Client Care Plans & Their Benefits

• Clients are Visual Learners!
  • Clients desire a visual to go with the education given within a skin care treatment session.
• Clients need PLANS to see the BIG PICTURE! 
  • Mapping out a plan gives consumers the understanding needed regarding why they need to stay on board with you from A to Z.
• Clients need DESCRIPTIONS + Education!
  • Plans provide the written description of items that may have been missed or would be forgotten by a client during a verbal consultation.
• Clients desire PROFESSIONALISM.
  • Care plans showcase professionalism and added value.

THE CLIENT CONSULTATION

The consultation for clients should be focused on the experience combined with education that exceeds many other providers’ level of care! YOU are the expert! Consumers are not impressed by simply the treatments themselves, but rather the focus on client understanding and their level of involvement in the process.

• EXPERIENCE
  • YOU will have all the Care Plans lined out, per skin condition! Along with your amazing ingredient knowledge!
• EDUCATION
  • YOU are the EXPERT in your treatment room, through a scientific focus on esthetics excellence!
• SUCCESS
  • Massive SUCCESS flows to YOU through AMAZING communication and education for your clients!

LEVELS OF SKINCARE PRODUCTS

In skin care, products that produce results will always contain several factors: a high concentration of active cosmeceutical ingredients that produce a direct change in the basal layer of the epidermis (stratum germinativum) and vehicles in a small enough form to drive the actives where they need to go to create new cell growth! So, always strive to use the best for your clients! Believe me, they will love you for it!

HINT!
ACTIVE INGREDIENTS: Ingredients that produce the CHANGE in the skin. 
VEHICLES/BINDERS/CARRIERS: Ingredients that hold the product together chemically; what carry active ingredients where they need to go in the skin. 

• Tier 1: Over-the-Counter Products
  • Contain small percentages/concentrations of active ingredients, if any. The vehicles used to drive the actives into the skin are larger in molecular size and not as advanced in nature; therefore, penetration to the basal layer of the epidermis is impossible. 
• Tier 2: Regulated/Professional-Grade Skin Care Lines
  • Sold to consumers by a Licensed Esthetician or professional entity. 
  • Zone where clients need to “live” during the maintenance stage of their skin renewal journey. 
  • Contains a high enough percentage of actives to reach the basal layer of the epidermis (where change happens!). 
  • Vehicles to drive ingredients in the layers of new cell growth are small in molecular size, which means best penetration. 
• Tier 3: Prescription-Level Product Lines
  • Sold to licensed professionals in a medical spa, dermatology office, or plastic surgery practice. 
  • Consumers must only use Tier 3 products (i.e. Tretinoin or Hydroquinone 4%) for a temporary period of time and then back down to Tier 2 products once the change cycle is complete. 
  • Active ingredients are high concentrations, meaning serious inflammation can happen if used incorrectly. 
  • Individuals must be monitored by a licensed professional during usage. 
  • May only be used two to three days at a time, before backing off for a few days, then beginning the cycle of usage again. 
  • Vehicles tend to help water down the active ingredients in order to cause less irritation during usage - hence the CREAM formulation for many prescription topicals (not all). 

INTRODUCTION TO INGREDIENTS
ACIDS = Break skin cells down
NOURISHERS = Build cells up 

Clients need a combination of BOTH on different days of the week to achieve ultimate RESULTS!

Mitosis Introduction
Mitosis is the process by which a cell replicates its chromosomes and then segregates them, producing two identical nuclei in preparation for cell division. Mitosis is generally followed by equal division of the cell's content into two daughter cells that have identical genomes.

Mitosis is a fundamental process of cell division that plays an important role in the growth and development of all living organisms. It is a complex process during which a single cell divides into two genetically identical daughter cells, each with the same number and kind of chromosomes as the parent cell. This ensures that genetic information is accurately replicated and passed on to future generations. Mitosis also plays an important role in tissue repair, allowing for damaged tissue to be replaced with healthy new cells. Without mitosis, most forms of life would not be able to survive or reproduce successfully.

Mitosis is a multi-step process that begins with the duplication of the genetic material within a single cell. This occurs in the interphase of the cell cycle, before the actual division takes place. During this phase, certain molecules such as histones and DNA polymerase start to replicate chromosomes so they can be accurately passed on to daughter cells. Chromosomes are then condensed and organized into distinct structures known as chromatids that can be easily separated during cell division.


Next, the process of mitosis begins with prophase which is characterized by the condensation of chromatin and the formation of the spindle fibers which will eventually separate the chromosomes in two. During metaphase, the chromosomes line up along the middle of the cell in a process known as metaphase plate. At this stage, spindle fibers attach themselves to each chromosome and pull them to opposite sides of the dividing cell.


Finally, during anaphase and telophase, the spindle fibers untangle and separate chromatids into complete chromosomes. The cell then divides into two daughter cells, each with the same number of chromosomes as the parent cell.


In summary, mitosis is an important process of cell division that ensures genetic information is accurately replicated and passed on to new generations.


Estheticians must become familiar with many different active ingredients that produce incredible results for long-term cellular change for their clients! By categorizing ingredients into Acids and Nourishers, Estheticians can ensure the consumer is receiving the ultimate skincare routine by ensuring recommendations from both categories. 

CATEGORY: ACIDS

• ALPHA HYDROXY ACIDS
  • Glycolic Acid: Derived from sugar cane; Molecular weight of 76 (lowest molecular weight of all AHA's - most aggressive!) ; Produces new cells by creating mitosis of keratinocytes - to create NEW cells!
  • Lactic Acid: Derived from sour milk; Molecular weight of 90; Exfoliates yet HYDRATES the skin; Produces firmer skin with less wrinkles.
  • Malic Acid: Molecular weight of 134; Produces new cells by speeding up cell turnover through cellular mitosis.
  • Kojic Acid: Molecular weight of 142; chelation agent produced by several species of fungi; Produces brightening effects to the skin.
  • Tartaric Acid: Molecular weight of 150; Naturally derived from grapes; Has keratolytic properties (creates mitosis to stimulate new cells) and produces hydration.
  • Mandelic Acid: Molecular weight of 152; Derived from almonds; Accelerates cell turnover without being too aggressive; Great for sensitive skin types.
  • Phytic Acid: Molecular weight of 160; milder AHA used for exfoliation and skin brightening. Studies have shown that in combination phytic acid with a glycolic acid work together to improve skin tone.
  • Citric Acid: Molecular weight of 192; Increases cell turnover, specifically for sensitive skin types or starter chemical peels/peel prepping solutions. 
• BETA HYDROXY ACID
  • Molecular weight of 138; Eats away at dirt and debris within the pore for acne skin conditions; Tightens pores; Pulls the "red" out of rosacea-prone skin conditions; Anti-microbial.
• RETINOL
  • Speeds up cell turnover through cellular DESQUAMATION (skin shedding!); Works BEST when utilized with other AHA's or BHA's; Not to be used independently or for long periods of time. Retinol is a type of retinoid, which is made from vitamin A.
• HYDROQUINONE
  • A skin lightening agent and tyrosinase inhibitor; Works by turning off "tyrosinase" - which is an enzyme turned on by HORMONE changes in the skin that produce splotchy hyperpigmentation through an increase in melanocytes in the basal layer of the epidermis; Carcinogenic in nature (toxic; cancer-causing if used in large doses over long periods of time)
• ARBUTIN
  • Arbutin is a glycosylated hydroquinone extracted from the bearberry plant; inhibits tyrosinase and thus prevents the formation of melanin from a NATURAL, PLANT-BASED perspective; Highly purified biosynthetic active ingredient that reduces the look of hyperpigmentation and uneven skin tone.
• BENZOYL PEROXIDE
  • Introduces oxygen into the pores, which KILLS bacteria; BPO is carcinogenic and causes oxidation (free radical damage) - therefore, it is best utilized for short periods of time for Grade 3 & 4 Acne ONLY.

KOJIC ACID FUN FACTS!
Kojic acid is a by-product in the fermentation process of malting rice, for use in the manufacturing of sake, the Japanese rice wine. 

HOW LONG DOES IT TAKE FOR KOJIC ACID TO BRIGHTEN THE SKIN?
When using kojic acid topically, consumers are likely to see results within two weeks. Consumers may see increased results - or faster results - if glycolic acid is added to the weekly treatment. 

HOW IS SALICYLIC ACID MADE IN THE LAB?
Salicylic acid is produced commercially via the Kolbe-Schmitt process. Here, phenol and sodium hydroxide are reacted to make sodium phenoxide. The phenoxide is contacted with CO2 to form sodium salicylate. The salicylate is acidified to give salicylic acid. 

SALICYLIC ACID FUN FACTS!
Salicylic acid (2-hydroxybenzoic acid) is a white solid first isolated from the bark of willow trees.

FUN FACT ON RETINOL DERIVATIVES!
Rosehip seed oil contains trans-retinoic acid, a naturally occurring form of vitamin A, which retinol is a synthetic compound.

5 TYPES OF RETINOL
There are 5 main types of retinoids used in the treatment of wrinkles, resurfacing + texture issues:

• Retinyl Palmitate: Least potent; Perfect for sensitive or dry skin types.
• Retinaldehyde: Stronger than retinol; Wonderful for sensitive or delicate skin but for those wanting more aggressive results.
• Retinol: The standard ingredient found in retinoid products.
• Tretinoin: A potent retinoid available by prescription only; For those seeking stronger pro-aging support.
• Tazarotene: The most powerful retinoid, available by prescription only; If skin tolerates retinoid products well and the client is looking for enhanced results, this would be a great option.
• Adapalene: Affordable and non-prescription; Effective for acne-prone skin conditions.

WHERE DOES HYDROQUINONE COME FROM?
Hydroquinone is a substance that can be found in nature but is often created in a lab. In nature, it can be found in some plants and fungi, such as the Agaricus hondenis mushroom. It’s also produced in the body of an insect called the bombardier beetle, which utilizes it as a defense secretion. Hydroquinone, also known as benzene-1, 4-diol or quinol, is an aromatic organic compound that is a type of phenol, a derivative of benzene, having the chemical formula C6H4(OH)2. 

HINTS ON BENZOYL PEROXIDE USE!
Use Benzoyl Peroxide serums for Week 1-3 for Grade 3 & 4 Acne treatment - THEN back off of it! Change over to a Salicylic Acid treatment serum and alternate with a Nourisher serum (Stem Cells, Hyaluronic Acid, etc.) for best results for Week 4 and beyond!

CATEGORY: NOURISHERS

• ASCORBIC ACID
  • The only VITAMIN to synthesize collagen proteins; Collagen PRODUCTION! (Fun Fact! Copper is the only MINERAL to synthesize collagen production!)
  • Antioxidant & Sunscreen BOOSTER! Use during the AM routine primarily.
  • Does NOT combine well with glycolic acid and retinol - as well as other ACIDS! Because it's an antioxidant, it NEUTRALIZES other chemical reactions! BEST when used ALONE in the skincare routine.
  • If used at night, use by itself and not in the presence of other acids.
• HYALURONIC ACID
  • Holds 1000x its own weight in water; Water binder + skin plumper! A type of Glycosaminoglycan - which is a type of PROTEIN in the Dermis called a Proteoglycan within the "Extracellular Matrix".
  • Synthesized in a lab, it is called Sodium Hyaluronate - which may be used in topical products as well as dermal filler products such as "Juvederm" and "Volbella".
• SQUALANE
  • A saturated oil that is used in skin care products as a moisturizer, helps increase hydration, and thanks to its anti-inflammatory properties, can help with acne and eczema.
• STEM CELLS
  • May be plant or human-based; PRODUCES NEW CELLS BY BUILDING THEM UP; One of the best sources of anti-aging topically. PLANT-BASED stem cells are heavily used in skincare.
  • Stem cells are undifferentiated biological cells that can differentiate into specialized cells and divide to produce more stem cells.
  • Adult stem cells come from adipose tissue or bone marrow. Stem cells can also come from umbilical cord blood.
• PEPTIDES
  • Peptides are fragments of proteins; made up of amino acids. When amino acids are combined in certain formations, they create specific peptides - and specific peptides create certain proteins!
  • Proteins = BUILDING BLOCKS of the skin (STRENGTH + TIGHTENING!)
  • Without peptides, the skin doesn't remain intact and the results are loss of firmness, appearance of wrinkles, and texture changes!
• PERFLUORODECALIN
  • The amazing attribute of this compound is its incredible ability to dissolve and carry large volumes of oxygen gas. This makes it a very interesting ingredient in various fields of science and medicine. Notably, it is used in artificial blood substitutes and in liquid breathing.
  • Oxygen delivered topically through the skin reaches capillaries that don’t get as much oxygen with regular breathing. This positively influences the blood circulation in these areas and the production of collagen, elastin and keratin. This ‘aeration’ process helps accelerate the skin’s healing by assisting the skin to breathe, and promoting the propagation of new cells.
• TOCOPHEROL
  • Vitamin E (Tocopherol) – A hydrophobic molecule, meaning a molecule that is not water soluble, Tocopherol restores hydration by nourishing the lipid barrier and preventing the evaporation of existing moisture, known as transepidermal water loss, or TEWL. It also acts as an antioxidant and is highlighted by its stabilizing abilities in this formula.
• NIACINAMIDE
  • Vitamin B3 (Niacinamide) – Also known as vitamin B3, niacinamide can improve the appearance of enlarged pores, brighten dull skin, as well as defend against environmental toxins. Niacinamide also has a hydrophilic molecular structure, meaning it attracts water from its environment.
• PANTHENOL
  • Vitamin B5 (Panthenol) – This form of Provitamin B5 is a hydrophilic, or water absorbing, humectant and conditioner that works to pull in and bind moisture to the skin.
• GROWTH FACTORS
  • Growth factors are polypeptides or proteins that play a key role in the regulation of a number of physiological processes. Topical application of growth factors also reduces signs of photoaging, promotes fibroblast and keratinocyte proliferation, and induces extracellular matrix formation.
  • Growth factors are natural substances made by skin cells to maintain healthy skin. They are responsible for supporting the repair of damaged skin, making components that provide firmness and elasticity to the skin while helping to maintain skin's protective functions.

ANTIOXIDANTS (NOURISHERS): THREE CATEGORIES

There are three categories of antioxidants that are additionally a part of the NOURISHER ingredient list, consisting of ENZYMATIC and NONENZYMATIC antioxidants, as well as PLANT EXTRACTS. Some antioxidants were already listed above individually with their own characteristics and benefits to the skin. Looking at antioxidants as a whole is helpful in determining the “skin food” that is most beneficial to your clients and ensuring antioxidants are part of their daily routine. 

What are antioxidants in skincare?

Antioxidants are ingredients that provide reduction in oxidation effects within the skin. Oxidation is by definition the process of “the addition of oxygen and the reduction of hydrogen” in chemistry. By introducing the type of oxygen that produces oxidative stress in the skin, the skin is then introduced to free radical damage. Free radical damage/oxidation (one in the same) causes aging in the skin and the degradation of collagen. Oxidation additionally steals an electron from paired atoms (with two electrons; an even amount of electrons) making them unstable. Antioxidants can produce the complete opposite reaction by providing an electron to unstable atoms and thus, reversing the signs of aging by providing a solution to oxidative stress. Antioxidants, however, must outweigh the number of free radicals and should be used daily in order to reverse aging.

Antioxidants are molecules that can help protect the skin from environmental damage caused by free radicals. Free radicals are molecules with unpaired electrons that can react quickly with other molecules, causing oxidative damage. Oxidative damage can lead to premature aging, wrinkles, and sunburns. 

Enzymatic Antioxidants

Examples of enzymatic antioxidants include: 

• Superoxide Dismutase: Helps break down potentially harmful oxygen molecules in cells. This might prevent damage to tissues.
• Glutathione Peroxidase: Has the capacity to scavenge free radicals. This in turn helps to prevent lipid peroxidation and maintain intracellular homeostasis as well as redox balance.
• Glutathione Reductase: Not only decreases the melanin (pigmentation) in your skin, but has also been found to decrease wrinkles and increase skin elasticity.
• Glutathione Transferase:  Provides protection against oxidant toxicity and regulation of stress-mediated apoptosis (the death of cells which occurs as a normal and controlled part of an organism's growth or development). 

Nonenzymatic Antioxidants 

Examples of nonenzymatic antioxidants include:

• Vitamin E (tocopherol): A hydrophobic molecule, meaning a molecule that is not water soluble, Tocopherol restores hydration by nourishing the lipid barrier and preventing the evaporation of existing moisture, known as transepidermal water loss, or TEWL. It also acts as an antioxidant and is highlighted by its stabilizing abilities in this formula.
• Vitamin C (L-ascorbic acid): The only vitamin to synthesize collagen production, acts as a sunscreen boosters, brightens skin, and provides antioxidant protection.
• Vitamin A: Helps to speed up healing, prevent breakouts and support the skin's immune system; promotes natural moisturization, which means it helps to hydrate the skin effectively, giving it a radiant glow.
• DHLA (alpha-lipoic acid): Helps fight signs of skin aging; decreases the synthesis of melanin, reducing hyperpigmentation by evening out skin tone.
• Coenzyme Q 10 (ubiquinol): Full of antioxidant properties that protect the skin from environmental stressors, energizes the skin, and helps skin retain moisture.
• Idebenone: Reduces skin roughness and dryness; increases skin hydration; reduces fine lines/wrinkles; and improves overall look of photodamaged skin. 
• Butylated Hydroxytoluene (BHT): A stabilizer that can be found in cosmetic products. It acts as an antioxidant that helps maintain the properties and performance of a product as it is exposed to air. 

Plant Extract Antioxidants

Examples of plant extract antioxidants include:

• Green Tea: Helps reduce skin irritation, skin redness, and swelling.
• Beta-Carotene: Helps maintain skin health and appearance, and may protect the skin against UV radiation from the sun.
• Polyphenols: Protects the skin against ultraviolet radiation and enhances the skin's cell growth.
• Flavonoids: Contains multi-active components used in common cosmetics primarily for antioxidant and soothing actions; provides protection from telangiectasias and petechiae caused by ruptured blood vessels.
• Pomegranate: Is rich in essential minerals and helps in reducing aging from the sun and pigmentation.
• Acai Berry: Is rich in omega-3, omega-6, and omega-9 fatty acids - which help skin appear youthful and plump.

WHICH IS BETTER FOR BRIGHTENING HYPERPIGMENTATION? VITAMIN C OR ALPHA ARBUTIN?
Vitamin C is an effective antioxidant that brightens the skin tone and reduces signs of aging. Alpha arbutin is a highly purified biosynthetic active ingredient that reduces the look of hyperpigmentation and uneven skin tone. They work BEST when used together! Vitamin C in the morning - and Arbutin in the evening! HINT: Alternate Arbutin and Kojic Acid nightly for even better results! 
​
PEPTIDE EXAMPLES

• Palmitoyl Tripeptide-5
  • Palmitoyl Tripeptide-5 is a deep penetrating, bioactive ingredient. This small peptide is a short chain amino acid with a unique sequence, designed to mimic the body’s own mechanism to produce collagen via the multifunctional protein called TGF-β. TGF-β is known as the key element in the synthesis of collagen and binds to a particular sequence in the body’s collagen production process.
• Pentapeptide-18
  • To ensure maximum muscle relaxation, we use Pentapeptide-18. This peptide mimics the natural mechanism of enkephalins. Enkephalins are neurotransmitters which work to suppress pain, and administer a calming response. Pentapeptide-18 couples to the enkephalin receptors on the outside of nerve cells initiating a decrease of the neuron’s excitability. The nerve cell’s activity is ‘turned down’ and the release of acetylcholine suppressed.
• Hexapeptide-8 & Acetyl Glutamyl Heptapeptide-1
  • Hexapeptide-8 and Acetyl Glutamyl Heptapeptide-1 are two peptides that mimic the N–terminal of SNAP-25 protein. They compete for a position in the SNARE complex, which destabilizes the pathway, so that it cannot support neurotransmitters efficiently. The vesicles struggle to even reach the neurological receptors. Any vesicles which do manage to cross the protein pathway and reach the receptors are hindered by another peptide called Dipeptide Diaminobutyroyl Benzylamide Diacetate. This peptide is an antagonist of the muscular receptor and acts by blocking the uptake of acetylcholine released from vesicles to the receptor sites.

Understanding cosmetic chemistry is essential when it comes to properly caring for your skin. By understanding the basic principles of how different ingredients in skincare products work, you can make sure you are using the right products for your skin type and concerns.


Chemical compounds are used in skincare to provide a range of benefits including moisturizing, exfoliating, and cleansing. Moisturizers help to keep your skin hydrated by drawing in moisture from the environment and locking it into the skin. Exfoliants help to remove dead cells on the surface of your skin that can lead to a dull complexion. Cleansers help to break down dirt, oil, and other impurities on the skin while also providing a gentle cleansing action.


There are certain ingredients that have been proven to be beneficial for the skin, such as antioxidants and natural oils. Antioxidants help to reduce free radical damage while natural oils provide nourishment and hydration. Some skincare products may contain artificial fragrances, dyes, and other additives, which can be irritating to the skin. As an Esthetician, it's important to understand ingredients from all angles in order to educate clients and ensure proper protocols and plans for long-term success for amazing outcomes!

​

Looking into the eyes of our students on Orientation Day, eager to gain an understanding of the industry that is changing lives all over the world, I smile in gratitude and excitement. As a visionary for the bigger picture, I look out from the stage platform in our Campus Extension lecture classroom over the sea of women (and men) encompassed within our walls. Their faces are filled with many emotions from fear and anxiety - to thrill, excitement, eagerness; and an unequivocal connection to a personal journey that is connected to each of us. My mind rises higher and fast forwards to their graduation day, their personal lives, their families, and their careers. I see the lives changed, the smiles created, and the life journeys defined by a passion that has fueled my heart for years. I know the struggle and I know the peace. I understand the unknowing and I know the understanding. In these inspirational moments, as I share our story, these individuals are exponentially changed. The journey begins.

There are many things in my life that help me define success. Success is not about the possessions you have, the ladders you can climb, or even the statuses you hold. Success is a level of peace you feel and personal processes you display in your daily life that helps you perform to your optimum level with ease. Success becomes a habit when you inherently practice consistency; and consistency is had when you are able to see the bigger picture. When you visualize the outcome, you want to perform. Your daily walk with your actions is connected to every other action; and you happily understand the secret that is held in hard work. Success is yours.

1. Rise Early. 
They key to 'doing it all wrong' lies in hitting the snooze button on your alarm clock. The 'Five Second Rule' is a well-known system practiced by many that ensures that you simply GET UP, and not focus on the inherent mindsets of pushback, obstacles, and negative outcomes that our brains are trained to create. Wake up early with gratitude, focus on the excitement and opportunity a brand new day creates, and enjoy the little things about a quiet start to the morning - inclusive of hot cups of coffee and planning out your day. These little steps and moments of calm are truly key components of an extraordinary life. 

2. Multitask. 
In watching people struggle through their workdays and ultimately not connecting or succeeding in jobs they want to master, the commonality of disconnection is their inability to multitask. Multitasking is another example of the mind expanding and being able to look at the bigger picture. It's almost as if you have a mental visualization of an aerial view of your company and all of the processes and people that make it work efficiently. What can you do within your realm of influence to create a better experience for your culture, your consumers, and your supervisors? Multitasking is a mental confidence that allows you to choose an hour of your workday and accomplish more within that moment than your competitors. This is a true key to success - and those that do not practice and uphold this mental connection will simply be, and always feel, behind. Not only will life be easier overall, but you will be the employee in your company that is irreplaceable.

3. Computer Skills Basics. 
In teaching individuals a skill set in the ever-evolving beauty industry, we focus on specific sciences and modalities that create change in the skin. However, a true understanding of these common computer programs will assist you in office organization, inventory and budget controls, design and marketing, and much more. Gain a thorough understanding of platforms such as Google Docs (for document sharing and PDF creation) and Microsoft Excel (for spreadsheets for every occasion). Having the capability to quickly and efficiently create documents and communicate digitally will set you a part from the competition and always connect you to your clients. Additionally, simple graphic design skills through platforms such as Canva, for example, are very critical regarding anything from resume design, to logo creation, to menu design. The future is yours! 

4. Communication. 
One of my personal favorite skills to teach and allow students to practice consistently is public speaking. Being able to formulate your thoughts internally with a beginning, a middle, and a closing remark are critical in story telling. Story telling is key to work-based activities such as client consultations, meetings with supervisors, or group discussions within your culture. Additionally, being able to communicate this same format digitally through emails to your clients and vendors, official company letters with your letterhead, and professional proposals to a government entity or new contractor to propel your company forward is absolutely important - and a very critical piece of the puzzle that sets successful people apart. Are you set apart? How well do you communicate? Evaluate your skill set and always level up - in order to set yourself up for a higher, and easier, way of doing business. 

5. Practice You.
My favorite quote of all time is: "No one is you and that is your power." Wow! My power? Absolutely! In a world where we grow up realizing that Super Woman is actually very much within us, I love this quote even more. Complete confidence in who you are is something no one can take away from you. No one holds the power to pull you down or make you feel less than. Absolutely no one. When the light bulb finally comes on, and you realize you have had the POWER all along, it is truly life-changing and mind-altering. You can hold your head up high, in true confidence, that everything is always going to be ok - simply because you say so. And today, I am choosing my power. There is nothing more powerful, or successful, than that. 

Public Announcement
7.27.2018

Southeastern Esthetics Institute has been approved as an entity to own medical records as of July 20, 2018, by the South Carolina LLR Board of Medical Examiners.

​Southeastern Esthetics Institute takes great pride in providing exemplary service to clients, patients, and students alike; and continues to strive for excellence in all areas of ethics, rules, and regulations.

Physicians & The Esthetician
by Courtney G. Freeman, Licensed Esthetics Instructor 
PUBLISHED IN DERMASCOPE MAGAZINE

In today’s modern and ever-changing world of cosmetic technology, Estheticians are required to understand skin from a cellular and scientific perspective. Estheticians and consumers alike understand the advanced changes that can be made within a medical setting - and physicians are realizing the supportive role that Estheticians can bring to their practices. There are many serious laws and regulations that must be taken into account when combining medical procedures with esthetics services, along with many specific protocols and processes that must take place in order to treat patients in a methodical manner. Estheticians are required to enlist specific personal and professional skill sets to work underneath physicians. Respect for the physician and the regulations of a medical practice are critical, while also understanding the Esthetician’s scope of practice. Working in a medical setting as an Esthetician can be both rewarding and beneficial for both yourself and your clients alike. Understanding the nature of advanced esthetics and the branches of knowledge needed are paramount to success in the evolving and popular medical spa arena. 
The skill set required of an Esthetician within a medical practice is multi-faceted and complex. The level of education and the mindset required to work alongside physicians and nurse practitioners is exceptionally important - with a clear focus on cellular change, anatomy, hormones, and scientific methods being a critical need of the individual. The firm understanding that Estheticians are unable to title themselves as “Medical Estheticians” is an important focal point, as it does not have any legal value and misrepresent’s the license originally obtained. Estheticians must understand their place in a medical setting - which is to provide esthetics services directly underneath the physician. With esthetics technology such as microneedling, dermaplaning, and cosmetic laser skin rejuvenation being at the forefront of esthetics services in 2016, Estheticians are required to understand the knowledge and skills required for the competitive advantage of assisting their clients with changes at a dermal level. With the supervision of a skilled, board certified physician, Estheticians can assess and perform the services necessary to assist clients in achieving real change. Respecting the skill set and scope of practice for the supervisory staff and physicians, along with performing only what is contractually within the job description of the Esthetician position is exceptionally important. Esthetics practitioners within any advanced setting should obtain certifications underneath their license for each individual advanced procedure. Specific courses for cosmetic lasers, for example, are crucial to add to the esthetics portfolio, in order to showcase added training beyond that of the esthetics fundamentals course. Estheticians looking to gain a competitive edge will not only obtain as much outside education as possible, these individuals will also build their skill set of public speaking, professional development, HIPAA compliance, OSHA regulations, and much more. Having a thorough understanding of the dermatology and plastic surgery procedures, in addition to all new and modern cosmetic procedures on the market, is critical in assisting your clients in answering questions. Constant continuing education and training on advanced techniques is paramount to the success of any Esthetician within a medical setting.
A thorough understanding of state laws and regulations, through constant monitoring of any changes with state board regulatory agencies, is a critical tool that must be taken seriously as an Esthetician in today’s market. Each state possesses specific requirements for Estheticians within their own board as well as laws under the state medical and nursing boards. Overall, Estheticians must always assume that the physician is the lead authority in any protocols for patients that are requiring an advanced procedure. Estheticians must obtain written permission and treatment plans through the physician overseeing the practice, with monitoring by the physician of all notations within patient charts, products and modalities used, and any other thought process made throughout the duration of treatment. Proper communication is exceptionally important between the physician and support staff when treating patients in a medical setting. Having daily and weekly communication when dealing with patients receiving treatment is critical. Thorough organization of charting systems, patient and employee safety and sanitation practices, and consistent monitoring by supervisory staff is the key to medical spa success. 
Estheticians must understand and uphold a high skill level in documentation and notation skills. Through the initial consultation with clients, the understanding of medications listed, immune system dysfunctions, stress levels, ingredients in products used, and past procedures performed on the client are important to assess. The Esthetician must also obtain the skills and knowledge needed to piece together proper Patient Care Plans within a medical setting that consist of combinations of needed procedures such as: chemical peels, microdermabrasion, dermaplaning, microneedling, cosmetic lasers, and more. The physician overseeing the practice must sign off on and give permission to the Esthetician performing the procedures. The correct use of medical terminology is especially important when it comes to medical charting. Dependent upon the medical charting system of the practice, the Esthetician must frame his or her language in the most objective terms possible, steering clear of any biased phrases that could be misinterpreted. Diligence and accuracy in record keeping is essential, and should be a very important part of the day-to-day activities of an Esthetician. In addition to daily charting, supervisory and management staff must check behind all service providers daily and/or weekly to make certain charting is being performed to the level needed for the practice. The charts must then pass through the physician overseeing the practice, in order to obtain the correct signatures, documentations, and authorization needed to move forward in treatment. Patient and client follow-up after procedures should be documented within the charting systems as well - and must be approved in terms of communication methods with the patient and documentation of the interaction. 
A complete understanding of liability insurance is exceptionally important to an Esthetician in this setting - as the supervisory physician must include these individuals within the malpractice insurance. A separate liability insurance policy on the practice as a whole, with policies on each individual practitioner, is also an added protection umbrella. All service providers within a practice should obtain copies of insurance policies that pertain to their performance for their own understanding. Seeking insurance providers that specialize in medical spa businesses and procedures is an absolute must. The option for these insurance providers is more prevalent today than recent years, as many individual procedures such as microneedling, permanent makeup, or cosmetic lasers are added to policies specifically. All persons approved by the physician for the performance of such procedures must be listed by name. At any moment that a new service provider is added, the insurance policies must be updated. Viewing these policies quarterly, not only yearly, is important for all supervisory staff to oversee. Maintaining complete compliance with both national and state regulatory agencies is an important factor. If there were every a setting that insurance was most important, it is that of a medical spa. Liability insurance not only covers the facility but each practitioner on the policies, with a specific focus on individual procedures within the practice. When adding a new medical esthetic procedure, it must be additionally added to the policy. Both the general liability coverage of the practice, in addition to the malpractice insurance of the physician overseeing the clinic must be updated to match all standards. All records in accordance with liability insurance standards of a medical spa office must be held at a high level of importance, as it is the basis of administration and authority within the safety parameters of the patients within its care. 
The office culture in a medical esthetics setting can be significantly different from any other business or spa environment, for the purposes of being OSHA and HIPAA compliant. From the front desk receptionists to any supporting staff member, all employees within a medical spa practice must be in tune with state regulations and compliance. A complete system must be in place per office, for the role of every action within the practice. From the time a patient walks into the office, to the manner in which they are spoken to at the front desk, to the escorting staff taking them into the treatment room, to the physician consultations, to the procedure itself, and to the conclusion and follow-up methods - all processes must be systematic in nature, in order to create a specific and defined flow that meets all requirements. The understanding and respect for organizational hierarchy exists in any office, but no more than that of a medical office. When independent thinking is encouraged in many salons or spas, the medical practice often adheres to a strict top-down human resource methodology. The understanding that an Esthetician cannot “over step their boundaries” is crucial. The freedom of customization and changing of protocols can be somewhat limited, which is an important factor to take into consideration when assessing goals for esthetics careers. Regardless of these processes, many individuals find the advanced setting of a medical practice more to speed with their own goals. Harnessing the qualities needed to advance in this setting are pieces of a puzzle that can take many years to perfect or obtain. Estheticians truly should seek out employment in a spa setting immediately after graduation, to obtain several years of experience treating the skin before implementing the idea that a medical setting is their ultimate goal. Job experience, additional education, and life experiences make a medical spa position that much more fulfilling and successful for both the practitioner and the business itself. 
To be competitive in the current esthetics market, practitioners must obtain consistent continuing education in advanced esthetics. The relationship between a physician and a supporting staff member such as that of an Esthetician must be respected from every angle. The level of professionalism of all team members of a medical spa practice must be held to the highest of standards, along with excellence in areas such as sanitation and medical charting. Compliance in the realm of liability and malpractice insurance is exceptionally important - and should be in the top priority list at the beginning of any medical spa business. The esthetics industry is exceptionally rewarding - assisting clients with not only their physical care but their emotional health and personal confidence as well. By changing the lives of our clients, we ultimately change our own. Living and breathing the spa industry is an experience only the select few are lucky enough to embody. Treating your career as an art, and ultimately respecting the laws and regulations which encompass that craft, are an important aspect of any endeavor in the advanced esthetics field.