Editors note: This article was originally published back in 2004, and since that time there has been increasing controversy of both the dangers associated with use and the questionable professional ethics of beauty therapists/aestheticians providing sun bed facilities. With the emergence of new sunbed (Or Solarium) standards in many parts of the world, we thought it would be a good idea to review and update the article.

While tanning booths and sunbeds are a popular revenue earner in many beauty salons, little thought is given to the damage they can cause to the cells of the skin through prolonged or unsupervised use.
The negative effects of UVA from the sunbed will often require remedial treatments that will cost far more than the cost of the sunbed tan did.

While it is true that the UVR spectrum of most sun beds does not cause erythema, there is still damage being caused at a cellular level, and for some individuals this can lead to melanomas and skin cancers.
In the US, the FDA warns that some tanning operators may claim that UVA sunlamps and sunbeds are safer than the sun and UVB lamps. This is not true. In fact, exposure to the UV radiation from sunlamps adds to the total amount of UV radiation you get from the sun during your lifetime, further increasing your risk of cancer.
Such was the concern; the American Medical Association (AMA) passed a resolution in 1994 calling for a ban of the use of suntan parlour equipment for non-medical purposes. U.S Dermatologists have also urged the FDA to take action to discourage use of suntan parlours and suntan beds.

In many sun tanning clinics, there is a degree of consultation with the client regarding the suitability of a particular skin type for specific frequency/duration of treatments, however in some clinics it is just a "pay and self-serve use" approach. (This is more prevalent in Hairdressing salons than Aesthetics and beauty clinics)
While sunbed clinic operators who do provide a consultation and believe they may be providing a safe service for their clients, there is an important factor to consider:
With the mixed ethnicity of many people, it is difficult to gauge the risk of using the sunbeds by simply observing the colour of their skin. Mixed genetic pools will often disguise or alter the REAL Fitzpatrick rating for the particular skin colour and therefore the risk. Without some way to measure the melanin content to calculate the risk, how can we be sure we will not have a time bomb on our hands? (My own skin is a perfect example of this) Although melanin measuring devices have been around for over ten years, a majority of operators choose not to use them. (Or don't think they need to)

In many countries, health authorities provide guidelines for the use of artificial sun tanning devices, (Such as this example from the UK) however with the emergence of more and more artificial UV related issues, (Including death) there are likely to be more stringent regulations on the horizon.

UVA is the silent killer of cells

Skin is a potential target of oxidative injury because it is continuously exposed to visible light, ultra violet irradiation and oxygen, all critical for the maintenance of cellular life.
Skin is the bodys first line of barrier defence, and as part of the skin structure there are numerous other types of barrier defence system designed to protect those structures themselves.

It is well accepted that alterations in skin lipids due to exposure to UVR result in membrane damage. The major reactive species that can initiate lipid peroxidation is the hydroxyl radical OH. Damages of the membrane function are associated with a variety of harmful skin alterations.

UVR leads to erythema, chronic exposure leads to acceleration of the skin aging process and increased risk of skin cancer development over time.

Sun light components responsible for photo aging are wavelength region arbitrarily defined as UVB, which is in the range of 290 to 320 nm. UVB light normally penetrates the epidermis.

UVA is in the range 320 to 400nm (also called long and short UVA respectively, or UVA 1 & UVA 2) and is considered less damaging at a given dose or irradiation, however it penetrates much more deeply into the skin and has a greater effect on dermal tissue.
UVA is the primary wavelength used in sun beds because it causes the tanning reaction both the immediate tanning and immediate pigment darkening reaction. (IPD) and the delayed tanning reaction, or new melanogenisis.
UVA can also evoke the sunburn reaction, but the erythema or sunburn producing capacity of UVA is very weak, but the long term deleterious effects on the skin and accelerating skin aging are high. Although UVA radiation causes less erythema than UVB, it is becoming increasingly clear that this spectrum of sunlight is insidious and cannot be disregarded.

  UVA Skin Cell Damage

• • Damage to melanocytes caused by DNA damage
  • Vit C oxidization 
  • Impair Vitamin A receptors within cell membranes
  • Excess keratinisation 
  • Edema 
  • DNA damage and inhibition of DNA synthesis
  • Depletion of epidermal Langerhans cells reducing skin barrier defence
  • Increase in matrix metalloproteinases (MMPs) cause damage to collagen and elastin fibres
  • Damage to cell membranes through lipid peroxidation
  • Increase in free radicals

UVA induced photosensitivity
What is not well know is that UVA is the portion of the UV spectrum most often associated with photosensitivity resulting from drugs and disease.

Sunbed clients taking certain prescription drugs can unknowingly increase their reaction to ultraviolet radiation. These drugs may not make them noticeably sensitive to sunlight, but they may make them very sensitive to the intense ultraviolet radiation in a tanning booth.
In the US, the FDA has published a list of medications that increased sensitivity to light (HHS Publication FDA 91-8280). 

These drugs include, but are not limited to:

• • Some antibiotics
  • Some high blood pressure medications
  • Some tranquilizers
  • Diuretics
  • Some birth control pills
  • Some oral diabetes medications 

A final word...
If you have a sun bed in your clinic & believe you are a Professional skin treatment therapist, think again!
A TAN IS A SCAR! This statement should be enough to stop skin treatment therapists offering the service of sunbeds in clinics.
It is well known that treatments for the ageing skin are a large part of the services offered by a beauty salon. Treatments for skin lightening, wrinkles, resurfacing, muscle atrophy and more, so why offer a service that is going accelerate all of these conditions?
In the eyes of consumer protection agencies it could be considered professional negligence.
The legal implications abound.

Note: In March 2008, Australian authorities introduced new regulations for operators of sunbed and solarium clinics. The regulations raised the minimum age for users from 15 to 18-years-old.
The regulations will also prohibit solarium use for people with fair skin. Under the new laws the frequency and duration of solarium sessions will also be limited.

2004 Virtual Beauty Corp

Are the high profile department store brands better than those used by beauty therapists or are they just well marketed with pseudo-science?

The skin care product market is huge: annual sales exceed $3 billion in the UK alone, however professional beauty therapists, aestheticians and skin treatment practitioners see only a very small portion of this revenue.
Why? You may ask. It is not that the products sold by department store chains and direct marketing is any better than the products the therapists sell, it is simply the mass marketing and accessibility that the cosmetic brands provides gives the perception they are.

The reality is in most cases that the department store brands are no more (and in many cases, less) effective than the products sold by salons, its just your customers dont believe it to be the case.
This makes it harder to convince them that the same amount of
money spent on a series of corrective clinic facials as on a flashy department store or direct sales product will give a better and lasting effect.

For most women today, beauty is less about vanity and more about self-confidence, and cosmetics are less about the science and more about emotions. This is why with the millions spent on advertising campaigns and celebrity endorsements you would be forgiven for believing all of the statements of how product X will make your wrinkles disappear virtually overnight are true.

The reality is however that in many countries there are insufficient consumer protection controls in place to force manufacturers and marketers to tell the truth. In many countries, the logic that if it cant harm you, then you dont need to know seems to be the norm.
With formulations for anti-ageing products becoming increasingly sophisticated, the boundaries of product efficacy are being constantly stretched. You would think that when promoting these products, there should be complete transparency and no room for ambiguity when it comes to efficacy claims.
The reality of course is much different.

Cosmetic Vs Therapeutic
Lets think about some of the statements made by some cosmetic companies regarding the efficacy of their products.
If you have products that are indeed making physiological changes to the metabolism of skin cells, restructuring DNA, and regenerating collagen to make wrinkles disappear, then we are talking about therapeutic formulations that could be considered drugs.

(Aestheticians and skin treatment practitioners undertake treatments on their clients that provide these physiological actions every day, however the therapist providing the treatments is appropriately qualified, trained and skilled.)

Therapeutic skin care products are generally not available from retailers, but logically limited to skin treatment therapists as professional products, with the prescription and use of them based
on the findings of a skin analysis consultation.

In fact, any product that has physiological altering properties should be only be used when the outcome is predictable. A typical example is retinoid reactions when too stronger concentration of vitamin A is used on a particular skin type and condition.

This therapeutic class of products in some countries also falls under the administration of some form of therapeutic goods legislation, where false and misleading efficacy statements are considered illegal and punished with reprimands and the kind of publicity that cosmetic companies try to avoid at all costs.

An example of enthusiastic marketing claims catching up with cosmetic companies was played out in Australia in early May 2007, where an astounding five top cosmetics manufacturers were ordered to withdraw advertisements after complaints to Australia's Therapeutic Goods Administration. (TGA)
Brands included in the complaints were Lancome, Clinique, Estee Lauder, L'Oreal and Payot.
The TGA's complaints panel established that the advertised creams, peels and serums were only cosmetics, however the companies were making claims that led consumers to believe that they were therapeutic formulations that would make a physiological difference.

Claims Vs Reality
In the case of Estee Lauder, the company argued that because they were known as a cosmetics company and their product Perfectionist Correcting Serum was being advertised in a fashion magazine "readers could not reasonably expect the product to have a therapeutic use".
They also testified to the TGA that the product used optical technology among other methods to blur the effect of wrinkles. This revelation was despite advertising promising that their AUD $160 product could fill in and smooth out expression lines instantly and "helps the skin amplify its natural collagen production".

The TGA complaints panel concluded it was unable to accept the claim was merely cosmetic and had "no doubt" it was intended as a therapeutic claim. This was due to the fact that consumers would reasonably believe that the expression lines would be instantly removed by biological means.

In the case of Payot, the TGA panel said it was concerned about the comparison they had made between its AUD$175 Payot Rides Relax to injections of the wrinkle-relieving toxin Botox.
The panel subsequently ordered Payot to withdraw its claims that the serum was "wrinkle correcting".

In Europe, cosmetic manufacturers and marketers have been facing similar scrutiny over advertising claims, with direct selling leader Avon being reprimanded in early 2007 by the UK Advertising Standards Agency (ASA) over a misleading advertising campaign for an anti-aging face cream that claimed to be a face lift in a jar.
In a ruling published by the ASA, they stated that the claims were unfounded and the company did not have (or could not provide) any comprehensive scientific evidence to support the claim, despite carrying out a consumer study.

In another case, cosmetics giant Clinique was investigated by the ASA for displaying misleading content regarding their anti-ageing treatment, Repairwear. In the advert, Clinique stated that the cream enabled the skin to steer hearty cells to the base of wrinkles, thus triggering the skins own natural collagen production.
An expert at the ASA testified that Clinique had not tested the product on consumer's skin and therefore the accuracy of the claim was not valid. The tests had been in fact undertaken in a laboratory environment.

The reprimanding of cosmetics giants for misleading claims is not new. Back in 2005, L'Oreal had a number of complaints against a series of adverts featuring celebrity model Claudia Schaffer promoting anti wrinkle and anti cellulite products upheld by the UK Advertising Standards Agency (ASA).
In the wrinkle cream advert, it was claimed that 76% of users had reported a visible reduction in expression lines over a three week period and that wrinkles could be reduced in the space of just one hour, an assertion that was considered by the panel to be extreme because the product could be reasonably understood to have a 'physiological action with a cumulative effect'.

Claims about the product's inclusion of Boswelox to counteract micro contractions was also investigated, and after consulting its own experts in the field, the ASA concluded that L'Oreal's specific reference to the product's effects on expression lines were unsubstantiated - a key point that was emphasised by Schaffer pulling a variety of different faces in the advert.

With the anti-cellulite product, the agency upheld complaints made against a product called Perfect Slim specifically claims that 71 % of women in a study had said it had visibly reduced the appearance of cellulite.
In upholding the complaint about the study, an ASA expert had examined the results of the trial but had found no evidence to support the claims, as it had been open and used no control or blind testing. Further details also proved that half of the individuals taking part in the study had not registered the improvement claimed.

Its all a matter of interpretation
It would appear that in some cases, cosmetics companies somehow confuse product popularity and customer satisfaction with efficacy and actual documented results. It is well known that product popularity and satisfaction is directly associated with customer self-assessment, (which at best is subjective) and this is in no way scientific evidence to support efficacy claims.

Unperturbed, they are encouraged to continue to make claims that make good marketing copy rather than provide factual information.
Despite all the diversional tactics of the marketers, independent experts such as consultant dermatologists believe that most of the research carried out by the cosmetic companies is indeed legitimate, with all of the cosmetics giants having good scientific grounding. The problem is however, that the science within the products is not so much in dispute as the techniques employed by some of these companies to cloud the science and therefore mislead consumers.

Why you ask go to all the bother if the product works so well? Why not simply tell the truth?

Thankfully, the action taken by the Australian and British authorities points to mounting pressure on the cosmetic companies to substantiate claims for cosmetics products that are said to make physical improvements to the skins appearance. 
Interestingly, professional skin care companies will rarely make claims of how well a particular product will work, only point out the potential for success if used appropriately. This is because they are well aware that the ultimate success will only come from the therapists knowledge and skill in performing the treatments and the clients willingness to follow up with their prescribed home care. This is something that consumers with high expectations also need to understand. 

What you can do
There is fierce competition between cosmetics companies to continue to innovate new products, and this is good for all of us. Much of the research and experimentation for department store brands is used by professional skin care manufacturers, and with hundreds of millions of dollars and thousands of researchers worldwide looking for the next big thing in a skin care breakthrough, it ultimately means that we have access to high-tech skin care products at affordable prices. 

Perhaps it is time to start marketing your own treatments using cues from the mainstream cosmetics companies.
Start compiling case histories of your most positive client outcomes, and use them to promote the real differences you can make. Ensure every client is prescribed appropriate take-home care products with detailed instructions on their use. More importantly, don't give them a reason to go elsewhere to buy department store skin care.

Its time for you to take your bigger slice of the multi-billion dollar skin care pie.

© 2007 Virtual Beauty Corporation

Dehydration has perhaps been the most bandied about terminology used to describe a variety of skin conditions where lack of moisture is evident.

The buzz word 'dehydration" earned it's fame in the 60's & 70's after cosmetic chemists discovered humectants. These had the ability to attract water in the skin and from the atmosphere and made the skin appear plumper, moisturised and makeup application easier. It did not take long for the marketing people of the cosmetic houses to convince the consumer that their skin was dehydrated unless they used a moisturiser. They smelt nice, felt nice, and made the application of makeup easier, becoming part of a womans daily skin care routine.
 

Because a skin feels dry or looks taut does not necessarily mean its dehydrated. It is here that the midsiagnosis of dehydration most often occurs.

Aestheticians and Beauty Therapists were also easy to convince, and because few therapists could correctly diagnose true dehydration, any skin condition lacking moisture was fair game for the label "dehydration". If we told our client her skin was dehydrated, she would book in for a treatment to correct the problem and buy take home care.

To be truthful, did we really know how dehydrated our clients skin was, or did we guess? If we guessed correctly, we sold product and satisfied a client, if we were wrong we often created another skin condition or wasted the clients money. Ill be honest and say that until I understood what caused dehydration, I guessed. Many therapists still do. Until recently, beauty therapy schools did not teach in advanced skills of this nature, consequently few therapists correctly diagnosed dehydration. Because a skin feels dry or looks taut does not necessarily mean it is dehydrated, and it is here that the misdiagnosis of dehydration most often occurs.

If the skin does not have well-formed acid mantle (hydrolipic film) and epidermal lipids, evaporation and fast TEWL will occur.
These epidermal lipids play an important role in transdermal water flow and retention.

Epidermal lipids help trap water in the microscopic bilayers between the corneocytes, while the skin surface lipids (acid mantle or hydrolipic film) help occlude (or seal) the surface. We would be correct to conclude that if there is a deficiency of epidermal and surface lipids, the water retention powers of the epidermis will be drastically reduced. A dehydrated condition or evaporation generally follows.

Conditions of lipid dryness, impaired acid mantle and essential fatty acid deficiency are too often confused with dehydration. By treating dehydration instead of repairing the retention powers of the epidermal skin conditions, will not only waste the clients time and money, but will challenge the credibility of the beauty professional.

Results are achievable when treating a dehydrated skin externally, but long-term effective results can only come from within.

Simply applying moisture to the skin surface with humectant and hydrating masks will have an immediate but temporary effect on the skin. However, it will be ineffective long term if the client takes no other measures to prevent further water loss.

Two steps go towards effectively slowing TEWL and prevent evaporation (dehydration).

Introducing water to the tissue by internal means and reducing the chemical and physical dehydrating factors. (Alcohol, coffee, sun, air-conditioning and medications like diuretics etc).

The other most serious established cause, the "fat free diet" (resulting in essential fatty acid deficiency) will compromise the health of the keratinocyte cell membrane thus resulting in low epidermal lipids. Corrections are made of these extrinsic (developed) causes by changes in the clients work/play lifestyle. This can begin with supplements like evening primrose oil or 2 tablespoons of safflower oil a day. 

The product used to carry out these treatments must have a number of cosmetic ingredients in them that are compatible with the skins's structure and function

The products used to do these treatments must have a number of cosmetic ingredients in them that will be compatible with the skin structure and function.

These are essential fatty acids, amino acids and glycosaminoglycans.

The essential fatty acids known as Vit F, linoleic, linolenic & arachidonic acids or Omega 3 & 6. A wide number of sources of these essential ingredients are available, evening primrose oil, flax seed oil, borage oil, safflower, spirulina, and ceramides that are ester linked to linoleic acid.

It is the application of these oils rich in essential fatty acids that is required for optimum maintenance of the skin cutaneous barrier function. The human body cannot metabolise EFAs and is entirely dependent on ingesting them from our diet. The skin however can metabolise them from surface application, making them the ideal massage medium or as an active in a cream or mask. All will result in improving the liposoluble phase (oil phase) of the acid mantle.

The hydrosoluble phase (water phase of the epidermis) made up by the NMF (natural moisturising factor), is essential in maintaining hydration of the epidermal horny layer. Forty percent of this water phase is made up of amino acids, amino acids are the basic building blocks of proteins.

Remember that collagen, elastin and keratin are the predominant proteins of the skin. Amino acids help to build, maintain, and repair the body. Without dietary protein, growth and all bodily functions would cease.

Sources of these amino acids within the cosmetic industry are wide and varied, most are plant based, the algaes being the most widely used. They will be available in toners, moisturisers, serums and masks.

The dermal reserve consists of glycosaminoglycans (interstitial fluid or GAGs). The main function of glycosaminoglycans is the maintenance of turgidity (bounce in the cellular space and the support of the collagen and elastin fibres in balance and proportion. There are three known support fluids of the connective tissue in the dermis they are hyaluronic acid (HA), mucopolysacharides (MPS) and chondroiton sulphates.

Seventy percent of all GAGs are hyaluronic acids, often referred to as a molecular sponge allowing for intensive saturation (thus hydration). HA also can function as a transdermal delivery system for other "actives since it forms a matrix on the skin, allowing increased skin penetration due to skin saturation and hydration. It works best when internal hydration is at optimum levels.

All of these actives will make a significant improvement in the clients skin, a series of weekly treatments spread over six weeks. In addition, the improvement in the clients work/play lifestyle and take home care will add up to a very happy client and your professional satisfaction.

Conclusion:

The term "dehydration" used to label a variety of skin conditions ranging from lipid dryness to early elastin & collagen loss, occurs because of lack of training to correctly diagnose a true dehydrated condition. 

The cause of true dehydration, is the skins inability to retain its limited moisture in the epidermis. As we have discussed, this will be due to a EFA fat free diet and a number of physical, chemical and environmental factors.

When all the negative factors causing the condition have been eliminated effective treatments can proceed.The first step in combating dehydration will always begin with restoring the acid mantle and ensuring the keratinocyte cell membrane is in optimum condition.

Do this with dietary supplements like evening primrose oil and topically applied treatments. using oil based (w/o) or wter based (o/w) creams that contain the actives that are compatible wor will enhance the skin structure and function.

To correct hydration levels of the body. Water is the perfect fluid to rehydrate the body, and 10% apple juice or 15% Spirulina in water can increase the absorption rate dramatically.To assist absorption, the temperature of the water should be as close to body temperature as possible.

In addition, remember if you massage during your facial treatment, do it after the mask not before. Heres another article for you to look forward to reading.

2001 Virtual Beauty Corporation

This article was updated Feb 2007