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Friday, October 10, 2014

Bathroom = Sanctuary—really!

Recently I had a client in for a facial who was living a very stressful life. She was so excited to be in my treatment room experiencing some relaxation and down-time.” In the confines of my facial room your kids, phone, and any other distractions simply can’t find you. And although there is something wonderfully relaxing about a facial treatment, there are things you can do in your own home that can help you find a bit of peace and quiet. It’s as simple as...going to the bathroom.

I recommended to this client that she use her bathroom as a sort of secret sanctuary room. While in the bathroom with the door closed rarely does anyone come knocking; usually you are left alone to do what you need to do. I suggested she use this truth as an opportunity to get some relaxation time—even if only for a minute or two.

Although we were laughing through this, what I said I really meant. Go into the bathroom, preferably the one that is used the least (less traffic) and shut the door. Put the toilet seat down and sit. I suggested having a lavender scented candle there she could lite (something that wouldn’t even be unusual in a bathroom) as well as an iPod with earphones in a nearby drawer. Simply turn out the lights, lite the candle, put the earphones on and tune into some relaxing music, like the kind I play in my facials.

Five minutes in the bathroom could be like an hour of relaxation to your body. Don’t or really can’t take 5 whole minutes? Then start with one. Taking just sixty seconds, literally, to sit on the closed toilet seat, drop your shoulders, take some healthy deep breathes, and R-E-L-A-X can make a world of difference to your psyche. Peace and quiet—even if it’s only for 60 seconds—means a lot. And one or two minutes away from your family and responsibilities is nothing!

Knowing you have this secret, accessible place to go into will help to ease any stress you may be going through in the household. Just tell whoever you have to go to the bathroom. No one will question this—really! Then take a minute or two to decompress and relax, and you’ll leave your sanctuary room/bathroom in a more peaceful and balanced place, ready to take on the goings on with your family life. Try it—what have you got to lose?

For more ideas, see:
Ha HaIf only!!!

Wednesday, October 8, 2014

Determining Skin Type

What is the best way to determine my skin type?

The best way to determine skin type is to look at your pores in the mirror. Wash your face, then take a good look at your skin. The trick is to be objective. Initially, you want to determine how clean your pores are. After washing, the superficial debris should have been rinsed away. But if you have congestion, such as blackheads, merely washing your face will not remove it.

If you still see clogged pores after cleansing, you’re emitting more oil than your pores can handle. The next question is where are these blackheads concentrated? Are they only on the forehead, nose, chin, or cheeks? Is the congestion concentrated in one area, or is it widespread in every pore on your face? After you’ve summed up how much oil you’re producing, there are several more questions you will want to answer.  
  • What about redness? 
  • Do you see many broken capillaries, and where are they located? 
  • Are you sensitive to almost everything you put on your skin or only certain products? 
  • Does your skin look flaky? 
  • Is it constantly peeling? 
  • Does your skin feel like it is tightly stretched over your face? 
  • How much sun exposure have you had in your lifetime?

The answers to these questions will help you understand more about your skin and what to use on it.

If you find a lot of blackheads throughout your whole face, you probably have oily skin. If the blackheads are limited to your nose, nose and chin, or nose and chin and forehead (classically known as the “T-zone), you probably have combination or normal to oily skin. If you don’t have any blackheads anywhere on your face—maybe a few small ones on your nose, you probably have normal skin (similar to combination). If no blackheads or blemishes and your skin feels like it constantly needs moisture, you probably have true-dry skin.

Depending on the time of year, you may still need to use normal to oily products in the warmer months and normal to dry in the colder weather. However, if you have true-dry skin, you will probably need to use products for dry skin all year round. It goes without saying that if you have problem skin and especially acne, you need to be using products for oily, problem skin.

I have written many articles describing skin types along with issues concerning problem skin for this blog (and in my books). Here is a link to a page that lists all of the skin type posts to date to help you get started understanding your skin type:
For some problem solvers, see:

Monday, October 6, 2014

What to expect in a facial treatment

My Chicago office lobby—now under new ownership
Here are a few explanations of what you might expect when you have a professional facial. This is a mixture of my own experiences of having facials along with what I offer my clients. Your experience will differ here and there. This is just meant to be a general indication of what to look for and expect. 

Entering the salon. Is it clean or in disarray? Is it comfortable and inviting? Would you want to come back to this environment on a regular basis? 

The greeting. Are you greeted within a reasonable time or are you wandering around waiting to be helped? Is the staff friendly or uninterested? It never ceases to amaze me how few businesses understand the concept of the first impression. It is important, and your initial perception of a place will usually be accurate. 

Yes, that’s me—in my mid-40s
The aesthetician. The first thing you want to look at is the skin of the person about to give you a facial. It’s not a good sign if she has an excessive amount of breakout. Remember, this is the person about to advise you on how to take care of your skin. Is she wearing a lot of makeup? How can you see her skin if it’s covered up? She should not have nails, and no fingernail polish. Don’t forget her hands are going to be on your face; nails are a definite no-no. Don’t be fooled by a white lab coat. It may give you the impression of a medical environment, but it’s really just a white jacket worn over clothes. Lab coats are regulation in a hospital or doctor’s office, but they are merely a facade in a salon.

Changing clothes. You will either change in the facial room itself or in a designated dressing room. Either way, you will be left alone to put on a smock that usually is knee-length and leaves your shoulders bare. A gentleman will either take off his shirt and leave his own pants on, or the aesthetician will provide him with gym shorts to change into. 

The room. Facial rooms range from small to tiny. Don’t expect a lot of space. I have been in facial rooms that barely allowed for the aesthetician to sit at the head of the facial chair. Most have a sink and a counter for products. Trolleys on rollers are often used to hold supplies within easy access of the technician. The room should be clean and orderly without a lot of clutter. Sometimes there are candles lit for atmosphere and licenses hanging on the walls. Since you are going to be lying down with your eyes closed for most of the treatment, as long as the room is clean, not much else matters.

The chair. Facial chairs vary in size, shape, and design. Although termed chairs, they are actually beds that you lie on in order to receive the facial treatment. Many look like upright chairs at first. Then as you sit down, the chair is unfolded into a bed and you are then lying down.

Hopefully the chair will be comfortable; unfortunately not all are. If it isn’t, you may be forced to find another salon. Don’t forget, you’ll be lying in this chair for at least one hour, which might become excruciating if you’re not comfortable. If you think something can be done to make it more comfortable (using a rolled-up towel under your knees, for instance), make your requests known. The aesthetician can’t read your mind, so don’t be shy about communicating your needs. How accommodating she is will tell you a lot. 

Preparing you, the client. You will climb into the facial chair, which will be covered with sheets and a blanket or two. I’m very cold-natured, so no matter how many layers are offered, I usually need an additional blanket. I have a heated mattress pad on my facial chair that I use all year round. Don’t hesitate to ask for more warmth, or for the blankets to be removed if you’re too hot. The key is for you to be comfortable. Remember, you’re paying for this. Also note that it’s a good idea before climbing into the chair and starting an hour-long treatment to use the bathroom, so you won’t have to get up in the middle of the facial.

Music. Sound is unfortunately disregarded by a lot of salons, yet music is very important to the overall mood of the room. Some places have individual iPods or CD players for each room; others have music piped in from a central location. Some salons I’ve been to had either no music or a radio on instead. Calm, soothing music can help you nod off or at least feel relaxed. A lack of background noise makes you focus on all the little sounds the aesthetician is making, including her breathing. And a radio, unless requested by the client, has no place in a facial. If you find there isn’t music in the room where you’re having a facial, request some and see what happens. Maybe they just forgot to turn it on. 

Ask questions. I have a client who went to get facials for over ten years with one particular aesthetician. My client never knew what product was being used on her skin and the aesthetician never talked to her about home-care products or even skin care in general. I frequently hear about aestheticians who are not terribly responsible as far as helping clients with their skin. Although it really is the aesthetician’s job to explain things to you, I also feel it is up to you to ask questions if you feel unsure about what is being done in the facial as well as what your at-home program should be.

In case the aesthetician you go to doesn’t volunteer much information, here are some good questions to ask that will help you determine (a) things about your skin and (b) if she is knowledgeable and qualified in her field.
  • How would you classify my skin? Or, what is my skin type?
  • Is my skin clean? Are my pores congested?
  • Am I dehydrated?
  • Do you see sun damage? Capillary damage?
  • Do you see any unusual moles?
  • Is there anything I’m not doing I should be doing? Or vice versa?
  • Tell me about the products you use. What makes them so special?
  • What should my basic, daily skin care routine consist of?
I feel that during your first facial, the aesthetician should explain what is being done, why it’s being done, and what it will do for your skin. In my own experience of getting facials and in my clients’ experiences, this is rarely done. I recommend telling the aesthetician you are very interested in what she is doing and asking if she would please explain each step as she goes so you can have a better understanding of her facial procedures. If she describes what she’s doing but not why, ask questions. If what she says doesn’t make sense, ask if she can explain it in a different way. A good aesthetician will be able to communicate with you without using a lot of skin care jargon. Keep in mind, this isn’t rocket science—something a lot of aestheticians in white lab coats may want you to believe.

When looking for an aesthetician, you’ll want to find someone with a point of view similar to your own. If you haven’t really formulated a viewpoint on skin care, look for someone who says things that make sense to you—common sense. Unfortunately, using verbose, aesthetic, or pseudo-medical terminology seems to be a popular way to communicate with clients. If you don’t understand what your aesthetician is talking about, ask questions. Her job is not to make you feel inferior or stupid for being inquisitive, but to help you understand your skin.

All the questions are really just to get you familiar with the procedure and with the person giving you the treatment. After the first facial, most of your questions will have been answered, and in subsequent treatments you can lie there in silence while the facial is being performed. And some of you may simply want to enjoy your facial (even the first one) and not ask any questions. In either case, just lie back, enjoy, and reap the benefits of a relaxing facial.

A word about spas. At the beginning of my career, I worked in a spa for nearly seven years, and I am familiar with how they operate. Don’t be fooled or convinced of the quality of a facility merely by their advertisements. The physical structure alone does not make a spa great. It is the people working there that will have the biggest impact on you and will make the biggest difference in the quality of your experience. A spa may hold on to a good review or reputation for years, long after the staff that made it great has left.

Many of my clients have frequented spas here in the U.S. as well as traveled to spas all over the world. Sometimes they’re great; sometimes they are a disappointment. Both experiences will cost you the same. Although I’m not going into detail on how to choose a spa, one important piece of advice would be to ask a lot of questions. Call first and get the lowdown on the staff and what treatments are offered. It will be hit or miss as to getting good treatments, but at least you can go in knowing what products they use in their facial and body treatments and how long the staff has been there. Personal experience, as always, will be your greatest teacher. Just like finding a good facial, a referral will go a long way in helping you choose a good spa.

For more information, see:

Friday, October 3, 2014

Accutane—side effects

What are the internal and external side effects of taking Accutane? 

The following information is used with permission and comes from two different sources in an attempt to give you a well-rounded view of the effects Accutane may have on your body. Although some of the information will repeat, I think this is a good thing because the more you understand about the potential risks and side effects, the more informed your decision will be.

All of the side effects listed indicate the seriousness that must be taken when considering Accutane. Remember, a quick-fix mentality focuses on now rather than looking ahead to potential consequences. In Accutane—easing the side effects (see link below), I discuss ways you can help ease the pain and annoyance of some of these effects. Know that you will experience some and maybe all of the side effects in varying degrees depending on your body’s constitution, so be prepared and hope for the best.

The following is taken from Physiology of the Skin II by Peter T. Pugliese, M.D. If you are interested in a more technical explanation about skin and its function, you may want to read this book. It is for “professionals,” but I know many of you who aren’t in this profession like to read as much as possible about skin care.

Side effects of isotretinoin may be mild or severe. Everyone on this drug will expect to have some side effects. Major side effects are:
  1. Cheilitis*, 90% of patients
  2. Chapped, flaky skin, 90% of patients
  3. Dry nose and eyes, 80% of patients
  4. Loss of hair, 10% of patients
  5. Painful joints and painful muscles, 15% of patients
  6. Excessive peeling of the palms and soles, 10% of patients
  7. Elevation of triglycerides in the blood, 25% of patients
  8. Abnormal liver function tests, especially the transaminase enzymes, 15% of patients 
*Cheilitis is inflammation of the lips, usually concentrating around the corners of the mouth. This can produce anything from redness and irritation to severe cracking and scaliness.

The following is taken from The Pill Book published by Bantam Books:

Side effects [with Accutane use] increase with dosage.

Most common: Dry, chapped, or inflamed
lips; dry mouth; dry nose; nosebleeds; eye irritation; conjunctivitis (pinkeye); dry or flaky skin; rash; itching; peeling skin on the face, palms, or soles; unusual sensitivity to the sun; temporary skin discoloration; brittle nails; inflammation of the nailbed or bone under toes or fingernails; temporary hair thinning; nausea; vomiting; abdominal pain; tiredness; lethargy; sleeplessness; headache; tingling in the hands or feet; dizziness; protein, blood, or white blood cells in the urine; urinary difficulties; blurred vision; bone and joint aches or pains; and muscle pain or stiffness. Isotretinoin causes extreme elevations of blood-triglyceride levels and milder elevations of other blood-fat levels including cholesterol. It also can raise bloodsugar or uric acid levels and can increase liver-function-test values.

Less common: Wound crusting caused by an exaggerated healing response stimulated by the drug, hair problems other than thinning, appetite loss, upset stomach or intestinal discomfort, severe bowel inflammation, stomach or intestinal bleeding, weight loss, visual disturbances, contact lens intolerance, pseudotumor cerebri*, mild bleeding or easy bruising, fluid retention, and lung or respiratory system infection. Several people taking isotretinoin have developed widespread herpes simplex infections.
*Pseudotumor cerebri is one of the more dangerous (and fairly uncommon) side effects of taking Accutane. The symptoms are severe headaches followed by nausea and vomiting along with visual disturbances, which indicates an increased and intense pressure on the brain.

As you can see, the side effects are many. This is a very powerful drug—make no mistake about it! Please read up on this serious drug before you consider taking it.

There are many articles about Accutane on this blog. Here are just a few:

Wednesday, October 1, 2014

Mature Skin explained

Mature skin is commonly used to describe a skin type, but actually, the word mature is arbitrary and only suggests the person in question is older. But how old? Old enough to have true-dry skin? Yes, as you age the oil glands tend to put out less and less oil, but even someone in her 20s can have true-dry skin. Would she use a cream for mature skin? Products for mature skin usually have special ingredients that repair and regenerate skin that has “broken down.” But many people could use these special benefits even though their skin may not be classified “mature.”

My issue with mature skin products is the marketing approach: trying to get older people to buy special (usually more expensive) creams. These products may manipulate older people into thinking they can repair a lifetime of natural aging when actually they cannot undo the past. My contention is that everybody—every skin—has specific and special regeneration needs, not just mature skin.

Finally, if a person with mature skin doesn’t actually have true-dry skin and uses one of these specialized products with a lot of oils in a heavy cream, watch out! As I’ve stated before, age and true-dry skin don’t necessarily go hand in hand. You are not guaranteed to have oil-deficient skin as you get older. It’s just not as simple as that. If you go to the department store and someone sells you a mature skin moisturizer, unless you do have true-dry skin, you could be headed for some skin care problems, most likely congestion or clogged pores.

Be careful how you classify your skin. Skin type should start with how much (or how little) oil your skin is producing. This is based on you as an individual, not on your age.