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1 Text copyright by The International Dermal Institute. No part of this text may be reproduced in any way without written permission from The International Dermal Institute

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3 There are 2 pathways that products and ingredients can penetrate across the skin s barrier in a normal, healthy intact skin. 1. Transepidermal route whereby the molecule transports transcellular (through the cells) or intercellular (lipid bi-layer). 2. Appendageal route comprises of the transport via the sweat glands and the hair follicles. This means of penetration is known as the shunt route. Adsorption: Absorption: Penetration: Enters the skin via: 3

4 The ph of the skin follows a sharp gradient across the stratum corneum. This gradient is maintained by sweat, sebum secretions and cellular metabolism. The acidic surface area of the epidermis becomes more alkaline as we move deeper towards the stratum germinativum and dermis to match the ph of blood and internal tissue at around 7.3. Older terminology used to refer to the transition zone as the Reins barrier, however, this term is no longer used when describing the ph gradient of the epidermis. This gradient is critical in the theory of galvanism as the acid vs. alkali of the two polarities is the principal of how a water soluble substance can be forced through the epidermis depending on its own ph and the polarity used to therefore attract it. 4

5 Two secretions from glands in the dermis come together on the skin surface to form the natural hydrolipid film. This used to be known as the acid mantle. Sebaceous glands secrete oily sebum through the hair follicles and eccrine glands excrete salty moisture onto the surface through the pores. The hydrolipid film acts as a natural barrier to help protect the skin from bacterial invasion. The hydrolipid film derives its name from its mildly acidic ph of 4-6, which repels certain bacteria that prefer an alkaline environment. Age and alkaline cleansing products both have a negative impact on the hydrolipid film. When the skin s ph is taken into an alkaline state the skin will, in time, return the surface to its normal acidic state of a ph of 4-6. However, from the age of 40 and onwards the cell renewal rate begins to slow down and it may take up to eight hours for the skin to regain its acidity. This repeated disruption of the ph of the hydrolipid film will result in a skin that is dehydrated, sensitized and less resistant to bacterial invasion. The ph of a product or the skin surface can be tested by using a specially graded ph pencil, Universal Indicator Paper or ph meter. A ph pencil can be very useful in a skin treatment center to educate clients about the difference between acid balanced and alkaline formulas. The application of electrical currents to the skin will also alter the natural ph of the hydrolipid film in a controlled and beneficial manner for the benefits of skin therapy treatments. 5

6 In skin therapy there are three major uses of direct current; 1. Desincrustation 2. Iontophoresis 3. Electrolysis Direct current flow Galvanic current is a low level, continuous current that flows in one direction. It has a low voltage and medium amperage. This makes it a direct current with dual polarity of a positive or negative charge. For an electrolytic process to occur the following are necessary; A direct current flow of electricity in one direction A pair of electrodes the two terminals of an electrolytic circuit. A pair of electrodes comprise of a cathode and an anode. The cathode which is the electrode connected to the negative terminal power source and has a negative charge. The anode which is the electrode connected to the positive terminal power source and has a positive charge Electrolytes ions in a solution (e.g. ampule/serum/desincrustation solution) A complete circuit the active and indifferent electrodes The direct electrical current of galvanic causes a chemical change in the tissues by reacting with the sodium chloride salts in the body. Direct current treatments rely on the use of dissolved ions to assist in the passage of current through the circuit. Ions are atoms or molecules that possess an electrical charge. Ions dissolved in water are referred to as electrolytes. Tissue fluids are full of electrolytes and therefore can conduct electricity reasonably well. Treatments that based on direct current are also referred to as galvanic treatments. Both an anode and a cathode are required to complete the circuit. The electrode at which the treatment is occurring is sometimes referred to as the working or active electrode, while the other electrode is referred to as the indifferent or inactive electrode. The working electrode may be a roller, a ball or tweezer electrode, ionto mask or a holder in which wetted gauze is fitted. The indifferent electrode is usually a metal rod covered with a damp cloth and held by the client or a dampened pad and placed under the clients shoulder or strapped to the arm. 6

7 For a current to flow, the electrodes must be in contact with an electrolyte solution. In solution, sodium chloride will ionize to give sodium ions and chloride ions. Water will also ionize slightly giving hydrogen ions and hydroxyl ions. The ions move freely throughout the solution however when a current is applied acid builds up at the anode and alkali builds up at the cathode. The use of Galvanic current introduces water soluble substances into the skin to affect various layers of the skin including the stratum germinativum. This process is known as Iontophoresis. The current can also be used to dissolve oiliness and blockages in a process known as desincrustation. Oxidation = addition of Oxygen and reduction of Hydrogen Reduction = addition of Hydrogen and reduction of Oxygen. + - Anode Active pole (oxidation) Salt Bridge (Skin) Cathode Passive / Inactive pole (reduction) Anion (-) Cation (+) 7

8 anode = positive electrode cathode = negative electrode active electrode = the electrode held by the Therapist to complete the circuit indifferent electrode = held by the client to complete the circuit anions = negatively charged ions cations = positively charged ions anaphoresis = the flow of anions to the anode cataphoresis = the flow of cations to the cathode In Galvanic treatments, applicators (electrodes) acting as poles work to either attract the actively charged elements in a desincrustation solution or repel the actively charged elements in an Iontophoresis solution or fluid. As opposites attract each other, so are the positive (+) elements in the substance irresistibly attracted to the negative (-) applicator and vice-versa. Therefore, the substances are PULLED not PUSHED into the skin and penetration occurs as a result of attraction from an opposite pole somewhere else on the circuit. Galvanic current and water provide the ladder across the skin for active substances. Use of the positive pole will give an ACID reaction, and use of the negative pole will give an ALKALINE reaction on the skin, therefore, when both polarities are to be used in a treatment, always finish with the positive polarity. 8

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10 One of the key techniques for treating oily and congested skin is the use of Galvanic Desincrustation. It allows a Therapist to electrically dilate the follicles aiming to soften compacted sebum within the follicle and is usually done prior to extractions or where the skin needs deep cleansing of oil build up. Desincrustation solutions have an alkaline ph, so are negatively charged, so they need the active galvanic electrode to be negatively charged. The client holds the positive electrode and the negative electrode is used as the working electrode. The desincrustation solution is applied to the skin and to the gauze or a sponge over the active electrode and moved around the effected skin area. The alkaline solution is attracted towards the positive electrode in the clients hand, with the negative ions in the solution being repelled from the negative electrode causing an alkaline reaction. Working on the theory that like poles repel and opposite poles attract. The desincrustation solution, combined with the action of the active negative electrode, results in saponification of sebum. The alkali and sebum react to form Lye (Sodium Hydroxide) softening the sebum for easier extractions. As a result of this process, Hydrochloric Acid is produced under the inactive electrode. Because of this, the electrode must always be covered with a sponge or gauze for protection. Desincrustation Effects (-) pole Alkaline reaction Softens the tissues Dilates the follicles Increases blood flow Increases sensitivity Emulsifies sebum Attracts negative ions Attracts hydrogen Desincrustation Uses 10

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12 Galvanic Iontophoresis Using the Galvanic current on the positive polarity is referred to as Iontophoresis. Galvanic Iontophoresis uses an acid ph solution that is water-soluble to achieve deeper penetration of a water-based product. In Iontophoresis, the skin therapist uses the positive electrode to make contact with the skin and the client holds the negative electrode. The negative electrode attracts the acid solution from the positive pole. Galvanic on the positive polarity has a calming and vasoconstrictive effect on the skin, so is not only ideal to help product penetrate deeper, but also helps to reduce sensitivity and redness on the skin. The basic principle of Iontophoresis is that a small electric current is applied to the skin. This provides the driving force to primarily enable penetration of charged molecules deeper into the skin. A positively charged product is placed on the skin under the active electrode. An indifferent counter electrode is positioned elsewhere on the body. The active electrode effectively repels the active substance and forces it into the skin. This simple electrorepulsion is known as the main mechanism responsible for penetration enhancement by Iontophoresis. The number of charged molecules, which are moved across the barrier, correlates directly to the applied current and thus can be controlled by the current density. Iontophoresis Effects (+) pole Acid reaction Tightens and firms tissue Constricts the follicles Decreases blood flow Decreases sensitivity Reduces edema Attracts oxygen Attracts positive ions Iontophoresis Uses Oil controlling serums Vitamin masques or concentrates Pigment brightening serums Hydrating masques Treatment moisturisers Oxygen serums Skin firming boosters 12

13 Tired Eyes - reduces puffiness, firms and regenerates Pigmentation - active ingredients help to lighten pigment and balance pigment production Aging - deep penetration of active ingredients to stimulate cell renewal and improve skin vitality Acne - the deepest form of cleansing for problem skins also helps to control oil and soothe inflammation Dry, devitalized dehydrated skins - infuses the skin to restore critical moisture levels to tired skins Rosacea & sensitized skin calms, soothes and constricts blood vessels When choosing to perform a treatment incorporating electrical modalities, a consultation is essential. An in-depth consultation will reveal any contra-indications to your planned course of treatment, and will also give you a glimpse into the client s current regimen and their expectations of your services. Keeping your consultation cards up-to-date will not only allow you to chart your clients progress, but will also be a vital legal record of whether or not each client has accurately disclosed related medical conditions (normally the most neglected part of the treatment). The consultation also helps you to ensure you have addressed their concerns. Key reasons for client consultation cards: - Ensures that treatments are carried out safely. They must sign the card - this is the Therapist s professional protection. - Produces a positive response from the client as their needs and concerns are being heard. - Makes the client focus on the treatment: skin health versus a treat! - Respect for the Professional Skin Therapist, through the education and insight they can provide about the client s skin condition. When looking to introduce electrical modalities, pay particular attention to answers for the following questions: - In the last year, have you been under a Dermatologist or Physician s care? - Do you have metal implants, a pacemaker or body piercing? - Have you had chemical peels, microdermabrasion or any resurfacing treatments? - Are you pregnant or trying to become pregnant? 13

14 Before commencing a skin treatment incorporating electrical modalities, it is vital to check that the client is not contra-indicated. The following is a guideline for some of the contra-indications to electrical modalities. If your client has a medical condition and you are unsure whether your client is contra indicated to electrical treatments, ask them to consult with their physician and provide you with a permission note to proceed with the treatment. Contra-indications: Diabetes Epilepsy Pacemakers Pregnancy Electro-phobia Cuts, abrasions, open sores Infection Asthma Metal implants, pins or plates Clients wearing jewelry Loss of skin sensation High blood pressure 14

15 1. Check safety, functioning and preparation of machine (-) polarity if for desincrustation. 2. Consultation. 3. Cleanse eyes and lips and cleanse twice. 4. Perform exfoliation. 5. Saturate sponge or gauze in Desincrustation solution and attach to working electrode. (-) 6. Cover indifferent electrode (+) with damp sponge or gauze and place behind the client s shoulder or in client s hand. 7. Apply remaining Desincrustation solution to clients face (T-zone). Perform desincrustation for 4-7 minutes. 8. Contact working electrode with clients skin and turn intensity on and up. Do not go higher than 2 milliamps. Do NOT stop moving the electrode. 9. Turn machine down and off before removing from the skin. Remove Desincrustation solution with damp sponges. 10. Complete extraction work and rinse the skin. 11. Application of a complex and gel masque is recommended for Iontophoresis on the (+) polarity for 4-7 minutes. 12. Remove residue from skin with damp sponges. 13. Tone, eye treatment, moisturize and sun protection. 15

16 The high frequency current is an alternating radio current called the Tesla Current. The glass electrodes are filled with a gas, either Argon or Neon. If the electrode is filled with Argon gas it produces the familiar violet ray. If the electrode is filled with neon it produces an orange/red ray. Both gases have similar effects, but argon is used on acne-type lesions, whereas Neon is used on general oily-type skins or to create warmth in a localized area for improved product penetration. High Frequency does not stimulate motor or sensory nerves due to its high oscillation, but stimulates the surface tissue, generating heat in the subcutis and increasing blood and lymph fluids. The Tesla current is conducted to the gas where it ignites. The gas is inert and in a vacuum so it is quite safe and stable. Once the gas ignites, light energy is given off which forms Ozone around the glass electrode. When the oxygen, naturally present in the air around the electrode, is electrified it forms ozone gas. Simply, high frequency forms ozone gas close to the skin surface which has a germicidal, healing and drying effect. The more oxygen that surrounds the electrode, the more ozone is formed and the greater the effect. Therefore, when the electrode is lifted away from the skin surface, and more oxygen surrounds it, a more intense drying and healing action occurs. This method is called "sparking" and uses the electrode on acne-type lesions. We achieve a "spark gap" by laying layers of dry, cotton gauze over the skin, thus creating a narrow space between the skin and the electrode for ozone to form in. Never create a gap of more than ¼ ( ½ cm), as tissue destruction can occur and the skin will heal leaving brownish marks. 16

17 Direct High Frequency is an external application that produces a germicidal effect through ozone formation at the skin's surface, via the glass electrode, where the air sparks between the electrode and the skin combines with oxygen. Uses for Direct High Frequency: 1. Acne-type lesions using an argon gas electrode for a "sparking" treatment. 2. Oily skins with overall congestion using a neon gas electrode for drying and germicidal effects Indirect High Frequency is the use of the current for relaxation and sedation. Unlike the direct method the current flows through the surface of the body, and has a regenerating action. Uses for Indirect High Frequency: 1. To aid penetration of a treatment cream/ampule by increasing blood flow in certain areas, whereas infra-red or massage would stimulate the entire face. 2. To assist in massage for an aging skin using the indirect method. 17

18 Effects: Germicidal - Healing - Drying - Effluvation - Indications for Use: Oily, congested skin Seborrhea Acne Method of Work: 1. Apply dry gauze and eye pads. Gauze may be layered to create spark gap. 2. Place electrode in working hand and make contact with finger before placing on skin surface. 3. Increase intensity and move lightly across the gauze in circular movements. 4. Superficial light movements have the greatest intensity. 5. Do not increase spark gap more than ¼ ( ½ cm). Continue working for up to five minutes. 6. Remove electrode by placing finger on the electrode, lift off the skin. 7. Switch machine off. Products to look for: 18

19 Effects: Stimulates - Stimulates - Stimulates - Stimulates - Indications for Use: Aging and loose skin. Post-operative skin conditions. Recent scar tissue (between 4-9 months). Clients who dislike firm pressure massage. Method of Work: 1. Prepare skin with massage cream providing slip and glide. 2. Remove all jewelry from client and operator. 3. Client holds glass saturator electrode. 4. Operator places one hand on client s forehead and turns up machine with other hand. 5. Both hands are now placed in contact and rhythmical massage commences over face and upper body. 6. One hand must remain in contact at all times to keep current flow continuous for approximately 8-15 minutes. 7. Small frictions are beneficial around the mouth and eyes. 8. Release one hand from the client to turn down and switch off the machine. Products to look for: 19

20 Check safety, functioning, and preparation of machine with electrodes. 1. Consultation. 2. Cleanse eyes and lips and cleanse twice. 3. Analyze skin. 4. Perform exfoliation. 5. Complete Desincrustation and extraction work if necessary; rinse the skin. 6. Apply dry gauze to the eye area. 7. Apply Benzoyl Peroxide preparation directly to problem areas with fingers and then apply a fine layer of a gel based masque over the top with a fan masque brush; allow to dry. Apply 1 layer of dry gauze. (Option: Benzoyl Peroxide may be applied directly to the skin without a gel masque). 8. Place mushroom electrode in working hand and make contact with finger before placing on skin s surface. Once in contact, remove finger to allow the current to flow. 9. Increase intensity and move lightly across the gauze in circular movements. Superficial light movements have the greatest intensity. 10. Do not increase spark gap more than ¼. Continue working for up to five minutes. 11. Remove electrode by first making contact with finger, then remove from the skin and turn machine off. 12. Remove gauze, then remove residue from skin with damp sponges and follow with a solution for post extraction (if extractions were performed). 13. Apply chosen serum or complex followed by appropriate masque. Remove with sponges or steam towel. 13. Tone, eye treatment, moisturize and sun protection. 20

21 Check safety, functioning, and preparation of machine with electrodes. 1. Consultation. 2. Cleanse eyes and lips and cleanse twice. 3. Analyze skin. 4. Perform exfoliation. 5. Apply 6 drops of a chosen Essential Oil Blend to suit the client s skin concerns. 6. Apply Massage cream. 7. Keeping one hand in contact with the clients skin, turn on the High Frequency current. Once the current is at a comfortable level, perform light European style movements over the face and upper body for a period of 8 15 minutes. One hand must stay in contact at all times to keep current flow continuous. 8. Upon completion, release one hand from the client to switch off the machine and then remove the other hand. 9. Sponge remove massage cream and finish with a steam towel. 10. Apply chosen serum or complex followed by appropriate masque. Remove with sponges or steam towel. 11. Tone, eye treatment, moisturize and sun protection. 21

22 1. Consultation. 2. Cleanse eyes and lips 3. Cleanse twice. 3. Analyze skin. 4. Exfoliation. 5. Apply Desincrustation solution. 6. Perform Desincrustation for 4 7 minutes on the negative polarity. 7. Complete extraction work and rinse the skin. 8. Application of a Benzoyl Peroxide preparation and gel masque is optional, cover with dry gauze. 9. Perform Direct High Frequency over gauze using the mushroom electrode for 3 5 minutes and rinse skin 10. Apply a Post Extraction Solution to areas where extractions were performed 11. Optional : Perform Indirect High Frequency over massage cream for 8 15 minutes and rinse skin. * would follow step 4, replacing steps Perform Iontophoresis with a serum, complex or gel masque (serum/complex added to gel masque base - optional) on the positive polarity for 4 7 minutes. 13. Rinse skin 14. Tone, moisturize and sun protection On the Menu Galvanic Current: This intensive treatment uses advanced technology with specialized formulas to provide key skin benefits. We will address specific skin concerns and achieve long lasting results. Direct High Frequency: This intensive treatment uses the latest technology to deeply purify and promote healing of the skin. Ideal for acne and problem skins that experience breakouts! Indirect High Frequency: Combining the benefits of technology and touch, this deeply relaxing European technique boosts circulation, nourishes the tissues and re-energizes tired stressed skin. 22

23 Skin Condition Oily blockages, microcomedones and stubborn blackheads. After extractions of microcomedones, comedones, milia. Aging, loose, post-operative skin, recent scar tissue. Leathery, resistive aging skins. Thickened oily skins. Young resilient skins. Indicated Treatment 4 minutes of galvanic current on negative polarity with desincrustation solution prior to extractions. 5 minutes of direct high frequency immediately after extractions. European massage with indirect high frequency for minutes. A massage cream may be used. Galvanic current on negative polarity with desincrustation solution (4 mins) followed by positive polarity with a complex, serum, or masque (4 mins). Reasons Negative polarity dilates follicles and softens comedones. Produces ozone gas which will help heal and dry breakouts. Allows a light pressure to stimulate blood flow. No stretching of skin. Negative polarity cleanses, softens skin and promotes absorption of Products that follow. Positive polarity seals in benefits. 23

24 Skin Condition Couperose, sensitive and delicate skins. Pustules, papules and inflamed acne lesions. Oily, infected, seborrheic and congested skins with dehydration. Wrinkles and premature aging. Indicated Treatment Galvanic current with a serum, complex, or masque. 4 minutes positive only 5 minutes direct high frequency at the end of the treatment over dry gauze. An oxygenating gel/cream may be used underneath the gauze. 5 minutes direct high frequency with neon gas electrode over dry gauze. For use after extractions. Use indirect high frequency and a moisturizer with fingertip massage over obvious wrinkles at the end of the treatment. Reasons Positive polarity reduces redness and sensitivity. High frequency creates ozone gas when in contact with oxygen - bactericidal effect. High frequency will have a germicidal action but no spark is created due to neon gas. Allows for warming of skin and therefore absorption of the product without stretching or pulling the skin. 24

25 Cleanse Exfoliate Pre extractions Extractions Post extractions Massage Serum/Complex/Masque Moisturize Home therapy prescription 25