Ep 99 – The Rogue Pharmacist: Rosacea is Not a Skin Disease

Man with rosacea cheek

Associated Skin Care Professionals (ASCP) presents The Rogue Pharmacist with Benjamin Knight Fuchs, R.Ph. This podcast takes an enlightening approach to supporting licensed estheticians in their pursuit to achieve results-driven skin care treatments for their clients. You can always count on us to share professional skin care education, innovative techniques, and the latest in skin science.

According to the National Rosacea Society, 77% of individuals with rosacea were simultaneously diagnosed with another skin condition. To learn more about rosacea, read Rescue and Rebuild in ASCP’s Skin Deep magazine.


About Benjamin Knight Fuchs, R.Ph.:

Benjamin Knight Fuchs is a registered pharmacist, nutritionist, and skin care chemist with 35 years of experience developing pharmacy-potent skin health products for estheticians, dermatologists, and plastic surgeons. Ben’s expert advice gives licensed estheticians the education and skin science to better support the skin care services performed in the treatment room while sharing insights to enhance clients’ at-home skin care routines.

Connect with Benjamin Knight Fuchs, R.Ph.:

Website: www.brightsideben.com

Phone: 844-236-6010

Facebook: www.facebook.com/The-Bright-Side-with-Pharmacist-Ben-Fuchs-101162801334696/


About Associated Skin Care Professionals (ASCP):

Associated Skin Care Professionals (ASCP) is the nation’s largest association for skin care professionals and your ONLY all-inclusive source for professional liability insurance, education, community, and career support. For estheticians at every stage of the journey, ASCP is your essential partner. Get in touch with us today if you have any questions or would like to join and become an ASCP member.

Connect with ASCP:

Website: www.ascpskincare.com

Email: getconnected@ascpskincare.com

Phone: 800-789-0411

Facebook: www.facebook.com/ASCPskincare

Instagram: www.instagram.com/ascpskincare



0:00:00.5 Speaker 1: DMK is the world leader in paramedical skin revision education, with certification programs designed to give licensed professionals a thorough understanding of the skin and an in-depth study of the DMK concept of remove, rebuild, protect, maintain. Created by the botanical visionary Danne Montague-King, DMK offers skin revision training and education for all ages, skin conditions and ethnicities in more than 35 countries, harnessing the body's innate healing mechanisms to change the health of the skin. Learn more at dannemking.com. That's D-A-N-N-E-M-K-I-N-G.com. 


0:00:49.3 Speaker 1: You are listening to ASCP Esty Talk, where we share insider tips, industry resources and education for aestheticians at every stage of the journey. Let's talk, 'cause ASCP knows, it's all about you. 


0:01:04.5 Maggie Staszcuk: Hello, and welcome to ASCP's Esty Talk. I'm your co-host, Maggie Staszcuk, and ASCP's cosmetology education manager. 


0:01:12.2 Ella Cressman: And I'm Ella Cressman, licensed aesthetician, certified organic formulator, ingredient junky and content contributor for Associated Skin Care Professionals. 


0:01:20.9 MS: The client consultation is your opportunity to build a relationship with the client, and determine exactly what their needs are. And that's what we're talking about today in ASCP's Etsy Talk. Often the consultation is skipped or rolled into the skin analysis for various reasons like timing, sense of urgency to begin the treatment, feelings of discomfort with paperwork or even having that conversation with the client. And we reached out to our listeners. We're gonna share some stories of consultations gone awry. With Exhale Skin Bar, they say, "My client suffered with acne. And during the consultation, I discovered she finds that using vodka on her face works best to heal her acne. She was convinced the minerals are so pure, and if it's okay to drink, it should be suitable for her skin." 


0:02:06.3 EC: Listen, I have no qualms with the drinking to cope. No, I'm just kidding. But I can relate that sometimes I've had a breakout where a shot of vodka and a good night's sleep feels like the best solution. 


0:02:20.4 MS: Yeah, for me, this is kind of like a "Do what I say, not what I do," kind of a thing. And there have been plenty of times where I've got a breakout, and I'm thinking, "What do I have in my mystery drawer that will make this thing go away?" And I'm yanking out toothpaste, or, "Where do I have a little bottle of acid where I can zap this sucker." And I know that's wrong, maybe I should try vodka. 


0:02:43.5 EC: Try vodka. Grey Goose it. I'm kidding. 


0:02:46.1 MS: Grey Goose, we should coin that term. I like it. 


0:02:49.1 EC: Grey Goose it. No, don't McCormick's it. That's just not a good idea. So now we have Project Inc? This is a good one. She said, "Years ago, I had a client come in for eyelash extensions that ask me what part of the body I plucked hairs from to glue to her eyes." That's a great question. 


0:03:10.0 MS: It's legitimate. 


0:03:10.9 EC: It's legitimate. 


0:03:12.4 MS: Where are those hairs coming from, Ella?  


0:03:13.9 EC: Oh well. She was afraid I was gonna use pubic hair. 


0:03:18.3 MS: Yep. Nope, those are different eyelashes. 


0:03:21.5 EC: Needless to say, she was so relieved when I told her I use synthetic fibers. Same, I don't want a pink eye. I don't. I do not want pink eye. I can't imagine... Well, you know what? Yay for that client for being brave enough to ask the question. 


0:03:38.9 MS: Yeah. This is why we do consultations. Clients just don't know. 


0:03:43.0 EC: Yeah, they don't know. 


0:03:45.0 MS: So Bunny Tail body waxing says, "One of my clients years ago actually wanted to shave off or micro-derm his nipples to blend in with the rest of his skin." 


0:04:00.2 EC: That is out of this world. That is crazy. What?  


0:04:04.6 MS: I'm trying to picture it in my mind, I'm not sure. 


0:04:07.2 EC: I wanna know, does she... What it... How does she... I wanna know the rest of the story. 


0:04:09.8 MS: How do you handle that?  


0:04:12.0 EC: Bunny tail body waxing, tell us more. 


0:04:14.5 MS: We don't offer that service here. 


0:04:15.8 EC: Yeah, we don't. No. Pass or scope of practice. So then we have also Taylor GST, said, "I had a client come in to the medical spa I used to work at. Her main concern was some sun damage and pigmentation about the size of a nickel on her cheekbone. She wanted whatever treatment I could do that would make it go away ASAP. She said she tried everything. Most recently, she took, drum roll, a nail file and tried to file down the skin to remove the pigment. 


0:04:48.2 MS: Ella, listen, this is like a real thing. That's like microderm abrasion. 


0:04:53.3 EC: A for effort. 


0:04:54.5 MS: Yeah, A for effort. 


0:04:56.5 EC: F for not the function. 


0:04:58.7 MS: Right. Go see your aesthetician. 


0:05:00.8 EC: Go see your aesthetician. I see where your mind was going client, however, there's just... I wonder how Taylor handled it. This is a great opportunity to explain how pigment really works. How it's not just on the surface, especially if it's the size of a nickel. On the surface, it's like Titanic. It's probably the size of a silver dollar underneath, yeah?  


0:05:20.5 MS: Yeah. Now you're leading us into what we're gonna talk about today, Ella, which is why we consult with our clients, educate our clients, find out why they're even coming in. So the consultation, like I said, it's your opportunity to learn as much as you can about your client's general lifestyle, their home regimen, what their skin care concerns are, and what they hope to get out of today's treatment. And you should also use this opportunity to turn your "customer" into a client with repeat visit. 


0:05:49.3 EC: Reference podcast. 


0:05:50.9 MS: Yes, so if you're a regular listener, you heard our podcast previously, The Professional Aesthetician, and we talk all about that. So how much information can you garner just from the consultation? So hopefully you're doing some intake paperwork, and your client maybe is mentioning what kind of home care they use. So for instance, if they are doing a multi-step system, what is that telling you about their client? They're not shying away from adding an additional step that will help them to reach their skin care goal. Or are they using bar soap versus, maybe they go to a department store and are spending a lot of money on something like Estee Lauder or Clinique. 


0:06:35.0 EC: Or maybe you're lying about it, because that's what I did on my first facial. True story, is that I had a bunch of samples that my cousin worked at Neiman Marcus and she gave me. And so when they're asking, "What skin care products do you use?" I wrote down, Chanel, Shiseido, but they were just little tiny sachets. 


0:06:50.2 MS: Well, but you were still using it, right?  


0:06:52.5 EC: Technically, but I made it. She didn't ask, the practitioner didn't ask, and I think she just had an expectation of me. But there's another point, 'cause I just... I literally did put it on that day, but I think that also implied, one, I had a system that I was using, which I didn't. It was just random. And two, that I was gonna afford that. 


0:07:13.6 MS: Well, still, it's opening the door for conversation. And I think, other questions are, what skin type does your client think they have versus they have? And again, just opening the door for that education, that conversation. And this also sets the stage for retailing, which I think begins at consultation. 


0:07:33.5 EC: Absolutely, I think it's one of the best things, actually. So we asked this question before in our podcast on retail selling, another plug. But where do you think selling starts? And as Maggie said in that podcast, "The minute they walk in," and absolutely does. It starts there, and it gets continued especially here in the consultation. As Maggie mentioned, the consultation is an opportunity for asking questions and starting conversations. And you do get a lot of information about the client in the initial part. The consultation is also your opportunity to upsell products and treatments. If you have treatments that you do add-ons, for example, that's just a great opportunity for that. But also to start formulating your recommendation, what you think it might be, formulating that recommendation in your head, and then dropping little hints to that. So while talking with your client, listen for cues such as, "My skin has been feeling really tight and dry." So okay, you're also analyzing, "What am I gonna do in the treatment room?" Do you wanna do microderm today? How about a Dermaplane? That will really help with that. 


0:08:44.9 EC: Also suggesting retail products that would reinforce. So you're looking at, what are they currently using? Where are the holes that can be filled? And how does that equal what their needs are, their expectations of the skin type they think they have versus what they actually have. It happened recently to me where the client came in thinking she had oily skin, but she in fact had inflamed skin and a compromised barrier. So talking through that and explaining at that point, "I think you're going to have to let go of these nine salicylic products." And she was in her 60s. She did not need that. That was the beginning of a, in this case, battle. She was a hard person. But this is not the hard sell opportunity, this is just the introduction of ideas, like, "Hey, we're probably gonna change this, but I'm gonna make sure." 


0:09:36.2 MS: A good consultation, I think, not only benefits the aesthetician, it's also benefiting the client. So thorough consultation is leaving the client feeling that they're in the hands of an expert, generally caring about them, is interested in them, and has the knowledge required to meet their skin care goals, meet their needs. And not just for the day, but is also setting up a treatment plan to help them over time to benefit their skin's needs. You can also use this time to patch test your client for treatments like perhaps a chemical peel, whether you're going to upsell and perform later that day or down the road, again, helping to achieve the skin care goals. And it saves your client from having to come back for just a quick patch test. And if this is not how you've built your menu, then adjust how you're charging and how you're selling on your menu. So perhaps you need to block your time by the hour, not by the minute or the service, and be sure that you're charging accordingly. 


0:10:34.1 EC: I think that's one part where aestheticians go wrong, is not allowing enough time for the initial consultation or the ongoing consultation. Other ways that aestheticians go wrong, is missing the opportunity to take control, to lead the conversation, and to also set realistic expectations, making sure that they understand what really can be achieved. We have this example from Taylor GSD with the hyperpigmentation spot. She wants it to go away ASAP. Is that realistic? No, but can it be done? Can it be softened? Absolutely. And do not allow the client to lead the consultation. Let them feel empowered, but not in charge. This is your domain. So asking the questions and getting the answers, and act like... It's a clinic, basically. You're in a clinic and you're trying to formulate, you're gathering information, formulating a plan. 


0:11:34.5 MS: Hey guys, stop. Let's take a quick break. 


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0:12:14.9 MS: Let's get back to the conversation. 


0:12:17.5 MS: I think asking the wrong questions is another area estheticians go wrong. You should use open-ended questions to generate the conversation, gauge what the client's needs and wants are. Oftentimes, I think, estheticians will just scan that consultation form and move right into treatment, instead of educating, having a conversation, finding out what the client wants. And I think that's important, too that being sure there's a balance between giving the client what they want and also giving the client what you think they need as the expert. 


0:12:51.2 EC: Yeah, those are like the blah, blah, blahs, like la, la, la, I'm just going through the motions of this. I'm not really taking it seriously, I just wanna get you back so I can pop your pimples, or whatever it is, so I can burn your face off with some acid, whatever that is. And that's just not fair. It's not fair for a lot of reasons. And one of those is failing to really understand the client's lifestyle. This is an important component. Because if you are... If you do feel that a chemical peel is best, yet your client is an avid hiker or a surfer, we're not here to change lifestyles, we're here to adapt to theirs. So is a chemical peel in their best interest? No. Really understand that. Do they work outdoors? Are they a sun worshiper? We're not gonna wag fingers, we're not gonna really change things, all we can do is provide limited information... Or we can provide the information and let them decide. All these will affect the type of treatment and what the post-care is like, and then also what the retail client receives. So if they are a sun worshipper, great. "I can still treat you. We're gonna do something a little lighter today. I'm gonna need you to be on this melanin suppressant for a couple of weeks, and I'll see you back and I can't wait. And go have fun in the sun." 


0:13:58.9 MS: Yeah, sometimes aestheticians will also assume they know what their client can afford. We've talked about that before, too. So believe in your products, your treatments, your self-worth. Assuming something is out-of-budget for your client, definitely means loss in revenue. If the product or treatment will benefit your client and they can't afford it or don't want to buy it, let them be the one to tell you. 


0:14:22.8 EC: Yes. And also with that said, there's a difference... Let's just do a presentation real quick. "Hi, Maggie. This cream is $150, and I'm not sure if you'll like it or not, but I thought you might wanna try it?" 


0:14:37.9 MS: "Yeah, no, thanks." 


0:14:38.9 EC: Versus, "Maggie, you told me that your skin is dry. I know that you are in love with the sun and you like to pick your pimples. So what I would suggest is setting... I'm not gonna tell you not to do that, I just gonna set your skin up to be super strong. So this has A, B, and C in it, and it's really gonna help your skin through it. And it's gonna be radiant and I think you're gonna love it." 


0:15:00.0 MS: "I want my skin to be radiant, Ella. Thank you. I need this product." 


0:15:05.2 EC: Blowing on. Nailed it. So it's all about in the way you present it. So I think that's really important. Another thing is, as you heard from my little amazing improv with Maggie, that I listened. I listened to what she said, I listened to her lifestyle, and I listened to what her needs were. And I nailed it. I was spot on. I asked all the right questions. And when we came down to it, I was able to sell the product she needed. So if you aren't really listening to the needs and the wants of your clients, you have a breakdown in communication, and you lose out on repeat clientele. Sometimes what you think the client needs is not what they want. Why don't we talk about one of your favorite consultation stories?  


0:15:51.9 MS: Well, one of my consultations gone awry, just thinking back in time. I used to have a woman... I'm pretty sure she had dementia, because every time she came in, it was like we had never met before. And she was an older woman. She would bring with her a box of hair dye, and it was funky colors. And she was booking a bikini wax, so you can imagine what that hair dye was for. 


0:16:21.5 EC: Okay. To match the drapes. 


0:16:22.5 MS: To match the drapes, yeah totally. Which is not a service that I offer. I'm just putting that out there to the world, I don't do that. So our consultation, which I was very good about doing, was to tell her every time, "This is who I am, this is the service that I do. And thank you for bringing me this hair dye, but it's not happening today." 


0:16:44.2 EC: Oh wow. Wow! That's such a heartfelt thing, like you handled that with such grace. 


0:16:50.0 MS: Thank you, Ella. 


0:16:51.0 EC: Yeah, that's awesome. Then she was able to come back still like it was the first time. 


0:16:55.0 MS: Like it never happened, yeah. 


0:16:56.5 EC: That's amazing. I have so many, I have... One of my least favorite ones was recently, and that's kind of inspired, how do you fire a client? Because they went through the whole... Here's the deal. I've been doing this for long enough, I feel like I've nailed it. I have a system that works for me that is incredibly successful, and it works with all new clients. And by the grace of the universe, I had someone come in and challenge it. And it was really good, 'cause sometimes you need that. She was not very nice. And I felt like... I felt like this was an opportunity for me to really... It was challenging in a lot of levels. 


0:17:31.9 EC: So she brought her products in just like I asked, because I do an audit. And it was explained to her how things work, and she was explaining to me that she knew her skin better than I did. And I said, "I think that's definitely a possibility. I can understand that." It was just hostile from the beginning. Yet, I asked the question then, "Are you sure that I will be able to meet your needs? Here's how I work. Here's who I am, and here's how I work. Is this something that's gonna meet your needs?" And she said, "Oh, yeah. You come highly recommended." "Okay, great." So we had this consultation. I understood her lifestyle, I understood past... She's someone who gets laser treatments once every couple of years, because she thinks that's what works. That's what's gonna shrink her pore size. 


0:18:11.8 EC: Well, I understood differently. I think my experience lends me to think that facials are better, and chemical peels, like more corrective services, and complemented by laser, but that's... Anyways, that was disagreement number one. Second, we finally go into the... 'Cause for me, the consultation continues into the treatment room. We're in the treatment room, and I like... When people have impactions or filaments, I like to just push on them a little bit to see how they come out, 'cause you feel like that tells you a lot about what's going on with the oil glands. And I like to do that in pretty natural state, not an influence state. And she proceeded to tell me how her other aesthetician did it, and how I wasn't doing it how her other aesthetician did it. And it got to the point, and I'm still explaining like, "This is who I am, this is how I work. Is this something you wanna continue with?" And she kept, "Yeah, yeah, yeah," to the point where I had to stop and put my hands on her face, and I said, "Do you trust me?" She said, "Well, you don't know my skin yet." I'm like, "Okay, fair enough. Okay, I'm gonna just keep fighting through it." 


0:19:09.7 EC: Turns out, she looked fantastic when she left. She even bought product. I was reluctant to rebook her, but that is one of... I was so angry for a couple hours after that, because I was so challenged and it felt very hostile. So it would have been really easy for me to not... To relent control of the situation and to do just what she wanted. But that, to me, was outside of what I felt was in her best interest. And so I didn't do that. And I don't know, it's just... It was very challenging, it was a lot of perspective. And for me, mostly it was confirming that my intuition was right. Because she came back later to pick up a product, to tell me that... Magnifying mirrors should be broken. I don't care of seven years bad luck, break them. Because she came back to tell me that she had loved her skin, she had gone home, pulled out her magnifying mirror and noticed that there was still some mask left in her pore, like right here. And I said some four-letter words in my head. 


0:20:13.5 EC: And then she also said that I didn't extract right here, which is in the inside bridge of her nose, which is delicate skin that you're not gonna want, and the extractions were still not worth it, and I explained to her, "I'm not going to extract those because it's gonna cause more damage." I was just being firm, and another client had walked in at that time. And I said, "Go ahead and head on into the room, long-term client, I'll be right in." And that client had left, said, "See you in a couple of weeks." She's still standing firm she's gonna continue to see me. When I went into... The client had come in, she's like, "Ooh, who was that lady? It almost felt so gross." And I was like, "Oh, I need to fire her." So another podcast, we'll talk about firing client. But that is a consultation that... That's like a worst case scenario consultation. But what I maintained throughout was, I was true to my practice, I was true to how I dealt, I was kind. I was respectful, but I was professional, and I maintain it and I never gave up that part of it. 


0:21:14.5 MS: Yeah, I think that's important. And I think when you have those consultations and the client coming in, and to your point, "It doesn't feel right," don't be afraid to say no, refer them out, fire them, whatever needs to happen. 


0:21:29.7 EC: Yeah, absolutely. But don't be afraid to still have consultations. 


0:21:34.8 MS: Oh, entirely. Yeah, huge, huge part of the treatment. 


0:21:38.0 EC: Another consultation story I could share is that, I was teaching for a large spa a certain modality. And I started out... I think it was like 10 people in class. I started out, "Okay, let me see you consultation forms." Maggie, it was one-quarter of one page. So what is that, 11? Eight-and-a-half by eleven? So 11 divided by four. That's how tall it was. What information can you get on 11 divided by four?  


0:22:07.0 MS: Your name?  


0:22:07.5 EC: Your name and your address. So there was no questions, there was no lifestyle. There was no, "What products are you currently using?" Do you know what question was on there? "Is it okay I talked to you about retail today?" What in the name of disservice is that?  


0:22:20.5 MS: Yeah. 


0:22:20.7 EC: That's gone wrong. Those are consultations gone wrong. You're missing out on so much opportunity. You're missing out on an opportunity to best service that client. You don't want them there for 19 minutes filling out paperwork, but it has to be comprehensive. 


0:22:36.2 MS: Now, listeners, we want to hear from you. What are your thoughts on the importance of the client consultation? Share with us on social media by commenting on our Instagram or Facebook posts, or by emailing getconnected@ascpskincare.com. Thank you for listening to ASCP Esty talk. And for more information on this episode or for ways to connect with Ella and myself, or to learn more about ASCP, check out the show notes. 


0:23:00.6 S1: Thanks for joining us today. If you like what you hear and you want more, subscribe. If you wanna belong to the only all-inclusive association for aestheticians, that includes professional liability insurance, education, industry insights, and an opportunity to spotlight your sick skills, join at ascpskincare.com. Only 259 per year for all this goodness. ASCP knows, it's all about you.Page Break 


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