Mechanical exfoliation is achieved through abrasive sloughing agents like corncob or almond meal, ground apricot seed, sugar, salt, exfoliating brushes and the more advanced technique of microdermabrasion. Chemical exfoliants range from gentle enzymes like papain and bromelain to the more aggressive alpha-hydroxy (lactic, glycolic, malic, citric) or beta-hydroxy (salicylic) acids and fall under the heading of chemical peels. Effective use requires an understanding of skin thickness and turgor that only comes with experience. And while the percentages are considerably lower than dermatologist peels, the acids' strength is really governed by the amount of cellular activity going on within the skin. Since it is difficult to know just how much cellular activity is going on within scar tissue most estheticians seem to prefer microdermabrasion.Microdermabrasion is very effective in stimulating fibroblasts which are responsible for production of collagen and elastin fibers and make scars more flexible. Be sure to steer clear of any technique that uses crystals as they can be deposited in the skin. Look for spas that use the "diamond head", a metal wand with cris-cross pattern, attached to a suction tube. A series of treatments will be required for maximum results.

MASSAGE

Jen Hartley is an expert on therapeutic massage for burns. A burn survivor herself, Jen suggests that incorporating several different techniques can be beneficial in alleviating some of the tension in the scar. Lisa Sickler, an educator for Babor Skincare System, suggests an invigorating massage from the chest upwards to stimulate blood flow and therefore increase oxygen to the cells. Then, finish with a soothing lymph drainage or pressure point technique. Massage can help moisturize, decrease itching, and applies pressure to the collagen fibers to make the scars more pliable.

TREAT

All the previous steps are designed to lead you to this moment. The treatment phase is the most important part of receiving a facial. It's at this time that all of those new cells uncovered by the cleanse and deep exfoliation will be coaxed to stay plump, moist and balanced. The idea of "masking" is to actually "suffocate" the skin so that it has to "breath in" all the healing ingredients. Masks are usually either hydrating, emollient, astringent or nourishing. It's common to combine several masks to effectively treat skin type and address skin condition.

Hypertrophic scars lack sweat and oil glands. A hydrating gel mask can combat dehydration while a nourishing mask rich in multi-vitamins can alleviate dryness. The efficacy of each mask will be improved when a warm paraffin mask is applied over it. The heat increases penetration and relaxes the collagen fibers. Impaired vascular function can prevent heat from dissipating so it's important to check the temperature on healthy skin first. Also, masks are often removed with a warm steam towels. Request that they be cooled to room temperature. This may require several compresses be applied, but it's less risky.

TONE

There is some debate as to whether this step is even necessary. Old theory required the use of toners to restore pH balance to the skin. Today's products are designed to maintain balance throughout the entire treatment. However, the fresh spray does feel good and the water molecules will carry the moisturizer a little deeper into the epidermis.

MOISTURIZE

Any emollient, hydrating emulsion will help the skin. Here is a list of ingredients proven to be beneficial in treating burn scars.

INGREDIENTS:

EMOLLIENTS- Allantoin, Collagen, Elastin, Shea Butter, Jojoba, and Vit E

ACTIVES- Co Q-10

ACIDS- Lactic and Glycolic

PIGMENT CONTROL- Kojic Acid, Licorice, Red Raspberry, Vit C and Sleepy Morning

Burn survivors need to take extra precautions to protect their skin from UV rays. The use of a sunscreen with SPF of 15 or higher is recommended. Each point in the sun protection factor represents 10 minutes. (15 SPF= 150 minutes of protection) Apply half an hour before going out and re-apply throughout the day.

MODALITIES

GALVANIC/ IONTOPHORESIS:

There has been little research in the use of iontophoresis with hypertrophic burn scars. The University of Colorado has had some success using it decrease local inflammation. Your esthetician may use iontophoresis to achieve deeper penetration of vitamin or hydrating masks, pigment brighteners, and skin hydrating, oxygenating or soothing serums.

MICROCURRENT:

The microcurrent is a low level electrical current often used in place of massage. It's benefits include increased blood and lymph flow, muscle re-education, increased production of collagen and elastin, improved cellular regeneration and absorption of product. Be aware that newly healed skin may be more sensitive than other areas. Also, burned areas contain many unmyelinated nerve endings which can be hypersensitive and can cause great discomfort when using electrical current.

COOL/WARM PELTIER:

The cool setting is used to assist in the reduction of inflammation and swelling. However, cold modalities reportedly make the burned area feel stiffer. The warm setting, used ideally around the neck and shoulder area, has a muscle easing effect. It is important to be cautious when using heat modalities over these areas to avoid an additional burn.

A good estheticain always starts with a consultation. Take this time to direct them through the type of treatment you expect. While he/she may be at a loss when dealing with burn scars, you can always share your preferences and concerns. You will receive a treatment that is both pampering and therapeutic.

References:

Lisa Sickler: lisawatts:babor@yahoo.com

University of Colorado Health Sciences Center: Rebecca.Sloan@uchsc.edu

Dermalogica: www.dermalogica.com