Fan Brush of Fury (Part One)
There is a natural point of contention between estheticians and prescription retinoid creams like Retin-A and Differin – we don’t make any money on them. But just as the reaction to Proactiv isn’t purely based on financial impact (as discussed in this article), the same holds true for prescription retinoids.
So from the esthetician perspective, here’s why they’re extremely unpopular:
Inflammation (e.g. too much stimulation)
As discussed in the last article, retinoids* create inflammation, evidenced by the redness it often brings. Inflammation can be both useful and damaging; with the worst case scenario being that it accelerates aging and degradation of the skin. Most estheticians strongly believe Rx retinoids cross the line in a big bad way.
They see retinoids as an overkill, sledgehammer response to skin conditions that could be more gently guided back to health.
Increased Sun Sensitivity
It’s a long-held belief, in both medical and esthetic circles, that retinoids increase sun sensitivity. Given that much of the visible damage to the skin is attributable to the sun (not to mention skin cancer), we worry about that increase.
Creates Fragility
Although retinoids do build up the thickness of the skin, it does seem to affect skin cohesiveness. This is one of the reasons it’s effective in acne treatments, but it can also make it easier to tear the skin surface. Clients cannot wax while on a retinoid regime as it can lead to scabbing, or worse, scarring. And of course, this torpedoes yet another aspect of our profession which leads to:
Limits Treatment Options
Imagine someone coming out of a cinema, having just seen a horror movie. They’re so hopped up on adrenaline and Red Hots that any tiny sound or movement makes them leap a foot. That’s the case, a lot of the time, with skin on retinoids. It’s very responsive. This makes it hard to plan a regime because you’re walking on eggshells – will the steam cause too much redness? Will the massage be too stimulating? Will the peel be too strong? Will the extractions tear the skin? Estheticians like to roll up their sleeves and do effective work – retinoids often limit us to moisturizing masks and light massage.
Limits Product Options
Well heck yeah we would rather you bought our products. We’ve researched them and believe in them - but we often can’t predict how they are going to interact with a prescription retinoid regime, and may need to sideline star performers because of that.
Product Line Education
Reinforcing all these beliefs are product line manufacturers – obviously their bottom line is affected by prescription products as well. Unfortunately, most further education for estheticians comes courtesy of one product line or another (and, it can be argued, much further education for doctors comes from drug reps).
Alright - that's the esthetician side of the story, but now we need to allow time for rebuttal. In the next article we'll see if these arguments have legs.
*And when using the term retinoids I'm referring only to prescription retinoids - this article isn't including over-the-counter retioids like retinol.
