Date post: | 28-Mar-2016 |
Category: |
Documents |
Upload: | kim-whitbread |
View: | 234 times |
Download: | 2 times |
Pixi Peel Training Manual Page 1
Aims:
For you to become an educated, safe and effective Diamond Peel skin
rejuvenation therapist.
Objectives:
To understand the underpinning knowledge required for you to safely
and effectively operate the equipment, to understand the
contraindications and the contra-actions to treatment, how to effectively
meet your various client skin care needs, to appreciate the health &
safety issues of treatment & equipment maintenance and how to consult
effectively with potential clients.
Pixi Peel Training Manual Page 2
Contents
Section 1 Introduction
1.1 Benefits & Clinical Application of Diamond Peel
1.2 Explanation of Benefits
1.3 DP performs three Actions
1.4 Frequently Asked Questions
Section 2 Pre Treatment
2.1 Vital Operational Procedures
Section 3 Background Theory
3.1 Skin Anatomy and Functions
3.2 Lymphatic System
3.3 Importance of the Skin
3.4 Epidermal renewal
3.5 Maturing Skin
3.6 Environmental Factors (Over-Exposure to the Sun)
3.7 When to use a Sunscreen
3.8 The Melanin Unit
3.9 Hyper-pigmentation and the Cause
3.10 Skin Disorders
3.11 Diamond Peel Dermabrasion: Pre-surgery and post surgery
3.12 DP and Micro-pigmentation
3.13 DP and Collagen replacement Therapy
3.14 DP and Topical Actives
Section 4 Products After Treatment
4.1 Products After Treatment
4.2 Home Care
Pixi Peel Training Manual Page 3
Section 5 Consultation
5.1 Client Consultation
5.2 Client Commitment
5.3 Contra Indications
5.4 Complete Client Medical Record Card
5.5 Sensitivity Skin Test
5.6 After Care Rules & Product Explanation
Section 6 Treatment
6.1 Treatment Protocol
6.2 Treatment Levels
6.3 Treatment Applications and Correct Pressure Levels
6.4 Facial Diagram Demonstrating Stroking Directions
6.5 To Commence Treatment
6.6 Face Treatment
6.7 Jaw Line Lift
6.8 Cheek Muscles Lift
6.9 Brow and Forehead Lift
6.10 Treatment for Acne-Prone Skin
6.11 Treatment for Acne and Post-Operative Scarring
6.12 Body Treatment
6.13 Indications for Body Exfoliation in Preparation Tanning Treatment
6.14 Body Exfoliation: Application
6.15 Cellulite
Pixi Peel Training Manual Page 4
Pixi Peel System
The Pixi Peel skin treatment performs a progressive rather than an aggressive treatment over a
course of 10 to 20 sessions. Pixi Peel Diamond Peel offers a safe, controlled method of skin
exfoliation.
DP allows you to perform superficial peeling of the Stratum Corneum reducing its thickness through
mechanical abrasion of the dead skin cells. By placing the hand piece with the diamond head onto the
skin the head will resurface the skin surface. The diamond head can gently remove the epidermal
cells layer by layer. Dead skin cells are drawn away through the vacuum action and rest on the filter
inside the hand piece.
1.1 Benefits & Clinical Application of Pixi Peel DP
• Total control in exfoliation, eliminating any guesswork that can often be associated with AHA or
chemical peels.
• Allows the entire face and neck to be treated in a single session, with particular attention paid to the
client‟s areas of concern.
• The client can return to a normal lifestyle immediately with no down time or interruption to daily
routine.
• Eliminates possible adverse reactions often associated with chemical solutions.
• Immediate visible results, even after the first treatment, helps keep the client motivated.
• Can safely treat all skin colours or types.
• Offers reduction of moderate early ageing signs such as lines and wrinkles offering an overall
rejuvenation for aged skin.
• Stimulation of Fibroblasts for collagen reproduction.
• Rejuvenation of the overall skin with improved tone, elasticity and muscle tone.
• Enhances penetration of approved topical actives after treatment.
• Successfully treats a wide range of skin problems associated with both the face and body.
• Performs a controlled and adaptable progressive skin exfoliation.
• Perfect for congested skin with open pores and comedones and acne prone skin.
• Deeper exfoliation for thickened blemished skin and acne scarring.
• Reduces the thickness of the Stratum Corneum.
• Successfully helps lift and eradicate Pigmentation marks. Perfect for sun-damaged skin.
• Total Body Exfoliation Diamond Peel offers a successful Cellulite treatment as the vacuum action
helps with lymphatic drainage, whilst exfoliation helps to smooth appearance of uneven skin.
• Can be used to treat the very delicate skin under the eyes by creating a lymphatic drainage effect
through reducing the vacuum suction on your machine
Pixi Peel Training Manual Page 5
1.2 Explanation of Benefits
The Vacuum Action
Boosts circulation, hyperaemia can be observed as the superficial skin is stimulated. Hyperaemia can
be observed as the superficial skin is cleaned. By encouraging hyperaemia we are improving the
micro-circulation; (increasing the blood supply) thus providing nutrients necessary for the stimulations
of fibroblasts for collagen regeneration i.e. increasing blood supply in the epidermal layers producing
skin regeneration. The degree of epidermal abrasion can be varied by changing the diamond heads
used on the skin and increasing the vacuum suction on the machine. The result is skin that is instantly
smooth and fresh, whilst promoting new skin and collagen growth resulting in a tauter, more
rejuvenated skin after a course of treatments.
Face and Body
Pixipeel can treat both the face and body allowing a wide range of skin problems to be treated safely
and effectively with predictability of results. Exfoliation is derived from the Latin „Exfoliatus‟. Definition
„to strip leaves‟ Cosmetic exfoliation encourages normal shedding of the Stratum Corneum; it is
considered non-invasive as no viable tissue is involved.
Peel and Lift
Pixipeel provides an excellent method for skin resurfacing and correcting skin irregularities but also
provides an exercise programme for tired muscles, achieving an instant lift within minutes. This is
achieved by utilising the vacuum function with skin exfoliation. The muscles of the face are
manipulated as the vacuum action compresses the muscle tissue intermittently, thus performing an
isometric exercise i.e., one that does not involve shortening or lengthening the muscle instead, simply
firming the muscle through manipulation by intermittently compressing the muscle tissue. This action
gives an instant lift to the cheek bone, jaw line and the upper eyebrow areas. Combined with
exfoliation, this procedure now offers you the opportunity to provide your client with both an exfoliation
and lifting treatment all within a 30 minute treatment. By performing both actions together in one
session the Pixi Peel treatment is even more appealing to your clients whilst earning your salon more
profit as the combined treatment cost to your client is higher yet takes no more time.
Lymphatic Drainage
Pixi Peel treatment also has a direct effect on the lymphatic system. The lymph flow is increased,
thereby removing waste products and skin tone is greatly improved by stimulating exhausted skins.
Perfect for clients suffering from puffiness below the eye.
1.3 DP performs three Actions
Pixi Peel Training Manual Page 6
1. Correction
By placing the hand piece on to the skin with the diamond head this will impinge directly on to the skin
surface. The diamond heads can gently remove the epidermal calls layer by layer. This action allows
for the controlled exfoliation of the Stratum Corneum allowing a smoother fresher skin to emerge thus
correcting surface irregularities. (Dead skin cells are drawn away through the vacuum action and rest
on the filter within the hand piece.)
2. Stimulation
The combined abrasion and vacuum action stimulates micro-circulation. Hyperaemia can be observed
as the superficial skin is cleaned. By encouraging hyperaemia we are improving micro-circulation
(increasing the blood supply) thus providing nutrients necessary for the stimulation of the Fibroblasts
for collagen regeneration.
3. Isometric exercise
The vacuum function can be utilized to manipulate the facial muscles as it compresses tissue
intermittently. Resulting in an immediate lifting effect to the upper brow, cheekbone, jaw line and
improves overall skin tone. The vacuum action has a direct effect on the lymphatic system. The lymph
flow is increased removing waste products.
1.4 Frequently Asked Questions
Question 1: What is the difference between AHA and epidermal skin abrasion?
Answer 1: Used in the incorrect strength, or in inexperienced hands, use of the AHA may cause
irritation, which can lead to Post Inflammatory Hyper-Pigmentation. Use of AHA products cannot be
controlled as epidermal skin abrasion in treatment of lines, wrinkles, scars etc. however when used in
acceptable concentrations they can play an important role in the home-care maintenance programme.
Question 2: Will epidermal skin abrasion reduce or prevent lines and wrinkles?
Answer 2: Regular exfoliation will remove dead skin cells allowing more radiant youthful skin. Just
like physical fitness our skin needs an exercise programme to keep it young and healthy. Through
regular stimulation to the micro-circulation regular treatment aids in the production of new collagen
and elastin formation. The deep lines that tend to appear above the top lip (known as lipstick lines)
respond very well with regular treatment. If any adequate exfoliation and stimulation programme is
followed at an early age, the skin can retain its youthful appearance longer.
Question 3: Does epidermal skin abrasion make the skin more sensitive?
Pixi Peel Training Manual Page 7
Answer 3: No. Epidermal skin abrasion does not cause skin sensitivity. However, whilst undergoing a
course of treatments, we would advise using a high protection sunscreen as the skin will be more
susceptible and receptive to sun exposure and products used.
Question 4: Will facial scrub provide the same results?
Answer 4: No. Because some products may scratch the skin, causing irritation, they are merely
loosening the corneocytes and not removing the dead skin cells in a controlled manner. They have no
stimulation effects on the micro-circulation, and cannot erase or blend scar tissue or help the
smoothing of lines and wrinkles.
Question 5: Is Micro-Epidermal Skin Abrasion suitable for everyone?
Answer 5: Occasionally clients with very sensitive skin may show a reaction to the diamond heads
employed, which, in extreme conditions may result in inflammation and an unnatural redness with
irritation. It is extremely rare, however. To prevent any such incident it is advisable to perform a skin
test immediately before commencing treatment. Treatment should not be commenced if the skin is
exhibiting extreme sensitivity, open sores, cuts, abrasions etc... if the client is receiving tropical or oral
medication treatment should not proceed without the physician‟s approval.
Question 6: Is there a danger of over exfoliation on the skin?
Answer 6: A normally functioning epidermis naturally renews itself monthly on average. However this
can vary depending on the age of other aggravating factors. This process of cell renewal is a
continuous process and removal of an overly thickened Stratum Corneum (Hyperkeratotic skin) would
not deplete the epidermis of its natural ability to replace the renew skin cells.
Question 7: I have heard that speeding up the mitosis of the cells can lead to a cancer cell being produced?
Answer 7: Epidermal skin abrasion will not increase cellular activity to an unacceptable level.
Abnormally high cell turnover, as seen in certain cancer causing agents such as UV radiation can
produce defective cells, which in turn may produce the cancer-causing cell. However, micro epidermal
skin abrasion will not increase mitosis of the cells to an abnormally high rate. Regular exfoliation -
(helping to remove the dead skin cells) will actually promote the production of a greater amount of
healthy cells.
Question 8: How does epidermal skin abrasion help with age spots, (Keratosis)?
Answer 8: Many age spots that appear on the face are benign. Simple Keratosis, Actinic Keratosis
and Seborrhoeac Keratosis all have a thickened Stratum Corneum in common. Regular exfoliation will
help smooth and reduce the thickened Stratum Corneum.
2.1 Vital Operational Procedures
Pixi Peel Training Manual Page 8
Hygiene in the Workplace
Sterilising the diamond heads between clients is essential to destroy any harmful bacteria which could
cause infection. Good hygiene in the workplace will prevent cross infection and secondary infection.
Personal Hygiene
We would recommend gloves to be worn, washing hands regularly before and after each client. Hair
should be tied back, and avoid touching your face. Cuts and abrasions on the hands should be
covered with clean dressings.
Ensure that the vacuum suction is started on a low setting; test on skin before performing a treatment.
The skin should be cleansed with a gel or water based formula and be completely dry before
commencing treatment. Change the disposable filter after each client.
Always check over you heads; high usage will need replaced.
Section 3 - Background Theory
3.1 Skin Anatomy and Function
The saying “beauty is skin deep” is a truthful assessment in determining the health and appearance of
our skin. Our skin is the part we display to the world. Its diversity can show our age origins and health.
The skin functions as a protective barrier against environmental stress and impedes the preparations
of water and toxins. As a sensory organ our skin regulates body temperature and transmits
sensations such as pain and pressures every minute of the day. The skin is the body‟s largest organ
comprising 15% of our body weight. Multi-purposed, it varies in thickness throughout the body.
However, this paper thin protective mantle supplies a tough suit of armour. Our skin is composed of
three primary layers: epidermis; dermis; and the subcutaneous tissue. The epidermis is a self-
renewing barrier to water loss and is resistant to chemical, physical and micro-biological insult. It is
approximately 0.1mm thick (or only half as thick as paper). The epidermis is not uniform and can be
divided into two basic layers; the outermost Stratum Corneum (dead skin cells), and the viable
Stratum Malphigihi (cellular acrive part of the epidermis). The stratum Malphighi can be divided into
highly differentiated subleases:
Pixi Peel Training Manual Page 9
The Epidermis
Stratum Granulosum
Outer most living layer it is in this layer that the cells begin to die and are being shed. The cells have
lost most of their moisture and lipids. This layer also contains the substance keratinohyalin, which is
the basis of keratin. Keratin is the fibrous material that makes the skin virtually impregnable to micro-
organism insult and internal water loss.
Stratum Lucidum
Two-to-three rows of dead translucent cells which have an indistinct outline but no nuclei; this layer is
only seen in the thick skin of the palms and soles.
Stratum Spinosum
Eight-to-ten rows of round cells, which fit together by short prickles projecting from each cell, hence
the name they are know by: Prickle Cells. Each cell is compactly arranged with its neighbours, they
are capable of motosis, although the mitotic rate is slowing down.
Stratum Basal
A single row of cells resting on a membrane which separates the epidermis from the dermis these
cells receive their own oxygen and nutrients from the dermis. The cells divide continuously to produce
new cells and are stimulated into increase movement by stimulating the skin. Situated at the base of
the epidermis 95% of the Stratum Basal is composed of Keratinocytes. The major cell type of the
epidermis is the Keratinocyte, which produces the highly resistant insoluble protein called Keratin.
Keratin provides the protective barrier of the epidermis. Basale Keratinocytes constantly divides
through mitosis to form identical replacements every few days.
Replaced Basal Keratinocytes migrate upwards and outwards to form layers of cells interconnected
by desmosomes, (prickles or spines) comprising the Stratum Spinosum. Hence the name Prickle cell
layer. Keratinocytes continually become transformed and their nuclei in the Stratum Granulosum or
Granular layer. Keratin becomes more evident in the Granular layer hence the name Granular cells.
As Keratinocytes mature in different layers of the epidermis and transfer from the Stratum Basal to the
Stratratum corneum they change their structure and chemistry. The entire physiochemical process of
the cellular proliferation represents the maturing of Keratinisation. As a result the Stratum Corneum is
constantly regenerated.
Various changes in the Stratum Corneum can send messages to the basal layer to reproduce cells at
different rates. Removing the upper layers of the Stratum Corneum by exfoliation will prompt the basal
layer to reproduce cells quicker. Melanocytes comprise the other 5% of the Stratum Basale. These
cells synthesise melanin, which is transferred via melanosomes e.g. arm-like extensions, surrounding
Keratinocytes. There is approximately one melanocyte to every 36 keratinocytes. Keratinocytes are
responsible for the distribution of melanin throughout the skin for sun protection. The combination of
Pixi Peel Training Manual Page 10
melanocytes with the neighbouring Ketratinocytes with which it supplies melanin is termed „the
epidermal melanin unit‟. Variations in genetically determined skin pigment are related to the
difference in the Melanosome structure produced by the melanocytes and not to larger melanocytes
in darker skinned races. Melanin offers minimal photo-protection. Melanocytes reduce in number and
function in old age.
The Dermis
The dermis consists of two layers: the upper Papillary and the reticular layer. The dermis is comprised
on connective tissue fibres, elastin fibres and reticular fibres. It also contains many dermal structures,
hair follicles and appendages, nerve fibres and endings, blood capillaries, fibroblasts, mast cells and
lymphocytes. The Papillary dermis is the thinner upper layer of the dermis situated beneath the
stratum Basale of the epidermis. It is composed of interwoven collagen and elastic fibres.
The Reticular Dermis
The deepest layer is composed of coarse collagen bundles and lies beneath the bulk of the dermis. It
contains most of the dermal protein fibres, structures and cells. The dermal; protein fibre gives skin its
strength and flexibility, forming a support for the epidermis. Collagen fibres amount to 70% of the dry
weight of the dermis.
Subcutaneous Layer
The layer of tissue beneath the Reticular Dermis is known as the subcutaneous tissue, composed
mainly of adipose, or fatty tissue. It functions as a heat insulator, shock absorber and as a source of
fuel that is mobilised during starvation and exercise. Subcutaneous tissue varies in thickness.
Pixi Peel Training Manual Page 11
3.2 The Lymphatic System
This is the system that carries lymph; a watery fluid derived from blood plasma, around the body. It
deals with waste products and works in conjunction with the blood, in particular with the white blood
cells, or lymphocytes, that are important to the body in its defence against disease. There is an
efficient network of Lymphatic vessels in the dermis, which become lymph capillaries in the
subcutaneous layer, helping to remove waste products from the skin. The lymphatic vessels and
capillaries generally flow parallel to arteries and veins and empty into the main lymph ducts, the
thoracic and right lymphatic duct. The lymphatic vessels have valves to help prevent back flow;
massage movements or vacuum application in the wrong direction can move lymph backwards,
possibly spreading infection. For this reason massage and vacuum treatments on a client that has no
infection the suction created by the vacuum will have a mild lymphatic drainage effect enhancing the
results of treatment.
3.3 Importance of the skin
The blood that circulates in the skin delivers nutrients to the tissues and dissipates or conserves body
heat. Other primary functions are to protect the body from harmful outside elements and to balance
the body fluids by releasing perspiration. Skin is a vital sensory perception. For example, if a pan is
hot, the skin is the first to know and send warning signals. The skin is the mirror to ones health. Tell
tale signs of eating disorders such as anorexia or bulimia often include thinning of the skin, fine lines
and drying and dehydration due to lack of nutrients. Vitamin C deficiency may result in broken blood
vessels; lack of vitamin D can inhibit wound healing and reduce skin elasticity.
3.4 Epidermal renewal
One of the unique features of the epidermis is its ability to regenerate itself. The process of
continuously regenerating and shedding epidermal keratinocyte is known as cellular turnover and
desquamation. On average in normal skins we develop a new coat of skin every four to six weeks.
However with age and poor general health, the rate is considerably slower. It can take up to 19 days
for Basal Keratinocytes to reproduce in the Stratum Basale. The time required for replicated
Keratinocytes to travel from the Basale to the Granulosum is between 26 to 42 days, with an
additional 15 days until corneocytes are shed from the Stratum Corneum. Therefore from Basale
Keratinocytes replication to complete cell turnover would represent a total epidermal renewal time of
60 to 76 days.
3.5 Maturing Skin
Pixi Peel Training Manual Page 12
One aspect of ageing is its effect on our skin. We can break down the components of ageing into two
categories: Intrinsic and Extrinsic.
Extrinsic or Environmental
In order to understand the changes involved in ageing skin, we must first understand the skin‟s
normal anatomy. The skin has three layers. The lowest layer is composed of subcutaneous fat, next,
the dermis, which is composed mainly of the ground substance (Fibroblasts, collagen, elastin, nerves
and vessels). The epidermis is the most superficial layer and is composed of a living portion made up
of Basale cells, Keratinocytes, Melanocytes, Langerhans cells, (cells vital to the skin‟s immune
function) and finally the Corneocyte or dead layer on the top.
The anatomy of ageing would be as follows:
Grossly the skin becomes dryer, rougher thinner with the appearance of pigmentation marks in sun
exposed areas. Microscopically there is no decrease in the number of Corneocytes; however, the
individual cells begin to look large and irregular. The Keratinocytes show a decrease in the number of
layers of these cells, and each cell tends to be shorter and broader.
The Melanocytes decrease in their density from 10% to 20% per decade. During exposure to sunlight
they produce melanin, although in a blotchy pattern. This answers the question why old skin tans
unevenly. The Fibroblasts, which are responsible for the production of collagen and elastin, increase
in size as we age while their functional activity decreases. The content of dermal collagen, the most
important component, decreases by 1% per year after the age of 20. The collagen fibres also become
thicker and more brittle with age due to an increase in the cross linkage.
Elastin fibres decrease and fragment with age. There is a definite decrease in the blood vessels and
blood supply. The number of pressure and touch sensors decrease, making older skins more
susceptible to thermal and mechanical injury. The amount of fat decreases and overall the skin is
thinner and more susceptible to various conditions such as dryness, infection, and skin cancer.
In addition to the intrinsic or natural ageing process, the effects of the extrinsic factors such as
sunlight are responsible for many of the cosmetic problems associated with ageing such as age
spots, pigmentation and wrinkles. Many factors influence cellular regeneration and desquamation.
Dermal growth factors, hormones and vitamins A and D, can influence epidermal cellular turnover. In
addition age general health, and genetics influence cellular proliferation i.e. (repeated and rapid
reproduction of new cell division). Generally, young skin regenerates more rapidly.
Pixi Peel Training Manual Page 13
3.6 Environmental Factors (Over-exposure to the sun)
When skin exposed to excessive sunlight, a natural response of the Stratum Corneum is to become
thicker to protect the sub layers of the skin. This may result in slower shedding producing thickened,
dry, and rough skin. Abnormal cell division is also seen in hyper-keratotic disorders, e.g. overgrowth
of the Stratum Corneum. Excessively dry rough skin is a condition that affects many people and
appears to be the result of abnormal desquamation. Over exposure to ultra violet rays can seriously
damage our skin. It has been fashionable over the last 50 years to acquire a tan. In addition there
appears to have been vast changes in the ozone layer which has added to the problems caused by
sun to the younger generation.
It is easy to recognise the additional signs of sun damage added to the normal process of ageing.
Darker skin races manage to look younger at the age of 50 that their paler skinned equivalents due to
the increased amount of melanin produced offering more protection. UV light affects the epidermal
cells, which are constantly dividing and replacing themselves. Eventually this process breaks down
and rough areas develop (Keratoses) which can develop into skin cancer. The same UV light causes
changes in the melanocytes, which produce the pigment and irregular brown patches like large
freckles appear. They are sometimes called liver spots but have nothing to do with liver disease.
These brown marks may develop in relatively dark skins that are not particularly prone to the
development of skin cancer. The UV light can penetrate into the dermis where the collagen and
elastic tissue give the skin its strength and flexibility.
Damage to these structures causes increased wrinkling and the thickened yellow appearance known
as elastosis, often seen in people who work outdoors, on the nape of the neck. Often small blood
vessels become conspicuous, especially on the cheeks, a problem known as telangiectasia. The loss
of elasticity also exaggerates the bruising effect that may occur after prolonged sun exposure.
This condition used to be called senile purpura but may be seen in sun-damaged skin at the age of
40. In severely damaged skin with marked elastosis, senile comedones (blackheads) may develop.
They have no connection whatsoever with acne but are extremely unattractive. UVB can also
penetrate the underlying dermis causing considerable deterioration to the collagen and elastin. This
causes wrinkling and a leathery appearance of the skin.
3.7 When to use a sunscreen
Pixi Peel Training Manual Page 14
It is impossible to anticipate when one will be exposed to the sun; therefore sunscreen should be
applied daily. Furthermore, just because it is cloudy in the morning, there is no guarantee that the
sun will not be strong by mid-day. On holiday, or when playing sport, sunscreens are most effective
when applied to cool, dry skin. It is therefore sensible to apply 20 to 30 minutes before going into the
sun.
3.8 The Melanin Unit
Melanin helps protect the skin from ultra violet light. From the medical point of view we all produce the
same number of pigment producing cells (melanocytes) per square centimetres of skin. However,
those with darker skin produce a different or increased amount of melanin (pigment) that those with
light skin hence the reason darker skin will survive sun-damage much better than fair skin with less
risk of developing skin cancer.
The colour of the skin depends not on the amount of pigment cells but the type of pigment that we
individually produce. Our parents genetically determine the type of melanin produced. Melanin is
produced in the deepest part of the epidermis. Melanocytes make pigment, which remains in the
epidermis and is gradually shed, being replaced by new pigment from deeper in the epidermis. Injury
to the skin can disrupt the normal pattern - e.g. dark marks that remain on the skin after acne has
cleared. The resulting dark marks are known as post inflammatory hyper pigmentation. Some rashes
such as eczema will have the opposite effect causing paler skin (hypo-pigmentation). Any rash or
trauma to the skin allows the melanin to drop to the dermis, the natural clearing mechanism is
disturbed in the affected area, and the skins own natural scavengers will slowly remove the unwanted
pigment.
3.9 Hyper-Pigmentation and the Cause
There are many reasons why hyper-pigmentation (Melasma) can occur. Most obvious causes are the
oral use of birth control pills or hormone replacement therapy, pregnancy, or interaction with certain
medications. Repeated sun exposure or over exposure also plays a part as does inflammation or
trauma caused to the skin. Certain chemicals found in perfumes etc. can also result in pigmentation
marks occurring. Regular Diamond Peel Dermabrasion treatment will show significant benefits to
sun-damaged skin and help remove unwanted pigmentation marks.
A course of Skin Smoothie treatments can achieve beneficial results in the treatment of pigmentation
marks. The treatment is an ideal choice as it allows a gentle approach in treating all skin colours.
Regular treatment can help the ill functioning epidermis to become better organised and thicker with
the horny layer on the surface to be produced in a more regular way. Regular treatment using low
Pixi Peel Training Manual Page 15
vacuum suction will help the pigment move through the epidermis and be shed normally. Clients
should be advised that a course of between 10 and 15 treatments might be needed. It is also
imperative that the client be advised to wear a sun-block at all times.
3.10 Skin Disorders
This is a specific disease involving the melanocytes which simply stop producing pigment in certain
areas. It can remain localised or spread relentlessly. It affects about 1% of the population irrespective
of skin colour. It presents itself as pure white patches; the melanocytes in the affected area stop
producing any pigment. (Treatment with Pixi Peel can not help this condition). Melasma, Chloasma
This is a darkening of the skin, which is usually symmetrical, and like a mask. Often occurring in
woman who are pregnant or as a result of the contraceptive pill, this can be referred as „Pregnancy
Mask‟. The condition is made worse by sun exposure and will normally remain on the skin for many
months after delivery or stopping the pill. The melanin has dropped to the dermal layer.
Treatment with Pixi Peel Diamond Peel Dermabrasion will help the trapped pigment move through the
epidermal layers to be shed in its normal organised way. However, many treatments may be needed
to improve the area affected. Pityriasis Versicolour (Tinea Versicolour) This is a condition common in hot
countries, and is characterised by areas of increased or decreased discoloration. The most common
areas affected are the front and back of the upper trunk, though this may spread to the back and
upper arms in some cases.
The condition is caused by a small yeast infection, which grows on every body‟s skin, often more
common in hotter climates. It presents itself as small, slightly scaly patches; their colour is variable,
ranging from white to pink to an orange colour. When conditions are favourable it changes its form of
growth and the rash appears. A prime condition for this is sweating and most common cases occur in
people who live in a sunny climate. The condition is often noticed after a holiday in a sunny climate
partly because the infected areas are exposed and do not produce a suntan. The infection can be
successfully treated by a dermatologist. The yeast clears quickly after the application of selenium
shampoo, although normal pigmentation does not return for many months. Due to the problem being
caused by a yeast infection, treatment with Pixi Peel micro-epidermal skin abrasion would not be of
any benefit.
Inflammatory Disorders
Pixi Peel Training Manual Page 16
Chronic Eczema is often confused with psoriasis as it shows a thickening of epidermis. Acute forms
exhibit tiny clusters of blisters that ooze fluid and then form crusts. It is a contra-indication to DP.
Psoriasis lesions do not itch like eczema and they are scaly silver plaques that cover reddened areas.
DP is a contra-indication.
Degrees of Acne
Acne Grade 1:
Consists of open pores, comedones, white heads and black heads.
Acne Grade 2:
Normally no inflamed. Both grades of acne are perfect for treatment with DP as regular treatment will
help remove the bond holding together and excessive build-up of dead cells, removing blockages and
cleansing pores, thus allowing the skin to rid itself of excessive oils naturally. Regular exfoliation with
DP will show significant results by reducing the cornocytes that are a contributing factor to the
development of comedones, blackheads and white heads. The reduction of excess cornecytes also
refines the thick, rough texture associated with oily skin. Regular exfoliation can substantially reduce
surface sebum.
Acne Grade 3:
(Active acne) exhibits a mixture of closed and open comedones, with papules and pustules. This type
of acne also responds well to DP but the client should be advised to use topical treatments or tropical
prescriptions products to help clear the inflammation and pustules.
Acne Grade 4:
This stage the acne is at its most disfigured. The extent of the active inflammation and pustules
normally result in the development of acne scarring. The skin becomes tender to touch. This type of
acne needs careful attention and a more intensive treatment programme incorporating topical
medication, peeling solutions and bleaching agents to stop pigmentation problems occurring. DP
should only be used over the areas that do not display active pustules in order to prevent spreading
the infection to non-infected areas.
Hypertrophic Scars
Hypertrophic scars are visible as a raised lumpy area over the site of injury. They form when there is
an excess of repaired dermis which causes a protrusion in the epidermis. Micro-epidermal skin
abrasion gradually erases the lumpy appearance and files the area down whilst blending surrounding
skin to make the scar less noticeable and unsightly.
How Stretch Marks are caused:
Pixi Peel Training Manual Page 17
The skin layers involved with stretch marks are the epidermis superficial layer, which is continually
regenerating, and the dermis, the under lying layer, which amongst others, has the function of
nourishing the thin basal layer at its highest borderline where the skin cells are continually produced.
The dermal has a wavy surface. After rapid weight gain or pregnancy these waves are ironed out- in
some places they are flattened, consequently the epidermis above it drops and becomes thinner as it
has to cover a larger area. This produces variations in the region of a fraction of a millimetre but
sufficient for the stretch mark to appear. The stretch marks appear when the dermis is lacerated and
therefore becomes thin. DP will not remove the stretch mark. However, regular treatment will show an
improvement to the treated area making the marks less obvious. Scar tissue should not be treated
until inflammation has disappeared from the area. Regular treatment with DP will help improve the
appearance of the stretch mark by creating a blending effect to the surrounding scar tissue, also
reducing any pigmentation problems that often making the stretch mark more noticeable.
3.11 Diamond Peel Dermabrasion: Pre-surgery and post surgery
DP offers an excellent tool for management of pre and post surgical treatments such as face-lifts and
laser treatments. It is recommended the client undergoing such treatments has a series of DP
treatments prior to surgery as treatment will prepare the skin helping stimulate fibroblasts needed for
new collagen regeneration. Using pre post surgery, or laser, resurfacing will enhance the results and
help manage the possible pigment changes normally observed after such treatments.
The ideal plan would be 4 treatments prior to surgery or laser and 6 treatments post surgery. DP used
as a once monthly maintenance treatment will also help prolong the results of such treatments and
keep the skin in tip top condition.
3.12 Diamond Peel and Micro-pigmentation
One treatment prior to the topical application of anaesthetic will remove the dead skin cells enabling
the anaesthetic to penetrate better but also allowing the therapist to see a more precise final
placement of the pigment and saturation often limiting the need for additional visits. Once the healing
time is complete DP can be used over the treated areas without worry of removing pigment. Provided,
of course, that the pigment has been placed properly and is sited in the upper dermis.
Pixi Peel Training Manual Page 18
3.13 Diamond Peel and Collagen replacement therapy
Diamond Peel Dermabrasion is perfect used prior to collagen replacement therapy injections as it
helps prepare the area for treatment. First, by removing the dead skin cells you enable for topical
anaesthetic to penetrate deeper thus having a better numbing effect, secondly, DP prepares the area
for implantation. DP should not be used post collagen injection for at least one month after injection.
The reason being that collagen can be manipulated for up to 48 hours after injection. However, if the
client experiences lumpiness at the site of injections 2 weeks after treatment a very gentle treatment
with Diamond Peel Dermabrasion will help to smooth the area.
3.14 Diamond Peel and Topical Actives
Quite often there is a lack of understanding the products that can be applied to the skin immediately
after treatment. Also, a lack of understanding on how important it is to prescribe the correct skin care
products for the client to use at home. This understanding is imperative if the client is to protect and
enhance the results of treatment.
4.1 Products After Treatment
The skin is receptive after treatment. No AHA's, No Glycolic, No UVA Treatments. The skin is exceptionally
receptive to any products applied directly after treatment. Therapists should check the pH of any
product they are going to use; a low acidic pH will cause irritation and stinging as would a product with
high alkaline content, where as a product with a pH level of between 4.5 and 7 are suitable. Skin care
products that contain a high percentage of botanicals are essential oils are unsuitable for use after DP
as some of the ingredients contained may cause an allergy. Should this occur, there is a real danger
of both the therapist and client thinking that it is treatment they are allergic to, where as it is actually
the ingredients within the skin care preparations. It is important that products are used that replace or
add moisture back to the skin so as to stop the skin becoming dry and peeling. Tropical nutrients,
anti-oxidants and hydrating moisturisers and skin brightening products not only contains skin
brightening actives but also Titanuim Dioxide and Zinc, which offer excellent SPF Factor and is
suitable for a sensitive skin.
Pixi Peel Training Manual Page 19
4.2 Home Care
Ensure you retail a range of products that enhance and compliment the benefits of your professional
treatment whilst ensuring your clients‟ skin is cared for 365 days of the year.
5.1 Client Consultation
A full and detailed explanation and evaluation of; what the treatment is and what results the client can
expect to achieve over a course of treatment. It is also important to explain to the client how the skin
will react during the course of treatment and to explain what settings you will be incorporating.
For example; if a client needs a more aggressive treatment plan treat sun-damaged skin or acne
scarring it is important that the first treatment be performed using a low pressure setting and
performing a very light exfoliation.
The therapist should try to understand the client‟s skin and how it reacts before becoming too
adventurous. Quite often therapists want to impress the client so much on their first treatment that
they apply too much pressure and work too aggressively. This results in the client‟s skin actually
becoming sensitive and, if the skin has been dragged and too much pressure applied, red stripes can
be evident. This is due to the therapist being too ambitious and not understanding the client‟s skin.
It is always advisable to keep the treatment light during the first treatment and then slowly progress to
a more aggressive treatment as the course progresses, this ensures the client‟s skin becomes used
to the treatment and the client will also understand what is happening. A client that goes home with
red stripes or red, sensitive skin will be a very unhappy client and will probably cancel the course of
treatment because the therapist has failed to explain or perform the treatment properly.
5.2 Client Commitment
The therapist should ask the client how committed they are to achieving results. For example; are
they committed enough to follow the rules provided by the therapist in respect of protecting their skin
and using the correct skin care products in between salon visits. The therapist must ensure the client
thoroughly understands the importance of using the correct skin care products in her home regime in
between treatments.
Pixi Peel Training Manual Page 20
5.3 Contra Indications
Diamond Peel Dermabrasion is normally not advisable where any of the following conditions exist:
Active or uncontrolled Diabetes
Raised Moles, Warts, Skin Tags
Skin Cancer & Auto immune diseases
Eczema & Seborreic Dermatitis
Telangiectasia
Rosecea & Active Acne
Herpes Simplex
Asthma, Keloid Scars
Herpes Simplex
Clients with a tendency to outbreaks of herpes simplex should obtain a prescription for Zovirax.
The medication should be used 2 days prior to treatment and 3 days post treatment.
Diabetes
The healing response is impaired if the condition is not under control; therefore, DP is not suitable
for clients who have this condition. If the diabetes is under control a doctor‟s note should be
received before you commence treatment.
Accutane for the Treatment of Severe Active Acne
Treatment should not commence for 6 months after discontinuing medication. A doctor‟s letter
allowing treatment to commence should always be sought prior to a treatment course even after 6
months of discontinuation of the drug. AHA and Retin A should be discontinued 7 days prior to
treatment and not resumed until the treatment programme is complete.
5.4 Complete Client Medical Record Card
Include client details on the record card and record areas of concern. This will ensure special
attention is drawn to their specific needs. Their progress made should be visible at each treatment
and results evaluated and documented on the client record card. Explain Contra-indications of
treatment and ask the client to sign the record card after each treatment.
5.5 Sensitivity Skin Test
It is most unusual for a client to be sensitive to the diamond heads employed; however, a skin test
should be performed on the back of the forearm. If the area becomes irritable or swollen do not
proceed with treatment. If the client develops red marks on the skin after treatment it is normally due
to the therapist applying too much pressure.
Pixi Peel Training Manual Page 21
5.6 After Care Rules & Product Explanation
Clients should be advised as to the adverse effects of ultra violet radiation; extremes of temperature,
the wind, effects of central heating and skin care abuse. Encourage the client to adopt a regular skin
care routine incorporating cleansing, toning, moisturising and applying sun protection products.
Advise on the use of SPF factor 30 to be used daily. Treatment can be repeated at intervals of seven
to ten days. A course of 15 to 20 treatments should be recommended for more problematic skin such
as scar tissue, lines, wrinkles and stretch marks.
Treatment
The Treatment
The client should be explained the treatment in full detail. For example; Pixi Peel Diamond Peel
Dermabrasion offers the prospect of superficial peeling by exfoliating the uppermost layers of the
Stratum Corneum. The controlled diamond head allows the operator to address various defects in the
surface of the client‟s skin including uneven texture, hyper-pigmentation, fine lines and wrinkles, sun
damaged skin, and the blending of scar tissue. The client will experience an instantly revived, more
glowing complexion, even after the very first treatment.
The vacuum action aids lymphatic drainage and allows a lifting effect caused by massaging the
muscles in the face. The most common complaint from a client would be a lack of explanation
regarding what result they can expect. Some clients are told that treatment will totally eradicate deep
lines and wrinkles.
As we all know this is not possible as we are working only in the superficial epidermis. However,
regular treatment will make the lines softer and the general improvement in skin texture will provide
an overall rejuvenated skin. It is therefore important to establish what the client hopes to achieve from
the treatment programme.
See a Difference after the First Treatment
Most clients will see and feel a difference after the first treatment. However, for optimum results, a
course of at least 5 to 10 treatments should be recommended. Explain the benefits of monthly
maintenance treatments to keep the skin in tip top condition.
Pixi Peel Training Manual Page 22
6.1 Treatment Protocol
• Ask the client to remove contact lenses.
• Cleanse the skin with cleansing gel.
• Ensure the client‟s hair is away from the face.
• The skin must be completely dry before commencing treatment. The therapist should wear gloves.
• Insert a clean filter for your client.
• Attach a sterilised diamond head to your hand piece.
• Select the correct treatment level on your machine.
6.2 Treatment Levels
We advise newly trained therapists to use low vacuum suction until they are fully confident in the
lightness of the strokes. Once the therapist is confident in the use of the Pixi Peel skin system, a
higher vacuum can be utilised. During treatment the skin should be held taught. The hand-piece
should be gently and quickly glided across the skin without using unnecessary pressure.
6.3 Treatment application and Correct Pressure Level
Treatment Level 1 allows a skin smoothie exfoliation revealing fresher, smoother, and healthier
looking skin. Regular treatment provides substantial cosmetic benefits reducing fine lines and
wrinkles, allowing skin re-texturisation, improved skin tone and clarity, lightening of skin
discoloration‟s, reducing pigmentation marks and improving the radiance and overall tonicity of the
skin. Perfect for the management of acne prone skin. Level 2 & 3 can be selected when working on
acne scars or more thickened skin. Level 1 should be used for treating Asian and darker skin tones
Pixi Peel Training Manual Page 23
6.4 Facial Diagram Demonstrating Stroking Directions
Pixi Peel Training Manual Page 24
6.5 To Commence Treatment
• Position the client semi-reclining.
• Stretch the skin with the thumb and middle finger holding the hand piece with the diamond head
attached. Place the head into position on the skin. Starting on the forehead at the centre, place the
head into position on the skin.
• Hold the hand -piece as if it were a pen; gently move in a sweeping action across the forehead
towards the temple area covering the entire facial area.
• On treating the cheekbone use very light quick strokes as this area is rather sensitive.
• Perform a gentle exfoliation to the entire facial area and neck area. On completion of a gentle
exfoliation you can return to the areas that need further attention such as thickened skin, pigmentation
marks, acne scarring etc. The secret of a treatments success lies in the pressure of the strokes used.
Light quick strokes should be used for a skin smoothie treatment, slower strokes to concentrate on
problem areas.
6.6 Face Treatments
Treatment of the delicate area of the neck
Level 1. Make contact with the skin; run the head gently and quickly from under the chin to the
collarbone using overlapping strokes to ensure even abrasion.
Treatment of the delicate skin directly under the eye
Level 1. Holding the skin taught place the head into the corner area, pass over the area once using a
light, quick stroke outwards.
Diamond Heads
B- 100 Ideal for Face
B- 150 Ideal for Face
B- 200 Ideal for Face
E- 200 Ideal for Face
F- 200 Ideal for Eyes, Chin
D- 180 Ideal for Body
D- 200 Ideal for Body
T- 100 Ideal for Body
T- 180 Ideal for Body
Indications for Treatment Level 2 & 3 are suitable for Acne scarring, Lines and wrinkles, Stretch
marks, Scar tissue, Sun-damaged skin, Cellulite treatments and body exfoliation.
Pixi Peel Training Manual Page 25
Perform a level 1 or level 2 treatment dependent on your client‟s skin sensitivity or if the client needs a
more aggressive treatment. Perform a light exfoliation over the entire area to ensure an even
exfoliation.
Return to areas of concern utilising slightly more pressure and using a slower hand movement.
For Treatment of Lines, Wrinkles, Acne Scarring Stretch Marks, Scar Tissue, Frown Lines etc:
Level 2 or 3. Stretch the skin with the thumb and middle finger. Place the facial head into position.
The head should be run quickly and without stopping length ways along the mark until initial
hyperaemia can be seen. Change direction, working across the path originally traced to stimulate the
surrounding skin. Finish with a circular movement to even the total abrasion. To create deeper
exfoliation on a problem area, allow the diamond head to pass slowly over the skin without exerting
too much pressure.
Telangiectasia
Level 1. Areas exhibiting minor telangectasias should be treated gently performing light quick strokes
over the area.
Completion of treatment, use the calming lotion with the masks.
Pixi Peel Training Manual Page 26
6.7 Jaw Line Lift to go in here put down picture 6.7
- Position diamond head onto Jaw Line and hold the skin taut with index finger as shown. - Hold for 2 seconds.* - The index finger should be lifting the skin upwards while the diamond head is pushing into the Jaw Line area.
Pixi Peel Training Manual Page 27
6.8 Cheek Muscles Lift
- Position the diamond head so that it is pushing upwards and under the cheek muscles. - Position the index finger so that it is supporting the top part of the muscle and hold for 2 seconds.* - Work along the cheek muscles in an up and out pattern. - NOTE: * Depending on the sensitivity of the clients‟ skin, this process may be repeated 3 or 4 times.
Pixi Peel Training Manual Page 28
6.9 Brow and Forehead Lift
- Position the diamond head into position under eyebrow muscle. - Push up and secure skin with the index finger approx. 1 inch (2 cms) above the diamond head. -Pushing upwards at all times continue motion to a count of 2 seconds.* - Work up the forehead following the same pattern. - NOTE:* Depending on them sensitivity of the client‟s skin this process may be repeated 3 or 4 times.
Pixi Peel Training Manual Page 29
6.10 Treatment for Acne-Prone Skin
Acne is an inflammatory eruption that occurs in and around the sebaceous glands of the face, neck
and back, caused by overactive sebaceous glands, hormonal activity and pore blockage. With acne
prone skin, dead cells build up around the hair follicles and interfere with natural drainage of oil,
causing the hair follicle to clog and fill. The resulting blockage can lead to several problems including
Comedones and congestion.
Even women in their thirties are being affected by different forms of acne often caused by stress
related problems or poor nutrition. It is important that the therapist educates the client in controlling
these outbreaks and advises on the correct skin care products or prescription medicines. It is
important before treating with DP that active acne is brought under control.
6.11 Treatment for Acne and Post-Operative Scarring
Depressed acne scarring, with acne scarring, a small portion in the deep germinative layer is
damaged, leaving it full of fibrous scar tissue. The scar is depressed, as healthy tissue destruction is
more in-depth. Using controlled micro-epidermal skin abrasion creates a precise action to be
performed only on the scar without affecting the healthy skin; it is possible over a period of time to
perform a blending effect of the surrounding scar tissue.
Ice pick type acne scars will not be improved by the use of DP. However, regular treatment will result
in an overall improvement in the quality of the skin.
The Method allows Two Actions:
First, abrasion of the superficial thickened scar tissue to the required depth greatly improves the
general appearance. Secondly, the vacuum action stimulates increased blood flow to the dermis,
aiding in tissue repair and correct cell renewal regeneration.
Pixi Peel Training Manual Page 30
6.12 Body Treatment
Pixi Peel Training Manual Page 31
6.13 Indications for Body Exfoliation in Preparation for SprayTanning Treatment
• To encourage the micro-circulation
• Improvement of skin tone
• Removal of hard skin
Note: As most spray tans contain alcohol you may find it is best to offer the body exfoliation 24 hours
prior to your spray tan.
6.14 Body Exfoliation: Application
• Cleanse the areas to be treated
• Allow high vacuum suction
• Follow the diagram illustration
• Attach the body diamond head
Lay the client on her back and starting at the feet, run the nozzle in a controlled and rhythmical
movement using long strokes working towards the heart. Move your hand slower and with more
pressure over the entire area. Continue up to the arms and then onto the abdomen and décolleté.
On completion wipe over with damp mitts and apply moisturiser to hydrate the skin.
Ask the client to lie on her front and repeat the process.
Body exfoliation can also be used for certain problem areas on the body; for example the backs of
arms or the shoulders etc.
6.15 Cellulite
Cellulite is a fatty tissue that accumulates in certain areas. It is often very difficult to remove and tends
to be resilient to diet and exercise. The whole area is characterised by inactivity, sluggishness and
stagnation. Lymphatic drainage is poor and blood circulation is limited. Toxic waste products and
water surround the tissues decreasing oxygen and nutrients to the cells thus slowing down the rate of
cellular regeneration. The skin tone is poor and the skin looks dull and sluggish.
Diamond Peel Dermabrasion makes the perfect choice for cellulite problems as the vacuum action
created during treatment will create a detoxifying draining effect reducing puffy swollen tissues and
improve the micro-circulation. A deep exfoliation treatment will refine the texture of the skin. The
vacuum action will also help create a lifting effect to the skin. Body exfoliation is perfect prior to other
body treatments as it allow the skin to be more receptive to the active ingredients utilised these
treatments