I wanted to make something that would help skin to actually be better, not merely feel or appear better.

A VITAMIN

I wanted to make something that would help skin to actually be better, not merely feel or appear better. Dr. Des Fernandes Copyright 2018 Environ Skin Care (Pty) Limited. All material and/or images contained herein are subject to copyright and remain the property of Environ Skin Care (Pty) Ltd. This material and/ or images may not be reproduced, copied or disseminated in any form or by any means, whether electronic, mechanical or otherwise without permission in writing from Environ Skin Care (Pty) Ltd.

table of CONTENTS WHAT ARE MY EXPECTATIONS OF THIS WORKSHOP? LEARNING OUTCOMES TOPIC 1: VITAMIN A: AN AMAZING MOLECULE TOPIC 2: VITAMIN A FOR HEALTHY SKIN TOPIC 3: THE VITAMIN STEP-UP SYSTEM TOPIC 4: RECOMMENDING VITAMIN A WITH CONFIDENCE 4 5 6 15 22 24 VITAMIN A 3

What are my expectations OF THIS SESSION? NOTES 4 LEARNER WORKBOOK

INTRODUCTION Welcome to the Environ Education Journey. Brand Story Beautiful Science Step into Retail THE ENVIRON BRAND STORY SKIN SCIENCE ENVIRON SCIENCE ESSENTIAL CARE FOCUSED CARE EVEN MORE CARE Step up into Professional CONSULTATION DEVICES COOL PEEL TECHNOLOGY NEEDLING LEARNING OUTCOMES By the end of the workshop, you will be able to: Identify the different forms of vitamin A Explain the benefits of vitamin A Describe the unique selling points of the Vitamin STEP-UP SYSTEM Recommend vitamin A with confidence VITAMIN A 5

Topic 1 VITAMIN A: AN AMAZING MOLECULE SECTION 1: WHAT IS VITAMIN A? Vitamin A is the greatest deficiency in the world. Most people are unaware that they suffer from a chronic, localized deficiency of vitamin A. As vitamin A is light sensitive it is destroyed every day in our skin and that is the main reason why we develop photoaging. You could say that the skin is constantly in need of vitamin A. Dr. Des Fernandes Vitamin A belongs to a family of organic chemicals called Retinoids. Retinoids occur naturally in the human body and are closely linked to the chemistry of vision in the retina of the eye. Vitamin A is the most important molecule for healthylooking skin. Everybody, everywhere, is exposed to UV light. This exposure damages the vitamin A naturally found in the skin. By absorbing energy from UV light, certain forms of vitamin A act as a natural sunscreen. The more vitamin A the skin has, the more protected the skin will be against sun damage. While taking vitamin A supplements (at least 5 000 IU per day) may help to replenish the vitamin A skin has lost, it is not nearly as effective as topical application straight onto the areas that are depleted of vitamin A. This essential nutrient needs to be replaced on a daily basis to promote healthy-looking skin and minimize the signs of photoaging. 6 LEARNER WORKBOOK

Vitamin A over the years 1930 Scientists first suggest that aging skin is caused by a vitamin A deficiency. 1948 Vitamin A as Retinyl Palmitate and Retinoic Acid is first synthesized. Professor Cluver from South Africa finds that oral supplementation of vitamin A protects humans from sunburn. 1964 1954 Retinyl Palmitate is used to treat intrinsic aging of skin. 1969 Retinoic Acid is popularized for the treatment of acne. 1985 Dr. Kligman demonstrates that Retinoic Acid can be used to treat photoaging and can rejuvenate skin. 1987 1990 Environ is founded and starts manufacturing and distributing the world s first skin care products containing vitamin A. Dr. Des Fernandes uses the topical application of Retinyl Pamitate for the first time to treat photoaging. VITAMIN A 7

SECTION 2: WHAT ARE THE DIFFERENT FORMS OF VITAMIN A? ACTIVITY The different forms of vitamin A are listed in the infographic below. Carotenoids is a pre-cursor to the Retinoid form of vitamin A. Write down the key points of each form of vitamin A that you would use when recommending vitamin A to a client. CAROTENOIDS (PLANT) AVITAMIN RETINOIDS (ANIMAL) BETA- CAROTENE ESTER (OIL) ALCOHOL ACID ETC RETINYL PROPIONATE RETINYL PALMITATE RETINYL ACETATE RETINOL RETINOIC ACID least active active more active most active Environ does not use these forms 8 LEARNER WORKBOOK

Beta-carotene Retinyl Propionate, Retinyl Palmitate and Retinyl Acetate Retinol Retinoic Acid VITAMIN A 9

SECTION 3: HOW DOES VITAMIN A WORK IN THE SKIN? DID YOU KNOW... Vitamin A is measured in international units (IU) per gram. The recommended dose is between 500 IU and 50 000 IU per day. The cosmetic and edible forms of vitamin A have to be converted into the active, Retinoic Acid form, so that the benefits of vitamin A can be experienced. THE METABOLIC PATHWAY OF VITAMIN A INSIDE A SKIN CELL RETINYL PALMITATE, RETINYL ACETATE, RETINYL PROPIONATE RETINOL RETINALDEHYDE RETINOIC ACID RETINOID REACTION Few people experience the side-effects of the topical application of vitamin A. This is called a retinoid reaction and is marked by redness of skin, exfoliation (flaking), mild breakouts and very uncomfortable skin. A retinoid reaction occurs when the skin is too deficient of vitamin A to metabolize it effectively. Exposure to sunlight destroys the vitamin A receptors on the cell membranes. To make more vitamin A receptors the DNA has to be stimulated by vitamin A. 10 LEARNER WORKBOOK

Identify the type of retinoid reaction in each image below: ACTIVITY VITAMIN A 11

Myth: Many people believe that vitamin A makes the skin thinner. The fact is that vitamin A will always make skin thicker and healthier-looking. However, when a retinoid reaction occurs the skin does become thinner, but as it is a transient reaction, it does not permanently damage the skin. The thinner skin is reversed when the reaction subsides and the vitamin A receptors are more actively absorbing vitamin A again. The retinoid reaction is a non-specific chemical irritation as there is too much vitamin A outside the skin cells. Some clients may have previously experienced a reaction to vitamin A. It is therefore important to know how to effectively deal with a retinoid reaction. A client may say: I have used vitamin A before, and did not have a good experience (redness, dryness and irritated skin with breakouts). My skin went from bad to worse and I am scared to try it again. The best response to give this client would be: This describes a transient retinoid reaction (vitamin A reaction) which is normal for a small number of consumers to experience. It simply means that your skin is really depleted of vitamin A and unfortunately the application of vitamin A then irritates the skin. The only way to fix this deficiency is to apply low doses of vitamin A. Start off by applying vitamin A once a day and slowly increase application to twice a day - always making sure that the skin remains comfortable. If the skin becomes uncomfortable again, slow down the applications. 12 LEARNER WORKBOOK

VITAMIN A and PREGNANCY It is important to understand the following facts about vitamin A and pregnancy, as this can be a concern for many clients: When looking at how vitamin A works in the skin, it is important to know that once vitamin A is absorbed, it is trapped in the skin. Humans do not have the enzyme systems to transfer vitamin A from the skin into the bloodstream. High levels of vitamin A in the skin cannot cause liver damage, interfere with the development of a foetus or other complications. Environ believes that our products containing vitamin A are safe during both pregnancy and lactation. However, the clients must check with their doctors about vitamin A use. It is important to remember that during pregnancy, the skin s response to cosmetics may temporarily be changed and therefore, should the client wish to continue using Environ, we advise the use of lower levels of vitamin A or discontinuing the use of vitamin A if the skin is too sensitive, especially during the first trimester. The client should start at a low dose of vitamin A when re-instituting it again, after the first three months of pregnancy. VITAMIN A 13

SECTION 4: WHY DID ENVIRON CHOOSE VITAMIN A? I believe that by combining vitamin A with an effective brigade of antioxidants I was able to produce the world s first effective cosmetic cream that could truly be called skin care. Dr Des Fernandes Watch the Eureka Moment animation and write down some of the key notes on why Dr. Des Fernandes chose vitamin A as the cornerstone ingredient of Environ. ACTIVITY 14 LEARNER WORKBOOK

Topic 2 VITAMIN A FOR HEALTHY-LOOKING SKIN SECTION 1: WHY IS VITAMIN A IMPORTANT FOR HEALTHY-LOOKING SKIN? What are the dangers of regular exposure to sunlight? What are the dangers of completely avoiding sunlight? ENVIRON MAKES IT POSSIBLE TO LIVE YOUR LIFE BEAUTIFULLY WITHOUT YOUR SKIN KNOWING IT OR SHOWING IT. You can t hide from the sun but you can reduce its effects. Put back what city life takes out. Replace the levels of vitamin A in the skin and be Reborn Beautiful. VITAMIN A 15

SECTION 2: WHAT HAPPENS WHEN YOU HAVE A VITAMIN A DEFICIENCY? DID YOU KNOW... Restoring vitamin A through diet takes seven days; restoring vitamin A through topical application takes a few hours. When there is a vitamin A deficiency in the skin, one or more of the following signs of photoaging may develop: sun damage laxity wrinkles roughness irregular pigmentation sallow skin elastosis breakouts 16 LEARNER WORKBOOK

KNOWLEDGE CHECK: Spot the vitamin A deficiencies on the following images. Indicate Yes or No next to each image. ACTIVITY Skin Image Yes No VITAMIN A 17

Skin Image Yes No 18 LEARNER WORKBOOK

SECTION 3: WHAT ARE THE BENEFITS OF USING VITAMIN A? How vitamin A benefits the skin over a period of 6-18 months. An influx of Langerhans cells indicates compromised skin immunity. A thickened Stratum Corneum, or outermost layer of the skin. A compromised skin barrier function. Before After The horny layer is more compact and smooth. Skin barrier function is improved. 1 1 4 4 2 2 3 3 5 5 Melanin is more evenly distributed. Effectiveness of fibroblasts is improved, which produces healthier collagen and elastin. Stratum Spinosum, or spiny layer, is thinner than it should be. Fibroblasts are unhealthy. The Langerhans cells become more effective. Abnormal cells are normalized. Melanin is unevenly distributed causing an uneven skin tone. VITAMIN A 19

SCIENTIFIC RESEARCH HAS SHOWN: KEY BENEFITS OF VITAMIN A Known as the skin-normalizing vitamin 20 Promotes a healthy-looking Dermis & Epidermis Vitamin A is essential for all the layers of the skin and helps to promote a healthylooking skin LEARNER WORKBOOK Promotes the effects of the Natural Moisturizing Factors Promotes a healthylooking barrier function, leaving the skin looking hydrated and refreshed Helps improve the visible effects of problematic skin conditions Normalizes sebaceous gland activity, leaving the skin more balanced Forms the basis of a normal, healthylooking, and wellfunctioning skin Promotes the effects of Collagen & Elastin Encourages the results of the synthesis of healthy Collagen & Elastin for a firmerlooking skin Helps support the effects of skin immunity Supports the immune function of the skin by potentiating the Langerhans cells to help maintain a healthierlooking skin Helps improve the appearance of pigmentation Helps stabilize pigmentation distribution, leaving the skin more even-toned in appearance

Vitamin A benefits references: 1. Shapiro, S. S., M. Seiberg, and C.A. Cole, Vitamin A and its derivatives in experimental photocarcinogenesis: preventive effects and relevance to humans. Journal of drugs in dermatology : JDD, 2013. 12(4): p.458-63. 2. Sorg, O., et al., Proposed mechanisms of action for retinoid derivatives in the treatment of skin aging. J Cosmet Dermatol, 2005. 4(4): p. 237-44. 3. Watson, R. E., et al., Repair of photoaged dermal matrix by topical application of a cosmetic (antiageing) product. Br J Dermatol, 2008. 158(3): p. 472-7. 4. Reichrath, J., et al., Vitamins as hormones. Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme, 2007. 39(2): p.71-84. 5. Katsambas, A.D. and A.C. Katoulis, Topical retinoids in the treatment of aging of the skin. Adv Exp Biol, 1999. 455: p. 477-82. 6. Sorg, O., et al., Retinoids in cosmeceuticals. Dermatol Ther, 2006. 19(5): p. 289-96. 7. Kang, S., The mechanism of action of topical retinoids. Cutis, 2005. 75(2 Suppl): p. 10-3; discussion13. 8. Saurat, J.H., Skin, sun, and Vitamin A: from aging to cancer. J Dermatol, 2001. 28(11): p.595-8. 9. Berne, B., et al., Decreased retinyl ester concentrations in UV-induced murine squamous cell carcinomas. Acta Derm Venereol, 1989. 69(6): p. 503-8. 10. Amann, P.M., et al., Vitamin A metabolism in benign and malignant melanocytic skin cells: importance of lecithin/retinol acyltransferase and RPE65. Journal of cellular physiology, 2012. 227(2): p 718-28. VITAMIN A 21

Topic 3 THE VITAMIN STEP-UP SYSTEM SECTION 1: WHAT IS THE ENVIRON VITAMIN STEP-UP SYSTEM? The Vitamin STEP-UP SYSTEM was created to address the effects of vitamin A deficiency in all skin and to aid the daily replacement of the benefits of this essential vitamin. The Environ philosophy behind the Vitamin STEP-UP SYSTEM is to start low, go slow. If the skin is prepared with low doses of vitamin A, it is less likely to react to a higher dose. As the skin needs to progressively adjust to high doses of vitamin A, the Vitamin STEP-UP SYSTEM was designed to allow skin to become used to increased levels of vitamin A by stepping up from one level to the next. The Vitamin STEP-UP SYSTEM containing vitamin A, other vitamins and antioxidants, is specifically used in the range of moisturizers that form part of the Essential Care segment. Consumers are encouraged to start on the Essential Care segment with the ranges that contain the Vitamin STEP-UP SYSTEM moisturizers, so that their skin can be Reborn Beautiful. 22 LEARNER WORKBOOK

SECTION 2: HOW DO YOU USE THE VITAMIN STEP-UP SYSTEM? Steps to applying the Vitamin STEP-UP SYSTEM : Start low, go slow. Start with the moisturizer containing the lowest concentration of vitamin A and other ingredients. Use 2-3 containers until skin is completely comfortable with this level of vitamin A. 1 Move on to step 2 with a medium concentration of vitamin A and other ingredients. Again use 2-3 containers until your skin is comfortable. 2 Medium concentration Move on to step 3 with a medium to high concentration of vitamin A and other ingredients. Again use 2-3 containers until your skin is comfortable. 3 Medium to high concentration Move on to step 5 with the highest Move on concentration to step 4 of vitamin with a high A legally concentration permissible, of vitamin and other A and other ingredients. ingredients. Again use 2-3 containers until your skin is comfortable. 4 High concentration 5 Highest concentration Low concentration TM Vitamin A is the cornerstone ingredient in the Environ skin care philosophy and must be replaced daily for skin to stay healthy-looking and resilient. Combined with other essential nutrients like antioxidants and peptides, the long-term enhancement of skin s appearance becomes clearly visible. VITAMIN A 23

Topic 4 RECOMMENDING VITAMIN A WITH CONFIDENCE SECTION 1: WHO SHOULD YOU SELL VITAMIN A TO? Compile the client profile of a client suited to use vitamin A. ACTIVITY 24 LEARNER WORKBOOK

SECTION 2: WHAT ARE THE UNIQUE SELLING POINTS OF VITAMIN A? Complete the mindmap by inserting words you would use when recommending vitamin A to a client. Normalize function ACTIVITY Reverse signs of damage When recommending vitamin A, I would use these words... Promote healthylooking skin Skin REBORN BEAUTIFUL It is never too early in life to start thinking about skin care. From the day of birth, skin is the canvas of life that presents our picture to the world. Dr Des Fernandes VITAMIN A 25

SECTION 3: HOW DO YOU MANAGE CLIENT EXPECTATIONS? Q Does vitamin A thin the skin? ACTIVITY Q Does vitamin A photo-sensitize the skin? Q Can I use vitamin A skin care while pregnant? Q I am worried that my skin is aging rapidly. Can I start on the final step? 26 LEARNER WORKBOOK

Q What happens after I ve reached the final step? Q How long before I see a result on my skin s appearance? Q What is the most effective form and dose of vitamin A? VITAMIN A 27

NOTES 28 LEARNER WORKBOOK

NOTES VITAMIN A 29

NOTES 30 LEARNER WORKBOOK

Q A Q A Q A Q A Does vitamin A thin the skin? Research confirms that vitamin A does not thin the skin. In fact it actually makes the skin thicker. This misconception most probably stems from the fact that skin feels smoother when using vitamin A and therefore it is assumed that the skin is thinner. Does vitamin A photo-sensitize the skin? This misconception stems from using the acid/alcohol forms of vitamin A. These types of vitamin A sensitize the skin to light. For this reason Environ s vitamin A moisturizers are enriched with the Ester form (oil soluble) of vitamin A. The Ester form of vitamin A does not sensitize the skin to light. Retinyl Palmitate, the storage form of vitamin A, is scientifically known to absorb the energy of UV rays and act as a natural sunscreen. Can I use vitamin A skin care while pregnant? Environ does not actively promote the use of vitamin A during pregnancy, especially during the first trimester. After the first trimester, it may be introduced at low concentrations. It is important to remember that during pregnancy, the skin s response to cosmetics may temporarily be changed and therefore we advise the use of lower levels of vitamin A / stopping the use of vitamin A if the skin is sensitive. The client s physician should always be consulted about its use. I am worried that my skin is aging rapidly. Can I start on the final step? Environ s Vitamin STEP-UP SYSTEM was created because consumers found that starting on medium to high levels of vitamin A would give them a retinoid reaction. To avoid this, it is therefore recommended to start on a low level of vitamin A and gradually increase the concentration of vitamin A by following the steps of the Vitamin STEP-UP SYSTEM. VITAMIN A 31

Q A Q A Q A What happens after I ve reached the final step? Vitamin A will always be an essential nutrient and has to be replaced daily for skin to appear healthy and youthful. The final step vitamin A enriched moisturizers contain adequate amounts of clinically proven concentrations of vitamin A and are recommended for long-term daily use. It is also recommended that you complement your skin care journey by having Environ facial treatments. This will further enhance the appearance of the skin. How long before I see a result on the appearance of my skin? Some consumers may notice changes in the skin s appearance within a few days of starting Environ, but in reality more time is required to notice a real improvement. The standard recommendation is to use Environ for three to six months before changes in appearance become noticeable. What is the most effective form and dose of vitamin A? It does not depend on the chemical form but rather the international unit dose. 10 000 IU Retinyl Palmitate = 10 000 IU Retinyl Propionate = 10 000 IU Retinol. Percentages are deceptive. We can formulate the above with 2% Retinyl Palmitate, 1 % Retinyl Propionate and 0.5% Retinol. NOTE: The concentration of vitamin A used in the moisturizers is not disclosed, as this is the intellectual property of Environ. 32 LEARNER WORKBOOK