Business tips
ASK THE EXPERTS
Our beauty experts answer your questions about every aspect of running a salon or spa business
What is PMOS and how does it affect the skin?
PMOS (polyendocrine metabolic ovarian syndrome) is the new name for the condition formerly known as polycystic ovary syndrome (PCOS), adopted following a global multistakeholder consensus process. The rename reflects the condition’s endocrine and metabolic breadth rather than an ovarian-cyst-centred model, but the underlying pathophysiology and skin findings described in pre-2026 literature remain valid.
PMOS is a common endocrine-metabolic condition affecting an estimated 6–21% of women of reproductive age. Despite the historical name, ovarian “cysts” are neither a feature of the condition nor diagnostic of it. Without cysts, many women missed out on a diagnosis; around 70% are thought to remain undiagnosed.
What causes PMOS?
The precise aetiology is unresolved. Excess ovarian and adrenal androgen production drives the visible features. Insulin resistance is also present in most affected women, and elevated insulin appears to amplify androgen output. Longer term, insulin resistance carries an increased risk of adverse pregnancy outcomes, type 2 diabetes and cardiovascular disease. Hyperandrogenism and insulin resistance together account for the skin features.
Does it have specific skin signs?
Typical skin features can appear early in the condition.
• Acne: The most common cutaneous feature, affecting over three-quarters of women and girls with the condition. Androgens increase sebaceous gland activity and sebum output, while insulin resistance contributes to epidermal hyperproliferation. Acne typically appears on the chin, jawline, cheeks, forehead, trunk and nose.
• Hirsutism: Androgen-driven terminal hair growth in a male-pattern distribution, sometimes accompanied by androgenic alopecia.
• Acanthosis nigricans: Velvety, hyperpigmented plaques on the neck, axillae and groin, closely linked to insulin resistance and obesity rather than androgen levels.
• Skin tags: Benign fibroepithelial polyps in flexural sites, reported in around one in five affected women.
Treating PMOS skin concerns
Acne vulgaris is more than a cosmetic issue; it is a common, often distressing manifestation of PMOS. Management works best when endocrine regulation is combined with standard dermatological care.
Prescribed combined oral contraceptives remain first-line for regulating cycles and lowering circulating androgens; anti-androgens may be added or substituted where the pill is contraindicated or insufficient. Metformin, used as an insulin sensitiser, also has trial evidence for improving acne.
Topical retinoids and niacinamide address hyperkeratinisation and barrier function, while alpha- and poly-hydroxy acids provide keratolytic exfoliation. Salicylic acid helps keep pores clear and has anti-inflammatory and bacteriostatic effects. Ceramide-containing moisturisers support barrier restoration, while benzoyl peroxide is a targeted treatment against C. acnes but can cause irritation.
For acanthosis nigricans, medical management should prioritise underlying insulin resistance through lifestyle intervention and metformin. Topical retinoids may reduce pigmentation, while urea or salicylic acid can improve textural thickening.
The 2026 rename does not change clinical management, but it is a useful cue to revisit client-facing language and documentation. Skin findings are frequently the presenting complaint and a legitimate entry point for referral to a medical practitioner.
DR GINNI MANSBERG
Dr Ginni Mansberg is a GP, TV presenter, podcaster, author and columnist. She is a physician specialising in women’s health, menopause and skin. She is also co-founder and medical director of cosmeceutical skincare brand ESK.
Should I create an online store for my salon?
An online shop is often viewed as a side hustle by skin practitioners, but it is a crucial part of the aftercare service you provide and can be a profitable revenue line for your business. Most therapists would agree that much of the benefit in supporting and maintaining healthy skin comes from the daily routine clients follow at home and the products they use.
Clients have made a significant investment in treatment and naturally want to learn how they can prolong its benefits. You have earned their trust and are now their go-to skincare adviser.
The salon case
Your client views you as a reliable source of information on which products will extend treatment longevity and which contain unsuitable active ingredients. Recommending and providing the right aftercare products should not be considered upselling, but an essential part of the care you provide. Treat your online shop as a digital extension of your salon or clinic.
The client case
Moving your salon from transactional treatments towards long-term outcomes involves extending the client journey beyond one course of treatment. The treatment plan you create with your client should incorporate the aftercare steps required and the products that will support them. Offering a convenient way to purchase these from your online shop is key.
Your online shop has two important advantages over high-street retailers:
1. You can stock professional products unavailable in high-street stores, including those that can only be sold following consultation.
2. The products sold through your salon and online shop have an unbroken connection between you and the checkout page. Use the time clients spend in your salon to educate and inform them, cementing this with a tangible takeaway.
The business case
A well-managed online shop, marketed as an essential part of aftercare, can provide an additional revenue stream. Retail margins can be significant, while the investment required may be relatively small compared with the potential returns.
This strategy can also support client retention. If you do not provide the products clients need, they may identify an alternative source through a search engine or AI tool, potentially leading them to a competitor.
Key considerations
There is no need to build your shop from scratch, as several purpose-built platforms are available. A typical salon may stock only two or three brands or 60–100 products, so select the most cost-effective option for a relatively small inventory.
Features to consider include:
• Transaction and processing fees
• Repeat orders
• Vouchers and gift cards
• Discounts and promotions
• Complementary products at checkout
• Financing options
• Abandoned-cart emails
• Membership capabilities
An online shop will not generate sales on its own. Market it within your salon and through social media, while using the client data it provides to support email marketing.
An online shop can extend the service you provide beyond the treatment room, strengthen the overall client experience and generate additional income for your business.
LISA KELLY
Lisa Kelly is the founder of Websites For Clinics, which helps aesthetic clinics, doctors, dentists and nurses attract new clients and generate new bookings to grow their clinic business.
Why is it important to think beyond the nail plate when doing manicures?
As a skincare therapist as well as a manicurist, I approach a manicure in much the same way as I would a facial: cleanse, exfoliate, hydrate, massage and protect. The nails may be the focal point, but the surrounding skin is what completes the finished result.
The word manicure comes from the Latin manus, meaning hand, and cura, meaning care – care for the hands, not just the nails.
I observe the entire area. The condition of the surrounding skin can give you valuable information about what may also be happening with the nails. A consultation should consider the hands, rather than focusing solely on the nail plate.
Our hands are exposed to so much – frequent hand washing, chemicals, movement and the elements. The skin can become dry, dehydrated and show signs of ageing quicker than anywhere else. People are more inclined to use skincare on their face than on their hands.
Incorporating the hands into a manicure creates an important moment of relaxation for the client. Those few moments of attention can become valuable downtime. Touch is a huge part of a treatment, and those five minutes can be the point where a client really switches off.
There is also a commercial opportunity for nail professionals. Upselling to a luxury treatment means you can charge more for not a lot more effort. I use the CACI Micro-Pro portable professional microcurrent device in my treatments, offering a fifteen-minute hand rejuvenation treatment followed by a fiveminute hand softening treatment. These can be carried out while another treatment is taking place, such as a pedicure or brow treatment, simply by applying the gloves and allowing the client to relax.
I developed Hydradrops from Personaility with the same skincare-first philosophy. My brief to the manufacturer was simple: fragrance-free, oil-free and skincare-grade ingredients. It contains ingredients you would typically associate with skincare serums, including hyaluronic acid, glycerin and cucumber extract. It hydrates without leaving an oily residue, making it easy to use throughout the day or at night.
Ultimately, treating the hands as skin is essential to the overall appearance of the manicure. The client gets healthier-looking, beautifully cared-for hands as well as beautiful nails, while the professional can offer a more complete treatment, create additional revenue and introduce retail.
A manicure shouldn’t stop at the nail plate. If we’re investing time in creating beautiful nails, we should also be looking after the skin that surrounds them.
JENNI DRAPER
Jenni Draper is a celebrity nail tech and beauty therapist, as well as an educator and founder of nail care and tool brand Personaility. She currently has a residency at hair boutique John Frieda Mayfair.