The Practice Lab

Most energy-based device settings are built around one number: the patient's Fitzpatrick type. In this episode of 10 Minutes with Tracey, Tracey Mancuso explains why that scale was never designed for lasers, how relying on it alone leads to PIH, burns and undertreatment, and the fuller assessment she uses instead.

In this episode:

Why the Fitzpatrick scale was created in 1975 to predict sunburn and skin cancer risk, not laser response

Eumelanin versus pheomelanin, and what each means for photoprotection

Why you never hand a patient the skin-typing form, and the questions they almost always answer wrong

How the aesthetic industry adopted Fitzpatrick for devices, and why fluence charts still lean on it

Why a tan doesn't change a patient's type, and what fluence should depend on instead

The Roberts Skin Type Classification System: phototype, hyperpigmentation, Glogau photoaging and scarring, combined into one code

The palmar assessment and the Lancer scale, and the gaps they fill

Building a full risk profile before you choose a treatment

As Tracey puts it: "Energy-based medicine requires risk-based stratification, not just some visual assumption." And on the intake form: "Unless they live in a cave, they are going out in the sun."

Free download: The DermaRoom Collective's skin typing and patient assessment forms are in the Downloads section at thedermaroomcollective.com.

About the host: Tracey Mancuso, BScHS, CMLSO, is the founder and course director of The DermaRoom Collective. A Certified Medical Laser Safety Officer with more than 30 years in aesthetic medicine, she teaches laser, light and RF treatment to practitioners.

Every sales rep makes the device look good. Alicia Yap decides on what happens after the cheque clears. In the first episode of 10 Minutes with Tracey, the founder of ClaraDerma+ talks through how she actually buys energy-based devices — why service and turnaround matter more than the technology, why the brand on the billboard isn't better than the one beside it, and how a $150,000 machine stops being frightening once you divide it by sixty months. She also explains the purchase she got wrong, and what it cost her.

In this episode:

Where to start if you're buying your first device, and the treatments that are reliably in demand

Why after-sale service is the single most important thing to check, and how to check it before you buy

What real supplier support looks like beyond the one-day training: marketing, events, and turnaround when something breaks

Asking reps for consumables, practice tips and event budget, and why they usually say yes

Hype versus science: what a heavily marketed brand genuinely buys you, and what it doesn't

Bringing your team into the decision, and the head spa she bought without asking them

Getting past the fear of the price tag by treating it as a monthly payment

Rapid fire: proven or new, one platform or several, and what matters more than the technology

As Alicia puts it, on chasing the brand everyone knows: "At the end of the day, the science is the science. You can get exactly the same results with a different machine if you know what you're doing and you're trained properly." And on where to get a straight answer: "If you wanna know the real information about the device, ask the trainers. The sales reps sometimes don't really know exactly what the device can do or not do."

About the guest: Alicia Yap, CMMA, CLT, is the founder of ClaraDerma+, a laser and skin clinic in St. Catharines, Ontario, and Founder and Education Director of ClaraDerma Academy. She is a Certified Master Medical Aesthetician and Certified Laser Technician, and has been running ClaraDerma+ for over a decade.

In this episode:

From the operating room to one of Canada's first RN injectors, and the year it took to convince a surgeon
Why she built nurse training in 1994 when nothing existed, sold it, and started again in 2016
Inside THMA's foundation program: facial anatomy, assessment skills, medical history, skin quality, neuromodulators, fillers and PRP, and the business of practice
Advanced training, and why lip enhancement is taught one-on-one rather than in a group
The adverse events course, and the informed consent conversation most providers avoid having
The biggest obstacle for a newly qualified nurse, and why it isn't clinical skill
Social media and the colleges: what you can post, what you can't, and why self-injecting content is a problem
Why a curriculum that hasn't changed in five years is a red flag

As Tracey Hotta puts it, on informed consent: "If it's documented in the literature and something happens and you haven't told them, you're accountable." And on the Instagram version of the job: "They go, oh my God, there's so much to learn. It's like, yeah, it's medicine. There's a lot to learn."

About the guest: Tracey Hotta, RN, BSN, CPSN-R, CANS, ISPAN-F, is the founder of THMA and a partner of The DermaRoom Collective. She began nursing in 1984 and moved into aesthetics in 1990, becoming one of the first registered nurse injectors in Canada. She is a past president of ISPAN, a founding member of the Canadian Society of Aesthetic Specialty Nurses, and a member of the Registered Nurses' Association's Quarter Century Club. She lectures on facial anatomy across North America.

Most acne education stops at the surface: cleanse harder, exfoliate more, dry it out. Alex Lee thinks that advice is why so many patients never get clear. In the first episode of The Practice Lab, the DermaRoom Collective's clinical trainer walks through the biology underneath acne — the pilosebaceous unit and the four drivers that feed it — and makes the case that barrier repair, not stripping, is what actually breaks the cycle. She also shares a cystic acne case that improved roughly 75% before she performed a single treatment.

In this episode:

The gap between graduating and facing your first real acne patient, and why Alex built a course to close it
The pilosebaceous unit, and the four pillars of acne: follicular hyperkeratinization, excess sebum, Cutibacterium acnes, and inflammation
Why over-cleansing and over-exfoliating make acne worse, and what barrier-first treatment looks like instead
Reading the pattern: cyclical jawline breakouts versus uniform, itchy presentations, and why one patient often has several types at once
A severe cystic acne case: two weeks of stopping everything, then a simple routine, then mapped microneedling
Where Alex stands on microneedling over active acne, including her extraction and antimicrobial protocol
Three things a practitioner can change the day after finishing the course

As Alex puts it: "The key to healthy skin is a healthy microbiome." Or, on why sequence matters more than product choice: "You need to have a healthy foundation in order to use those ingredients and to use them properly."

About the guest: Alex Lee, CBAM, is a medical aesthetician practicing at Beauty Mark Medical Aesthetics in Prince Edward Island, and clinical trainer for The DermaRoom Collective. She is Course Director of Understanding Acne: From Pathophysiology to Practice.