Truth or Consequences: Separating Fact from Fiction

Winter 2009 DISTRIBUTOR OF Truth or Consequences: Separating Fact from Fiction 20 Skin Care Myths By Carol and Robert Trow Excerpted from a future article to appear in Skin Inc Skin care professionals and consumers are bombarded daily with a myriad of information about skin care, skin science, and skin health from the media, manufacturers and an ever increasing number of physicians, all attempting to justify that what they profess and advocate is the truth and nothing but the truth. Sometimes what is claimed accurate, is sometimes not. More often, the truth may lie somewhere between these two poles. Everyone from David Letterman to mass market publications proudly announce their top ten list. Well, we are no different except ours focuses on 20 skin care myths. We are proud to throw our hat in the ring and offer up a variety of skin care facts not in priority order that may well call into question some common beliefs and long held traditions. See how many you agree with. Let us know those we may have missed. This list is not meant to be all-inclusive; but, hopefully to start you thinking about what is real, how you know it is real and to question those who make a variety of claims about their products, ingredients and the science behind them. Our role as skin care professionals has a large educational component that mandates that we remain current in our field as well as provide education on skin health to our patients and clients. Sharing these myths with consumers will help to strengthen your credibility as a skin care expert. Remember, you are not selling hope in a jar, but rather providing realistic and truthful solutions to help deal with extrinsic and intrinsic aging. MYTH: Higher SPF ratings are better. SPF ratings, soon to be revised by the FDA, only refer to protection from UVB rays. One needs sun protection that has chemical and physical blockers plus antioxidants. A higher SPF also gives a false sense of security and introduces more potentially harmful chemicals to one s body. Plus, SPF 50 is only marginally more protective than SPF 15. Sunscreens need to be re-applied every 90 to 120 minutes. Fact: SPF 30 has only 2% more protection than SPF 15, and SPF 40 has only 1% more than SPF 30. MYTH: Layering several products with SPF ratings increases protection. You are only protected to the extent of the higher rating of one product. A foundation of 10, moisturizer of 15 and a sunscreen of 20 does not yield a rating of 45. MYTH: Topical creams containing collagen can replace collagen. There is a lack of impartial, empirical evidence that topical application of collagen or elastin can penetrate the dermis, even with nanotechnology. These can provide moisturization to the epidermis. Injections and use of vitamin A and C are effective. MYTH: Natural or organic products are always better. Buyer, beware! Many natural and organic products are not as they claim. Plus, many times, active ingredients have to be synthesized to be bio available and efficacious. Synthetic compounds can actually be identical to those found in nature and be more effective. Natural vs. laboratory-processed should not lead to an up or down decision on whether a product is good or bad. Not all chemicals are bad and not all natural or organic ingredients are good. MYTH: Using larger quantities of a product will yield better results. Less is more. Normally, a pea sized amount of product will do the trick. Excessive amounts of product can cause skin problems and waste money. MYTH: Mineral oil is bad for your skin. Today s cosmeceutical mineral oil is a far cry from the industrial type that was previously used on skin. Mineral oil is a very effective ingredient in helping remove excess oil from the skin. Oil attracts oil and the modern mineral oil formulated for use in skin care has a different molecular weight and will not harm skin or clog pores. Mixed with kaolin, fine clay, it makes a potent cocktail to assist in controlling oil production in Continued on page 5. A H E A L T H Y S K I N F O R A L I F E T I M E Page 1

Resurfacing Facial Protocol 50 Minute Treatment A Revitalizing Peel with Vitamin-infused Soothing Mask Makeup Removal: Remove makeup with Eye Make-up Remover. If necessary, apply Aquatrol to remove foundation or waterproof mascara. Wipe off with warm towels or cotton/sponges. Pre-Cleanse: Apply Aquatrol to the face, neck and chest. Apply Claytech Masque over pre-cleanser and massage for 2 3 minutes. Cleanse: Apply Cleansing Gel. Remove with warm towels or cotton/sponges. Tone: Apply Alpha Toner Forte with cotton to face, neck and chest. Peel: Apply with a brush peel of choice for appropriate amount of time based on client s skin type: Greetings We recognize that the current economic environment places a strain on everyone. DermaConcepts is committed to work with you and your staff to provide support in every possible manner. For 2009, prices will remain the same. As you can see in this issue of our newsletter, we are launching several new products (C-Quence Lip Balm, Serum C-Quel 2 & 3, and the Home Peel Kit). An additional new generation of vitamin A products is on the horizon for this spring. Our professional treatment protocol series is available at no charge, just for the asking. Copies of a myriad of articles on skin health, skin science, and how to build your practice are always accessible on our website (). A new, expanded website with refresher information, product knowledge and lots of other goodies is planned to go live no later than March, 2009. We have been offering customized pre- and post-procedure protocol kits for many practices. In response to their success, we have put together a series of take home product kits based on specific skin profiles at a discount (see page 5). As a reminder, there are no minimum orders, free shipping on orders over $1,500 and a 5% discount plus free shipping on those above $2,000. Finally, be sure to sign up early for the Advanced Skin Analysis seminar by world renowned author and educator Florence Barrett-Hill. Limited enrollment classes will be offered in Atlanta and Boston. (Order form on inside back cover.) Warm regards, Carol and Rob Trow LAC-PAMGEL 10% (sensitive and Fitzpatrick IV VI skin type) ACM#1 TCA 2.5% Cream Mask (first time peel, normal skin) TCA PAMGEL 1% and 2.5% (oily, congested skin) Neutralize: Apply Peeling Neutralizer over peel; remove with Cleansing Gel. Treatment: Apply with a brush a thin layer of Serum C-Quel and a small amount of Moisture Gel to face and neck. Masque: Place tissues along the hairline. Mix 2 level scoops of Alginate Masque powder with 3 measures of tepid water in rubber bowl. Apply and allow to set. Masque may be left on for 5 10 minutes. Remove Masque and massage in any excess products. Protection: Apply Original Eye Gel and RAD SPF 16 (am) or Alpha Day Lotion SPF 15 (am), or Debut (pm). Happy New Year from the DermaConcepts office staff! (Left to right): Kaylyn, Kaela, Adrianne, Nicole, Marie, Lisa and Tainah. Questions & Answers: Ask Environ Q: What are the differences between LED and IPL? A: Light Emitting Diode (LED) is a natural, non-ablative method to aid in skin rejuvenation. Yellow light assists with photo-rejuvenation, blue light helps with acne and red light serves as a photo-dynamic therapy. Combining light sources in a series creates a more effective treatment regime. Intense Pulse Light (IPL) transmits a broad spectrum of light through a small, smooth hand piece gently placed over the skin. The light penetrates the tissue and is absorbed by the blood to improve vascular conditions and/or reduce pigmentation. IPL can be helpful in the reduction of erythema, flushing, photo-aging, pigmentation and acne. Using LED and IPL in alternating series normally provides more effective results than the use of each method on its own. The most effective treatments combine LED, IPL, mild peels (lactic and low level TCA) and home skin care products that contain the following in significant concentrations: vitamins A and C, antioxidants, peptides and growth factors. Have a question to Ask Environ? Email us at info@dermaconcepts.com. Page 2

New Products Launched! C-Quence Lip Balm Environ s new C-Quence Lip Balm nourishes and cares for your lips, leaving them naturally soft and supple. The formula contains UVA and UVB filters that provide an SPF 25, protecting against premature aging, UV damage and wind-burn. It is 100% fragrance free. This vitamin-rich, enhancing lip treatment softens and hydrates. It contains antioxidants such as Lutein (vitamin E) and vitamin C which reduce the appearance of fine lines and ward off free radicals, leaving lips with a healthy glow. The hydrating formula soothes dry, chapped lips and assists in stimulating collagen production for fuller, more lustrous lips while helping to control uneven skin tone. Ingredients such as shea butter and bees wax deeply hydrate and moisturize while rosemary extract provides anti-bacterial qualities and Squalane, a plant derivative, improves skin elasticity to ensure smooth, supple lips. Serum C-Quel 2 & 3 Serum C-Quel 2 contains vitamin A (Retinol) and vitamin C (Sodium Ascorbyl Phosphate). It can be used on clients who have previously had Serum C-Quel 1 treatments or who are using Environ Original Mild Day and Night creams or C-Quence 1. It is available in a box of 2 x 10ml bottles Serum C-Quel 3 contains vitamin A (Retinol) and vitamin C (Sodium Ascorbyl Phosphate) and can be used on clients who have previously had Serum C-Quel 2 treatments or who are on the Original Ultra Day and Night creams or C-Quence 3. It is available in a box of 2 x 10ml bottles. TCA Home Peel Kit Reduce the amount of time you need to spend with patients by giving them the TCA Home Peel Kit a safe, easy-to-use peeling treatment that they can use in the comfort of their own homes. This kit is excellent for: softening superficial lines and wrinkles; improving sun damage; improving hyper pigmentation; reducing scars (with the exception of Keloid scars); improving problematic skins prone to breakouts with or without scarring; reducing upper lip lines; and improving general skin texture. TCA peels typically tighten the skin and provide a lifting effect. Post-peel, the skin appearance will continue to improve for 14 to 21 days! It is recommended that the Environ Original Range (topical Vitamin A) is used for at least 3 weeks to a month prior to commencing peeling treatments. The Home Peel Kit should be sold only after consultation and review with a medical practitioner. Contains: 25 ml ACM2 (Trichloroacetic Acid), 30 ml Alpha Toner Forte and a Peel Brush. New Year s Specials* Valid thru June 30, 2009 Jump Start Your New Year Sales with these pre-assembled at-home kits. Beginner Regimen Toner Mild Original Eye Gel Debut RAD Claytech Masque Accelerated (Anti-Aging) Regimen C-Quence 1 C-Quence Cream C-Quence Eye Gel C-Quence Toner Rejuvenating Body Regimen DermaLac EssentiA RAD Pigmentation (Clarifying) Regimen Clarifying Lotion C-Quence 1 C-Boost RAD Dry Skin Regimen Aquatrol Claytech Masque Super Moisturizer Rich Night Cream Hydration Oil Capsules *Please Call Us for Special Discounted Pricing! Note: All previous specials expire on 1/31/09. Page 3

Hydroquinone: The Controversy Continues By Carol and Robert Trow Australians have long known about boomerangs. When thrown properly, they fly away only to return. In the classic horror movie Poltergeist, everyone thinks the monsters are gone. When they awake, the little girl exclaims They re back! The iconic baseball player Yogi Berra once said It ain t over til it s over. Like these examples, the hydroquinone safety debate is back with additional funding. The use of hydroquinone in overthe-counter cosmeceuticals has been banned in many countries but not the United States. The Center for Food, Safety and Applied Nutrition which oversees the Office of Cosmetics and Color has obtained $66.8 million, a part of which will be used to address yet again the safety of hydroquinone in skin bleaching products. Finally, a revolutionary alternative to hydroquinone. EVENESCENCE Introducing the new Skin Lightening Range to assist in the improvement of dark blemish marks, age spots and uneven skin tone. Clarifying Lotion Fragrance/preservative-free, non-oily. Can be used on individual spots or on the whole face and neck. DISTRIBUTOR OF DermaConcepts 508.539.8900 A HEALTHY SKIN FOR A LIFETIME is a distributor of Environ Skin Care for the Eastern United States. Hydroquinone has been acknowledged as a potential carcinogen and cause of other skin problems and is currently banned in a myriad of European, Asian and African countries but not in the United States. What does the rest of the world know that we don t? The ongoing debate about the safety of using hydroquinone as a skin lightening ingredient in over-the-counter products has raged for 40 years. Over the past two years, the FDA has been accepting comments in response to a proposed ruling issued August 29, 2006 (21 CFR Part 310 1978N-0065) that would require products containing hydroquinone to be removed from over-the-counter status. The FDA simply said that over-the-counter products containing hydroquinone are not generally recognized as safe and effective, and are misbranded. In response to this proposed ruling, the FDA received untold numbers of responses from skin care manufacturers, dermatologists, and physician associations, such as the American Academy of Dermatology, taking issue with the FDA s safety concerns. The majority of responses to the proposed removal of hydroquinone as an over-the-counter skin bleaching ingredient came from physicians who felt that their frequent use of hydroquinone had not resulted in their seeing health problems and that it is a cost effective and efficacious way to treat skin conditions such as hyper pigmentation. This group urged the FDA to withdraw its proposed ruling. On the other side, there are other groups of physicians who state that they strongly agree with the FDA s proposed decision to ban hydroquinone as an over-the-counter ingredient and urge that the testing requirements for approval are conducted pursuant to a new drug application (letter to the FDA from Dr. Alan Fleischer, a noted Professor of Dermatology). Some additional governmental bodies, notably the City of New York s Commissioner for Consumer Affairs, Mark Green, entered the ongoing debate as early as 1992 by calling attention to fifteen (15) studies which questioned the safety of bleaching creams (May 20, 1992 letter to FDA). Again, in December, 2006 when the hydroquinone issue resurfaced, The City of New York strongly supported the FDA s proposed rules to limit access to hydroquinone. The FDA received a letter from the American Academy of Dermatology Association (December 27, 2006) signed by Dr. Stephen Stone opposing the potential ban. His letter is available on the FDA web site. We can only hope that the additional studies that may come from the proposed governmental funding may put to rest the seemingly never ending controversy on the safety of hydroquinone. To learn more, go to the FDA s website at www.fda.gov and search hydroquinone. While the order of information may be misleading, read at least the first 50 references to get a feel for the issues. The lurking question: what caused over 50 countries to severely restrict the use of hydroquinone while the United States has not? Page 4

Truth or Consequences, continued from page 1. problematic skin. Vitamin A is the best ingredient to normalize skin. MYTH: Mineral oil is comedogenic. Cosmeceutical grade mineral oil is not comedogenic. The myth is that industrial grade mineral oil and lubricants are the same as those used in cosmetic ingredients. So-called medicinal, white mineral oil has met stringent safety standards. To remove sebum plugs in the follicles, one needs an oily based substance. Water based products cannot melt or remove sebum plugs. MYTH: Preservatives in skin care products are bad. Preservatives help prevent the growth of bacteria, fungi and other organisms that would not only deteriorate the product s effectiveness and spoil the product but also allow harmful bacteria to get on or in your skin. While there is concern over the use of parabens, the research is not definitive that topical application leads to harmful accumulations. Parabens are found throughout nature. For example many fruits and vegetables such as strawberries are naturally full of parabens. But, further study is needed. MYTH: Packaging is not important. Packaging in skin care is vitally important. Not for aesthetic reasons but rather to protect the efficacy of product ingredients. Wide mouth jars, transparent containers and pumps that are not airless all pose problems in keeping ingredients safe and potent. MYTH: Blackheads are caused by improperly cleansed skin. Blackheads or comedomes are caused by clogged pores. Excessive scrubbing can irritate and further inflame skin. Blackheads often contain dirt, oil, and dry/dead skin cells that need to be removed. Products that help dissolve sebum are most effective. MYTH: Drying problematic or oily skin clears up acne. The opposite is true. When we over dry skin, we are creating an environment whereby the skin is signaled that it is too dry and therefore produces more oil. Use drying products sparingly and look to lightly moisturize oily skin. The goal is to keep skin balanced. MYTH: Get a base tan to prevent burning before going on vacation. Any tan is a scar. There is no such thing as a healthy or safe tan. Self tanners are safest. MYTH: All sun damage to skin occurs before eighteen years of age. Sun damage continues to occur throughout your life. Recent information suggests less than 50% of sun damage happens before one is eighteen. It is never too late to protect your skin. MYTH: Antioxidants reverse wrinkles. Antioxidants are essential in fighting free radical formation and are important in helping to prevent skin damage. But, they cannot make wrinkles go away. MYTH: Skin damage and the signs of aging can be cleared up quickly. If a product sounds too good to be true, you can bet its claims are false. The damage did not happen overnight and cannot be magically repaired. Expect at least three skin cycles (a cycle can be between 21 40 days depending on age) to begin to see measurable results. MYTH: All alcohol in products is bad. Some compounds that contain alcohol can act as emollients which can decrease the skins water loss. Cetyl, benzyl and oleyl alcohol are examples of good alcohols. Know what comes before the OH in chemical compounds. MYTH: Sun exposure will improve acne. No, sun exposure can only hide its appearance for a while, but will lead to skin damage, pigmentation, and a drying that signals the skin to produce more oil. MYTH: Skin care products can last three or more years. Despite a myriad of claims to the contrary, most skin care products lose a great deal of their potency within twelve months. It is best to use the entire contents within one year. Preservatives do not last forever. Ingredients can get contaminated with bacteria or evaporate. MYTH: Strong scrubs, soaps and abrasives are good for your skin. Be careful how you wash your face. Too much scrubbing or abrasive products can remove protective oils, create tiny, micro tears and contribute to aging, irritated skin. Less is more. A gentle cleanser and light moisturizer works well for most people. MYTH: Vitamin A thins the skin. Actually, the reverse is true. Skin can become thin due to the lack of vitamin A. Vitamin A helps to create new, healthy, and normal skin cells. Vitamin A is arguably the most important skin care ingredient, bar none. It is one of the few if not the only ingredient that is backed by over a half century of objective, scientific research supporting its efficacy. MYTH: The only form of vitamin C that works is L-ascorbic acid. First, a trick question. What is the color of L-ascorbic acid? It is clear, the color of water. L-ascorbic acid only remains in its most potent state for a limited time. A new era in vitamin C formulations, one of the best antioxidants for your skin, has arrived. There are several forms that have been developed such as VC-IP that are not water based which means they can better penetrate into the skin and remain more potent for longer periods of time. MYTH: There is one antioxidant ingredient that is best. Every year there is a hot newly discovered antioxidant that is touted as the best. Not true. A cocktail of antioxidants provides better results than just one. Look for products containing a plethora of antioxidants. We hope you have found this list of skin care myths informative. For many of you, some are familiar. And for your patients or clients, and newer staff, they may prove to be enlightening. If you d like to share any other myths that you find interesting, please email them to info@dermaconcepts.com. Page 5

Retail Sales & Service Upgrades Turning Ideas into Action A How to Guide By Carol and Robert Trow Excerpted from Skin Inc, Month 2008 (Second of a Two-Part Series) Last issue highlighted the critical case for improving retail sales and service upgrades as an essential building block to ensure the financial viability of a spa or med spa. This issue we are going from theory to practice. Sell though Education In the spa, selling must be based upon education. The more you and your staff know, the better they can impart knowledge to their patients and clients which in turn will yield better treatment results and increased retail sales. Again, it is about educating not selling. The skin care professional must create an at home skin care protocol that will extend and compliment the results of whatever professional treatment or service that a client has had. Link specific products DermaConcepts Appointed NYC Metro Distributor We are pleased to announce, effective immediately, DermaConcepts has been appointed the Environ distributor for the New York City Metro Region including all of Connecticut, New York and New Jersey. Regional in-person trainings will start in January 2009. Our entire team of trainers and account managers welcome our newest clients and look forward to supporting the new members of our extended family. Environ in the News The past few months have seen much press coverage for Environ and its staff in the U.S. These publications have praised our products in their editorial or products sections: Elle (Sept 2008), InStyle (Nov 2008), Skin Inc (Nov 2008). with specific services and treatments to create a pre and post treatment protocol. One important caveat: if you carry more than three lines, it will be hard to get the support, financial and other, from a vendor. Do not spread yourself too thin. If you carry too many lines or only a product or two from a vendor, support may be hard to come by. If you invest in a vendor, they will invest in you. Private label may also have a role but beware as most private label products do not carry with them all the training and support needed to grow your business. Ensure the lines have different selling points. Carry six deep of each item. Establish a clear retailing strategy. If you need assistance, look to a vendor who acts as a strategic partner to help. Read professional journals and magazines like Skin Inc regularly to get ideas. Find ways to network with your colleagues. Make sure that you set aside time for ongoing training of your staff so they can develop selling skills and product and protocol knowledge. One way is to insist that vendors conduct monthly product knowledge sessions for your team. Establish Job Expectations Hire for success. Make sure everyone on your staff (front desk personnel, skin care professionals, nurses and even the office manager) understands that selling retail products is part of their job. If this is not reinforced regularly, you will have a very limited chance of succeeding. Continually clarify job responsibilities, driving home the obligation of all staff to participate in the retail selling process. Teach your staff to create a short dialogue, relating the services a client is signing up to receive or is receiving to home care products. In effect, have your team become treatment tour guides. They need to be mindful that less is more conversations Keys to Your Retail Success Superior service that provides results. Fluff and buff treatments lose appeal. Outstanding customer service. Treat clients like guests at a 5-star resort. Demonstrate good listening skills. Commit to ongoing staff education and training. Pick vendors carefully. Select limited distribution, destination products. Hire for success. Establish realistic sales goals. Reward performance. should be short and to the point. Any conversation with a patient or client needs to focus on what the client wants to improve upon, not what the skin care professional initially thinks is wrong with an individual s skin. You are in essence, borrowing someone s watch to tell them the time. Ask questions, don t tell. Do not underestimate the importance of front desk personnel to the sales process. They need to be rewarded as well for success. All too often, the front desk staff are the first ones to gain a client s trust which begins by answering the phone, making an appointment, greeting them at their first service and speaking with them as they exit the spa. Simple etiquette goes a long way. After a treatment, the service provider should walk the client to the front desk, ensuring all is well and let them know what products you have recommended for at-home use. The front desk personnel should help them close the sale. Training Selling is a learned skill. You must assume that your staff comes to you with little if any sales training. Establish a structured program to teach them how to recommend products and upgrades. One of the most effective tools is role playing. Start every day with one member of the staff being assigned to speak on the key selling points of a line or specific product. Look to your suppliers as well to do this for you invite them in to conduct training on-site and to provide the Continued on back cover. Page 6

Retail Sales, continued from page 6. incentives for your staff if they are successful. Have the Right Products and Vendors To ensure you are carrying the right products, make sure they are selected to meet the clients needs, not yours. Commissions, Incentives and Contests Think about assigning one person to be the retail driver, focusing on keeping track of what is selling and by whom. Paying commissions is not effective unless you monitor performance and provide feedback every month to your staff. Essentially, an incentive program should be purpose driven. Pick an area you want to see improvement in such as the number of items sold, the average sales per skin care professional or front desk person or promotion of a specific item or line. Be clear how success will be measured. Make the reward clear. (See sidebar for some ideas.) Make Vendors Strategic Partners How should you pay for these rewards? By now you can guess our answer, get your vendors to chip in, supply free products, cash and the like if their products are at the center of the contest. It is a win-win situation. All vendors can not do all of the following but you should ask them what of the list they will do for you. If they do not do what you need, move on. The options include: no minimum orders, seasonal incentives, participation in employee incentive programs, employee discount programs, education and training programs, marketing and open house support, trade out/buy back program, direct ship to clients, newsletter support, collateral materials at little or no cost, special discounts for testers, no questions asked returns, visitations, technical support, hotline, protocol development, signature treatment design, menu assistance, and a speaker s program. Retail Space Your retail space should be neat and clean, provide good visibility, create excitement and be easily accessible. It should also be educational and informative organized by collection, range, order of application (e.g. cleanse tone, treat, protect). Allocate at least 15% of your space to retail and keep impulse items by the check out station. Also, remember that most woman average 5 5, so keep things as best you can at eye level. You should be able to measure your sales as a percentage of total spa revenue; by type of item sold (skin care, spa accessories, gift, or apparel); retail sales per ticket; sales by staff member; and sales per sq. ft; and inventory turnover by item. A simple fact: higher retail sales and faster turnover = greater profits. You should look to turn over your inventory every 60 to 90 days. Finally, all of the above lead to a retail sales program [1] that has you preparing for a sale with product knowledge; selecting the right product mix; making sure your skin care supplier is a strategic partner not a vendor; making the investment in training and educating your staff; asking and discovering your client s needs, initially ask, do not tell; present products as solutions and a continuation of professional treatment protocols; practice overcoming objections; and close the sale. Never forget to follow up with calls after their visit so you can build on the initial sale and translate it into future visits and additional product sales. 766 Falmouth Road, C-17 Mashpee, MA 02649 Tel: (508) 539 8900 is a distributor of Environ Skin Care for the Eastern United States. Incentive Program Ideas Up Up and Away: Fill balloons with coupons for prizes and money. When a target/goal is hit, the staff member breaks the balloon and wins the prize. Off to the Races: Set up a race track on a board. Assign each staff member a horse. The first one around it wins. Poker: For each target achieved, give a card from a special deck. At the end of the contest period, the one who can make the best poker hand wins. Pass the Buck: The one with the highest single sale of the week, largest upgrade, etc. gets $25 or $50 and hold onto it. As each subsequent sale is larger, the one holding the money has to pass it to the new leader. The one with the money at the end of the period gets to keep it. Please call us at (508) 539 8900 if you d like a copy of the entire article. References: 1. ISPA, Retail Management for Spas, 1995 (www.experienceispa.com).