Waxing is a daily occurrence in the life of most estheticians.  We have honed our technique, we know what wax to use, and our customer service skills are topnotch.  What else is there to know?  As professionals, it is our responsibility to know that to do when something goes awry, or when we are presented with a condition that falls outside of what we normally see.

When waxing goes wrong, the most common risks are skin lifting, ingrown hair, and the development of keloid or hypertrophic scarring.  Though these incidents may be few and far between, they can turn an otherwise ordinary waxing service into a nightmare for both client and esthetician.  That is why it is absolutely essential to know the hazards of waxing and how to mitigate problems, should they arise.

Skin Lifting
Skin lifting is one waxing problem that strikes terror in the hearts of most professionals.  We’ve all be there, or imagined it:  along in the treatment room with our client, happily waxing away without a care in the world–until we remove the wax and the skin comes with it.

At the point, we’re usually wishing we had removed half an eyebrow instead.  At least then we could fill it in with pencil.  After some very choice expletives dance through our heads, we think, “How did that happen?”

Lifting happens when both dead and live skin cells are pulled off with the wax, creating an abrasion similar to scraping one’s knee.  When lifting is visible, the area will be shiny and slightly “dewy” and the client may report a stinging sensation.  However, depending on the client’s skin tone, the abrasion may not visible.  In fact, the client may not even realize that anything out of the ordinary has happened until a day or two later when a scab starts to form.

Why does skin lift?  Here are a few of the top reasons:
1)  Poor technique.  If you pull up when removing the wax, or do not hold the skin taut, this can cause lifting to occur.
2)  Incorrect wax temperature.  Both hard and soft wax will have a greater risk of causing lifting if the wax is too warm.  Soft wax an also cause lifting if it too cold, as it can become gummy on the skin.
3)  Compromised skin.  If the client’s skin is dry, dehydrated, or flakey, the risk of lifting increases.
4)  If the client is using certain medications (systemic and /or topical) that make the skin thinner or more sensitive, lifting may occur.  Two examples are prednisone or Retin-A.

If lifting happens during a waxing session, some basic first-aid treatment will be needed.  As mentioned, lifting is an abrasion and should be treated accordingly.  An abrasion will go through the normal process of scab formation, peeling, and healing. The object is to keep the skin hydrated and protected during this time to minimize the client’s discomfort.  Suggest the use of an over-the-counter salve such as Neosporin to protect the area against bacteria and keep the area hydrated.  There is not much else that can be done to speed the healing process, beyond letting nature take its course.

In the event of more severe lifting, or if there is bleeding, cover the abrasion with a bandage if possible and refer your client to a physician.

Prevention is best.   First and foremost, analyze the skin prior to waxing.  This is especially important for brow and Brazilian waxing.  Skin in these areas tends to be more delicate, making lifting more of a possibility.  On the face, women are using more anti-aging products, which can lead to even thinner skin around the eye area.  In the Brazilian area, the creases of the upper legs and buttocks make be severely dry and dehydrated–after all, who moisturizes their buttocks?

Noticing signs of compromised skin during the initial consultation can prevent pain for your client and trouble for you.  If the client’s skin is too compromised to wax, it’s always better to be safe than sorry.  let the client know why it would be unsafe to perform the service, send her home with the proper pre-wax product to improve th condition of the skin, and reschedule so that she can safely receive her waxing service at a later date.

Remember, even if have done all we can do to make sure lifting doesn’t occur, it can still happen.  The best we can do is to be prepared.

Ingrown Hair
Ingrown hair can be exacerbated by waxing treatments, so it’s good to have an understanding of this condition.  An ingrown hair is a hair that gets trapped underneath the surface of the skin.  If the growing hair is able to exit the pore (follicle), its only option is to curl back down into the skin.  Ingrown hairs appear to lie flat just under the surface, running parallel with the skin, or they can turn back into the follicle, creating an infection in the skin that can exhibit as red and bumpy.

Though anyone can get them, ingrown hairs most often occur in clients with thick, coarse, and/or curly hair, and in those with an overabundance of dead cell buildup, and dry or dehydrated skin.  Friction and improper shaving or waxing techniques may also contribute to the formation of these not-so-welcome visitors.  Clients who get ingrown hairs from shaving may not get them from waxing, and vice versa; however, there are those who will get them no matter what.

so, what can we do as estheticians to help our clients deals with this troublesome condition?  As we learned earlier, if the skin is in poor condition (dry/dehydrated), the hair will not be able to exit the follicle.  Proper exfoliation plays a huge part in keeping the surface free of dead cells.  The client can exfoliate at home with a light scrub or loofah, followed by a hydrating product to keep the skin supple, which will allow the hair to break through the surface.  In-office treatments (such as a light chemical peel or hydrating treatments) may also be offered to encourage hairs to exit the pores.

The only thing that is not recommended is for the esthetician to extract an ingrown hair.  Unless the technician has been trained to do so, attempting to extract the hair can lead to infection or scarring, creating more discomfort for the client.

For the clients who are severely affected by ingrown hair, it is a good course of action to refer them to a physician or certified professional who offers clinical treatment options for hair removal, such as laser or electrolysis.  Waxing may not be the best method for these clients.  Another treatment option you can suggest to them is sugaring which removes the hair while also removing dead cell buildup, so that trapped hair can be released.  for clients who have between treatments instruct them to use a Bump Fighter razor.  These razors are designed to cut the hair just above the skin, so regrowth won’t get trapped.

Keloid and Hypertrophic Scarring
Keloid and hypertrophic scars are similar in appearance and can be difficult to tell apart.  The only characteristic they share is that they are both scar tissue.

Keloids are typically thick, fibrous, tumor-like growths that extend beyond the boundaries of the original wound, such as an infected ingrown hair.  This is why, tempting as it may be, extracting an ingrown hair is not recommended–not everyone who gets ingrown hairs will experience scarring, but it is certainly a risk.  Hypertrophic scars are elevated and may resemble keloids, but they do not extend beyond the original area of the wound, and unlike keloids they may reduce over time.  In the Brazilian area, where we see raised scarring, it is most likely to be hypertrophic.

Anyone can scar, but those most prone to keloid or hypertrophic scarring are those with a genetic predisposition and those with darker skin (Fitzpatrick types IV, V, VI).

If your client has a predisposition to keloid or hypertrophic scarring, performing a thorough analysis and recommending proper aftercare is key to executing a safe hair removal service.  Exfoliation and hydration, as mentioned previously, should be used to reduce the risk of ingrown hairs so that scars do not have a chance to form.

Who knew there was so much to take into consideration when waxing?  As professionals, we need to pay attention to the skin and listen to it when it talks to us.  Lifting, ingrown hair, and scarring may not be common, but if we know what to do when we encounter these issues, we can become heroes to our clients.  Stay educated, keep current, and involve your clients in the process.

*Written by Crickett Enos, “The Wax Chick”  crickett@thewaxchick.com
Cricket is a licensed esthetician in California, with more than 10 years of experience in the beauty industry, six of them as an instructor in advanced eyebrown design and Brazilian waxing.  She is also a certified makeup artist, certified Alexandria Sugaring professional, and has a degree in business administration.  

This article was originally published in the November/December 2011 edition of Skin Deep Magazine published by the Associated Skin Care Professionals.

This article is taken from the July/August 2011 issue of Skin Deep Magazine

Too often, clients want an immediate appointment at a medical office, or they call to find out what actions they can take to get rid of, or decrease, the breakout.  To treat acne effectively, an esthetician and physician should work together to minimize acne’s underlying causes.  Clients must be on a stable skin care regimen that maintains a good balance of oil and hydration levels so that breakouts do not occur.  However, this regimen may change depending on the weather, the season, and for some women, what point they are at in their menstrual cycle.

Women can have naturally occurring high levels of testosterone or a condition called polycystic ovary syndrome (POS); both can lead to increased bouts of acne.  POS is a condition characterized by the accumulation of numberous cysts on the ovaries.  It’s associated with high levels of male hormone, chronic anovulation (absent ovulation), and other metabolic disturbances.  One of the most important characteristics of POS is hyperandrogenism — the excess production of male hormones (androgens), particularly testosterone, by the ovaries.  This accounts for the male hair growth patterns and acne in women in POS.  Androgen production can be reduced or blunted by taking hormone modulators prescribed by a medical professional.

Many women notice that their acne breakouts are less severe when they are taking birth control pills.  This is because birth control pills cause testosterone levels to drop.  These male hormones are responsible for the development of the male reproductive system and secondary male sexual characteristics, such as voice depth and facial hair.  In men, testosterone is produced in large quantities by the testes, but it also occurs normally in smaller quantities in women.  A side effect of testosterone production in both sexes is that it increases oil production and the frequency of acne breakouts.

There is a temporary pharmaceutical aid to treating POS, called spironolactone.  Spironolactone is a diuretic, which means that it increases the amount of urine passed, causing the body to lose water and salt.  It helps treat medical conditions, such as heart, liver, or kidney disease.  It also (sometimes quite effectively) blocks the release of excess hormones like testosterone.  However, patients must take spironolactone regularly, or hormone production simply resumes when the medication is stopped.  Spironolactone can also negatively affect a male fetus, and therefore cannot be given to pregnant women or women thinking of becoming pregnant.  It’s important that patients taking spironolactone are followed closely by their physician, so that blood pressure and potassium levels (which are affected by the drug) can be monitored.

This is but one of several effective medical treatments for acne, all of which require patience and adherence to a regimen for best results.

Editor’s note:  This article describes the relationship between hormonal conditions and acne breakouts, and how an esthetician might be involved in treating various symptoms while working in conjunction with a physician.  

Photo Courtesy of Joey DelPalazzo, Church Street Studios, Philadelphia, PA

Leading up to it….

I can’t remember a time in my life when I’ve felt more like myself…not in high school (which was all about fun), not in college (which was all about preparing for a future that I hadn’t fully thought through), and not in my initial foray into life as a working professional (which was all about competition, status, and proving something to my family and friends).

I was busy, but I wasn’t making progress with my life. I was working full-time in local government, cultivating a makeup artist hobby, making extra money as a promotional model, and like most of my friends, I was complaining about something everyday. I was also doing all the things that I was supposed to do: I was buying a house, going to church, trying to figure out how to be more appealing to a man, and wondering why my life wasn’t exciting. I was wondering why I felt stuck in a routine that wasn’t making me particularly happy: I had bought life’s wolf-tickets.

I began to realize two things. First, the life I’d worked so hard to obtain wasn’t really the life I wanted. Second, just because I was doing all the things that I thought I was supposed to do, I wasn’t guaranteed a particular outcome.

I bought the house because my friends were buying houses. I was looking for a husband (while trying to seem cavalier about it) under every rock because everybody, particularly the church people, kept telling me that taking care of a man and birthing a baby would make me happy because it was what God had called woman to do (…and I thought sex would make me feel like I was living in a state of constant euphoria). I kept a job that really wasn’t working for me because it made my family proud.

As I did all the perfunctory things, it never occurred to me that I wouldn’t have guaranteed outcomes. I mean, I really approached life with this idea that I would insert certain things (effort, accepting student loans, perseverance, etc) and would undoubtedly get certain things out. I would get an education, be competent, and the drama of work-life wouldn’t come my way because difficulty at work only came to people who weren’t that smart, who didn’t perform, and who had done something stupid to cause their problems. I would learn to cook because I was supposed to do it and enjoy it because, after all, I am a girl. I would volunteer because it would make me compassionate. I wouldn’t have sex because I was worried about AIDS, single motherhood, and a man who would treat me as a used rag afterwards. Life was supposed to flow. If I did all of these things, I would get the great husband, progress up the work ladder, become wealthy, and be content with something like knitting.

What was I thinking?!?! Actually, I think I was thinking what all of my friends were thinking all the while learning, “this ain’t it!” I had chosen goals and benchmarks that weren’t mine. I was focused on achievements that didn’t have enough personal value to bring me satisfaction. I was filling prescriptions meant for other people. I was a project manager for somebody else’s life!

BUT! Thankfully! Whew! I have substantiated many of my empty aspirations. Indeed, I have come a long way. Perhaps, I am a late bloomer, but, at least, I’m starting to get it. Undoubtedly, if I had wed or become a mother, my self-discovery journey would be different, but such is not my lot. I have figured out the key to my confident self which is not to avoid myself. I have learned to confront me. I have learned to ask me prodding questions. I wrestle with my personal truths. Indeed, introspection is the best thing I have yet to discover.

Thus, as I ski toward 35, I am finally okay with not having the life of my adolescent dreams. I’m grateful that I’ve learned what the fight is all about. As you grow, you realize what’s important to you and you fight for that! You learn what’s important to the people you hold dear and you help them fight for their stuff. You don’t fight for the things that don’t really mean anything to you: why go to war over meaningless spoils? And when you see how complicated and busy life can be, you will abandon those things that aren’t intimate to you like buying a house because your friends are doing it or keeping a job you hate because your family would be proud or just because it’s the way you pay bills. You get tired of performing for the people watching the movie of your life once you realize you’re acting out a story line that you didn’t write, fulfilling a role intended for another actress. You fight for your best life because it frees you up to be strong, constant, and happy to receive goodness and hope in this life. I refuse to live my life thinking that the only happiness is in heaven or will occur once I’ve paid my debt of insertions to qualify for particular outcomes owed to me.

Without a doubt, I like drinking red wine nearly every night even if my saved friends give me the side-eye for it. I know that every strong or pointed opinion doesn’t make me judgmental.  I love my tiny apartment, even if some people think a grown woman should be doing better. I work really hard to figure out how to grow Blush & Brushes and the divisions I’ve envisioned for it even if some people don’t embrace the idea of aesthetic beauty. I love complaining about my sore body after working out because I want attention. I like how I’ve learned that every argument isn’t a breakup as such adds depth to life. I like what I envision my old self to be…I can’t wait to be THAT 95-year-old (I keep journals so that the young people in my life can read about me to me!). I like thinking about how to be a better teacher and how to inspire.

I love my life! And, I desperately, want you to love yours!

Now, more than ever, clients are questioning what is being put into the skincare products they use.  With terms such as natural and organic being thrown around the industry, it’s important to know not only what these terms mean, but how they affect the way the product is labeled, the way the ingredients are listed on the packaging, an the overall effectiveness of the products.

Terms Defined
What exactly does it mean when a products is labeled natural or organic?  How do you explain the difference to a client?

In the broadest sense, a natural product is something that originated from a plant or animal source, and an organic product is natural product that was grown without the use artificial fertilizers, herbicides, or pesticides.  Many ingredients used in beauty, makeup, and skin care products are already derived from plant sources.  But exact definitions vary.  Ruth Winter, in her book A Consumer’s Diction of Cosmetic Ingredients (Three Rivers Press, 2009), defines a natural product as one that is extracted directly from plant or animal products, as opposed to being produced synthetically.  Others say a plant extract created artificially in the laboratory also counts as natural, since it is plant-based and chemically identical to the traditionally harvested plant.

In the world of skin care, the biggest difference between products labeled natural and organic is the amount of regulation imposed by the government.  The US government does not regulate natural skin care products, which means anything can be labeled or described as natural, regardless of what it contains or how it was produced.  Organic products, however, are heavily regulated by the government.

Organic Isn’t Easy
The US Department of Agriculture (USDA) sets strict regulations for organic products:  how ingredients must be grown and processed; where the word organic can appear on the product label; and how the label may be presented on the actual product.  Growers must adhere to a special system of farming that maintains and replenishes the soil fertility without the use of toxic materials such as pesticides or fertilizers.  Third-party certifiers appointed by the USA enforce these regulations with annual inspections of organic farms and processing facilities.

The National Organic Program (NOP) is a government agency that works with the USDA to help regulate the use of organic ingredients in skin care products, and to make sure that these types of products are correctly labeled.  There are four labeling categories for certified products:

100 percent organic;
Organic:
Made with organic ingredients; and
Less than 70 percent organic ingredients.

Products in any of these four categories can legally use the word organic, but different conditions apply to each.  If a company uses the word incorrectly, outside of these regulations and the USDA certification program, the NOP can impose an $11,000 fine on the brand for each incorrectly labeled product.

100 Percent Organic
In this category are products that have been certified by the government as containing 100 percent organic ingredients.  The product is permitted to display the USDA Organic label on the front of the packaging.

Organic
The government certifies that products in this category contain at least 95 percent organic ingredients.  They are also permitted to bear the USDA Organic label on the front of their packaging.

Made with Organic Ingredients
Only 70 percent of ingredients need to be organic for a product to b certified in this category.  These products cannot use the USDA Organic label, but are allowed to have descriptive text on the product label to say it is made with organic ingredients.

Less than 70 percent organic ingredients
These products cannot use the USDA Organic label, and the only place where the word organic can be used on the product’s packaging is in the ingredient list on the back of the product.

What’s Natural?
The main reason why the federal government doesn’t regulate natural skin care products is because there is no formal definition of what natural means within the beauty industry.  Different brands may use the word in completely different ways.  This creates confusion and frustration for the consumer.  How can a government agency possibly regulate something if the product manufacturers themselves can’t clearly define what it is that needs to be regulated?

The Natural Products Association (NPA) is one organization attempting to establish a definition, along with fair, useful rules and regulations for products and ingredients within the beauty industry.  The NPA is a nonprofit that serves as an industry watchdog on regulatory and legislative issues, and works to clear up consumer confusion about natural products.

In May 2008, the NPA, along with brands such as Burt’s Bees, JR Watkins, and Yes To Carrots, created the natural Standard for Personal Care Products.  This voluntary standard is the closest thing the beauty industry has to a formal definition of natural.  It consists of the following four components.

Natural.
At least 95% of the ingredients in the product must be all-natural.  The NPA defines natural ingredients as those formulated without any artificial ingredients,, and minimally processed.

Safety.
The products must be completely void of any ingredients deemed harmful to human health by the US Food and Drug Administration (FDA).

Responsibility .
The product cannot have been used in any sort of animal testing.

Sustainability.
The product, its ingredients, and its packaging must be environmentally friendly.  Ingredients should be biodegradable, if possible.  The product’s packaging should be made up of recycled materials, or at least be easy for the consumer to recycle.

To be considered natural by the NPA, a product must meet all four components, and its manufacturer must disclose all ingredient information, fully and accurately.  A product that has met all of these requirements can use the NPA Natural Seal on its label.

The NPA Natural Seal is the closest equivalent for natural products to the USDA Organic label for organic products.  The main difference is that the NPA Natural Seal is a voluntary standard that is neither required, nor endorsed, by the federal government.

Mind you, I purchased this wine at the new Wegman’s Liquor Store on Route 70 in Cherry Hill.  The store had a decent selection of items and was particularly convenient since I was in the shopping center already; however, it is not a replacement for Total Wine!  Total Wine is a much larger store and focuses on, well, wine!

• Alpha hydroxy acids (for example, glycolic and mandelic acid);
• Beta hydroxy acids (salicylic acid);
• Vitamin A acids (retinyl propionate, retinol, and retinoids); and
• Benzoyl peroxide, which not only kills bacteria with an infusion of oxygen within the pores, but actually peels in the pore.

For inflammed acne, use mandelic or salicylic along with benzoyl peroxide.  For non-inflamed acne, use mandelic or glycolic acid along with benzoyl peroxide, and then introduce an exfoliating serium.

Taken from Skin Deep Magazine, September/October 2011 edition

1)  Cerave Facial Moisturizing Lotion with SPF 30
Despite my much seeking, I have yet to find more than one sunscreen that I absolutely love.  Most of them are oily, hard to rub in, or leave that blue/white/gray hue on the skin.  However, I am pretty happy with this one.  It absorbs quickly and isn’t greasy.

2)  Bath & Bodyworks Shea It Isn’t So foot cream
Okay, this one came from my personal stash!  I simply love this product.  It moisturizes the skin without making your feet slippery.

3)  Glytone Restore and Lipid Recovery Cream
If you have dry skin, whether chronically or seasonally, this product, in the words of my little brother, “is the business”!

4)  Chi Infra Texture Dual Action Hair Spray
It gives shine and hold for hair that isn’t quite thick and not extremely fine!  It works with that hair that is right in the middle and likely to go limp due to humidity.

5)  Maybelline Great Lash
No matter how many other mascaras I use, I always come back to this one!

6)  L’OCCITANE Hand Cream
I like the feel of this cream.  It is “cosmetically elegant”, absorbs quickly, and leaves your hands feeling luxurious.

7 )  MAC Paint
This product does double duty!  I use it as an eyeshadow base.  It is excellent for preventing creasing.  I also use it as a stand alone eyeshadow.

8 )  Sebastian Reshaper
I like this product because it offers hold without causing hair to become hair and immovable.

9) Up and Up Makeup Remover Wipes (Target Brand)
I was on my way to a photoshoot and didn’t have my regular wipes.  I popped into Target and decided to give these a try, and I’m glad I did. I did put them in the Neutrogena case because the bag they come in does not seal well which would, undoubtedly, cause the wipes to dry out quickly.

10)  Thayer’s Alcohol Free Witch Hazel
Toner need not be expensive to be effective.  In particular, it should remove residue from makeup, hair products and debris from the skin without drying the skin or making it sensitive.

I’m drinking Quinta De Ventozelo which is a caramel colored 10-year-old port wine. And boy, can I taste the brandy!  I can also taste sweetness that I can’t quite describe.  I think I taste licorice, but I definitely smell “brown liquor” which is throwing me off a little.  My senses are stressed!  It also has more of a bite than my regular red wine favorites.  The more I taste it, the more it seems like it should go with a dessert, like a cheesecake or red velvet cake.    It seems like it should go with something creamy and moist, but also like a traditional pound cake wouldn’t be a good idea.

I think I might stop by a bakery tomorrow to pick up a dessert to see how it pairs.  If i were going to drink this wine alone, I would use a small glass.  It doesn’t have the same “sipability” as red wine (translation:  large wine glass…lol).

This wine isn’t awful at all.  It is just dying to be paired with something great!

Last week, I was a traitor and shopped at Cook’s Liquor Store on Haddon Ave instead of my regular wine store, Total Wine (In my defense, I only stopped at Cook’s because it was on the way to the new Krispy Kreme at Haddon Ave and Cuthbert!).  I got an idea from Wine Spectator magazine to grow my wine palette by intentionally choosing wines of which I had no expectations!  So, while Cook’s is decidedly smaller than Total Wine, it offered a selection of wines that included several that weren’t familiar to me (but that isn’t too hard…LOL).

I bought Micante Maremma Toscana, a dry red wine, called ” A “Super Tuscan” blend of Sangiovese and Cabernet Sauvignon” by wine.com.  After I let it aerate for about 10 minutes, it was excellent!!!!  Excellent, I tell ya!  It didn’t have a bite at all.  It was surprisingly smooth…and, apparently, stronger than me with 13% alcohol!  I had my version of a single glass, which is probably about twice the size of a restaurant serving, and I slept VERY soundly.  I was even a little groggy the next morning:  wine generally doesn’t have that affect on me normally.  Shucks, I can drink pinot noir while baby-sitting and trying to pronounce the word of the day!

Now, I have three wines on my list of “must keep in the house”:  garnache, pinot noir, and micante.  By the way, my “house wines” are listed from least to most flavorful.

A couple of notes:  1)  You MUST let it aerate for about 10 minutes!  It is a completely different wine when you let it breathe.  I would say this is the perfect “busy wine”.  You know, the kind of wine you pour while you’re doing small tasks so that it is ready to enjoy when you’re ready to drink.  2)  You must NOT drink what’s left in the glass sitting on the bed-side table the next morning!