|This is a great source of frustration for many experienced therapists, and there is no easy way to explain other that the main reason for this failure is that they have invariably taken the wrong approach for the particular situation.
What works for one client may not work for another, and it is generally a lack of understanding about the intrinsic and extrinsic factors that influence the skin's functions is why some treatment strategies fail to deliver the results the therapist has promised or their client has expected.
- Wrong order of treatment
- Hormonal influences/blocking factors
- Incorrect diagnosis of condition
- Miscommunication/client compliance
- Insufficient consultation to discover cause
- Missing critical steps in treatment
- Client compliance/honesty
- Unrealistic client expectations
- Not using holistic approach; only treating symptoms
- Client “sabotage” trying to speed up process
- Chronological age/treatment effectiveness
To ensure that you have done your absolute best to get a result, there are a number of what I call " crucial factors" that need to be understood and will influence the direction of any strategy and provide the client with a reasonable expectation of outcome.
In this series of articles I will address each of these " crucial factors" and attempt to explain their importance in the grand scheme of treatment success and client expectation. You can see by the list that there is a combination of factors identified; some are the clients fault, but most are a result of the therapist not really taking the time to find out the real cause of the condition or not following through with a sound, realistic strategy.
The most important is to determine the clients cellular age and level of cellular damage.
There are two ages: Chronological age is the age in years, while biological age is the age at a cellular level.
These two numbers are not always in synchronisation, and lifestyle factors such as nutrition, medication, illness, in fact, all things that cause oxidative stress will change or "skew" the age of cells, especially skin cells.
It is important to understand the different levels of cellular damage that will occur as part of the clients working, playing and living environments, because cellular damage will dictate the success of the clinical treatment as well as how many treatments may be needed to get the desired result.
Then there is the genetic component to this story, Some humans have what it often referred to as longevity in their gene pool, and this often means that their cells have a longer life span before reaching the end of their regenerative cycle. This means that, despite extrinsic factors such as oxidative stress, the cells in these individuals are slower to age or damage. This is why some people appear "ageless".
Each decade comes with different levels of cellular damage, and some cells of the skin age earlier than others; for example the melanocyte cell. What may also change the chronological age of a cell is the amount of oxidative stress it has had to endure because of the clients working and play environment, and this is why it is imperative to gather this information as accurately as possible during the consultation process.
We must also think in a three dimensional manner; thinking about how the age of particular cells will manifest themselves as skin conditions. Consider these examples:
- Fibroblast: Will exhibit as a loss of structural integrity or adhesion resiliency
- Keratinocyte: Will exhibit as poor corneocyte compaction (Hyper-keratinisation)
- Circulatory: Will exhibit as vascular damage
- Melanocyte: Will exhibit as pigmentation
- Cell membrane: Will exhibit in the form of lipid peroxidation
Each "level" of damage or ageing will determine the level of recovery that can be expected:
- Oxidative stress and Lipid Peroxidation (a compounded and untreated form of oxidative stress) both begin damage within the cells environs and the cell membrane. They are mostly recoverable.
- Mitochondria DNA damage: Damage has moved to the individual cells mitochondria in the cell membrane.
- Recoverable, but more effort and time required. Client compliance is crucial for success.
- Mitochondria ageing and Cellular senescence: The complete cell is affected. May be unrecoverable depending on circumstance.
|Accompanying this are cellular age related blocking factors that lead to conditions such as Essential Fatty Acid Deficiency and Impaired enzyme activity; both of which will also affect treatment outcomes if not addressed and compensated for in any strategy.
The level of oxidative stress the client has been exposed to over their life also plays a role in increasing the cellular ageing, and must be taken in to account.
In many cases any oxidative stress and lipid peroxidation related conditions can be recoverable with the use of topical and nutritionally delivered anti-oxidants in conjunction with appropriate treatments.
Finally, conditions related to Mitochondria ageing and Cellular Senescence (particularly pigmented conditions will be more difficult, and in many cases could be considered untreatable.
Clients must acknowledge that an optimum result will not occur due to cell age or damage.
If you and the client are determined to continue with a program, then there must be a strict adherence to full homecare protocols and product prescription; along with a commitment to at least a minimum of 24 of clinical services.
Given this knowledge, is it likely that a skin treatment that works rapidly on a younger, healthier skin will work as efficiently on a skin with a greater cellular age?
This article was supplied by Florence Barrett Hill
For more info visit: www.pastiche.co.nz