Michelle Gellis, AP, Dipl. Ac.
Editor’s Note: This is the second in a two-part series. The first article appeared in the November issue.
In my previous article, I discussed the importance of goal setting and understanding patient expectations during the intake process. In this follow-up, let’s explore the practical aspects of creating a treatment plan, managing patient expectations over time, and the critical role of documentation in ensuring successful outcomes.
Treatment Schedule
Once patient goals and expectations are clearly defined, it’s time to outline the treatment schedule. Patients typically come for weekly treatments, but this frequency may vary based on the patient’s age, skin condition, and the severity of the cosmetic concerns.
Understanding Collagen Production by Age Group
Collagen production is a key factor in cosmetic acupuncture results, and it varies with age:
- Ages 20s-30s: In this age group, collagen production is still efficient. Patients may notice improvements in skin texture and elasticity within 3-6 weeks of regular treatments.
- Ages 40s-50s: As collagen production declines, it may take 2-3 months for patients to see noticeable results, such as reduced fine lines and overall skin rejuvenation.
- Ages 60s and beyond: With further age-related decline, results may appear after 3-6 months, with improvements in skin firmness, elasticity, and reduced deep wrinkles.
Emphasize to patients that results vary based on individual health, lifestyle, and adherence to post-treatment recommendations, such as maintaining a healthy diet, managing stress, staying hydrated, and protecting the skin from sun damage.
Genetics are an important component regarding the results your patients will see. People with darker skin tend to have thicker skin with fewer wrinkles. Keep in mind that genetics only accounts for so much. Studies on twins have shown that lifestyle habits such as smoking, stress, exercise, and where we live can all affect our appearance.
Age certainly has something to do with the aging process, but it’s just a piece. Everyone’s skin ages at a different rate, but as we age our collagen production, circulation, and hormones diminish.
Evaluating Patient Lifestyle as It Influences Skin Health
To effectively treat skin conditions, a comprehensive understanding of a patient’s lifestyle is crucial. Key questions to ask should focus on:
Sleep: Quality sleep (7-9 hours) is vital for skin health, promoting collagen production and cellular repair. Lack of sleep can lead to increased stress hormones, skin inflammation, collagen breakdown, and premature aging.
Sun Exposure: Sunlight is necessary for vitamin D synthesis, but excessive exposure can cause UV damage, leading to photoaging, sunspots, and increased skin cancer risk. Patients who frequently sunbathe may show signs of premature aging.
Diet: A nutrient-rich diet supports healthy skin. Antioxidant-rich foods (berries, greens, nuts) neutralize free radicals, omega-3 fatty acids hydrate skin and reduce inflammation, and vitamin C boosts collagen production. Patients should limit processed foods, sugars, and alcohol to avoid skin inflammation and accelerated aging.
Protein: Adequate protein intake supports skin health by aiding wound healing, maintaining skin structure, and promoting collagen production. High-quality protein sources like poultry, fish, tofu, and legumes are recommended, with intake adjusted for age, activity level, and overall health.
Smoking: Smoking constricts blood vessels, reducing oxygen to the skin, leading to collagen and elastin breakdown, premature aging, and a lackluster complexion. It also harms the lungs, which are connected to skin health in Chinese medicine.
Hydration: Proper hydration is essential for maintaining skin elasticity and radiance. Patients should drink at least eight cups of water daily to avoid dryness, dullness, and wrinkles.
Alcohol Use: Alcohol dehydrates the skin, triggers inflammation, and hinders nutrient absorption, leading to a dull complexion, poor wound healing, and broken capillaries. Chronic abuse can result in severe skin disorders, jaundice, and accelerated aging.
Medications: Certain medications can affect skin health. Antidepressants may cause dryness and photosensitivity; steroids can thin the skin and cause acne; NSAIDs may impair nutrient absorption; birth control pills can either improve acne or cause pigmentation issues; diabetes medications may lead to dry, slow-healing skin; and blood thinners can increase bruising.
Drug Abuse: Substance abuse, including amphetamines, cocaine, and prescription painkillers, can lead to severe skin damage, poor healing, and a dull complexion. Seeking professional help is essential to mitigate these effects and improve overall skin health.
Setting a Realistic Timeline
When setting a timeline for treatment, it’s important to manage patient expectations carefully. For most patients, especially those with moderate to severe signs of aging, the typical course of treatment involves weekly sessions for about 3-4 months. After this initial period, treatments can be spaced out based on the patient’s progress and maintenance needs.
Encourage patients to view cosmetic acupuncture as a long-term commitment. Just as maintaining physical fitness requires consistent effort, maintaining the results of facial acupuncture will require ongoing treatments, typically once a month, depending on the patient’s lifestyle and goals.
Documenting the Process
Thorough documentation is essential throughout the treatment process. This includes taking “before” photos, which serve as a baseline for tracking progress. It’s important to use consistent lighting and angles for all photos to ensure accuracy.
Documenting the patient’s concerns and your observations during the intake is equally crucial. This documentation not only helps track the patient’s progress, but also protects the practitioner in case of any disputes regarding the treatment outcomes.
Taking “before” and “after” photos allows both the practitioner and the patient to visually track improvements over time. These photos should be taken with consistent lighting and angles to provide a clear comparison. If using a camera phone, ensure that the images are stored securely in a HIPAA-compliant manner to protect patient confidentiality.
Physical Exam & CM Diagnosis
After documenting the patient’s facial concerns, conduct a comprehensive physical exam, including pulse and tongue diagnosis from a Chinese medicine perspective. This helps inform the treatment plan and set realistic expectations.
Remember that patients with significant deficiencies may take longer to see visible results. For example, resolving blood stagnation often requires more time than addressing qi stagnation.
Treatment Planning
Once the physical exam and CM diagnosis are complete, it’s time to formulate a treatment plan. Discuss with the patient how many sessions they might need, how often they should come in, and any potential side effects. Bruising, lightheadedness, or mild headaches are some of the more common, though rare, side effects.
It’s important to review the patient/practitioner contract and informed consent, ensuring the patient understands the treatment plan and is aware of what to expect.
Managing Long-Term Expectations
Patients need to understand that cosmetic acupuncture is not a one-time fix, but rather a continuous process that requires maintenance. Some patients may continue with regular treatments for years as part of their skincare routine.
Explain to your patients that while the effects of acupuncture are cumulative, they will need ongoing treatments to maintain their results. Encourage them to think of cosmetic acupuncture as part of their long-term self-care routine, much like regular exercise or skincare regimens.
Take-Home Points
Creating realistic expectations and documenting the treatment process are critical components of a successful cosmetic acupuncture practice. By setting a clear treatment plan, managing patient expectations over time, and maintaining thorough documentation, practitioners can build trust and ensure a positive experience for their patients.
It’s important to communicate that cosmetic acupuncture is a long-term commitment that can yield significant benefits with consistent care and realistic goals. As patients see their skin improving gradually, they will appreciate the holistic and sustainable approach that acupuncture offers compared to more invasive methods.
By fostering open communication, setting achievable goals, and keeping detailed records, you can help your patients achieve their desired outcomes and maintain healthy, radiant skin for years to come.
Author’s Note: This article is a condensed abstract from my book, Treating the Face: A Comprehensive Guide for Acupuncturists and Health Professionals, and serves as part two of a two-part series. The insights provided here offer a glimpse into the detailed guidance available in the book, designed to enhance your practice and patient outcomes.
