- Dehydration: Real or Misdiagnosed
- Cellulite & Fat: The differences explained
- Is Vitamin B the new C?
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 misdiagnosis 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.
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. Here's another article for you to look forward to reading.
About the Author:
Florence Barrett-Hill - CIDESCO, ITEC Diplomas. Independent Technical Educator & author to the Professional Aesthetics Industry
Florence Barrett-Hill is an internationally acclaimed dermal science educator, practitioner, researcher and author with a vast experience covering all aspects of professional aesthetic therapy and paramedical skin care. Florence holds over a dozen diplomas and international qualifications covering every aspect of modern skin treatment therapy, and is well respected by her industry peers for her 30+ years of knowledge she loves to share.
Florence is the programme director of Pastiche Resources, an Internationally recognised postgraduate beauty industry education provider.
Is cellulite different from fat? Yes, there is a difference, despite what many an over-worked and harassed GP will argue. Under the microscope, the components of both fat and cellulite look the same, but that's where any similarity ends.
To understand why there is a difference, and what the skin treatment therapist can do to help treat the cellulite condition, we need to understand fat, and it's role in the body.
It is a common misconception that cellulite is brown fat. In fact, the adult body has very little or no brown fat, this being replaced with white fat rapidly from birth through early childhood.
Fat, or adipose tissue, is found in several places in the human body, with the location of where it resides under the skin (in the fibrillar network of connective tissue set between the superficial dermal layer and the muscular mass) being driven by the sex hormones estrogen and testosterone. Consequently, each gender has its own specific locales of accumulation, with adult males tending to carry body fat in the chest, abdomen and buttocks, producing an apple" body shape, while adult females predisposed to carry fat in their breasts, hips, waist and buttocks, creating a "pear" body shape.
Fat tissue is made up of one of two types of fat cells: white or brown. The most predominant white fat cells are large cells that have very little cytoplasm, only 15 percent cell volume, a small nucleus and one large fat droplet that makes up 85 percent of cell volume. The white fat cells play important roles of energy storage and metabolism, provision of heat insulation and mechanical cushioning.
The very few brown fat cells left in the adult body are somewhat smaller, are loaded with mitochondria and are composed of several smaller fat droplets. The mitochondria in the brown cells consume the fat within the cell to generate heat. (Thermogenesis) Consequently, deposits of brown fat is found almost exclusively in newborn babies, as it is the babys means of keeping warm until feeding starts to fill its white fat cells.
Fat cells are formed in the developing foetus during the third trimester of pregnancy, and later at the onset of puberty, when the sex hormones "kick in." It is during puberty that the differences in fat distribution between men and women begin to take form.
One amazing fact is that fat cells do not multiply after puberty, and as the body stores more fat, the number of fat cells remains the same. Each fat cell simply gets bigger!
How fat enters the body, how it is processed and arrives at its resident locations is a complex and fascinating journey of biochemistry and outside the scope of this article. (more information can be found here) More relevant is how and why fat is metabolised as fuel or retained as a fat deposit or cellulite.
Excess fat accumulates from the storage of nutrients the body doesn't use. The human body metabolizes excess caloric intake, whether from carbohydrates, lipids or proteins into triglycerides for storage in the vacuoles of fat cells. (Adipocytes) This fat storage in normal circumstances is spread widely over the body surface with tendencies to accumulate where the inherited body shape dictates.
Cellulite will form more readily in women due to an inherent difference in the underlying connective tissue structure. In women, the subcutaneous structure is said to form an almost mattress-like construction at the interface between the dermis and hypodermis, with minute parallel strands attaching the skin to the underlying structure. It is where these strands anchor the skin, the characteristic pockets of 'peau-de-orange" skin, or depressions of cellulite, may appear.
Cellulite is also considered an inherited condition. There is a body type that will show the cellulite condition despite how low the overall body weight is. ( See photo at left)
These pockets of cellulite can be found in the gynous regions: hips, bottom, at the top of the thighs and sometimes the knees.
Cellulite can also be developed by excess fat storage, which will aggravate the inherent anomalies in enzymatic or hormonal functions that diminish lipolytic enzyme levels or accelerate the biosynthesis of enzymes that favour lipid accumulation.
This type of cellulite is more wide spread over the body, and is always found with a moderate/severe weight problem and is compounded by a sedentary/negative lifestyle and poor eating habits.
Formation of Cellulite
Cellulite has been defined as a four-step process, beginning with a normal, pre-cellulite skin.
The thigh area is the body area most susceptible to cellulite accumulation and the area targeted for the action of most cellulite treatment products.
Normal thigh area skin is quite healthy; in the pre-cellulite condition there is a thick epidermis (0.10 - 0.15mm) with a good reproductive activity in the basal layer. The surface is smooth and firm, with the dermis also healthy and being quite thick, (1-2mm) with little sun damage.The capillaries extend up into the uppermost regions of the dermis providing a good blood supply of nutrients and clearing fluids.
Ultrasound scans of normal thigh area tissue also show a dense tissue development with little retained fluid, the fibroblasts are quite active, with no accumulation of cross-linked collagen or elastin nodules.
The fat cells beneath the dermis are active, with no clumping, and are quite distinct and of normal diameter, (not engorged with excess fat) Moreover, no fat deposits protrude into the dermal region.
Cellulite formation stages
Stage 1: The first events in cellulite formation are invisible, occurring at the cellular and molecular level. A dermal deterioration is the hallmark of the first stage of cellulite formation. Blood vessel integrity breaks down, with the upper dermal region showing a loss of capillary networks.
This is not unlike the deterioration associated with sun damage. Fat cells become engorged with lipid, often swelling to two or three times their original size, and begin clumping together. An excess of fluid is retained in the dermal and sub dermal regions. Fluid accumulation is most likely due to the capillary breakdown, but whether this is a cause or an effect of the disturbed fat metabolism is a subject of debate.
Stage 2: In the second stage of cellulite development, the tissue at the sub dermal and dermal levels has deteriorated; blood vessels in the afflicted area are disrupted. Some regions have normal microcirculation while adjacent regions can have markedly reduced blood flow. Fat cells engorged with lipid, clump together in the skin fat layer. This exacerbates the microcirculation problem, with the blood vessels being pushed away by the regions rich in fat deposits. In addition, fluids tend to accumulate, increasing the problem in the sub-surface region. The surface effects are minimal, yet the "orange peel' look of the skin can now be detected. In general, a surface lumpiness or unevenness can be seen.
Stage 3: This stage is a continuation of the process in stage 2. Vascular deterioration begins to effect changes in the dermis, resulting in a less active dermal metabolism. This affects the protein synthesis and repair processes, (proteosomal decline) with protein deposits forming around the fat cells. In addition, the micro-circulatory and lymphatic systems are unable to function efficiently, unable to bathe cells with nourishing fluids and dispose of wastes. This creates a toxic situation for all cells in the dermal and epidermal area.
Stage 4: This final stage of cellulite is marked by hard nodules in the dermal region, comprised of clumps of fat cells surrounded by a hard reticular protein layer. (See fig.2) The surface displays considerable unevenness, and can feel bruised when pressed or pinched. In addition the tissue is slow to return in shape and colour after pressure. (Impaired lymphatic)
Summary of Cellulite Factors
Cellulite differs from normal fat because of how it is retained and formed in to its distinctive appearance. It is not simply an effect of having excess fat. Cellulite can be found in thin, normal, and over weight women, and is a secondary feminine sexual characteristic, appearing only after puberty with the increasing influence of sexual hormones.
The most common factors of cellulite formation are venous and lymphatic inefficiency, sedentary lifestyles, and metabolism problems. (Women with cellulite often have a high level of cholesterol)
Other aggravating factors include menopause, (due to the slowing down of the metabolism) obesity and pregnancy, (due to circulatory deficiencies and habitual poor posture) the contraceptive pill, (stimulation of some women's appetite, and cause water retention) and stress.
Hereditary/Racial characteristics can also play a significant role in cellulite development, but are aggravated by one or more of the above.
Treating the causative conditions as a group or individually is the best practice, (depending on the approach of the therapist) but all will have to be addressed to get a satisfactory and long term result.
A combination of salon treatments and take-home care products will ensure some effect, however if used individually only a partial result will usually be achieved.
More importantly, both therapist and client must be dedicated to the program for lengthy periods of time, (some 4-6 months), as it must be remembered that it took many years to develop the cellulite condition, and it is not going to vanish over night.
If the cellulite is not too intrinsic (hereditary) and localised, it can only be seriously addressed by a change in the work/play lifestyle that exacerbated the condition in the first place. Only then can both therapist and client look forward to a satisfactory result.
About the Author:
Florence Barrett-Hill is an Internationally acclaimed independent beauty therapy technical educator, therapist, researcher and author who has vast experience covering all aspects of professional beauty therapy and paramedical skin care. She holds over a dozen diplomas and international qualifications covering every aspect of modern skin treatment therapy, and has over 30 years of experience to share.
Florence's book Advanced Skin Analysis is read by beauty professionals in 13 countries worldwide, across 4 languages and is a text in many beauty therapy schools and colleges. Florence can be contacted through her website: www.pastiche-training.com
The increasing popularity of Vitamin B has many in the skin industry asking if Vitamin B is, in fact, the new C.
There are many parallels between the two so one can understand why this thought might cross our minds but, first remember that not all are created equal. Additionally, the quality of the particular vitamin chosen, other factors such as; the concentration of the vitamin in a product, the mechanism of its release out of the cream base and the manner in which it is transported to its destination to start its activity are all of importance.
Here are some of the parallel functions Vitamin B and C have:
• These vitamin groups are used in both water and lipid-soluble forms.
• They both inhibit melanogenesis.
• They both have a positive influence on cell regeneration
• They both assist in wound healing
• They both contain anti-oxidant properties.
If they are so similar, why do we need both?
Well, the two vitamin groups are similar, yet they contain different but distinct properties. It is these particular
properties that hold the reasoning why they should perhaps both be included in a skin maintenance program.
In the Vitamin B group, which in recent years have enjoyed increased attention, there are 12 individual vitamins; however, the following are the ones of focus.
Vitamin B1 Thiamine, Vitamin B2 riboflavin, Vitamin B3 Niacinimide, Vitamin BS pahtenol, Vitamin B6 pyridoxine, Vitamin B6 pyridoxine triphalmitate, Vitamin B7 Biotin, Vitamin B9 folic acid.
Niacinamide (Vitamin B3) is probably the most widely known, research shows that in concentrations of 4% it is useful in the treatment of inflammatory acne grade 3 and up, Pyridoxine (Vitamin B6), Azelaic Acid and Zinc are known to individually inhibit the enzyme Sa-reductase, which is instrumental in the treatment of non-inflammatory or inflammatory acne. When these three were added together at very low concentrations, 90% inhibition of 5a-Reductase activity was obtained.
The Vitamin B group is also useful in wound healing, cell formation and epithelization after skin lesions (injuries, acne), and suppresses skin itching.
A deficiency in Vitamin B can lead to dermatitis and hair loss.
They also increase the production of ceramides, lipids in the outer layer of the epidermis that shields skin against moisture loss and protects it from harmful substances. Ceramides, along with other lipids like cholesterol and fatty acids, form a protective barrier against water loss, so replacing ceramides lost through the normal chronological ageing process, the use of harsh cleansing products and other inappropriate skin care products helps to keep skin barrier defense intact, including protection from ultraviolet radiation.
Vitamin B is multifaceted and needed for proper functioning of almost every process that occurs in our body. It is of critical importance for metabolism, the nervous system, vital organs, eyes, muscles, skin and hair.
The Vitamin C group includes L-ascorbic acid or ascorbic acid. Ascorbyl palmitate, aminopropyl phosphate, ascorbyl glucoside, magnesium ascorbyl phosphate, ascorbyl tetriasopalmitate, and sodium ascorbyl phosphate.
Vitamin C is a category of immense interest. It plays a vital role in the maintenance of skin health.
In the olden days, sailors and others who couldn't get fresh fruits and vegetables suffered bleeding under the skin, ulcers and joint weakness. That's because vitamin C, also known as ascorbic acid, is key to the production of collagen, a protein that aids in the growth of cells and blood vessels and gives skin its firmness and strength. Vitamin C also helps with wound healing and ligaments, and it helps your skin repair itself.
Some types of Vitamin C can, in fact, be irritating to skin and additionally, especially in the case of Vitamin C, higher doses do not mean that the vitamin will be well absorbed and can be discharged. The packaging, as mentioned at the beginning of this article, plays an important but underestimated role. Free vitamin C only has superficial effects on the skin or may be used in a formulation as an antioxidant. Derivatives can only achieve substantial impact on the skin in combination with penetration-enhancing substances such as liposomes or nanodispersions.
Advantages of vitamin C, when combined with the penetration-enhancing substances, means that the concentrations can be reduced, and hence keratolytic and pro-oxidative side effects eliminated.
Vitamin C activates the synthesis of collagen and neutralizes free radicals. These properties are what make it a desired ingredient when dealing with the treatment of scars. It is well known that Vitamin C is a tyrosinase inhibitor and reverses DNA damage caused by the harmful effects of sun damage. It is also able to strengthen the vascular wall and supportive connective tissue, beneficial in anti-ageing skin care programs.
The Vitamin A story must also be taken into account when thinking of skin health. Vitamin A works in synergy with Vitamin C, Vitamin B, and Vitamin E; however, Vitamin E is the most abundant lipophilic antioxidant found in human skin. In humans, levels of vitamin E in the epidermis are higher than the dermis. Vitamin E first accumulates in the sebaceous glands before it is delivered to the skin surface through sebum.
Back to Vitamin A and the benefits of it to an anti-ageing regime.
The derivatives of vitamin A are known as retinoids (found in animal-based foods) and carotenoids (found in plant-based foods). Carotenoids have to be hydrolyzed into a retinoid form for the body to utilize. Vitamin A is essential for the health of, not just your skin - in particular the production of enzymes that build your collagen - but also your vision, your immunity and it is an important antioxidant.
Dr Albert M. Kligman is credited as being the first dermatologist to show a link between sun exposure and wrinkles. He coined the term "photoaging" to describe skin ageing caused by the sun.
In 1967, he patented Retin-A, a vitamin A derivative known generically as tretinoin, as an acne treatment.
Today it is still being prescribed as an acne treatment, but Dr Kligman started to notice that his patients using Retin-A (brand name) presented with fewer lines and wrinkles than those who did not, and in 1986 he received a new patent for discovering the drug's wrinkle-fighting ability.
Now, we know even more about this vitamin, its benefits and its challenges.
Redness, irritation and peeling of the skin, sometimes referred to as “retinoid dermatitis”, are often experienced. Since the vitamin receptors increase with the duration of treatment, it is recommended to start with small doses and then gradually augment the dose. With time and adjustments to the dose, these effects usually settle down.
The benefits of Vitamin A when it is applied to the skin includes wound healing, reduce wrinkles via stimulation of collagen synthesis, increasing skin smoothness, protecting the skin against UV radiation, and diminishing of pigmentation.
Vitamin A is used for skin conditions including acne, eczema, psoriasis, cold sores, wounds, burns, sunburn, keratosis follicularis (Darier’s disease), ichthyosis (non-inflammatory skin scaling), lichen planus pigmentosus, and pityriasis rubra pilaris in the medical field.
Vitamins are sensitive to atmospheric oxygen, and using it in formulations with penetration-enhancing substances such as liposomes or nanodispersions are highly recommended. This not only increases the penetration of the vitamins, but does so with less irritation to the skin.
With the multi-faceted benefits these three vitamins provide, you can treat an array of skin conditions from acne to ageing across the generations.
It is my conclusion that a proper maintenance skin care regime with a focus on anti-ageing and all the conditions we see in the ageing skin should be supported by the A, B, C of skin health.
Gone are the days where we thought Vitamin A, Vitamin C, and Vitamin E were the holy grail for skin.
Since Vitamin E is an abundant lipophilic antioxidant in human skin, let's put Vitamin B into our mix and give our clients the full vitamin deck.
One last important note on the use of vitamins in skin care: Due to its sensitivity to oxidation, especially when exposed to the sun, it is best applied at night when your skin is in a ‘state of repair’.
(Barrett-Hill, Cosmetic Chemistry, 2009)
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Vitamins in cosmetic products – just additives or added bendefit as well? – dermaviduals. (n.d.). Retrieved from
Retinoids and their use in cosmetics – dermaviduals. (n.d.). Retrieved from
Active Agents, the effective skin care - vitamins, oils & more - dermaviduals. (n.d.). Retrieved from http://www.dermaviduals.com/english/publications/ingredients/active-agents-the-effective-skin-care- vitamins-oils-and-more.html
Sebaceous glands as transporters of vitamin E. (n.d.). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16477469
Sebaceous gland secretion is a major physiologic route of vitamin E delivery to skin. (n.d.). Retrieved from
About the Author:
René Serbon is a skin treatment practitioner, corneotherapist, industry educator, guest speaker/lecturer at various industry conferences, symposiums and trade shows. She is passionate about increasing the industry base knowledge and changing the lives of her clients, one skin at a time with treatment methods that equate to real sustainable results.