Of all the many diseases of obscure etiology, rosacea should rank near the top of the list. It is known that a lot of people have rosacea—an estimated 13–14 million in the United States.2 It occurs most frequently in people ranging from 30–50 years of age and is found primarily in fair-skinned people with northern European ancestry. Women, for some reason, are affected about two to three times more often than men.3 Rosacea is characterized by a persistent erythema of the face for a duration of at least three months. Diagnostic signs include flushing, papules, pustules, telangiectasias, edema, plaques, a dry appearance, ocular manifestations and phymatous changes. Symptoms include burning and stinging. A major finding is central facial flushing, often accompanied by burning or stinging. Patients generally have finely textured skin, although the face may appear rough and scaly, suggesting a low-grade dermatitis. Known triggers to flushing include emotional stress, alcohol, spicy foods, exercise, cold or hot weather, hot drinks, and hot baths and showers. Rosacea patients frequently have sensitive skin and may feel pain with many products, even when they are gently applied to the skin.

A present controversy is the concurrent existence of acne and rosacea. As a rule, no comedones are seen in rosacea. My personal opinion is that acne is a separate disease from rosacea. I base this on the fact that rosacea is characterized histopathologically with the appearance of perivascular infiltration. This would suggest some basic vascular pathology, which is to say, it covers a lot of area, but it presents a clue or starting point. Why do only men get rhinophyma with rosacea? Studies have shown possible associations between rosacea and the face mite Demodex folliculorum 4, 5 and Helicobacter pylori infection.6, 7, 8

Treating rosacea with oxygen. Treatment by the medical profession for rosacea is essentially an attack with antimicrobial agents, but for more resistant cases, physicians use surgery, dermabrasion, laser and more recently, intense pulsed light (IPL). The esthetician has limited use of these modalities, but there are still effective treatment methods available. Since there appears to be a bacterial component to rosacea, an antimicrobial product should be used along with an anti-inflammatory. You have your choice of many anti-inflammatory agents, both natural and synthetic. Bioflavanoids and other polyphenols from green tea are effective. Consider also bisabolol from the plant chamomile. One very powerful antioxidant found in pomegranate is ellagic acid, with a great many other positive properties, such as an antiperoxidant, antiseptic, antibacterial, astringent, antifungal, antiyeast, and it is a sunscreen, as well, when added at 0.5%.

Topical oxygen should be applied in a wet form, carefully following the directions of the manufacturer. When you see the skin blanch, you know you have reached the top of the dermis with your oxygen treatment. At the same time, you will have killed many of the superficial and deep-surface bacteria, and probably killed the demodex, or else made them very unhappy.

The treatment program for rosacea should follow an initial three treatments the first week, two the second week and one the third week. Depending on the improvement, scheduling of the subsequent treatments can vary from biweekly to monthly. As the reader is well aware, rosacea clients do not all respond the same, so adjust your treatment to meet the needs of a particular client.

Aging skin

Aging remains a major topic in science because, even today, the process isn’t fully understood. It is known, for example, that tissues and cells undergo damage, that a person’s DNA may also be damaged, and that a lot of systems do not work as well at age 50 as they do at age 20. There are many questions, but few answers, although a great deal has been learned during the past few years about some important aspects of aging that can be translated into skin care. Energy and living are forever linked, and so is the aging process. Having adequate energy for every organ is essential for the normal function of each organ, and that means each cell must have a good supply of energy. The skin is one organ that almost always comes off on the short end of the metabolic stick.

Waste products accumulate in the skin, its blood and nutrients are shunted to other organs in emergency situations, and nasty metabolic by-products are frequently sent to the skin to be neutralized. The sun and cold are not the skin’s friends, nor are harsh detergents and soaps. Next to the stomach, the skin is the most abused organ in the body. The skin can be helped, however, if enough energy is supplied to it, and that is one thing oxygen therapy can do.

The mitochondria. Tremendous strides in the information known about mitochondria have been made during the past 30 years. They are the major energy source for the cell and are damaged rather easily because they do not have adequate repair mechanisms. In a previous article, mitochondria were discussed, as well as how they produce ATP. Every movement or thought, and most chemical reactions that occur in the body, require ATP. In fact, so much ATP is used by the body that each day, it makes and uses about 80 pounds of it. Staggering! Oxygen is critical to the process of generating ATP.

Aging skin features a decrease in circulation, metabolic activity, ATP production and a sluggish immune system. The skin is also insulted daily with free radicals, both inside and outside the body. Any treatment of aging skin should begin with an adequate antioxidant regimen. A good, glycation-free diet with a modest caloric intake can prevent many unnecessary hospital days.

Treating aging skin with oxygen. Oxygen can be used as an adjunct treatment in your skin care anti-aging program. Remember to always use wet oxygen.

Include in your aging skin treatment program three oxygen treatments during the first week, and a series of three treatments the next week. During this time, you could use one enzyme peel each week for the first two weeks. During the third week, look for changes in texture, color and fine lines. The third week, give two more oxygen treatments—although the timing is not critical, they should be two to three days apart, but do not administer them back to back. After the third week, you can adjust your treatments to once a week or alternate weeks for six to eight weeks, depending on the condition of the client’s skin.

Look at two parameters in order to evaluate wrinkles.

How deep are they? Even one or two deep wrinkles suggests a great deal of damage to the dermis. Little wrinkles will hold a thread; moderate wrinkles will hold a string; severe wrinkles are deeper and wider than the wire in a coat hanger.

How long are they? Except for the nasolabial fold and the labiomental fold, wrinkles that measure longer than an inch are really bad. These wrinkles reveal that there is a great deal of dermal damage and will most likely fail to respond to anything other than deep surgical peels.

Oxygen and the skin

Oxygen revitalizes the epidermis and stimulates cellular growth by increasing cellular proliferation. It will kill surface bacteria, deep anaerobic bacteria and fungus. Oxygen will supply energy to the epidermis and to the dermis, helping to heal any small wounds and irritations. In the dermis, it will help produce collagen and elastin and help restructure the extracellular matrix. Oxygen is a micronutrient and it will assist with many metabolic processes in the skin. Lastly, it is critical for many enzyme reactions, and the presence of oxygen can often accelerate these reactions.

How often can you use oxygen therapy? The cost of the treatment must be considered, but the client is the most important factor. Remember that using oxygen is an art. You must know how to use it. If a company tries to sell you an oxygen treatment without adequate education or instruction, steer clear of it. You will begin to see oxygen used more often in esthetics within the next few years, and perhaps in combination with other treatment systems.

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