on offer at Chadstone this season—say nothing of the hypertrendy pieces that will send your heart aflutter. CLASSIC RED “There is a shade of red for every woman,” said legendary style icon Audrey Hepburn. This season, that sentiment is more true than ever. Designers as eclectic as Aje, Country Road and Golden Goose are all offering pieces in head-turning hues of cherry, scarlet, and crimson. Go big – head-to-toe red ensembles, then polish the final look with classic black accessories.
SETTLE PETAL Contrary to the eternalised The Devil Wears Prada quote, florals can be groundbreaking—you just need to know how to style them. For the autumn winter ‘21 season embrace a darker colour palette, looking to hyper-feminine dresses from Bec + Bridge and Kenzo. High fashion florals are given added finesse when paired with perennial wardrobe classics, like beige trench coats, chunky knits and leather jackets. The best part? You can swap out your chunky winter boots for minimal leather sandals come summer, making delicate floral dresses the ultimate trans-seasonal investment. MICROSCOPIC MINIS After an uncertain 12 months spent largely indoors, is it any wonder that fashion is looking optimistically forward, toward a time where shorter hemlines are back on the agenda? This season, the microscopic mini is all grown up, finished in hyper-sophisticated tweed and worn with a matching blazer (Cher Horowitz, eat your heart out), or paired with demure, feminine blouses. Your moodboard is ‘Versace-clad supermodels circa the ‘90s’—with that image in mind, you can’t fail. LUXE LEATHER With ticks of approval from Celine, Hermès, Alexander McQueen, and Boss, the fashion industry has well and truly fallen back in love with leather. This season, classic wardrobe staples—blazers, shorts, well-cut trousers—are reinvented in buttery leather, fashion’s most durable material. Play it safe with tasteful injections (think: pleated mini-skirts) or go all-out with a head-to-toe leather ensemble by Sandro. APJ http://bit.ly/3lKnTeC
Skin Energy celebrates its 1st anniversary
HAVING SOLD HER PREVIOUS BUSINESS and relocated to the Gold Coast from Brisbane, Gay Wardle had a dream – she wanted to open another clinic to provide niche, quality skin treatments to the local community, as well as a live clinical environment to continue to train eager business owners and practitioners in her methodologies on a one-on-one basis. As everyone knows, Gay passionately loves sharing her knowledge and helping people. While she is heavily involved in her own training programs – live and online, as well as lecturing and mentoring students undertaking the Bachelor of Applied Health Science (Clinical Aesthetics) with
ACHW, Gay enjoys the practical application of her knowledge. It is this ability to appropriate theoretical knowledge into the clinical environment that students love so much about her and for what she is renowned for as eager business owners book to shadow her methodologies.
were more favourable. So, on the 10th March, at 4.30pm Gay launched a soiree to celebrate the first anniversary of the opening of SKIN ENERGY.
And so, Gay launched SKIN ENERGY – a niche skin clinic on the Gold Coast just before COVID-19 last year. With COVID upon us there was no scope for celebrations or even for the clinic to function to its full potential. However, 12 months down the track the circumstances
Each guest received a goodies bag that included a discount voucher that they could invest toward four amazing packages.
In her usual amazing generous style, guests were greeted to champagne and flowing live music provided by a local talent.
Over 50 guests were welcomed and after mingling and joining in the celebrations, they were given an opportunity to be updated with amazing education on skin
principles for better health, as well as a comprehensive lecture on the latest information on gut health, the microbiome and how to optimise health for both skin and body, presented by Debbie Dickson and Daniel Dickson who flew in from Sydney with their team to support the event. The level of information presented was of very comprehensive and clients and friends were grateful for this educational experience. While the lecture was in operation the aroma of food from catered Paella cooking was underway for guests to enjoy. Guests were seated under semi-cover in
the garden and with the forecast of rain, there was always the risk of one of Gold Coast summer showers. So, we prayed! Amazingly, we had perfect weather until the end of the event when heavy showers decided to descend, just as guest were leaving. Perfect timing to a perfect day. SKIN ENERGY is a delightful medi-clinic that provides the very best of both of advanced skincare results, health support and personal nurture. Having started in her professional journey as a beauty therapist, and moving on to become a qualified dermal clinician, Gay’s treatments transition a client’s skincare journey to include the best of an amazing personal and
skillfully delivered tactile experience, while also incorporating the very latest in advanced clinical procedures and protocol, offering her clients the best of both worlds. We wish Gay and her team every success with SKIN ENERGY, while she also continues to be devoted to her training. APJ SKIN ENERGY 232 Ferry Rd, Southport 07 5528 2100 To access Gay’s training courses for professionals, visit www.gaywardle.com
ACTIVATING THE VAGUS NERVE WITH ESSENTIAL OILS Tina Viney
WHILE OFTEN OVERLOOKED, THE ROLE OF THE NERVOUS SYSTEM is so important in enabling our body’s ability to repair, whether this is from stress, or an invasive procedure that we have undertaken, or even just the accumulation of intense concentration that we are often subjected to though our daily workload. Throughout our busy day we rely on the “fight and flight” response of our sympathetic nervous system to give us the energy we need to cope with our daily stressors, while for repairing the body we need to activate and switch on the parasympathetic nervous system which allows our body to repair, healing, and rejuvenation. New studies have identified the role of the vagus nerve as the important “gearshift” that allows us to effectively make the switch between the fight or flight sympathetic state, to the rest state of the parasympathetic mode. While there are breathing exercises that we can do to help regulate the vagus nerve I want to introduce you to another simpler way of achieving this using certain essential oils. So, what exactly is the role of the vagus nerve and why do we need to activate it? The vagus nerve if often referred to as the wanderer, as it goes from the brainstem and wanders down throughout the body affecting every organ in the body. It triggers your mouth to release saliva, which helps start to break down proteins and fats so that they can be better absorbed, it helps the stomach to release hydrochloric acid, it helps the pancreas release digestive enzymes and the gallbladder to release bile – all important tasks for healthy digestion and for nutrient assimilation to our circulatory system. And then the most important function of the vagus nerve is that it contributes to the gastric motility wave in the body, allowing for the release of waste and toxins for elimination. As we know, when we are stuck in fight and flight sympathetic dominance, this is when problems arise, for example, stagnation in the digestive system can contribute to IBS or constipation through the accumulation of wastes. Anatomically, the vagus nerve starts at the back of the head. It then splits and whines around both sides of the neck as it moves across to branch out to both sides of the body. However, it is the thickest right behind the earlobe, right at the junction of the masseter or chewing muscle. While traditionally calming essential oils such as lavender and chamomile have been used to sooth the sympathetic nervous system, studies have identified a new approach. When we are
stuck in sympathetic dominance the vagus nerve is stagnant, so, when addressing the vagus nerve rather than calming it, we need to stimulate it to perform its task. To achieve this a blend of Clove and Lime essential oils diluted in a carrier oil have been identified as being highly effective. By applying a couple of drops on each side of the vagus junction this formula can help encourage vagus nerve activation. The beauty of essential oils is that their molecular weight is so minute that they can quickly enter the bloodstream. A gentle blend of 3% within a carrier oil of these two oils have been reported to improve calmness, ease digestive discomfort, and improve feeling of tiredness. While helping to encourage the parasympathetic nervous system to gently perform its function requires the use of calming oils, the vagus nerve as the switch that allows the body to shift gears from sympathetic mode to parasympathetic mode will need to be activated not sedated if it is dormant. This is where a blend of Clove and Lime essential oil have been proven effective in stimulating helping the vagus nerve to perform this task. Another consideration relates to vagus nerve infection. Researcher Michael Vanek introduced the concept of the vagus nerve infection hypothesis. Basically, it states that as the vagus nerve can also be susceptible to minor infections that can put the body into cell damage response or sickness response. This can result in feeling tired, and when prolonged, can contribute to chronic fatigue syndrome, while chronic pain can progress to fibromyalgia. According to Dr Vanek, a lot of these things can be traced to an infection of the vagus nerve. Further studies conducted by Dr Marco Rubio on vagus nerve stagnation, also identified that infection was often the cause. He conducted ultrasound examination of people’s necks and he discovered infection of the vagus nerve due to toxin in the mouth, from problematic root canal and other dental issues that contributed to an accumulation and congestion of toxins in the oral cavity. As toxins drain along the trigeminal nerve, they intersect with the vagus nerve contributing to infection. Clove oil can also be helpful here as it contains a therapeutic constituent called eugenol. Eugenol has been used in dentistry for years because it does two things - it numbs the pain and it also helps to address the underlying toxins. So, if the vagus nerve is congested, it will restrict lymphatic and blood flow, resulting in wastes not being adequately drained. The combination of clove and lime oils can not only stimulate the vagus nerve, it can also help with any underlying minor congestion due to a mild infection. APJ
Have you completed your Pandemic course yet?
Pandemic Infection Control Program
gains international momentum
FAR-REACHING ACROSS THE GLOBE THE PAN001 PANDEMIC INFECTION CONTROL PROGRAM is being implemented by several countries – Italy, UK, Florida (USA) Chile and Spain, with many more reviewing it to introduce it to their professional networks. Additionally, the International Professional Standards Network (IPSN) – a global leading organisation in standards across many industries, has requested to promote this program through their network. We are also pleased to report that the Australasian College of Health and Wellness will be incorporating the PAN001 PANDEMIC INFECTION CONTROL PROGRAM within the third year of the Bachelor of Applied Health Science (Clinical Aesthetics). IT’S NOW YOUR TURN This program was launched not as just another course, but as a SELFREGULATION PROGRAM designed to introduce a uniform standard of safety
across various jurisdictions, both nationally and internationally. Developed by Professor Laurence J. Walsh – a leading authority in infection control standards who has been instrumental in the establishment of clinical safety standards through various regulatory initiatives. The two chapters on the Pathophysiology of Viruses alone sets it apart as a unique program of the highest standard. It is further supported by the International Safety & Infection Control Charter, uniting practitioners across the globe. By undertaking this programme, you will be joining the global movement for a safer world. You will also allow us to gain government endorsement of this program to protect you during future disruptions. A movement can only be achieved through the power of numbers. The more of us who undertake this program the stronger our voice for better protection and change. Developing and launching this program has been an expensive process however, you can complete the program for just $355 or $255 if you are a current member of APAN. You can access and complete it online. We urge you to prioritise completing this program as it will further validate your compliance to the highest standard of safety and provide you with an additional competitive advantage within your business or professional environment. The collective benefits of this program are unique and important to the integrity of our profession. APJ To access further information and to register visit bit.ly/2WphF86
Pandemic Infection Control Program We pledge safety for all
Join the International Movement Towards a Safer World This certified online study unit will equip you to gain: • The latest information on the pathophysiology of viruses and pandemics • Update your safety protocols in line with the latest evidence-based information • Join the global movement • Assure your clients or patients that they are in safe hands • Fight against the need for lockdowns
Enrol Today! 07 5593 0360 www.apanetwork.com
Professor Laurence J. Walsh AO
The International Safety & Infection Control Charter
Leading authority in immunopathology and infection control.
Skeyndor have upgraded their formula to step-up your treatment results. Corrective Deep Lines Filler Cream combines two filling techniques to give a fuller and plumber looking skin. Containing a unique blend of natural extracts combined with leading peptides, this formula will provide visible results from the first application. With continued use the skin’s tone and elasticity will improve providing a fresh and more youthful appearance. Contact Vogue Image Group 1800 55 45 45.
CORRECTIVE DEEP LINES FILLER CREAM
AMAZING UNDER-EYE CONCEALER Just launched from Jane Iredale, Enlighten Plus Under-eye Concealer is a silky, full-coverage concealer with broad spectrum sun protection that smooths, depuffs and protects for brighter, youthful eyes. Available in a gentle pump allowing the release and application in the one sweep. Contains probiotic ferment, an antioxidant-rich moisturiser for optimal freeradical protection, Persian Silk Tree Extracts that helps smooth the appearance of fine lines, Honeysuckle Flower extract as well as SPF 30 broad spectrum UVA/UVB sun protection. Contact MargiFox Distributors 1300 850 008 margifox.com.au.
BODY REMODELLING DOUBLE DRONE GEL-CREAM New from Skeyndor, comes an amazing treatment system supported by effective next-generation body care products for home use. Body Remodelling Double Drone Gel-Cream will help redefine the figure, tone and correct orange-peel skin using the latest patented cosmetic delivery technology known as Cosmetic Drones ®. The combined action of two complementary drones, one anti-cellulite and a toning drone, provide a more rapid and direct remodelling effect. Contact Skeyndor Australia’s Head Office 1800 55 45 45.
Dr. Anne-Marie’s BRIGHTENING C SERUM Brightening C Serum is a truely clean and green product that is Aloe Vera based and contains a complex blend of Vitamin C extracts, as well as Rosehip oil, Jojoba oil, Apple fruit extract, Melon fruit extract, Beta Glucan and Marine Collagen. It is made in Australian, not tested on animals, is vegan, cruelty free and contains 100% Certified Organic ingredients. All key actives are of Australian origin and locally sourced. As we are entering the autumn months it is an ideal product as it offers excellent hydrating and moisturising properties and has an inbuilt natural SPF3 from the Aloe plant. Contact Dr. Anne-Marie’s Dermal Care today for this and other innovative products to enhance your treatment results. email@example.com dramdermalcare.com.au 0403 846 622.
LRT CREAM DELIVERING AMAZING LIFT
Roccoco Botanicals, the innovators of skin formulations have taken one of their most active products to the next level. LRT CREAM is a rich, luxurious moisturiser that combats the signs of ageing. With a powerhouse of active ingredients, it will visibly firm and tone the skin’s appearance, toning skin tissue of the neck, jawline and decolletage for a more youthful appearance. LRT CREAM will diminish the appearance of fine lines and wrinkles, restoring skin elasticity and smoothness revealing a supple, healthy glow. Contact Roccoco Botanicals 07 3807 1420, firstname.lastname@example.org www.roccoco.com
COBRA EYE SERUM A high potency vitamin for the skin that strengthens, invigorates, and enhances cellular reproduction in the delicate tissue areas around the eyes and neck. Cobra Eye Serum formulated by Clinical Skincare is a new generation formula that will reduce dark circles, puffy eyes, lines, and wrinkles developed specifically for the delicate areas of the face, such as eyes and neck. It will also relieve and detoxify congestion in the extracellular matrix. For further information please contact ClinicalPRO 1800 628 999 or Email: email@example.com
INTRODUCING A NEW ERA IN TREAMENT RESULTS WITH VITAMIN A Vitamin-A Advanced Repair Serum with Natural Retinaldehyde formulated by Clinical Skincare is a unique patented technology that binds natural retinol with natural cyclodextin for enhanced delivery without irritation. This formulation will allow you to introduce an active form of vitamin A that is suitable for all skin types, especially sun-damaged, mature, and atrophic skins without the common reactions to high dose vitamin A. It is also excellent for treating acne and acne scars, as well as for controlling rosacea. For further information please contact ClinicalPRO 1800 628 999 or Email: firstname.lastname@example.org
RADIANIX® SUPPORTS SKIN HEALTH AND BODY DETOXIFICATION Ultraviolet exposure causes photoageing, sunburn, sunspots, and pigmentation as a result of triggering the production of melanin. Glutathione diverts brown/black melanin into light coloured melanin that brightens the skin. As a master antioxidant glutathione also neutralising free radicals damage and supports the maintenance of healthy cells. When taken orally, glutathione is broken down by the gastrointestinal and liver. RadianiX® Glutathione is formulated in WaferiX® sublingual technology. When administered sublingually, the wafer quickly dissolved, releases glutathione for rapid mucosa absorption, bypassing the lost in GI tract/liver, achieving a therapeutic level into the body for optimal benefits. For further information please contact Entity Health 0421 433 660. email@example.com, www.entity-health.com.au
ISSADA LAUNCES SHEER DEFENCE SPF 50+
ISSADA’s 0.5% Retinol +HA is a gentle vitamin A formulation ideal for a retinol newbie. Furthermore, the gentle-strength retinol treatment formula is fortified with the benefit of hyaluronic acid. This effective combination helps to reduce fine lines, improve skin texture, refine pores, and minimise breakouts. Ideal for introducing the skin to retinol before progressing to a higher strength such as ISSADA’s 1% Retinol formula, which will allow you to step-up treatment results once the skin has been prepared and strengthened. To become a stockist call ISSADA 07 390 42288 visit issada.com/partners
ISSADA 0.5% Retinol + HA
THE PERFECT ACNE SOLUTION Sheer Defence is a silky smooth, lightweight skin formula with SPF50+ for optimal protection from harmful UV damage. This must-have products prevents premature ageing and defends against fine lines, wrinkles, and pigmentation. Sheer Defence is designed to wear beautifully beneath makeup, in combination with other skincare, or alone. Apply daily as part of your skincare routine. To ensure full protection apply evenly to the skin 20 minutes before exposure to the sun. To become a stockist call ISSADA 07 390 42288 visit issada.com/partners
GINGER&ME – THE ULTIMATE MINDFULLNESS BRAND
Meder Eu-Seb Concentrate delivers fast results for clients suffering acne and re-occurring inflammation. Microbiome friendly Eu-Seb Concentrate can be used during systemic acne therapy even with Roaccutane use, to maintain the health and diversity of the skin's microbiome. Featuring Prebiotic BioEcolia Eu-Seb Concentrate promotes speedy growth of healthy microflora and slows down the development of pathogenic and undesirable microflora, while enhancing anti-inflammatory effect through the introduction of Chamomile Recutita extract. Additionally, Meder Eu-Seb Concentrate will also normalising and regulating sebum secretion. For this and other evidencebased formulations contact Meder Beauty Science 046633 8844 firstname.lastname@example.org mederbeautyscience.com.au
GINGER&ME is dedicated to the Sisterhood with a focus on mindfulness, empowerment, and skin health results. Carefully crafted face, body and gifting collections join the signature ‘Mindfulness Sessions’, professional treatments featuring a guided meditation, to support skin, mind and body health. A mindfulness brand, skin journey and connection to help navigate our modern world, crazy lives and to encourage every GINGER to find their ME. For further information contact INSKIN COSMEDICS 02 9712 8188 or visit www.gingerandme.com
Dermatonics® CALM & HYDRATE STARTER KIT
COLLAGEN SERUM (Contains 5% Collagen, 5% Vitamin C & 87% Hyaluronic Acid) If you are looking for an amazing multifunctional serum you have come to the right place. Aiyuskin Aesthetics has produced an incredible serum that is highly effective with all the goodness of multiple actives in the one product. Collagen Serum contains a plant-based collagen from seaweed to help repair, strengthen and stimulate the skin’s own collagen and elastin production. vitamin C brightens the appearance of the skin improving texture instantly, while the hyaluronic acid hydrates and plumps the skin tissues. Collagen Serum will bring your treatment results to the next level. Suitable for all skin types. For further information contact Aiyuskin Aesthetics 0433 664 022 email@example.com.
One of the newest starter packs in the Dermatonics® range is their Calm & Hydrate Starter Pack that features the key products for your clients with dry or easily sensitised skin, as well as for eczema-prone or rosacea-prone skin. With their unique Copper Peptide Calming Mist and signature Nourishing Face Oil, this 4step routine will help your clients achieve hydrated and nourished skin, while respecting and helping repair the skin barrier. For further information contact Dermatonics 02 9188 8819 firstname.lastname@example.org
Aiyuskin Botanical Pink ClayMask is a must-have for all types and conditions that need to achieve glowing skin year-round. This Pink Clay Mask provides added benefits through the infusion of several healing herbal powders including chamomile and calendula, which are used for their soothing and calming benefits. This product is free from preservatives due to its natural powder form. Botanical Pink Clay Mask will soothe and calm fatigued or sensitive skin conditions leaving it feeling refreshed and revitalised. For further information contact Aiyuskin Aesthetics 0433 664 022 email@example.com.
HIGH-GRADE 20% VITAMIN C SERUM
BOTANICAL PINK CLAY MASK
Aiyuskin Aesthetics is an Australian-made “green and cleans” skin treatment range made with the finest ingredients for safety and results. Beautifully formulated skincare products feature organic plant extracts, 100% cruelty free, vegan, and natural ingredients. Aiyuskin 20% Vitamin C Serum contains high doses of vitamin C extracts obtained form Desert Lime and Australian Kakadu Plum, renowned as the world’s highest level of vitamin C content. This amazing blend will give the skin an antioxidant boost, while strengthening the skin’s elasticity, brightening, and refining the complexion. For further information contact Aiyuskin Aesthetics 0433 664 022 firstname.lastname@example.org.
HAIR REMOVAL: OPTIONS AND LIMITATIONS
Why electrolysis is becoming centre-stage in permanent hair removal Tina Viney
THE MANAGEMENT OF UNWANTED FACE AND BODY HAIR HAS BEEN a constant challenge for humans since the dawn of time. While methods and cultural preferences have changed throughout the course of history, the demand for face and body hair removal continues to be the number one procedure with 85% of females requesting some sort of hair removal from salons or clinics in Australia. In this article I will explore recent advances and how they compare with laser and IPL hair removal, the causes for excessive hair growth and solutions. But first, let’s look at the technology of electrolysis and some recent advances. WHAT IS ELECTROLYSIS? Electrolysis is a method of permanent hair removal. The process involves the insertion of a very fine, disposable, sterile probe (the same diameter as the hair) into the hair follicles’ natural opening in the skin. A tiny amount of energy is then skilfully discharged into the hair follicle. The selection of energy is based on the skin and hair type presented; the amount of energy varies from 0.1 of a second to five seconds depending on the method of electrolysis used. This procedure damages your hair follicles to prevent growth and causes existing hairs to fall out. There are three methods of electrolysis: • Galvanic: which chemically dissolves the follicles •
Thermolysis: also called diathermy or radio frequency (RF) diathermy in some countries. which uses heat
Blend method: which uses both methods.
While these are the traditional methods, there are now newgeneration devices that offer amazing capabilities, such as increased speed, different frequencies, and higher megahertz, such as omni-blend and pico-blend. These new advances in technology allow for greater client comfort, enabling higher rate of hair reduction, quicker results, as well as new capabilities in aesthetic treatments. APJ 76
The number of treatments required will vary from person to person, and this is usually discussed during the consultation process. The first sign that electrolysis treatment is working is that the hair growth becomes softer, finer, and lighter in colour. There is an immediate aesthetic improvement for the client, which continues gradually over the course of treatment. Electrolysis does yield permanent results, but to achieve this it takes time as hair that needs to be targeted grows in different stages. CAUSES OF UNWANTED HAIR There are various causes of unwanted hair. The majority fall into the category of normal systemic causes which are triggered by the onset of puberty, pregnancy, or menopause and other normal and abnormal hormonal activities. Additionally, psychiatric disorders such as anorexia nervosa can lead to either thinning and brittle hair, or to hypertrichosis (excess body hair). Emotional disorders and long-term stress that cause hormonal changes are also significant causes. Another common cause is topical stimulation; the removal of vellus or virgin hair growth, for example, by plucking. This can stimulate a deeper and richer blood supply to the hair follicle causing hair growth to become coarse and terminal in nature, which requires management over time. Prescribed drugs for medical conditions may also contribute to excessive hair growth, e.g. steroids, or combination hormone replacement therapy (HRT), which may contain a small amount of testosterone. While non-permanent hair removal is suitable for a large proportion of the population, there is a growing number of genuine medical or psychological needs for a permanent solution to unwanted hair growth. This is especially true in medical conditions that contribute to excessive hair growth that contribute to embarrassment and emotional trauma.
Adding to the conditions mentioned above there is also polycystic ovarian syndrome, pilonidal sinus conditions, thyroid conditions, and gender dysphoria, Cushing’s syndrome and adrenal tumours, just to name a few. In these instances, electrolysis should be considered, as this modality has a unique ability to destroy the hair germ cells that results in permanent eradication of all hair growth, regardless of skin and hair type or colour. It can be carried out anywhere on the face and body and must be performed by a highly skilled and experienced practitioner.
Speed: Laser pulses take just milliseconds and can treat several hairs at once, which means that small areas can be treated in just minutes.
Lighter growth and colour: New hair growth tends to be less dense than before, and the new hair is often a few shades lighter than the original hair.
Efficacy: Many people see long-term results after three to eight sessions. This method is good for large areas of hair removal, such as backs and legs.
ELECTROLYSIS VERSUS LASER OR IPL Laser and intense pulse light (IPL) both target the melanin within the hair follicle, diffusing heat within the surrounding tissues. There are several different types of lasers, e.g. Alexandrite, Ruby and Diode. Lasers usually work on either visible or infrared light spectrum, depending on the type.
Disadvantages of laser hair removal • Laser hair removal is not suitable for everyone, and there are some risks involved. The main disadvantages include: •
In contrast, IPL uses a variety of different wavelengths to deliver heat energy at varying depths within the skin. While both laser and IPL will substantially reduce hair growth, it is not permanent removal, and the technical term required by the TGA is ‘hair reduction’ not hair removal.
Not suitable for all colouring: The laser works best on people with light skin and dark hair because the laser targets dark colours.
Risk of adverse reactions: Some of the more undesirable side effects of laser hair removal can include discoloured skin, swelling, skin redness, blisters, potential burns and scarring. However, some of these resolve within hours of the treatment.
Photo-sensitivity: Lasers can increase the skin’s sensitivity to sunlight, so direct exposure to the sun must be avoided immediately after the procedure. People having laser treatment should avoid sunlight for six weeks before treatment to prevent discoloration of the tanned skin.
Dangers of numbing products: There have been incidents when topical numbing products for laser hair removal have led to serious and life-threatening side effects that occurred after individuals applied a numbing agent to large areas of the body, causing system absorption that resulted in heart failure.
As the focus of these methods is the melanin pigment within the tissues, this system is generally not effective on fair hair on white skin, black hair on black skin or on red hair. This is due to its inability of these devices to differentiate between the skin pigment cells and the hair pigment cells. Therefore, IPL and laser are ideal for treating dark hair on fair skin, but regular top up treatments will still be required to keep hair growth reduced. Now, let us look at the pros and cons of laser or IPL hair reduction and compare it to electrolysis: Advantages of laser and IPL hair removal: • Precision: The lasers quickly target coarse, dark hairs.
As there are several risks with working with laser and IPL practitioners should ensure they undertake appropriate qualifications and training, as well as comply with their state and council regulations.
Comparatively electrolysis offers the following:
CLIENT/PATIENT EVALUATION As with any treatment, a person must undergo a comprehensive consultation with their practitioners. Likewise, an electrologist will to examine and discuss their health and medical history. This will allow them to ascertain an appropriate treatment plan.
Advantages of electrolysis: • Permanent: Electrolysis yields the best track record for overall results compared to any other method when it comes to getting rid of hair permanently. •
Many different hair and skin types can benefit. In addition to producing more permanent results, electrolysis is exceptionally versatile. It can help inhibit new hair growth for all skin and hair types and may be used anywhere on the body, including the eyebrows. It can also be used among a wider variety of people, this is because unlike laser treatment, electrolysis does not target the hair pigment (colour), instead attacking the follicle itself. People who are not good candidates for laser may still get electrolysis.
No recovery time: People can resume their daily activities immediately after the procedure.
Maintenance-free: There is no need to schedule an annual electrolysis session — once the hair has been removed no more treatments are necessary.
Disadvantages of electrolysis Although there are many benefits to electrolysis, there are a couple of drawbacks to consider: •
Several sessions: If larger areas are being treated with electrolysis, such as the legs or back, it can take several, long sessions to achieve permanent results. Also, removing coarse hair, such as from around the bikini line, requires more sessions.
Discomfort: People undergoing electrolysis hair removal may experience some pain and discomfort, especially with the old technologies. However, the new technologies are able to deliver quick and relatively pain-free options.
AFTERCARE With electrolysis, very little aftercare is necessary. Although the skin may feel irritated and appear slightly red, these symptoms tend to resolve within a few hours. For permanent hair removal, a person will need several treatments. This is because the skin has multiple follicles for each hair, so dormant follicles may begin to grow hair between sessions. Followup sessions treat these newly active follicles. TRAINING STANDARDS Over the past 12 months electrolysis has gain a great deal of attention as a go-to modality for the permanent removal of hair, especially white hair and blonde hair, as well as with excessive growth in facial hair as a result of medical conditions. While there is training available, please understand that this is an invasive procedure and gaining basic training is not enough. Make sure that your trainer is formally qualified and is offering you training that is either government-approved or internationally recognised. This modality has a real future as a specialised area, and it warrants correct and thorough training in both theory and practical application. APJ
THE OZONE PARADOX
Risks and benefits of ozone therapy in health and aesthetics Tina Viney
CLEAN SKIN MEANS HEALTH SKIN, AND IT IS A NECESSARY PROCESS to undergo with any aesthetic procedure, regardless of the skin type and condition, but even more so for oily or acne skin conditions that harbour infectious bacteria. While in cosmetic medicine, peels and other topical treatment solutions are used to cleanse the skin, in traditional beauty therapy the skin is often streamed, sometimes with the inclusion of ozone at some stage during the steaming process. Within Australia, the inclusion of ozone to a steamer used for aesthetic therapies is permitted, however, this is not the case in the USA, where the ozone component is prohibited because it is considered toxic. So, let us take a closer look at ozone, its use and its risks and benefit. But first, let us see why we used steam in aesthetic treatments. THE ROLE AND BENEFIT OF STEAM IN AESTHETIC CARE Cleansing: By far the most common reason that a steamer is used on the skin for aesthetic care is for the purpose of supporting and improving the cleansing process. The steam stimulates the oil glands and dissolved debris within the sebaceous glands allow for ease of extraction of blackheads and comedones.
Although it may seem that pores open and close, closed pores are simply pores that have become clogged due to overactive oil glands causing a build-up of hardened sebaceous matter. Changes in skin temperature will not change the size of the pore, however steam can help release debris. Pores may therefore appear enlarged in oily or acne skin conditions, as well as in people with less elasticity in their skin. Provide a calming sensation: Warm steam also provides a relaxing and comforting feeling and can relieve stress. Think also soaking in a thermal bath to relax. Increase the effectiveness of creams, serums, and masks: When steam is released on the face, it exposes the skin to the water vapour, this increases the temperature of the skin. The increased blood circulation, improves oxygen and nutrient delivery from the dermis to the epidermis. With increased blood circulation, products can also more easily pass through the skin barrier. This was demonstrated in one study that tested how higher temperatures affected the absorption of nicotine patches on the skin. The researchers noted a threefold increase in nicotine absorption across the skin at 42°C compared to 32°C.
This suggests that absorption levels in the skin are more effective at higher temperatures, which also suggests the potential benefit of facial steaming and absorption of skin creams and other products across the skin barrier. Boost collagen production: Some commercial facial steamers suggest that steaming helps to boost the production of collagen and elastin by activating the dermis, however, at this point there is no scientific evidence to back this claim. WHAT IS OZONE? Ozone (O3) is a potent form of oxygen composed of three oxygen atoms. Ozone is both a natural and man-made gas. In nature, ozone is formed naturally through both lightning and the interaction of ultraviolet radiation from the sun with molecular oxygen (O2). The ozone layer, the range which spans several kilometres above the earth’s surface, reduces the amount of harmful UV radiation that reaches us at the surface level. Ozone therapy has been used in medicine since World War 1, although at the time it lacked sufficient research to have made it into the mainstream medicine. Ozone is the strongest naturally occurring oxidant. From the research that has been done on ozone therapy, it has been found to be an effective tool in modulating the immune system, enhancing circulation, destroying bacteria and viruses, and enhancing oxygen delivery by the body. BENEFITS OF OZONE THERAPY Medical ozone disinfects and destroys microorganisms including bacteria, viruses, fungi, yeast and protozoa. The cells that are most susceptible to foreign invasion or infection by pathogens are also the most vulnerable to oxidation. With the use of ozone therapy, ozone destroys cell growth by disrupting cell growth, thereby eliminating the pathogen. Research has shown promising results in the following conditions though the therapeutic use of ozone:
Boosted Immune Response Ozone is a potent immune system modulator, meaning when the immune system is in overdrive (like with autoimmune diseases) it will calm it down, and when the immune system is under-active it will stimulate it, such as with cancer and chronic infections. Antioxidant While ozone is an oxidant it increases antioxidant production even more than vitamin C. Ozone works by increasing endogenous production of antioxidants (production stemming from within the body). Increased Oxygen Efficiency Ozone stimulates increased oxygen uptake, which has good implications for anaemia and diabetics. Improved Circulation Ozone improves circulation and enables more oxygen to reach the capillaries; therefore, providing cells with more oxygen. Those with chronic inflammation tend to have weak circulation. OZONE SAFETY PRECAUTIONS The use of ozone (O3) gas as a therapy in alternative medicine has attracted scepticism since it is considered an unstable molecule, and therefore this poses risks. However, copious volumes of research have provided evidence that O3's dynamic resonance structures facilitates physiological interactions useful in treating a myriad of pathological conditions. Specifically, O3 therapy induces moderate oxidative stress when interacting with lipids. This interaction increases endogenous production of antioxidants, local perfusion and oxygen delivery, as well as enhances immune responses. While ozone has its risks, when administered correctly, it has several healing benefits. Therapeutic dosage of ozone gas can be administered any of the following ways: •
Auto-Haematotransfusion: Blood is drawn from the body, mixed with ozone gas, then reintroduced to the body.
Injections: Intravenous or intramuscular injections.
Infected wounds and expedited wound healing
Internally: Ozone dissolved into water as a medicinal drink.
Viral Infections and Diseases
Bacterial Infections and Diseases
Rectal Insufflation: Ozone gas administered through the rectum.
Topically: Ozone gas can be administered directly to the skin through a sealed bag or special medical chamber.
Antibacterial and Antifungal Ozone has antibacterial and antifungal properties that make it a good choice for treating infections and wounds. Ozone gets inside the cell walls of bacteria and fungi to oxidise and destroy the lipids within. In fact, ozone has also been demonstrated to destroy pathogenic biofilms, which are notoriously hard to treat. This implies that ozone may be a useful treatment in cases where antibiotics fail, like against resilient microbial infection where biofilm is present.
HOW IS OZONE USED IN SKINCARE? In a traditional vapozone device there are two switches – the steam and the ozone. Initially, the steam is introduced on its own for 10-15 minutes followed by the introduction of the ozone that is then combined to the steam. The steam becomes ozonated as the air meets radiation from the UV lamp installed onto the device, creating a softer defused dryer steam, that is pleasant. Ozone guarantees improved purification and reactivation of the skin. The combination of steam and ozone creates an antibacterial effect and stimulates an antioxidant effect on the skin, while also increasing the skin’s oxygen uptake. For this reason, it is useful when treating acne or oily skin that suffers from breakouts. This phase should be included for an additional 10 minutes. It is also important to note that during the ozone phase the eyes should be covered. While it has been ascertained that ozone is unstable, the amount used on the skin during a vapozone treatment is so minimal that any risk is alleviated. APJ
For a list of references, please contact the editor.
TIPS FOR BETTER BUSINESS technical trends. Studies confirm that businesses and staff that commit to their on-going professional development are happier and more engaged employees that are less likely to leave the business. They are more motivated and productive because knowledge elevates their confidence and self-esteem and as a result, their productivity increases. Investing in employee development is a marketable asset for company brand and reputation. And the stats back this up. LinkedIn’s 2018 Workplace Learning Report found that 94% of employees would stay with a company longer if it allowed them to expand their career skills. That is all well and good however times and workplaces change.
PROFESSIONAL DEVELOPMENT AND WHY YOU NEED TO OWN IT WE LIVE IN A CONSTANTLY CHANGING WORLD. New technologies products and services are constantly on the rise. Our world as we know it, is forever changing and business owners are constantly challenged to give more and demonstrate to consumers that they are up-to-date with advances in their area of service. It is now also a standards requirement by regulatory and industry bodies that personal service professionals provide evidence of maintaining their currency, over and above their original qualifications, by investing in a certain level of professional development each year, or every two years. So, what is professional development? According to Guskey (2000) “Professional Development (PD) is defined as the processes and activities designed to enhance professional knowledge and skills.” PD refers to all training, certification, and education that workers need to succeed in his or her career. It is no secret that different jobs require different skills. Even if today, you have the necessary skills, it is guaranteed that you will need additional skills in the future. Technology updates,
new discoveries entering the market require that we are constantly updating our processes and enhancing our skills and the old models of thinking and doing. 10 years ago, the term ‘cloud’ had a direct connection to rain and weather. Today, the context is just as likely to be referring to online storage of data. What is CPD? (Continued Professional development?) The CPD Standards organisation defines it as “Continuing professional development (CPD) is the intentional maintenance and development of the knowledge and skills needed to perform in a professional context. This could mean honing current skills, it could mean developing them to a new level, or it could mean learning new ones that will allow an employee’s job role to expand or prepare them for potential promotion.” Membership to industry bodies is often required, along with evidence that specific content or hours of professional development have occurred to maintain status and membership. An example of this is CPA for accountants. Why invest in your own development, isn’t that what my employer is supposed to do? There are many reasons why businesses should invest in the professional development of employees, including measurable benefits of skilled employees staying up-to-date with industry and
Not all workplaces budget for professional development, others may have limited budgets that restrict options such as multi-day training or conferences. And this year, budgets are being prioritised to keep doors opened and staff employed. However, the updating of skills and knowledge should be every employee’s responsibility, they should not look to their employer to always pick up the tab. This is a strong misconception in our industry. It is useful to think of PD as an investment, for both you and your employer. One option is for both parties to contribute to the investment. While you might be contributing time and effort your employer might be supporting you in a range of ways including accessing study leave and covering your absence or sharing part of the cost. Also remember that the cost of your professional development can also be used as a tax deduction. Experts advice employees to re-frame their thinking. You own your career. Start owning your professional development. It is useful to think of PD as an investment. An investment of your time and development. Applying a ‘return on investment’ mindset to planning your professional development is important because it focuses your thinking on the potential return in terms of career benefits. In the instances where your employer is contributing by way of funding or enabling you study time, they will expect a
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return on their investment. This could be the application of new skills back into the workplace, up-skilling others, or if they have paid for your education, they may request an agreement that you will remain in their employ for an agreed period to ensure their investment can benefit the business. Plan for your development and success, by asking the following questions. 1. What are the intended learning outcomes from this activity? (if the activity is a formal course this is a good question to ask the course provider). 2. What is the relevance of this activity to my current work role? 3. How will my employer benefit when I achieve the intended learning outcomes? 4. How can new knowledge expand my scope of practice? 5. What are the longer-term benefits for me - higher salary or job satisfaction? A world of choices There is a smorgasbord of continuing professional development (CPD) choices available to professionals who are willing to think creatively and analytically about their current role and career aspirations. There are two broad categories to think about: 1. Formal professional development – expanding scope of practice. 2. Informal work-related professional development – refining and updating my skills. Formal professional development includes: • Full and part-time tertiary study •
Accredited courses, workshops, online learning, webinars (internal including internal workplace training and training from external organisations)
Writing papers and delivering workrelated presentations
From an early age, we are taught to think
about development as a formal learning process. Kindergarten, onto primary school, where each year we progress to a new level of learning. Onto secondary school, for some apprenticeships, others university. Consequently, we tend to believe that development occurs in a formal learning environment. This simply is not true. While formal accredited training provides us with a qualification, Professional Development refines and updates our knowledge and skills to a new level. This can occur in a variety of ways:
awards CPD points towards your ongoing professional development. For further details visit https://apanetwork.com/arap One of the best ways to enhance professional development is through the APAN ONLINE AESTHETIC CONFERENCE. Please also check the article on Lateral Learning in this journal. This conference is a fully certified and you will receive a Certificate of Attendance and 10CPD Points. To register visit www.apanconf.com
Taking control of your PD Your development starts and stops with you. Over time the following activities help you to be proactive and to drive your own professional development. •
Conferences and seminars (including virtual conferences, webinars)
Reflecting on your strengths and areas for improvement in your work.
Listening to and acting on feedback from your manager and colleagues.
Being alert for professional development opportunities and assessing their relevance to your professional development needs.
Ensuring that you have discussions with your manager about professional development and the organisation’s needs. This can lead to a useful discussion about the level of support possible, i.e. the extent to which your employer is willing to invest in your professional development.
Keeping up to date with technical developments in your area(s) of specialisation. Honing existing skills and developing new ones.
Just as the world and workplace changes and adapts to new ways of working, as professionals, we do, too. Do yourself a favour and reframe the way you define professional development and enjoy exploring new ways of increasing your skills and capability via informal learning along the way. APAN is the only Aesthetics independent industry body that has a CPD program in place. Our ARAP and CTARP programs review qualifications for registration and
TIPS FOR BUSINESS OWNERS BUSINESS OWNERS HAVE HAD MUCH TO CONTEND WITH over the past 18 months, from adjusting to safety and regulatory requirements due to COVID19, changes in consumer behaviour, the financial disruptions due to lockdowns and reopening, and the challenges this has brought to both them and their staff. Meanwhile, business analysts are researching and identifying strategies to help businesses move forward. Here are some expert tips and suggestions: Tip 1: Scaling While many are scaling down on product purchases and investing in equipment, expert caution against businesses going too hard on this strategy. Instead, they
TIPS FOR BETTER BUSINESS advise to look at options that will increase your financial revenue. When under financial pressure it is important to carefully consider cutting back on waste, but guard against being fear-driven and taking on a paupers’ mentally. Remember, a business cannot grow if you trim your stock too much, or heavily cut back on provisions that will attract consumer spending. Guard your heart against feardriven tactics. Tip 2: Innovation Don’t be afraid to innovate. Introduce something new. A new service, a new product line, name changes to the services you provide. Combining modalities in a complementary way that will allow your clients to experience the various services on offer as part of a program, rather than just focusing on a narrow approach to a solution. For example, add a body treatment that focuses on stress management, pain management, or better sleep to a program that is designed to improve their skin. Look at doing things differently. Tip 3: Social issues Much has been written about consumers’ increased desire to see businesses take a stand on social issues. The three p’s business model – people, planet and profit – has evolved as interest crosses generations, but is most consistently propelled by Gen Z. Currently 15-24 years old, as more of this group is entering the workforce, and their voice will be louder than ever as both as consumers and employees. No previous generation has been as demanding of their employers to demonstrate a corporate social conscience. Tip 4: Email Marketing While you cannot survive today without a social media presence, email marketing is experiencing a comeback. Keep your messages fun, educational, offer greater value to your clients and promote positive news that is happening in your environment. Reward referrals and treat them as your valued community. Tip 3: Ad spend The spike in eCommerce, and a related impact on advertising budget allocations, are both projected to continue. As Amazon, Walmart and other players have attracted more shoppers, they’ve also grown their ad sale businesses. According
to eMarketer, advertising on eCommerce platforms jumped 39% in 2020 and will grow another 30% in 2021, capturing 13% of total digital ad spend. Tip 4: Measurability Measurability is helping drive change. According to experts, businesses need to ensure they review the success of their strategies regularly to identify what is working and what isn’t. This will allow them to eliminate what is not working and invest more intently in what is. As they say, “what you can measure, you can grow”. Tip 5: Collaborations If you have a room that is not being used, look at renting it out, or introduce a service that will complement what you are offering your client and rather than sending them to another business, provide them with something new within your own business. WORK EFFECTIVELY WITH YOUR TEAM: During difficult times, reach out to your own team that know and understand your business and challenge them to each come up with one idea that can help grow the business. Here are six tips: 1.
5. Set a daily schedule on paper or on the computer: Tick off what you have accomplished during the day. This is positive reinforcement and helps you see what is remaining. Don’t procrastinate on things you don’t like to do and leave them to the end as they won’t go away. 6. Staff debrief on how things went: As a business owner it is good to have a debrief each morning before employees commence work to keep up to date with what is happening, but also to change goals as required. While in the past a debrief on how things are progressing could be reviewed once a month, with the current challenges this may now need to shift to once a week, or in some instances, even once a day. It is the cumulative effort of these individual steps that can make a real difference. APJ
Listen to your employees – make survival a team effort. Ask your staff to examine good options and give their suggestions as this can give enormous value to the business. Stress that this is important not just for the survival of the business, but also for their own future job security.
2. Give them opportunities to have a voice. What they may come up with can improve processes, shorten times, or develop new products. 3. Acknowledge those who have contributed: Encourage those that make a suggestion to refine the strategy that will help the business increase profit share, increase client numbers, quality customer service reviews, new processes and such. 4. The setting of daily goals: This can be done from management down. It is essential to know what you are aiming to do. Keep the goals achievable to increase the momentum for progress.
EMPLOYRR PERKS AND INCENTIVES TO BUDGET FOR IN 2021 THE ISSUE OF INCENTIVES AND STAFF REWARDS regularly comes up as businesses seek creative ways to show their appreciation of their staffs’ contribution to the business growth. However, when it comes to incentives
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and perks there are two camps in the business world: 1.
Those who believe that staff should not need to be rewarded to do their work well and to the expected level.
1. Those who believe that staff need to be rewarded if they are to perform at their optimal level. Both are correct, but for different reasons. So, let us look at when and how perks and incentives could be considered. As a business owner, the most valuable asset you have is your employees, and when they are happy, they will put in extra effort to make sure the business is successful and continues to grow. WHEN AND HOW INCENTIVE SHOULD BE CONSIDERED Every employee should be given by the business an HR Agreement that clearly states what the behaviour and expectations are. Additionally, they need a Workplace Agreement that outlines their job description and their daily tasks and duties that they will need to fulfil for which they are paid. This should include services they will be delivering, as well as the expected revenue they will need to generate by way of repeat bookings or product sales with clearly defined targets. Each employee must generate sufficient business revenue for the doors to remain open and for the business to survive, as well as for their employment position to remain viable, regardless as to whether they are permanent, part-time, or casual. This part of their agreement should not be incentivised, as their wages is their incentive. However, every business needs to continue to grow to meet with on-going cost increases, additional training, introduction of new technologies to improve productivity, and to remain current, through updates on systems and processes to support business efficiency. To achieve this every staff member should also be required to contribute to the ongoing increase in daily and weekly revenue. This is where incentives can help your staff support business growth above and beyond the basis job duties and responsibilities. We are often asked for recommendations on perks and incentives that are
affordable and creative without putting a financial strain on the business. Businesses want to show their appreciation of their staff as being important members of the team, but they cannot always afford a high financial contribution. Here are a few suggestions for you to consider: Talk to each staff member and see what their specific areas of needs are. Do they have children, do they have ailing parents that they like to check-up on? Do they love going to the gym to stay fit? Do they have a hobby that they enjoy? To ensure a perk is meaningful to the receiver, you need to know and understand a little about their private life, needs and wants. 1.Time out with pay Reward your staff member that meets an additional target with the option to take 2-3 hours off, while still being paid. This could be greatly appreciated especially if it frees them to do something that is important to them while not losing out on their wages. 2. Gym Memberships After being stuck inside for the vast majority of 2020, your employees might find that they have put on a few extra pounds or were not as active as they have been in the past. As a way to help them get back into shape and feel good, you could offer them a gym membership. Depending on your budget it may be three or six months to help them reach their fitness goals. Being able to go to the gym is also a great way for employees to lower their stress levels. Lower stress means happier employees. With a gym membership, they will be able to take care of themselves so that they can give the business their all. And healthy employees are more productive and take fewer sick days. Many health insurance providers will also offer a discounted rate to employees with a gym membership because living a healthy lifestyle saves on healthcare costs down the road. So, gym memberships are a great perk to offer employees with benefits for everyone. 3. Self-Care Packages One of the things that 2020 taught a lot of people was how important it is for them to engage in self-care. If they did not take the time to do something for themselves
that did not involve work or kids, they may be included to experience burn out. When employees reach that stage, it is hard for them to focus and do their best work. To ensure that your employees are taking care of themselves, you might consider putting together some self-care packages. These can include gift cards to get a massage or go out to a nice dinner, a basket of healthy snacks or even movie tickets so that they can get away for a few hours for some fun. You could also include a treatment of their choice in your business to a certain financial value. 4. Prepaid Rewards Cards There are few things employees like more than cold hard cash, and while prepaid debit cards are not cash, they’re just as good. You can place orders for gift cards in bulk, making it easy to have on hand for a last-minute reward for a job well done. Some prepaid gift card providers even give you the option of customising the cards so you can put your own branding on them or add a special message to commemorate the occasion. Prepaid rewards cards are great because they are versatile. and your employees can use them just like cash to buy whatever they would like. 5. Health Insurance Offering your employees health insurance is a great way to let them know how much you care and want them to be happy and healthy. You can cover basic needs including optical or dental and hospital for as little as $120 a month. Talk to your health insurance company as they often have special deals. The cost of offering employees health insurance does not need to break your budget and you get benefits as well. When employees can go to the doctor and take care of minor issues, there is reduced absenteeism. That means they are at work more. Health insurance lets your employees know that they are valuable and that you care about them, and they will repay you by working hard. MAKE IT PERSONAL AND MEANINGFUL Perk should be incentives for helping the business to move the next level. They should be considered above and beyond their standard job requirements. As with everything, perks and incentives need to
TIPS FOR BETTER BUSINESS be budgeted and must be positioned against expected business growth figures. That way they will be rewarding for all parties concerned. APJ
2. Automation Another type of bot, where some accounts pay to have software like, follow and comment on
WHY YOUR BUSINESS WILL FAIL IF IT IS NOT CLEAR ON ITS PURPOSE FOLLOWERS – ARE THEY FRIENDS OR FOES? WE KNOW YOU FEEL IT. THAT RUSH WHEN YOU SEE A NEW ACCOUNT has started following your business. It makes you excited. You start thinking about how many people have followed you in the last week. Could this be it? Could you be making the ascent to business Insta notoriety? Your business is starting to get noticed! And off you go to bed, basking in the glow of Insta satisfaction and dreaming about that you are finally making an impact and being noticed. The next day, you log in and see your Insta account has dropped seven followers ...! You are not alone. Social media experts agree that this happens to everyone, so here are some pointers to help you understand your followers. Are they your friend, or here to ruin your day and dictate your mood? 1. Fake out. Unfortunately, there are still a lot of bot activity on Instagram. Even though there has been a good clean out of fake accounts, as soon as the bots are gone, they are back in some other form. You will find that when Instagram cracks down on fake accounts, your numbers may drop.
their behalf. There are also sneaky types of software that follow an account, and if you do not follow back, then you get unfollowed. 3. You’re so vain. No, not you, personally. But did you know that when it comes to how successful your Insta account is, it actually has nothing to do with how many followers and likes you have? Yes, it is nice to have a huge following, but those metrics are considered vanity metrics. What you really want to look at is your post engagement, how many people commented, tagged someone, saved the post, sent the post to someone, viewed your profile, and visited your website? Those are the metrics you want to be looking at. The more engagement you have, the more engaged your audience is with your content, which, over time will turn into customers. Hopefully, we have made you feel a bit better about the fact that having loads of followers isn’t always the winning factor. APJ
EXAMPLES OF BUSINESSES ACTING without integrity or purpose are unfortunately available in spades. A recent banking royal commission uncovered a business model among many financial institutions which deprioritised or even exploited their customers. An example was a recent discovery that Crown Casino in Sydney has turned a blind eye to the imprisonment of employees in China and money laundering by criminals through Crown accounts in Melbourne and Perth. In both cases, the pursuit of the owners and shareholders’ self-interest and disregard for the interests of their customers, employees, and the community, ultimately led to their downfall. It is no longer acceptable in the current environment to operate without purpose or integrity. And those that do will be quickly found out. So, what has changed? Historically, business values revolved around competing interests - between owners, employees and clients. Lower prices are good for clients but mean less money for the business. Higher wages are good for employees but are bad for the owners.
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In the past business coaches advised that business survival was predominantly focused on economics. Owner’s preferences were to drive down wages, increase prices and service profitability, however, this model is fast losing traction. Business analysts now identify that the interests of owners and shareholders does not always need to be at odds with those of customers, employees, or the community, in order for businesses to thrive. Engaged employees who are fairly remunerated perform far better and contribute more fully to the business’ success. Clients who have an excellent customer experience and feel they are getting value for money can be strong advocates for a brand, contributing to its success. On the flipside, society is much more likely to shine a spotlight on poor business practices with the primary focus being on how the owners and shareholders’ selfinterest are achieved above all else. Today, clients, employees and the community can hold businesses to account much more readily, thanks to social media or through choosing to spend their money elsewhere. A mutually beneficial engagement between all stakeholders can maximise everyone’s interests, without sacrificing a business’ success or profitability. What is the role of purpose and values? The old view was that the only purpose a business had was to pursue the selfinterest of owners and shareholders. With this view no longer considered acceptable, businesses need to be guided by a higher purpose. The purpose as expressed by leaders is critical. This is what all stakeholders can buy into. An owner who says “I’m just here for the money” sets him or herself up against the interests of employees, clients and possibly the community to which they wish to appeal. But an owner who says, “I am here for a higher purpose” invites those other stakeholders to buy into and align with that higher purpose. This is particularly true for employees, who will not be motivated by the pursuit of profit alone. By aligning owners and employees around a higher purpose there can be a
deeper engagement ultimately for the benefit of all stakeholders. This is not to say that it is not appropriate for owners to be profit maximises, they need to be, to survive in any competitive environment. It is just that, that discussion, needs to be kept among owners. That statement of purpose should be focused on how it will best serve the clients and/or society, without sacrificing the primary benefit to owners and employees. It should be clear, concise, and engaging.
It is also advisable to indicate how the business is addressing the issue of environmental sustainability. While you may only need to redefine your purpose and values with perhaps just minor shifts, this can have a powerful impact in delivering the right message to your current and potential clients that your business is purpose and valuedriven, this will foster trust and engagement for both staff and clients. APJ
Is it time for you to revisit your purpose statement? Experts stress that a business’s purpose should be client-focused. It should express what makes you different while making a commitment to mutually beneficial outcomes. The next part of the equation is to manage the hearts and minds of owners and employees through agreed values. By encouraging your staff to agree to behave according to an agreed set of values the business can push towards its stated purpose and achieve maximum benefit for all stakeholders. Purpose statement should provide clarify on your integrity, safety, excellence, and empowerment. These values should guide the management and staff’s behaviour towards achieving the shared purpose. Here are a couple of suggestions: “We strive to provide you with exceptional skincare results, while supporting you in your wellness journey for optimal health and quality of life.” “Our management and team are committed to services delivered with the highest industry standard of safety, integrity and treatment outcomes, while nurturing you to enjoy an amazing experience that will support your wellbeing and beyond.” By focusing the mind and behaviour of employees on the shared purpose and values, it will enable a clear message to be communicated that will support the betterment of the clients, employees the business, and ultimately the community and society.
THE SHIFT TOWARDS AN AUTHENTIC MINDSET IN BUSINESS SUCCESS TODAY THE MOST INNOVATIVE LEADERS THAT ARE SHAPING TRENDS ARE NOT CONFORMERS. They are the bold individualists who carve their own paths. So learning to embrace one’s inner authentic voice is the new key to success, say Harvard Business School faculty Francesca Gino, Tandon Family Professor of Business Administration, and Frances X.Frei, UPS Foundation Professor of Service Management. Too often, people are advised or feel pressured to bury the special or quirky aspects of their personalities, recalibrate their speaking or personal styles, or think twice about sharing honest opinions at work in order to demonstrate that they are “a good fit.” But that approach does a disservice to both the employee and the
TIPS FOR BETTER BUSINESS business, Frei and Gino say. The pair recently taught a short, intensive course for MBA students called “Anatomy of a Badass.” The focus of the course addressed the importance of being polite, but unapologetically bold and authentic at work. The course was based on research that shows that being true to who you are leads to greater professional performance and personal satisfaction, and if companies are serious about increasing diversity and inclusion, encouraging everyone to bring their individuality and unvarnished opinions with them is a good start. Gino, who studies innovative leadership and wrote a 2018 book on successful rulebreakers, Rebel Talent, spoke with the Harvard Gazette about what it means to be authentic at work and why it matters. Here is an excerpt of the conversation: . Gazette: Though everyone can find it hard to feel comfortable in their own skin, especially at work, you say the idea behind this course came out of the challenges of marginalised people, face, even as more companies say they want everyone to feel welcome and valued at work. Francesca Gino: So often, when we talk about good, indifferent, or inclusive workplaces, we think about the conditions that each of us can create to foster a more collaborative, whether we’re having a conversation, a meeting, and other interactions. What we don’t give a lot of space to, though it’s almost as important or maybe even more important, is what if you’re the person who doesn’t feel welcome or appreciated for the views and perspective that you bring forward? And that’s where, having this courage to just show up for who you are is powerful. So how do we truly show up at our best and bring our ideas forward no matter what the context is? Gazette: What does it mean to be a badass? Gino: It means having the courage to bring your full self forward. Now, authenticity is a word that is thrown out there a lot. I think the confusing part for a lot of people is that it is often assumed
that if you’re authentic, it means that you’re not filtering. And that is not the case. You’re being thoughtful about it. What it means is that, in moments where you and I are in a meeting with others, and everybody is suggesting X and I fundamentally believe that we should be doing Y, I feel the courage to speak my mind instead of doubting myself and staying silent. Finding my voice and gaining the courage to express my opinion will allow me to feel valued and it will allow me to help shape a company policy that may not have happened if I did not speak up. In some way, it is bringing out who we are rather than checking our identity at the door as we go to work. It is really thinking about what makes you, you; what are your personal strengths and talents, to make sure that you are leveraging them in the work that you do, or in your personal life, rather than quieting them down. Gazette: So, how does authenticity affect someone’s work life? Gino: I’ve done quite a bit of research on authenticity inside of organisations and here are a few that are surprising to people: One is that authenticity benefits how we perform. One of the studies that I have done with a few colleagues shows that people doing an interview, if they are more authentic, which might mean answering questions by bringing forward the real you versus not, end up being more likely to get the job. We have data on entrepreneurs pitching ideas to venture capitalists: If your pitch is more genuine and authentic, you are three times more likely to get money for your venture. So, there’s good evidence that authenticity helps, especially when compared to another strategy where you try to cater to the expectations of the other person,” Gino said. “We also have evidence that authenticity allows you to engage with your job more
deeply, which means you’re more likely to stay with the business and, also form a deeper relationship with your colleagues.” “And I have research that shows that if you are among a minority and you’re going through an experience where you are feeling excluded, authenticity actually can buffer against that experience,” Gino
confirmed. “We can have the courage to speak up and bring our ideas forward, but this does not mean that we do it in an arrogant way - we must always communicate our opinions in a respectful way. “What we need to understand is not to get confused about what we mean with authenticity. When we are authentic, we still need to be filtering. It does not mean that if I love to wear my pyjamas because I feel comfortable that I go to work in my pyjamas. There’s still judgement in terms of how to bring some of your talents forward. Also, being authentic does not mean that I fundamentally believe that my ideas are better than yours. We can have the courage to speak up and bring our ideas forward, but always in a respectful way. “I think that we often associate the idea of a [badass] as a person who’s loud and comes through and squishes others, but that’s not the idea. It is more what we’re picking up with it. And the reason why we used it in the course title is to say it requires courage. But that does not mean that we shouldn’t be respectful of other people’s views. And we should bring our ideas forward in a way that they are part of the conversation, but not necessarily stated as ours is the only voice that we should listen to,” Gino stressed. Both Gino and Gazette agreed that there is value in not stopping ourselves by stereotypes that inhibit us expressing our views, opinions and putting forward our recommendations. Finding our voice and presenting our opinions and observations in a respectable manner can, not only be valuable to the business and rewarding to us, but it can also empower others to find their voice. There is power in the release of creative ideas especially when shaping a business brand. APJ
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HYALURONIC ACID Internal and Topical Use Tina Viney
WE ARE ALL FAMILIAR WITH HYALURONIC ACID and its benefit as a topically applied product in skincare. We are also aware of its benefits in plumping the skin when administered through cosmetic injections. But what about hyaluronic acid as a supplement? In this article let’s will explore the broader applications and benefits of hyaluronic acid as well as their benefits and risk considerations. While we are familiar with its use in the cosmetic world it is useful to know that hyaluronic acid is available in a variety of forms including: • dietary supplements •
If you do a quick search on hyaluronic acid, you will find thousands of products, from liquid serums to pills to creams that make a variety of claims. As we known creams and serums focus on hyaluronic acid’s ability to ease skin redness and reduce wrinkles, while oral supplements predominantly focus on acting as a lubricant for joints. However, new evidence suggests that taking hyaluronic acid internally can help benefit joints and the skin as well as other conditions. THE ROLE OF HYALURONIC ACID IN THE BODY Within the body, hyaluronic acid plays an important, albeit diverse role. It is a major component of epithelial tissue and it also seems to play a role in cell division and movement. This is because hyaluronic acid is a chief component of synovial fluid - the fluid found inside a synovial joint, such as the in a human’s hips or wrists, where it acts as a lubricating agent. Hyaluronic acid is also found in joint cartilage, where it coats all the cells, and it even plays a role in the body’s innate immune system (high hyaluronic acid levels can be used as a marker for prostate and breast cancers). The average person has ~15 g of hyaluronic acid in their body, and about 1/3 of it is degraded daily. APJ 90
In short, hyaluronic acid does a lot of things, from skin repair to joint lubrication, so it makes sense that it is recommended for possible treatment for a wide variety of health problems ranging from osteoarthritis to sun burns. But what does the science say about its efficacy? Here is a summary: AGEING SKIN: Research shows that injecting a specific hyaluronic acid product (Juvéderm Ultra Plus, Allergan) into facial wrinkles has been demonstrated to reduce wrinkles for up to one year. Also taking a product containing hyaluronic acid and other ingredients e.g. (GliSODin Skin Nutrients Advanced Anti-Ageing Formula) orally has shown to decrease wrinkle depth and skin damage from the sun when used for three months. DRY EYES: Most research shows that using eye drops containing hyaluronic acid up to eight times a day can help relieve symptoms of dry eye. OSTEOARTHRITIS: Hyaluronic acid injected into the joint has been shown to reduce joint pain and stiffness. Hyaluronic acid is approved by the FDA for this condition, but not all people seem to benefit from this treatment. Also, any improvement is usually short-term. Having hyaluronic acid injected into the joint is not recommended for all people with osteoarthritis, but it can be discussed with your doctor. Some early research shows that taking hyaluronic acid orally may reduce pain in some people with osteoarthritis. PROMISING RESULTS While the below conditions have shown that hyaluronic acid has provided benefits, some of the research is not conclusive and may require further investigation: FOOT SORES IN PEOPLE WITH DIABETES: Research shows that applying products containing hyaluronic acid and other ingredients helps heal diabetic foot ulcer compared to regular treatment. However, it is not clear as to whether the benefits were attributed just to the hyaluronic acid or due to the other ingredients. Further research is required.
EYE TRAUMA: Some research suggests that hyaluronic acid might be injected into the eye to treat detached retina or other eye injuries. SHOULDER PAIN: Early research shows that injecting hyaluronic acid might improve pain in people with hemiplegic shoulder pain due to a stroke. Some researched has shown that it can provide positive relief in pain management. NASAL SURGERY: Early research in people who have had nasal surgery shows that using a hyaluronic acid nose wash might improve sinus scarring and crusting better than a salt-water nose wash. KIDNEY, BLADDER OR URETHRA INFECTIONS: Research shows that injecting hyaluronic acid with chondroitin sulphate directly into the bladder can reduce the number of urinary tract infections in women. THINNING OF VAGINAL TISSUE: After menopause, vaginal tissue gets thinner due to atrophy. Early research suggests that applying a solution containing hyaluronic acid to the vagina helps to reduce burning, itching, and painful intercourse in women with thinning vaginal tissue. WOUND HEALING: Early research shows that applying hyaluronic acid to the skin might be helpful for treating burns and skin wounds. WHAT ABOUT ORAL ADMINISTRATION OF HYALURONIC ACID? There have been a few studies on oral treatments of hyaluronic acid, and they all seem to have quite positive results. One study found that daily supplementation with oral hyaluronic acid enhanced several markers of quality of life in adults with osteoarthritis of the knee. This study also concluded that oral intake of high purity hyaluronic acid is effective in the treatment of knee osteoarthritis. It also found that partnering oral hyaluronic acid supplements with exercise also had positive results.
Another interesting discovery is that there is sufficient evidence to indicate that orally administered hyaluronic acid is absorbed in the digestive tract and that it does migrate to the relevant connective tissues including the skin. There is also evidence that it can have a biological effect without even being absorbed. This function however depends on there being enough hyaluronic acid molecules present to interact with the relevant receptors. SIDE EFFECTS Investigations about any side effects examine the following: • Oral administration •
Applied topically to the skin
Applied to the eyes
All the above confirmed that hyaluronic acid was likely safe when used appropriately with very rare cases of allergic reactions. Special precautions and warnings were given in three areas: Pregnancy: Hyaluronic acid is possibly safe when given by injection when pregnant. However, there isn't enough reliable information to know if hyaluronic acid is safe to take by mouth or apply to the skin when pregnant. Stay on the safe side and avoid use or consult with a physician. Breast-feeding: Hyaluronic acid is possibly safe when given by injection when breast feeding. But researchers do not know if it affects breast milk and what effect that might have on an infant. There is not enough reliable information to know if hyaluronic acid is safe to take by mouth or apply to the skin when breastfeeding. Stay on the safe side and avoid use or consult with a physician. Hardening of skin and connective tissue (scleroderma): Applying hyaluronic acid to the skin might make skin ulcers worse in people who have a condition called scleroderma. If you have scleroderma, it is advisable not to use hyaluronic acid on your skin. APJ
For a list of references, please contact the editor.
CELEBRATING WOMEN WHO CHANGED THE WORLD Florence Nightingale
1829 - 1910
IF WE LOOK BACK THROUGH HISTORY AND EVEN TO THE PRESENT TIME, we will discover incredible women whose contribution helped to change the world for the better.
As part of an INSPIRATIONAL SERIES in each issue of APJ Journal this year we will be featuring the life of one extraordinary woman highlighting their life and achievements. In this issue, we profile FLORENCE NIGHTINGALE – known as “The lady with the Lamp”. I am sure you all have heard of Florence Nightingale. Known as the founder of modern nursing, Florence early on in her life identified the need for formal training and the important role that this can play in patient safety, as well as how maintaining a clean hospital environment can support patient health and their recovery.
TRAINING AS A NURSE When Florence was 24, she told her family she wanted to become a nurse as she felt inspired by God to help others. In essence, she felt it was her calling. Her parents were horrified as hospitals in Victorian Britain were not considered a safe place, and women who worked as nurses usually came from poor families. This was not an area that a wealthy young lady would move into and “get their hands dirty”. However, Florence disliked how rich women had leisurely lives like her mother, Frances Nightingale. She believed that a woman should have a purpose in serving others and in pursuing a formal way of doing so.
BACKGROUND Florence was born to a wealthy family on May 12, 1820 in the Italian city of Florence. Her parents owned a winter house in Hampshire and a summer house in Derbyshire. Florence (‘Flo’) and her older sister Parthenope (‘Pop’) travelled regularly and enjoyed a privileged lifestyle of vacations and expensive clothing. Their father was William Nightingale, a rich banker, who taught his daughters subjects girls did not normally study, such as mathematics, philosophy, Italian and history. From early on Florence stood out as an intelligent and gifted child who excelled in mathematics. In reviewing her life, we identified five key facts about Florence Nightingale that defined her: •
Apart from maths Florence was also fluent in languages, notably English, French, German and Italian.
As hospitals were considered very unsafe places her parents objected to her choosing to pursue nursing, however she was determined to become a nurse from an early age.
Due to her compassion and care Florence not only took care of the dying soldiers she often wrote letters home on behalf of the dying, or even those who died notifying their families.
Determined to work hard, Florence went to Egypt in 1850 to study nursing and in the following year she trained in Germany as a nurse. As she pursued nursing as a profession, Florence passionately dedicated her life to her work and for this reason refused to get married, thinking it would interfere with her work. In 1853, Florence had her first job in a hospital in London, where she took the post of superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street in London. A SPECIAL REQUEST By 1854 the Crimean War began while Florence was working in London. Meanwhile England, France and Turkey were fighting together against Russia contributing to many casualties of war. As wounded soldiers continued to arrive the British public became angry that soldiers were dying in an overcrowded Army hospital that was built on top of a cesspit and full of rats.
Florence was so passionate about committing her life completely to nursing.
As the unrest continued the government was pressured to address this problem and the Minister for War, Sidney Herbert was a friend of Florence, he approached her to help the hospital and arranged for her to go there with a group of nurses.
From an early age she excelled and during the Crimean War she soon had a following with 38 nurses working under her.
As soldiers were dying in huge numbers from diseases like cholera and typhoid Florence immediately set to work improving hygiene
conditions, cleaning soldiers’ wounds and bed sheets. Like most people at the time, she knew little about how infectious diseases spread. As she investigated the issue of sanitation a sanitary commission was appointed to visit the hospital to flush out the sewers and improved the hospital’s ventilation system. This helped improve sanitation and minimise the impact of bacteria and the spread of disease. FLORENCE THE STATISTICIAN By implementing sanitising changes this contributed to saving lives. Florence’s fame grew and she was sent to other countries to help introduce hotel safety measures. In 1857 on her return from Scutari in Turkey, the newspaper reported about the ‘angel’ at Scutari that made Florence a celebrity, but Florence was dedicated to her work and did not care about becoming famous. Instead, she was concentrating on writing a report. The data she had collected at Scutari showed that out of 18000 soldiers, 16000 had died from infectious diseases, and they had caught these diseases inside the hospital. However, the data also showed that more soldiers survived as the sanitary commission worked towards improving sanitation in the hospital. Putting her mathematical mind into action, Florence created a diagram to show her statistics about the soldiers clearly on paper. Now known as the Rose Diagram, it shocked the government and British Army into making important changes in hospitals. Following the implementation of the Rose Diagram fewer people would die, and the US Army successfully used Florence’s ideas during the American Civil War. FLORENCE THE PIONEER By 1860, Florence opened a nursing school at St Thomas’s Hospital in London. The nurses who trained there were known as Nightingale Nurses. They took the ‘Nightingale Pledge’ and spread
Florence’s caring methods at home and in other countries. Florence’s book, ‘Notes on Nursing,’ advised people how to care for the sick. It was written in simple language so that everybody could understand it. Florence even investigated how to improve living conditions for starving people in India. In 1883, she was awarded the Royal Red Cross by Queen Victoria for her work. She then became the first woman to receive the Order of Merit, from King Edward VII in 1907. Florence Nightingale improved medical care for everybody and inspired nursing as a respectable and honourable profession, leading more and more women to seek nursing as their profession of choice. Because Florence did not discriminate between different social classes or religions, her ideas and kindness united people all over the world. FLORENCE NIGHTINGALE’S “ROSE DIAGRAM” In recent times several temporary field hospitals have sprung up across Britain for the treatment of COVID-19 patients. Named “Nightingale Hospitals,” they pay homage to the famous “lady of the lamp.” Florence Nightingale’s pioneering approach to sanitation, shaped by her bloody experience during the 1853–56 Crimean War helped shape the understanding of public health in Victorian Britain and laid the foundations for the profession of nursing as we know it today. One of the many radical innovations set out in her 1860 handbook Notes on Nursing reads: “Every nurse ought to be careful to wash her hands very frequently during the day.” She is credited with having reduced the mortality rate in Scutari, the military hospital where she led a team of voluntary nurses, from 40 per cent to two per cent through her ventilation and sanitation strategies. Less known, though no less pioneering, is Nightingale’s work as a statistician. Already hailed as a hero by the time she returned from
the Crimea, she was determined that its lessons be learned. With the personal backing of Queen Victoria, she led a Royal Commission into the health of the army, working with William Farr, the era’s leading social statistician. Unusually for the time, Nightingale’s wealthy father had educated his daughters in mathematics for which Florence had a talent. The commission’s report, replete with charts and tables, was published in 1858. It showed, with remarkable clarity, not only what Nightingale’s experience had taught her that far more soldiers in the Crimea fell victim to disease than to the Russian cannons, but that, even in peacetime, soldiers living in cramped, unsanitary barracks died at a quicker rate than civilians. In our time of COVID-19, we are more accustomed than ever before to reading the world through data: our screens and inboxes are filled with constant statistics, maps spotted with clusters of infections, line-graphs colour-coded by country. The world held its breath as we waited for the curves to flatten. We are so used to seeing these forms that it is easy to forget they were invented - bar, line, and pie charts are the brainchild of one William Playfair, a Scottish engineer, political economist, and secret agent (“an ingenious Scot of questionable repute,” as one biography puts it), who developed them in the late 18th and early 19th centuries. Nightingale’s unique contribution to the field of data visualisation is something that has become known as her “rose” diagram (although she did not describe it as such). In the most famous example, two circles divided into twelve wedges show the number of annual fatalities at Scutari by month from April 1854 to March 1856. The wedges are colour-coded: blue represents deaths by disease; red, battle wounds; black, other causes. The two “roses” show the months from April to March to illustrate before and after the arrival of the sanitary commission in March 1865. Two things are immediately and profoundly clear: first, how much larger the blue areas of the wedges are than the red; and, consequently, how the total area of the chart (representing total number of deaths) is massively reduced after the sanitary commission’s intervention. Nightingale was battling an entrenched belief - voiced by Britain’s chief medical officer at the time - that deaths from certain contagious diseases were “practically speaking, unavoidable”; her “rose,” resembling an explosion radiating outwards, blew apart that assertion and called for the government to do more. Nightingale knew the power of well-presented information. She reformatted the appendix of her Royal Commission report and self-published
two thousand copies under the title Mortality of the British Army (1858), distributing it to people in high places whom she thought could help her cause. The “rose” itself first appeared in an 1859 pamphlet, supplementing the findings presented in Mortality. With its distinctive wedges, the “rose” sticks in the mind, and its circular form, like the face of a pocket watch, conveys an almost mimetic sense of the cyclical passage of the months. The Crimea took a physical toll on Nightingale from which she never really recovered. Plagued for most of her career by recurring bouts of chronic illness (possibly what we would now call myalgicencephalomyelitis, or chronic fatigue syndrome), Nightingale waged much of her war from her bed or the confines of a couch. Despite her failing health she lived to ripe age of 81. By the late 1800s, as “germ theory” gained acceptance, her views on hygiene were vindicated - even if we find ourselves reminded endlessly anew of the importance of handwashing. APJ
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CLINICAL STUDY POINTS TO OXYTOCIN’S ANTIAGEING BENEFITS Tina Viney
WE ARE ALL FAMILIAR WITH THE NEUROPEPTIDE HORMONE OXYTOCIN – often referred to as the love hormone. It is wellknown that oxytocin is responsible for that euphoric feeling we experience when we are in love, or that warm and fuzzy feeling when we are close to our loving and loyal pet, or hugging a beautiful baby as it suddenly gives us a cute toothless smile.
protect against photo-ageing and, possibly, intrinsic ageing of the skin,” she said.
While oxytocin has been linked to our emotional wellbeing, a recent study examined its impact on skin ageing with interesting findings.
“Searching the literature, I found several basic science studies on oxytocin and the skin. The research showed that both oxytocin and its carrier protein are synthesised in keratinocytes,” she said. “In addition, there was evidence that fibroblasts express an oxytocin receptor and that binding of oxytocin to this receptor suppresses a senescence-associated secretory phenotype composed of an array of proinflammatory cytokines, chemokines, extracellular matrixremodelling proteases, and growth factors.”
The results of a pilot study, discovered that high oxytocin (OT) levels correlated with more youthful-looking skin, as measured by skin age score (SAS), even with a strong history of lifetime sun exposure. Nicole Hayre MD, graduate of Massachusetts Institute of Technology, and founder of Cosmetic Dermatology Centre in McLean, Virginia, undertook the pilot study based on clinical observations of skin appearance. “I have been impressed that people who are in love generally look fantastic and seem to have a glow to their skin that is absent in people who are going through divorce or suffered the death of a spouse,” she told Dermatology Times. “Granted, a person’s mood and whether they are caring for themselves are important contributors to appearance, but I was curious about whether there was some biochemical explanation.” “This research links previous findings on the neuropeptide hormone’s role in preventing the release of certain proinflammatory cytokines, which may lead to skin ageing, with clinical evidence of oxytocin levels’effect on the skin’s appearance. Together, the clinical and pre-clinical evidence identified the oxytocin signalling pathway as a potential target for strategies to
The observation that factors such as social bonding, mental state, and enjoyment of intimacy in personal relationships differentiate the two cohorts turned Hayre’s attention to oxytocin.
CONNECTING THE DOTS To explore the relationship between oxytocin levels and skin ageing, Hayre designed the clinical pilot study. Participants included six women aged 48 to 61 years with Fitzpatrick skin types II to IV. Individuals were excluded if they had undergone cosmetic procedures/treatments in the previous six months, were using topical anti-ageing products, or were on hormone supplements. All participants had an average body mass index and were nonsmokers. Each woman provided a 24-hour urine sample for oxytocin measurement and completed a questionnaire on sunscreen use and ultraviolet light (sun/tanning) exposure. Hayre used data from each participant’s history to calculate sun exposure score (possible range, 1 [least] to 7 [greatest]). Using photographs taken with a medical imaging camera and software system (Canfield Scientific,
Parsippany, NJ), she used the images to grade facial skin ageing for each subject and calculate their SAS. From that value and the expected SAS score, which correlates with chronological age, she calculated an estimated percent change of SAS, she said. (Table). Sun exposure scores for the six participants ranged from 1 to 7, oxytocin levels ranged from 86 to 306 pmol/L per 24 hours, and actual SAS scores ranged from 23 to 53. The results for estimated per cent change of SAS showed that the actual score for all participants was lower (more youthful) than expected. A plot of each woman’s oxytocin level against the per cent change showed an inverse, almost linear relationship between the two variables—the higher the oxytocin level, the greater the percent change in SAS (Figure). It was interesting to find that several patients with high oxytocin levels had SAS that correlated with more youthful skin, in spite of high sun exposure scores, whereas others with lower oxytocin levels and minimal sun exposure had higher SAS scores. This evidence connects clinical findings with previously published benchwork research showing that oxytocin binding to receptors in fibroblasts can halt skin degradation by inhibiting SASP, the study confirmed. CLINICAL TRANSLATION The researchers would like to expand the pilot study and further explore oxytocin’s potential importance in the skin. Hayre is now working with a pharmaceutical company to evaluate a safe, nonhormonal, botanical that appears to have an OT-like effect on the skin.
In the meantime, it may be possible to take advantage of oxytocin’s potential benefits by encouraging certain behaviours. “For skin health, dermatologists tell patients to wear sunblock, use appropriate skin care products, and avoid smoking,” Hayre said. “Perhaps our counselling should also include advice about making time for love and affection. Research shows that aside from intimacy and hugging partners, family, and friends, snuggling a pet and even caressing the skin can release oxytocin.” The study concluded that higher oxytocin levels protect the skin and make subjects appear healthier and more youthful and this will more likely encourage further social interaction. “This oxytocin Social Exchange System appears to work as a positive feedback loop which I speculated likely affects more than just the skin.” Hayre adds that this theory intrigued her to search the literature for information on other biological effects of oxytocin. “We have always known that love and affection improve mental and emotional well-being, but I am amazed that after centuries of medicine we are just learning about the importance of our social interactions on physical health,” she said. “To me, all of this is evidence that we really do need to take time out every day from our busy modern lives to enjoy one another’s company,” adds Hayre. “It is essential to our good health.” APJ
For a list of references, please contact the editor.
PIGMENT BOUNCE-BACK Danielle Hughes
DANIELLE HUGHES IS HIGHLY RESPECTED AS AN AESTHETICS EDUCATOR renowned for her weekly broadcasts sponsored by Skinfaktor. While there is a plethora of information of what certain technologies and products can offer by way of skin results, much less is presented on the risks or side effects that also much be carefully considered when determining a client treatment plan. Danielle is an avid researcher of clinical studies and she loves to uncover risks and long-term safety considerations of various treatments and technologies. In this article she discusses the risk of pigment bounce-back post treatment, what it is, what causes it, how to avoid it and how to treat it. For decades the professional beauty industry has treated hyperpigmentation conditions such as melasma, with the ‘hard and fast’ rule, that is, slash and burn the unwanted pigment and pray that the new skin cells surface without the undesired overpopulation of melanin. It’s not just laser and intense pulsed light (IPL) modalities, this ‘hard and fast’ rule of correcting hyperpigmentation extends to different depths of acid peels and microdermabrasion – all of which work on the premise of creating a controlled trauma, removing cells and promoting new cell migration. Seemingly we turn a blind eye to the simple fact that the pigmentation has likely been caused by trauma or inflammation, and rather than actually seeking to correct the cause of the condition, we look to the quick fix because that’s what our clients are seeking. The thing is, as I’m sure you’ve seen firsthand throughout your career, despite having the credible studies, peer reviewed articles and the remarkable ‘before and after’ evidence that support efficacy, these treatments often yield only a temporary outcome. The final outcome of course being pigment bounce-back – that is, melanin distribution rebounding back into the same pattern we initially tried to slash and burn away. So, let’s back it up for a moment, and review the melanogenesis process.
HOW MELANOGENESIS COMES ABOUT Melanogenesis is the process of melanin synthesis, primarily responsible for the pigmentation (or colour) of human skin, hair and eyes. A number of intricate reactions take place during this highly complex process, however the enzyme tyrosinase and tyrosinase-related proteins I and II play a major role. This enzymatic reaction and response forms a treatment baseline for regulating melanin production and subsequent pigment reduction – but this is only part of the puzzle. Ultimately, the process of melanogenesis results in the production of melanin and its transfer into surrounding keratinocytes as a protective mechanism against ultra violet radiation and other environmental aggressors including infrared radiation (heat), and even aspects of air pollution. Extra pieces of the puzzle start locking together when we look at the melanocyte, resident organelles and its unique communication receptors that digest cytokine-delivered information and command a response. In the case of hyperpigmentation conditions, factors such as hormones, medication, stress and of course, environment can affect the clarity of the messages sent down by the keratinocytes. Think about it, you’re listening to the radio, going in and out of reception. Chances are you are only getting part of the story. What key information have you missed? And how do these ‘exclusions’ interfere with the story hoped to be conveyed? In the case of the melanocyte, it may have missed the instruction sent down that says ‘hey little guy, stop producing melanin, we have enough up here to protect us’. Consider this. What if the message was suddenly stopped altogether because the keratinocyte itself was wiped out by an aggressive treatment? This fact alone identifies the need for an entirely different treatment approach to simply exfoliating away the pigment-filled cells. By enhancing cellular communication and healthy function, we have a greater shot at fixing the actual cause of the dysfunction, rather than offering a short term, symptomatic approach.
WHAT CAN CAUSE PIGMENT BOUNCE-BACK?
WHAT IS PIGMENT BOUNCE-BACK? Pigment bounce-back is a condition that arises post-treatment as a delayed response to the treatment administered. The ‘life-cycle’ of skin rehabilitation after a treatment involves a number of processes and variables, from inflammation and initial barrier recovery to re-epithelisation (new cells and tissue populating the treated site) and remodelling. These are well known processes that work to re-establish homoeostasis after trauma, wound, or irritation. But let’s not forget, inflammation, wound and trauma also stimulate pigment production. And here lie a vicious cycle. The unpopular fact is, that whilst during an initial restabilisation phase the skin may look firm, bright and more even in tone, the delayed response can establish a pathway for increased pigment, synthesised to furnish the keratinocytes with extra protection, just in case that evil aggressor comes for it again – as is the case in a course of laser, or a course of acid peels. As we come to the end of summer, it’s expected our clients will have heightened pigment response that needs addressing. But could their vulnerability have been increased by the treatments we administered last year to correct their pigmentation issues? It’s certainly food for thought as we develop new treatment programs during 2021 and consider opting for the more targeted approach that yields a superior long-term outcome.
Acid Don’t be fooled into thinking that the only ‘bad guys’ are laser and IPL. Acid peels are just as damaging and hold just as much risk for pigment bounce-back. In particular, the unbuffered, low pH, highly concentrated or multi-acid cocktails. Some well-known culprits include: glycolic acid, kojic acid, retinoic acid, salicylic acid, trichloroacertic acid (TCA). Laser and IPL These sources of light energy deliver a thermal interference into the skin, destroying certain targets. The desired outcome of a pigmentation protocol is to destroy the melanocyte, making way for a ‘fresh, healthy’ melanocyte to take its place. There is no shortage of evidence promoting this treatment approach, however there is just as much research documented alerting practitioners to the risks of post-inflammatory hyperpigmentation and pigment bounce-back. Most studies, including a newly submitted article in October, 2020 on post inflammatory and rebound hyperpigmentation as a complication after treatment efficacy of telangiectatic melasma with 585nm Q-switched Nd:YAG laser and 4% hydroquinone cream in skin phototypes III-V, identified that thermal treatments be administered with extreme caution in darker skin tones, Fitzpatrick types III-V. In considering our multicultural society. This fact is of high importance and relevance to a consultation and treatment prescription. Microdermabrasion It may not deliver an energy signature into the skin, but microdermabrasion mechanically traumatises the stratum corneum, and has a knock-on effect to other layers of the skin. Every mature keratinocyte (corneocyte) is programmed to send a final cytokine messenger before it moves on to the ‘afterlife’. This message sends back details of the environment it has been subject to. For example, this girl is always out in the sun, or this girl is having monthly micros. These messengers are digested and certain cellular functions adapt to better survive the environment. This can
result in a thickened, tougher cell (plastic-like in appearance) or new cells with increased melanin reception to protect. The unique relationship between the melanocyte and keratinocyte cannot be ignored – they work together to better protect us. Following a microdermabrasion treatment, the skin will feel smooth like a baby’s bottom, but what may follow is excess pigment production. HOW CAN WE AVOID PIGMENT BOUNCE-BACK? It’s probably too late to try closing Pandora’s Box, as the popularity of these treatments aren’t going anywhere. In fact, in specific circumstances, they do have their place. By undertaking a thorough consultation, elevating your understanding of skin science and exercising restraint with treatments and homecare prescription, we can minimise the risk profile associated with pigment bounce back. Here are some prudent (and modern) approaches to pigment reduction for greater long-term results: 1. Peptides Specific peptides are delivered in advanced skincare to supplement impaired cell-metabolism and enhance cell-tocell communication (particularly effective if the melanocyte’s receptors are being interfered with by internal factors). 2. Enzymes (that aren’t presenting among a family of acids!) Non-irritating, gentle exfoliation support. 3. LED Anecdotal evidence exists to support yellow (non-thermal) light accelerating the effects of a pigmentation treatment protocol within certain parameters.
4. Lymphatic Drainage When waste products are created within the skin (example
cellular debris post-laser treatment), it’s the lymphatic system’s tasked to remove the destruction. When the lymphatic system is impaired, waste product become stagnant, extending the inflammatory phase and increasing the risk of pigment bounceback. Manual lymphatic drainage promotes nutrient and hydration support, healthy connective tissue, improves skin tone and reduces the risk of developing inflammatory skin conditions, such as acne and post-inflammatory hyperpigmentation. 5. Skin Needling Dr. Lance Setterfield, who I considered a global authority in skin needling, advocates that this modality has the ability to reassert health cellular communication between the keratinocyte and melanocyte and normalise melanogenesis, melanocyte differentiation and distribution. Popular practice now supports a less-is-best approach to skin needling, that is 0.3-0.5mm to achieve the desired outcome for hyperpigmentation disorders. To access his manual visit https://apanetwork.com/the-conciseguide-to-dermal-needling. You can also access his online study course from www.apanetwork.com. 6. Electroporation Non-thermal, alternating radio frequency energy matched to the natural cycle of the cell, holding it in a state of flux that allows for temporary increased permeability of the cell wall allowing delivery of whole molecules of ingredient to be accepted. This specialised method can effectively deliver pigment regulating peptides into target cells, without collateral damage associated with thermal modalities. CONCLUSION New research is now confirming more gentle ways of both preventing and treating pigmentation, while still achieving skin rejuvenation and improving overall skin health and skin conditions.
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SCIENTIFIC NEWS might accelerate ageing. Researchers believe that with premenopausal women the effect of hormones, buffer the potential negative effect of pregnancy and reproduction on biological age acceleration. Perhaps when the hormones are gone, the consequences can show themselves.
GIVING BIRTH AND AGEING POST-MENOPAUSE
Shirazi, T., Hastings, W., Rosinger, A., & Ryan, C. (2020). Parity predicts biological age acceleration in postmenopausal, but not premenopausal, women. Scientific Reports, 10(1), 20522. doi: 10.1038/ s41598-020-77082-2. Pregnancy is characterised by extensive, energetically costly changes across numerous physiological systems, so it is not surprising that there is a link between reproductive function and physiological dysregulation, resulting in ageing. Many questions remain, particularly the apparent discrepancy with the U curve of none or many births showing increased ageing later in life, yet not those females reporting 2-4 births. APJ
half that of one of the worst offenders – beef. And that's all before adding milk, which carries its hefty environmental baggage. Over 9.5 billion kg of coffee is produced worldwide each year, expecting to triple by 2050, raising pressure on forests and other habitats in the tropical regions where it's grown as farmers look for new land to till. Researchers found the average carbon footprint of Arabica coffee from Brazil and Vietnam (the two major coffee exporters) was calculated as 15.33 (±0.72) kg of carbon dioxide equivalent per 1 kg of green coffee (kg CO2e kg-1) for conventional coffee production and 3.51 (±0.13) kg CO2e kg-1 for sustainable coffee production – a 77% reduction difference in carbon footprint. ` With a drink containing approximately 18 g of green coffee (Starbucks Coffee Company, 2019), each kg of green coffee
No surprise – every mother knows that you feel like you've aged overnight once reaching menopause. Recent science proves that you do age quicker the more you give birth. As we know, there are many metabolic, immunological, and endocrinological changes in the body during pregnancy and lactation and the various disease risks associated with pregnancy and reproductive investment more generally. In investigating these changes, the researchers measured biological ageing in several ways based on nine biomarkers designed to assess metabolic health, kidney and liver function, anaemia and red blood cell disorders, and immune function and inflammation. Researchers found that when comparing women with zero or few live births, with those of many live births, had quicker biological ageing markers than those who reported three or four live births. This was true even when controlling for chronological age, lifestyle, and other health-related and demographic factors. The ageing appears post-menopause suggesting the presence, or lack of ovarian hormones in postmenopausal people. Ovarian hormones are protective against some cellular level processes that
WHAT IS THE CARBON COST OF YOUR COFFEE HABIT? For many of us, coffee is essential, but not so for the planet's survival. Weight for weight, the coffee produced by the least sustainable means generates as much carbon dioxide as cheese and has a carbon footprint only
makes about 56 espresso beverages. Thus, the carbon footprint of each espresso is 0.28 kg CO2. If you add milk,
Research and Scientific New Developments In every issue of the journal, Terry Everitt our scientific educator, conveys a few items of scientific interest. In italics, are his thoughts on the subject matter of the research study.
this increases substantially; caffe latte, flat white, and cappuccino estimated to be 0.55, 0.34, and 0.41 kg CO2e, respectively. Remember that milk is a byproduct of beef production, one of the significant agricultural carbon footprints. While your coffee habit is not causing world destruction, how the coffee gets to you makes a significant impact. The study outlines via the life cycle of production, manufacture and transport.
showed at least four distinct cellular senescence states that arise from coordinated metabolic and epigenomic changes.
Nab, C., & Maslin, M. (2020). Life cycle assessment synthesis of the carbon footprint of Arabica coffee: Case study of Brazil and Vietnam conventional and sustainable coffee production and export to the United Kingdom. Geography and Environment, e00096. doi.org/10.1002/ geo2.96 Coffee cultivation faces an uncertain future, with climate change predictions suggesting a 50% reduction in the suitable growing area by 2050 at the same time as a tripling of demand. While a cup of coffee will not make much difference in isolation, think how many cups of coffee (more so with milk) you get through in a week, month or year. APJ
2. Early (anti-inflammation) inflammatory cytokines become activated.
Four phenotypic variations in cellular senescence: 1. Initiation (proliferations arrest) tumour suppressor proteins p53 and retinoblastoma are featured.
3. Full (increased inflammation and metabolism) - genes of proinflammatory cytokines are expressed. 4. Late (decreased inflammation and metabolism) - the inflammatory response and metabolism decline; interferon secreted in response to the cytoplasmic DNA fragments of the nuclear genome and mitochondrial DNA. Thus, the formation of the senescenceassociated secretory phenotype (SASP), secrete various proteins that act on surrounding cells/tissues and promote chronic inflammation and cancer cell growth. On the other side, since senescence-related gene activities are regulated metabolically in a chromatin context, combinations of metabolic and epigenetic intervention would regulate senescent states and contribute to prevention and control of ageing-related diseases.
CELLULAR SENESCENCE DEPENDS ON EPIGENETICS A recent study from Kumamoto University Japan indicates that cellular senescence variations during the ageing process could control health and onset of age-related diseases. Using inflammatory cytokines secretions
Nakao, M., Tanaka, H., & Koga, T. (2020). Cellular Senescence Variation by Metabolic and Epigenomic Remodeling. Trends in Cell Biology, 30(12), 919-922. doi:10.1016/j.tcb.2020.08.009 Cellular senescence has become a major focus of research in regard to ageing, particularly around the senescenceassociated secretory phenotype (SASP) and the damage it occurs. While nowhere near being used in aesthetics, this study provides essential milestones in considering a deeper understanding of cellular senescence and body ageing mechanisms. APJ
VEGAN DIETS NEGATIVELY IMPACT SURGICAL WOUND HEALING Do you have a client with slow or ineffective wound healing with no apparent reason? Studies suggest that it may be in the diet, so check if they are vegan. Results are based on a prospective observational study of 21 omnivores and 21 vegan patients who underwent surgical excision of nonmelanoma skin cancer. After six months, vegan patients had a higher modified SCAR score than omnivores, showing worse scar spread, more frequent atrophic scars and worse overall impression. Fusano, M., Fusano, I., Galimberti, M.,
Bencini, M., & Bencini, P. (2020). Comparison of Postsurgical Scars Between Vegan and Omnivore Patients.
SCIENTIFIC NEWS Dermatologic Surgery, 46 (12), 1572-1576. doi: 10.1097/DSS.0000000000002553 Vegans also showed a significantly lower mean serum iron level (p <.001) and vitamin B12 level (p < .001), as well as more frequent wound diastasis (p = .008). Therefore, this study suggests that a vegan diet may negatively influence the outcome of postsurgical wound healing and surgical scars. Veganism has been implicated previously regarding wound healing yet this I believe is the first comparing different diet on same wound healing process. APJ
low-fat diet. Many studies had no specific indication of comparison of one diet compared to other diets. This has shown the current state of nutrition research is not perfect. The researchers concluded that the Mediterranean diet was the only diet that demonstrated significant and beneficial effects for all the parameters analysed [from body-weight to blood pressures], without evidence of potential adverse effects.
NOVEL FINDINGS ON MOLE GROWTH COULD PAVE THE WAY FOR SKIN CANCER TREATMENTS Moles stop growing when they reach a specific size due to regular interactions between cells, despite having cancerassociated gene mutations.
WHICH DIET IS THE BEST? This is a loaded question with multiple possible answers, however, a group of researchers across regions of Italy performed a meta-analysis of metaanalyses. Technically, they performed an umbrella review of meta-analyses of randomised, controlled trials, trying to answer the posed question. They were using only meta-analyses of randomised, controlled trials, (researchers examined eighty articles reporting 495 unique meta-analyses) with parameters that allowed crossreferencing between studies. Not only the results, but more importantly, these researchers analysed the quality of the included research, and found multiple difficulties. Definitions varied such as vegetarian diets – some were lacto-ovo vegetarian and others vegan; differing denominators of a low-carbohydrate or
Dinu, M., Pagliai, G., Angelino, D., Rosi, A., Dall'Asta, M., Bresciani, L., Ferraris, C., Guglielmetti, M., Godos, J., Del Bo’, C., Nucci, D., Meroni, E., Landini, L., Martini, D., & Sofi, F. (2020). Effects of Popular Diets on Anthropometric and Cardiometabolic Parameters: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials. Advances in Nutrition, 11(4), 815–833. https:// doi.org/10.1093/advances/nmaa006 There are multiple barriers to performing randomised controlled trials with people's diets. Keeping to a diet is difficult for most, even within a study, so they tend not to follow it. Most studies rely on food diary to report everything they eat, which is notoriously unreliable. This study provides gravitas lacking in most dietary studies due to the meta-analysis methodology of reviewing meta-analysis. APJ
Mutations of the BRAF gene causes melanocytes to produce melanocytic nevi (moles), which are believed to contribute to the development of sometimes-fatal skin cancer and melanoma. However, studies recently show that while mutated, not all continue to form skin cancers. Many forms harmless pigmented moles - 90% of moles have these cancer-linked mutations but never form tumours. It has been the common thought that stress caused by rapid cell growth may stop the growth of moles through a process called oncogene-induced senescence (OIS). This study's researched models suggested that mole cells communicate when moles reach a specific size and stop growing. Such is standard communication taking place in many normal tissues to enable them to achieve and maintain the correct size.
Research and Scientific New Developments In every issue of the journal, Terry Everitt our scientific educator, conveys a few items of scientific interest. In italics, are his thoughts on the subject matter of the research study.
that the darker the skin, less damage occurs, primarily due to melanin content and its protection.
Ruiz-Vega, R., Chen, C., Razzak, E., Vasudeva, P., Krasieva, T., Shiu, J., Caldwell, M., H., Yan, Lowengrub, J., Ganesan, A., & Lander, A. (2020). Dynamics of nevus development implicate cell cooperation in the growth arrest of transformed melanocytes. eLife, 9, e61026. DOI:10.7554/eLife.61026 While the study was with mice, it allows a pathway to understanding the mechanisms that control differing skin cell growth and cause some increase to cause skin cancer. Nevi are benign, clonal, proliferative lesions that arise due to oncogenes' activation, but rarely if ever progress to malignancy, yet some do. This research helps us better understand the mechanisms that persist at many stages along the road to cancer. APJ
aged 25 to 79, it highlights molecular mechanisms underlying these changes. This is an exciting forward step in understanding the damage that occurs which we see so much of. APJ
A recent study has proved how this occurs in providing an accurate estimate of the genomic changes in skin cells due to different types of DNA damage and establishes the normal range of somatic genomic changes across a range of ages and races. Without all the details here (you can get them in the open-access version via the DOI below), the researcher's analysis identified and measured the impact of various internal and external sourced impacts on DNA replication errors and somatic mutation load and profiles in every single cell-derived lineage. This study shows gross chromosomal rearrangements in human cells comes from common fragile sites of DNA replication providing somatic mutations in the skin of healthy individuals that induce instability of the genome and consequent transformation, even in cells not directly damaged by UVR. (Fig. A). Saini, N., Giacobone, C., Klimczak, L., Papas, B., A., Burkholder, Li, J., Fargo, D., Bai, R., Gerrish, K., Innes, C., Schurman, S., & Gordenin, D. (2021). UV-exposure, endogenous DNA damage, and DNA replication errors shape the spectra of
IPL UNDERSTANDING OF CLINICAL ENDPOINTS A helpful study by some leading dermatologists compared clinical endpoints with four different IPL filters and a range of pulse duration to help guide optimal treatment parameters.
SKIN SHIELDED FROM THE SUN ACCUMULATES GENOMIC DNA CHANGES FROM UVR We all know that DNA in skin cells change due to intrinsic and extrinsic sources, leading to mutations. Also, well known is
genome changes in human skin. PLOS Genetics, 17(1), e1009302. DOI: 10.1371/journal.pgen.1009302 The total amount of genomic changes from metabolic by-products accumulates as a person gets older. However, the amount of genomic changes caused by UV damage is unrelated to a person's age. While this was a small study of fibroblasts and melanocytes cell lines of 21 respondents
Working with the Stellar M22 Universal IPL from Lumenis, tested several filters (515 nm; 560 nm; 590 nm and 530–650; 900–1200 nm vascular filter), fluences, pulse duration and pulse numbers (i.e., multiple sequence pulsing or MSP). They marked out a 4x3 grid on the back of a 65-year-old male, Fitzpatrick skin type
SCIENTIFIC NEWS NONTOXIC BOTULINUM TO DISPERSE BOTULINUM
III and treated each square with four different filters and three pulse durations (4 ms, 6 ms and 10 ms).
While rare, botulism can cause paralysis with no way to reverse it, other than waiting for the toxins to wear off, potentially fatal.
The pronounced post-procedure erythema response increased with increasing fluence, decreasing wavelength, fewer pulses and shorter pulse duration. The vascular filter had a relatively more robust erythema response than the 590 nm filter, which was comparable to the 560 nm filter. This trend in erythema continued at 24 hours post-procedure. One-week follow-up showed erythema resolution with some crusting in areas treated with the 515 nm filter and a single pulse at all fluence ranges and pulse durations and 560 nm single pulse squares at 20 J/cm2 for all pulse durations. Two weeks follow-up saw all crusting resolved, however, some areas (515 nm, single pulse, 10 ms pulse duration, 18 and 20 J/cm2 fluences) had well-demarcated hairless hypopigmented square-shaped patches. Four weeks follow-up. The areas treated with the 515 nm filter showed the most significant improvement in erythema and pigmentation with exact demarcated regions in improvement observed with the longer pulse duration (i.e., 10 ms), single pulse high fluences (i.e., 18 and 20 J/cm2). Areas with a more significant erythema response during the healing process showed an improved clinical response at the four-week follow-up visit. However, more aggressive settings also increased the risk of hypopigmentation and hairloss. Most significant clinical endpoint response at 4-week follow-up was observed with more robust initial reactions. This was most apparent at higher fluence levels, and fewer pulse counts. However, when the IPL is pushed to aggressive parameters, there is a risk of hypopigmentation and hair loss as seen in this case study. I do not think there is much surprise in one patient's results using one machine, with different settings, yet is useful. The modulators that the practitioner
instigates on the device are the critical values, continuously measuring effectiveness and limiting adverse effects. Lipp, M., Angra, K., Wu, D., & Goldman, M. (2021). Intense Pulsed Light: A Methodical Approach to Understanding Clinical Endpoints. Journal of Drugs in Dermatology, 20(2). doi:10.36849/ JDD.2020.5638 We know the IPL is a versatile energy device that can produce excellent clinical outcomes across various chromophore targets in improving skin texture and tone. Equally, IPL can cause multiple adverse effects, many of which are long-lasting. It is important for practitioner to understand both light physics as well as the machine's technology and its vast fluence, pulse duration, and filters. It is much harder than just pressing the button on the device to get precise clinical effective results. APJ
There are some 'anti-toxins', but these only work before the toxins enter the motor neurons and by the time of administration, it is too late. Given the massive uptake of this toxin to paralyse muscle function for beauty sake, this can be problematic. Admittedly the small amounts used for this purpose is not usually fatal and will wear off , with ptosis is the common side effect of poorly placed botulinum. New research (in mice) using a detoxified botulinum toxin as the delivery carrying specific antibodies showed that these socalled nanobodies could be delivered in tandem into neurons, neutralising botulinum toxins type A and B simultaneously. This information indicates 'botox' reversal within hours to work within the neuron; which has never been achieved until now. Miyashita, S., Zhang, J., Zhang, S., Shoemaker, C., & Dong, M. (2021). Delivery of single-domain antibodies into neurons using a chimeric toxin–based platform is therapeutic in mouse models of botulism. Science Translational Medicine,13(575), eaaz4197 DOI: 10.1126/ scitranslmed.aaz4197 This is a significant advancement. Much more research is needed to get this process working in humans, not only to dissolve botulinum toxin yet as a vehicle for other precision delivery of drugs into cells. APJ
Research and Scientific New Developments In every issue of the journal, Terry Everitt our scientific educator, conveys a few items of scientific interest. In italics, are his thoughts on the subject matter of the research study.
UPGRADE YOUR SKILLS AND KNOWLEDGE IN
MICRONEEDLING Dr Lance Setterfield, M.D. Online study course now available in Australia WORLD-RENOWNED as one of the leading masters in Collagen Induction Therapy, Dr Lance Setterfield has updated his on-line study course in line with his manual The Concise Guide to DERMAL NEEDLING: Revised and Expand Manual - Third Medical Edition.
Enable clinicians to achieve and maintain the best result using this modality
Enable clinicians to grow their business substantially through the introduction of micro-needling services as the foundation for all other cosmetic treatments
Determine the appropriate skincare products to use (which ingredients to use and which to avoid)
The course is non-product aligned and covers the application of both rollers and pens. However, the knowledge you will gain will go far beyond the use of Micro-needling. It includes valuable information on how you can combine this “treatment” with a variety of other modalities to optimise results, while avoiding complications.
Determine which device to use and what needle depth for the desired outcome
Determine if the inflammatory response should be provoked and sustained
Gain the skills and knowledge on how to combine micro-needling with other modalities for optimising results
Gain the knowledge on how to avoid complications
WHO SHOULD UNDERTAKE THIS COURSE? Medical professionals and non-medical professionals. (Clinicians who are performing or overseeing microneedling procedures.) COURSE GOALS AND EXPECTATIONS: •
Expand practitioner's scope of practice by ensuring enhanced foundational knowledge accepted as standard practice in the industry
COURSE OBJECTIVES AND COMPETENCIES:
COST: $699 – If you do not have The Concise Guide to Dermal Needling – Third Medical Edition you will need to also purchase that. The cost is $135 + freight. Completing this course will earn you 10 CPD points toward your professional development. WHAT DO I DO TO ENROL? Contact APAN to make your payment. You will then be given the access Code to download the study course. You will also need to read and agree to the terms and conditions of accessing the course. TO REGISTER CONTACT APAN 07 5593 0360 www.apanetwork.com email@example.com APJ 107
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