If you see something, say something…

A client came to me recently with a back that looked a lot like the above. Their intake form made no mention of any skin conditions or areas to avoid. Being that these growths were located in a not so visible area of the body, I wanted to probe the client further to see if (a) they were aware of the amount and irregular shape of these spots and (b) if they knew what they were. Massage protocol for many benign growths on the skin including moles and skin tags is to work around them, but with a back like the above, it would seem near impossible to avoid them. In the case of my client, the brown spots turned out to be what many doctors have dubbed “the barnacles of old age” also known as seborrheic keratosis.

This skin condition presents a lot like warts because the growths are slightly elevated off the upper layers of the skin and range in color from light to dark brown. But unlike warts the growths are not viral in origin. In fact, dermatologists are not sure what causes the condition to begin with. They can appear anywhere on the skin and often do so in middle-aged people and the elderly. They have a rough, textured hand feel, hence the “barnacles” nickname. However, because the irregular looking growths can resemble some types of melanoma, a skin biopsy is needed for a true diagnosis. See below for an extreme version.

An irritated or darkly pigmented version of the stuff…yikes.

This is why it is an important part of my job to say something when I see something. I can never assume the client is informed. I would much rather repeat something they already know, than for the sake of “spa etiquette” keep my mouth closed. The aforementioned “spa etiquette” is the hushed voice inside that says they paid to relax, not get a medical speech.

Now, assuming the dermatologist did a skin biopsy to rule out cancer, a person with seborrheic keratosis can choose to remove their growths if they are unsightly or aggravated by clothing/touch. They can be removed in the following ways:

  • Cryosurgery: This is where dermatologist applies liquid nitrogen to the growth with a cotton swab or spray gun. This freezes the growth. The growth tends to fall off within days. Sometimes a blister forms under it and dries into a scab-like crust. The crust will eventually fall off.
  • Electrosurgery and curettage: Electrosurgery (electrocautery) involves numbing the growth with an anesthetic and using an electric current to cauterize (burn) the growth. A scoop-shaped surgical instrument, a curette, is used to scrape off the treated growth. This is the curettage. The patient does not need stitches. There may be a small amount of bleeding. Sometimes the patient may only need one or the other; not necessarily both to remove the growth.

In both treatments, the skin may be lighter where the growth was removed. This usually fades with time, although it can be permanent. Most removed seborrheic keratosis do not return. However, a new one could occur elsewhere.

Since seborrheic keratosis is a local-contraindication for massage (this means to avoid the affected area), I wanted my client to get clearance from their dermatologist before applying any essential oils or lubricants onto their back. Worried that they might be disappointed (and they were at first) by not being able to have their back included in the massage, I assured them that they would still get a relaxing experience, especially when the head, neck and feet are such perfect little stress release valves. Fifteen minutes into the massage, they were out for the count and I felt that I had done my “mitzvah” (i.e good deed for mankind) for the day. Happy times.


The skinny on Detox treatments

On almost every spa menu you encounter, there is at least one or more treatments offered that promise to detox the body. Often these treatments are also listed as “slimming.”  They run the gamut of simple to downright high tech in their descriptions and promises. In order to really understand how these treatments work, or don’t in some cases, it’s important to clearly define what toxicity is and how our bodies naturally deal with it.

The lymphatic system is your body’s sewage drainage system. It’s a complicated network of small vessels that run alongside your veins, ferrying fluid laden with cellular waste products and toxins into nodes that filter the fluid and eventually dumping into an enormous vessel that brings everything back into the heart for re-use. Any part of this network goes awry and your body gets backed up in its own toilet water. The physical repercussions of minor back ups are bloating and swelling in the extremities, usually caused by diet and lifestyle (i.e. too much salt and sitting). Major back ups can manifest in a condition known as lymphedema, most commonly occurring when lymph nodes have been removed or blocked by infection. The system fails in such a way that the extremity swells to incredible proportions. Often the skin around the area will begin to break down and get infected if the lymph fluid is not manually moved by highly trained professionals specializing in a form of massage called MLD . Really scary. Really toxic. See below for a tame example:

A typical case of Lymphedema

Detoxification treatments deal with the minor backups. In Chinese medicine, the skin is referred to as the third Lung, as it is a living breathing organ, drawing in Qi (energy) from the air through its pores. Issues with one’s skin were often indicators of a systemic condition that would be treated with tonifying, detoxifying herbs and heat. In keeping with this theory of outside manifests inside, detoxification treatments are applied to the skin in order to draw out internal toxicity. The application of “sea” mud or clay is used to assist in this process. What is interesting about these mineral rich organic compounds is that they have a negative charge. To spare you all the chemistry lesson on the quick, toxins including viruses and other impurities have a positive ionic charge. The negative attracts the positive up to the surface. When they meet, a reaction takes place that neutralizes the toxin. Tingling of the skin and warmth are byproducts of this reaction. Apparently the medicinal property of clay/mud has been known since the time of the ancient Egyptians and even prior. Clay was used by the ancients as an anti-inflammatory/anti-septic both topically and internally, where it had a laxative affect on the GI tract. It was also found that the presence of clay chokes the air out of Candida (yeast infections) and dries out boils, acne and other skin eruptions. Most spa treatments involving a mud or clay application are followed by a wrap in some kind of heat sealing foil, which promotes sweating. Sweat combined with the ionic neutralization of toxins really double teams the release of impurities for what can be a more thorough detox through the skin. There is a nominal amount of water weight lost from the detox wrap, which is where the “slimming” effect comes into play, but you will need to hydrate in order to replace lost electrolytes after the treatment. Will your skin feel taut and brighter? Yes, temporarily. Will you need to do this every week? Depends on your lifestyle. I believe a clay/mud wrap detox can be done once every 6 weeks, much like a facial, to help eliminate impurities if you actively upkeep your system between treatments. Hydration, exercise and a diet rich with enzymes from fresh fruits and vegetables are what I would suggest to keep things on track. If you know you are the type that is prone to excess (too much of anything is never a good thing), perhaps the detox should be done more often; however the more you do on your own to restore balance to your body and keep the drainage system working well, the more effective these treatments will be for you.

Here are the things to be wary of when choosing a Detox or Slimming Treatment:

  • Promises of ridding your body of fat/cellulite: You are born with a certain amount of fat cells that can get bigger if you gain weight or shrink in size when you lose. They can pucker close to the surface of the skin, which is what we call cellulite, with the loss of collagen associated with age and/or lack of muscle tone. Only liposuction, an invasive treatment performed by a surgeon, removes fat cells. At best, the look of the puckering might be smoothed out by the drawing up and out of fluids in the spaces between the cells. Also, there may be a small reduction in weight, which we know is water loss, that can make the client feel lighter and tighter, but only temporarily….
  • Promises of  permanence: Any loss of inches, weight and/or tightness of the body is only temporary. Once you drink or eat anything post treatment, the “weight” will be back on. Diet, proper hydration and exercise can build up muscle tone  and shrink fat cells for a permanent result, if maintained.
  • Any detox treatment that encourages the purchase of supplements and/or diet packs: There is a commercial incentive here. They are selling the product more so than the detox. There are plenty of dubious supplements on the market that are not subject to FDA regulation for fat burning, weight loss and detoxification. If you have such an interest in the internal detox, consult a nutritionist or Chinese herbalist who will assess your diet and lifestyle in order to recommend what is best for your individual systemic needs.
  • Detox treatments that involve anything other than a clay/mud application: Some places will advertise applications of coffee, chocolate, honey and herbs, etc. None of these have the ionic relationship that the mineral clay/mud has with impurities; therefore, scientifically speaking, how can they effectively detox? They may feel nice, even luxurious, when rubbed onto the skin, but actually pulling toxins and water out? Not so good.