Face mapping is common practice under many skin care philosophies. Chinese medicine and contemporary medicine both use forms of face mapping to make sense of physical symptoms on the face, such as acne, and how they relate to what exactly is going on inside the body. The skin is the body’s largest organ, and is therefore a reflection of our overall health. As estheticians, being able to read the skin is our biggest asset when it comes to treating acne.
All Acne is Not Created Equally
Acne is as complex to understand, as it is to treat. The first step in beginning to treat acne is to understand why a particular client is having acne. All acne is not created equal. This is why so often we have clients that come to us having taken every prescription under the sun with no relief. Antibiotics do not work for every acne patient because not all acne is entirely bacterial; just like birth control doesn’t work for all acne because a deficiency or over-production of the sex hormones is not always the cause for acne in women.
The key to treating acne successfully is to understand what type of acne your client has. Is it bacterial? Is it hormonal? Is it caused by inflammation related to their diet? Do they have a genetic predisposition to over-active sebaceous glands? These are just some of the many reasons why a person might be experiencing chronic acne.
As estheticians, we have to use the tools available to us to figure out the best course of action for our client. Unlike dermatologists, we don’t have the luxury of performing blood tests on the spot to see if our client’s androgen levels are too high, or if they are experiencing elevated cortisol. The best tools we have are our eyes, our hands, and our ability to read the client’s skin.
Here are some of the most common facial zones where clients experience acne and what they suggest might be going on in the body:
The Forehead:
Diet & Stress
The principles of face mapping suggest that recurring breakouts on the forehead are related to poor diet, digestive problems, high stress levels, inadequate or irregular sleep, small intestine issues, liver issues or even reactions to hair products.
Discuss your client’s eating habits and sleep patterns. High amounts of sugar and processed foods can often translate into those small pimples on the forehead that are usually difficult to extract and don’t resolve with traditional peels and chemical exfoliants. Encourage your client to adapt a low glycemic diet and drink the recommended amount of water.
Irregular sleep, meaning too much, too little or inconsistent sleep, can also rear its ugly head on the forehead. For healthy skin, encourage clients to “live like a clock” and aim to get eight hours of sleep every night, going to bed and rising at a similar hour daily.
Jawline & Chin:
Hormonal Imbalance
For many female clients of reproductive age, persistently mild to moderate acne may be a result of over-active hormones. These imbalances typically result in tiny, under the skin bumps resembling milia, as well as painful cysts deep under the skin. An over production of androgen affects sebum production, leading to pores clogging from the inside out. This inside-out effect makes it particularly difficult to treat, as pores continue to fill with sticky sebum no matter how often they are extracted or exfoliated.
If you believe your client’s acne is hormonal, encourage them to visit their OB/GYN or endocrinologist to perform the proper blood tests and prescribe appropriate medication. Birth control and spironolactone are commonly prescribed for hormonal acne and are generally very effective.
If your client is reluctant to pursue the prescription route, encourage them to adapt a low-glycemic diet to limit inflammation, avoid dairy and drink plenty of water. Prescribe gentle home-use skin care that will neither aggravate nor over treat the skin, and leave the heavy exfoliation and extractions for the treatment room, as clients can go overboard easily and make matters worse. Keeping the skin calm and healthy is key!
Nose:
Excess Oil Production
Persistent blackheads on the nose can be tricky to banish. While traditional Chinese medicinal face mapping attributes nose breakouts to high blood pressure, many clients experience sebaceous filaments and blackheads due to over-active oil glands, which canbe genetic.
The most effective method of treatment is gentle BHA exfoliation and extractions. However, keep your client’s moisture barrier in mind when prescribing home care products. Clients are often desperate to clear their skin and end up stripping their acid mantle and causing more harm than good. Unfortunately, sebaceous filaments do not go away. The best thing you can do is try to keep them clean and clear when they do inevitably fill up. Assure your client that there are methods to reducing their appearance when delivering the news.
Neck & Chest:
Adrenal Stress
According to Chinese medicine, breakouts on the neck and chest are caused by adrenal stress due to high stress levels. This can appear as acne breakouts, pigmentation, redness or flushing. Traditional considerations include fragrance usage, inadequate sun protection and hormonal fluctuations.
Encourage your client to extend their facial skin care to their neck and décolleté, and perform a patch test before using new fragrances perfumes or body products. Sunscreen usage on the neck and chest is essential to maintain the client’s overall youthful appearance.
Hairline:
Product Buildup
Acne on the hairline is often caused by buildup of hair products, just as shampoos, conditioners, gels, hair spray and styling products. Known as “pomade acne,” breakouts on the forehead, upper back and even chest if the client as long hair can be a sign of overly occlusive hair products. Products that are oil-based or cream-based, like creams, oils, and pomades, are more likely to cause a breakout.
Encourage your client to eliminate products one by one to nail down the culprit. Begin by asking your client to switch to a milder shampoo, like baby shampoo, or to something fragrance- and color-free. Rich conditioners are also often to blame for breakouts, so allowing them to have any contact with their scalp. The best practice? Ask your client to lean his or her head back, apply the conditioner no closer than a few inches from the scalp, and rinse, while limiting conditioner-skin contact. Then, cleanse the face and body.
