The Making of an Esthetician

Tonight after we have theory, I finally get to see the microderm demo. We have to practice it once before we can do it on a client and I’m glad for that. It didn’t look too bad, though, and it doesn’t seem as scary as I thought it might be. We were given a handout showing in detail how we’re supposed to do the passes. I think the main thing I’m questioning is what the difference is between getting a microderm or getting a peel. Why would you want to do one over the other? Is the end result the same?

1. Sharōn Ronen, L.E./Spa Owner - Skin Haven Spa Studio
   April 28th, 2008 at 5:24 pm

   I have been a licensed esthetician for eight years, and a spa founder/owner. I believe microderm is only appropriate for a small portion of the population, quite honestly. However it became very popular and unfortunately is often performed on clients who are not ideal candidates. In addition, with machine microdermabrasion, the esthetician cannot fully control the pressure and intensity, nor can we truly provide the ideal amount of pressure for the various areas of the face.

   I am a big believer in peels because that way you dissolve away the skin’s layers rather than abrading them, which is preferable to most people. With peels, we also have many treatment options in terms of which type of peel to use on which client to best serve their needs and fulfill their goals. For example, acneic clients vs. hyperpigmented clients vs. lightly scarred clients vs. anti-aging concerns can each have a different blend of fruit acids (or retinols) in their peel to serve a specific treatment purpose.

   Everyone has their own opinion, but in my years of experience I have provided many clients with excellent results using peels, and have heard from many of them that microdermabrasion did not come close in terms of results, and often times caused irritation, redness and discomfort.

   I hope that helps!

2. Diana Krueger, Owner/Skin Therapist - Esthetically Yours LLC
   May 3rd, 2008 at 8:36 am

   I agree with Sharon Ronen concerning the overuse of microdermabrasion. It is one mode of mechanical exfoliation and can be hard to control. If you choose mechanical exfoliation, I prefer the Dermafile as you use the various grits of diamond files by hand and have an excellent “feel” for how much pressure you are using. Also, there are no crystals to contend with.
   I do prefer various chemical peels to correct pigmentation, acne, etc. I would strongly suggest continuing education to learn as much about chemical exfoliation as you can. Excellent results can be had with happy clients. Also, do a thorough exam of their skin, lifestyle, products they are using, and medications they may be taking. Some clients are not good candidates because they will not follow the homecare directions.
   Good luck in your future endeavors and keep learning!

3. Vera Gaines, Owner/Esthetician - SKINFIT
   May 4th, 2008 at 7:53 am

   I have been doing Microdermabrasion for 5 1/2 years now and clients love it! Keep in mind that Microdermabrasion works on the surface of the skin, while peels tend to work down into the skin. Depending on the type of peel you use, they have different results on the skin. Which to use depends on their skin and the condition you are trying to improve. Alternating treatments between Microdermabrasion and Chemical Peels work very well for our clients and they love the results.

4. Sandra
   May 5th, 2008 at 11:50 am

   Sharon, Diana, and Vera: Thanks so much for all the information! It does help and I really appreciate it! I’ll be sure to let you all know when I do my first microderm and my first chemical peel.

5. karen g., esthetician - somerset dermatology
   June 7th, 2008 at 5:05 pm

   I like to combine a peel with the microdermabrasion. Pts. love how much more faster the two treatments work together. You have the chemical action of the peel then the physical action of the microderm. I always use a oatmeal mask at the end of the treatment and let the patient rest with this on. Irritation is pretty much gone. And you have a rested pateint. Good luck.

6. Sandra
   June 7th, 2008 at 5:43 pm

   Karen: Thanks! I still haven’t practiced doing a microderm yet, but I have watched a couple. I’m actually going to a chemical peel class tomorrow and I’m looking forward to it. It’s supposed to be a really good class. Thanks for the tip about the oatmeal mask.

7. Monika
   June 10th, 2008 at 6:23 pm

   I agree with Sharon. Peels is the way to go. The majority of my clients get peels regularly once a month. It’s the treatment that you gets the most results hands down. Its proven within 6 treatments your skin radiance and tone go up by 140%! Hyperpigmentation is more stubborn it lightens by 50%, but thats huge. The main goal is to try to get them to peel, its all how you prepare the skin beforehand. But after the downtime the skin is softer than a babies bottom!

8. Sandra
   June 11th, 2008 at 1:03 pm

   Monika: I just went to a peel class on Sunday and it was so interesting. I’m looking forward to doing one (I haven’t yet!) and learning more about them. Thanks!

9. Lynn, Esthestician
   June 19th, 2008 at 11:51 am

   I believe the difference depends on the skin type. If the client has papuals or pustuals, the micro dermabrasion is way too abrasive and would be very irritating. The chemical peel would be much better for this skin type. Also, with the microdermabrasion peel , you do not have peeling days after. With chemical peels, depending on the % percentage , you peel up to 5 days later (possibly more). Also, chemical peels (glycolic, TCA etc…) penetrates deeper into the dermis. I hope this makes sense….

10. Sandra
    June 23rd, 2008 at 9:31 am

    Lynn: I’ll keep that in mind about microdermabrasion being too abrasive for clients who have papules and pustules. I mean, that does make sense. I still have yet to practice one and I’d better get going on that! :) Thanks!

11. Deanna Vaughn, Owner/ licensed prof. - Esthetic Technology Group
    July 24th, 2008 at 10:50 pm

    Sandra,
    To answer your question on which one is better, first you have to understand that all of the things in your treatment room are tools to bring about change in the skin. We use a variety of tools such as products, machines, temperature, touch, technique, etc. It is how you as a professional decide to use these tools based on the clients needs. Each tool you choose is going to give that client a different experience. Some people naturally will like the experience that a peel provides and some will like Microdermabrasion. You should have both so that you can offer a variety of services and be “one stop shopping.” There are many different companies that make various peel products and they can be fun to use with good results.
    I will say this on the machines- there are many makers of equipment and most people pick equipment without really trying to learn what “goes on under the hood.” You drive a car but can you tell me how it works if we lift up the hood? Most will say no. When it comes to doing microderm. you will succeed in providing a great abrasion only if the piece of equipment you are working with is engineered to work effectively. Although it seems like a simple thing to design however it is not. The science is all in the handpiece for it is this small item that most companies fail to work effectively. Think of a handpiece like a garden hose, if you put your thumb on the hose you can control the water spray. Many estheticians have become frustrated with microderm. because their machines are hard to control. For one, most of the companies that sell microderm. units are showing you a technique to do on the skin that will never give you a consistant even abrasion.
    A machine that has separate controls for vacuum and crystal flow will not give you a consistent treament. They actually cannot give you an accurate reading of what pressure you are truly doing on the skin.
    A well engineered microderm. unit should be able to do a consistant even abrasion and allow you good control of the abrasion you are doing.
    Microderm. is good on a variety of clients for face as well as body. My guess is those who say it is not a good tool have never tried a well built piece of equipment.
    With microderm. you can control what you are doing in the sense that you control the speed, intensity, and number of times you go over the same area. If you desire to go back and target a hyperpig. spot, wrinkle, or scar again, you can do so provided the person can tolerate it. Good training will teach you technique and how to calm the skin after microderm.
    Microderm. offers one aspect that peels do not and that is suction. It has been proven by the University of Michigan Derm. that collagen remodelling starts with the very first treatment you do. However to be effective with stimulating new cell production, you will get best results if done in a series of treatments.
    One thing to note is that microderm. removes moisture from the surface of the skin so it is imperative that you do a mask with colloidal oatmeal and products containing hyaluronic acid to calm and hydrate. I love Karen’s post tx. use of a mask. Post treatment discomfort can come from not properly caring for the skin after or from going too aggressive. You should work progressively and not aggressively with microderm.
    The type of abrasion that is done by home kits containing abrasive particles and machines that use a diamond type tip will not give a consistent abrasion because you are still relying on your hand to create the constient abrasion and it is not the same as a well built piece of equipment where the machine controls the output as long as you move it in a certain type of technique.
    I have had times where a client I was working on had certain conditions or facial features that may have not been ideal for abrasion, so therefore I would do a series of 3 micro. tx.’s (one a week) and then a series of 3 peels after (again one each week). You definitely would not do microderm. on inflamed/ infected acne because exfoliation would not be your primary goal. You need to kill bacteria and reduce inflammation while doing gentle exfoliation. Microderm. would cause you to impair the healing process if they were inflamed. I hope this helps you in your quest for knowledge. There is a lot of science around technology and equipment can be one of the biggest investments you make.
    Good luck to you and keep asking questions and learning! Skincare is a very rewarding field!

12. Sandra
    August 5th, 2008 at 11:24 am

    Deanna: We’re shown how to set the machine, but we really don’t know much about them. When purchasing one, what questions would you suggest I ask? I finally practiced doing a microderm and it wasn’t as easy as it looks. It really does take practice and there’s a lot more I need to learn about it. Thanks for the comment!

13. Deanna Vaughn, owner/ lic. prof. - Esthetic Technology Group
    August 7th, 2008 at 11:02 am

    Sandra,
    Ask the following questions:

    1.Can the machine use different types of media (Sodium Bicarbonate or Aluminum Oxide crystals) as well as a crystal-free feature.
    2. Is the machine manufacturer FDA registered? They should be.
    3.Does the machine require you to dump used crystals in a trash can?
    You never want to dump crystals in the trash- it exposes you to debris that can be hazardous.
    4. Does the machine have separate controls for crystal flow and suction (vacuum) pressure?
    You will never get perfect level of either pressure (too much of one and not enough of the other) and ultimately not be able to give client a consistent even abrasion.
    5. Does the handpiece operate at 90degree or 45degree angle?
    Should be 90degree to get the best abrasion. Think of it like holding a flashlight. Holding straight up (90 deg.) will get you a perfectly round circle. 45deg. will unfortunately give you an oval pattern and inconsistent abrasion.
    6. Is there one opening for crystal to come out and one port to allow used crystal to come back in?
    Should be one opening for crystal coming out and multiple openings for used cyrstal to come back in. This will minimize clogging along (especially with 90deg. handpiece).
    7. Handpiece should be able to be autoclaved if necessary- Made out of stainless-steel or aviation grade aluminum.
    8. What kind of pattern does the machine abrade when you test it on a magagzine page with black ink?
    Should be a perfectly round circle that has removed ink from the entire opening of the cap on the end.
    9. Does the machine have the capabiblity of seeing a difference on the magazine if you put it on low, medium, and high settings?
    You should see a difference with each setting without shredding any paper on the highest.
    10. Filtration on the inside of the machines should be .01 micron HEPA air filtration.
    11. Also it should be easy to use, little maintenance, and have things like a good warranty and training.
    For more in-depth answers to your questions please see contact information on http://www.esthetictechnology.com and I would be happy to send you more for you to read to educate yourself!