Rosacea is one of the most challenging and mysterious skin conditions seen by dermatologists, as well as by health coaches and aestheticians. While health coaches and aestheticians don’t diagnose or treat rosacea, they do play integral roles in helping clients reduce triggers, and calm flare-ups. The right diet, lifestyle, mindset, and topical skincare recommendations can make a world of difference in the lives of people who live with this often embarrassing skin condition. As the practice of Nutritional Aesthetics™ becomes more mainstream, more health coaches and aestheticians are working together to more thoroughly serve clients with rosacea. It’s now commonplace for these professionals to share best practices together in professional forums, as well in their local referral networks. Here are some examples of how aestheticians and health coaches can work together to offer rosacea clients a better experience.
An aesthetician asks a health coach for advice about rosacea:
Aesthetician: Many of my clients are aware of the impact that certain foods like red wine and spicy foods have on rosacea and make efforts to avoid them. Still, I have clients that are plagued by triggers that seem to be food related. What questions can I ask them about their diets to help them identify more possible triggers so they can change their diet accordingly?
Health Coach: When investigating possible dietary triggers, it’s useful to ask open-ended questions and collect a detailed inventory. The world of food labels and ingredients can be tricky, and substances that can create a general inflammatory response such as gluten, sugar, and sulfites listed as unfamiliar ingredients, of which even the most conscientious client is unaware. Certain triggers are unique to each individual client, so you might recommend food journaling so your client can keep track of how her skin reacts to different foods and substances. If your client’s symptoms still persist, and the food journaling hasn’t revealed further triggers, consider recommending a guided elimination diet with a health coach or nutritionist, and/or consulting with a natural health physician to get tested for food sensitivities.
Aesthetician: Something else I’ve encountered in my practice is a client who won’t stop over-cleansing and over-scrubbing, although I’ve given her every explanation I can think of on how that is irritating and damaging to her sensitive, rosacea prone skin. Any ideas on how I can get through to her?
Health Coach: I know it can be frustrating when a client doesn’t implement the advice you have offered and continues to struggle despite your concerned efforts. It helps me to remember that information, although important, is rarely sufficient to change behavior on its own merit. For example, most smokers know how smoking negatively affects their health, and yet continue to light up. Instead of delivering educational or scientific explanations to your client, why don’t you try a fresh, motivational, interview-style approach with your client, and see if how that shifts her reaction and behavior.
Aesthetician: Can you give me more specifics about this approach? I’m not a therapist or coach. Will I be able to use it effectively in the spa setting?
Health Coach: Sure. The steps are actually quite straightforward but in my experience, quite powerful! Remember, you are not responsible to fix this, only to help facilitate and inspire change. Remember to leave (or pre-schedule) enough time for additional consultation in your appointment.
- First, start a non-judgmental exploration of the feelings and motivations behind her excessive face scrubbing. Start with open ended questions: Can you describe your cleansing routine in detail? How do you know when your face is clean? What does it feel like? Seek deep understanding through reflective listening.
- Clarify the client’s stated desired skin goal in the same language she used to express it. You’ve told me that you want to have less redness in your face, is that right?
- Gently point out the revealed discrepancy and wait to hear how the client wants to proceed. Hmm, You have told me that you really like your face to feel tight and scrubbed before you go to bed, but we’ve identified that the scrubbing action can contribute to increased redness. How do you think I can help you with this?
- Offer suggestions only in the context of shared problem solving, and offer support generously. That’s a great idea, I’d be happy to provide you with a demonstration of a gentle, yet effective cleansing routine, and send you home with products to use. I’ll also send you home with some notes, reflecting what we talked about today. Avoid debates or arguments, and just roll with any resistance that arises. Return to step one as needed.
A health coach asks an aesthetician about rosacea:
Health Coach: My clients tend to love beauty products and use several different skincare formulas. What ingredients would you recommend that those with rosacea-prone skin avoid in their skincare routines?
Aesthetician: Many of people turn to DIY treatments because they believe they are safer and more natural than products on shelves. However, some natural ingredients like apple cider vinegar, lemon juice, and warming spices like cinnamon or ginger can further sensitize the skin and flare up rosacea. I also recommend that clients avoid products that are disruptive to the skin’s protective barrier, such as foaming cleansers, astringents, and scrubs; since friction causes too much stimulation and heat. Rosacea skin is highly vascular, and adding friction and heat to those areas can cause the capillaries to dilate, and remain dilated permanently. I also recommend that clients avoid sensitizing ingredients like synthetic fragrances, and certain preservatives like phenoxyethanol.
Health Coach: OK, then what ingredients are beneficial to clients with rosacea?
Aesthetician: I recommend cooling, calming plant-based ingredients like pure aloe vera gel, cucumber, and glycerin. Rosacea-prone skin also benefits from gentle plant oils like apricot kernel oil, olive oil, and sea buckthorn oil, which calm, nourish, and protect delicate skin.
Health Coach: I’ve heard that inflammation is associated with rosacea. Are there any ingredients I can recommend to help reduce topical inflammation?
Aesthetician: Green or white teas are great because they’re easy to find, brew at home, and use chilled as a toner to help reduce redness and inflammation. Calming herbs, hydrosols, and essential oils like calendula, chamomile, and lavender are also great choices.
Health Coach: Is there a particular topical regimen that you recommend for rosacea-prone skin at home?
Aesthetician: I recommend keeping it simple. Often, using too many products, or products that contain a lot of ingredients–even natural or anti-inflammatory ingredients–can overstimulate already sensitized skin. Many people are drawn to products with a lot of botanical extracts, but it’s not always possible to know all of the ingredients in these extracts. Many contain high amounts of alcohol, in addition to chemical preservatives which can be skin irritant. Instead, stick to gentler preparations such as herb-infused oils, hydrosols, and herbal teas.
Health Coach: I have a client who is interested in seeing an aesthetician, but has heard scary stories of microdermabrasion and peels gone wrong. What should she ask her aesthetician?
Aesthetician: There are many schools of belief surrounding rosacea among aestheticians. I never recommend microdermabrasion, scrubs, or any type of aggressive exfoliation for clients with rosacea skin. Lengthy facial massages, steam, and hot towels are also contraindicated. Instead, ask if the aesthetician is trained in modalities such as acupressure or manual lymphatic drainage. Also ask about cooling treatments like the Lucas sprayer, and gentle enzymatic exfoliation in place of scrubs or acids.
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