Issue link: https://www.ascpskindeepdigital.com/i/1191176
70 ascp skin deep january/february 2020 you don't overtax their already struggling immune system. Lastly, you will need to know what medications your client is taking. Are any of them photosensitizing? Clients with cardiovascular disease can have circulatory issues that restrict blood flow and oxygenation of the tissues. People with black skin of African descent have a higher incidence of high blood pressure.6 ACE inhibitors, a category of blood pressure medication, work by not allowing blood vessels to narrow, but a side effect of this medication is the development of a skin rash. A skin rash can be a sign of impaired barrier function, so you must be knowledgeable about greater TEWL to determine the best treatment plan. Breast cancer tends to be discovered later and progresses more aggressively in black women ages 40–50.7 Clients who have had breast cancer surgery may have had lymph nodes removed. You need to consider that possibility when developing your treatment plan, since a lack of lymph nodes will impair the functioning of the lymphatic system. Impaired lymphatic flow could increase inflammation, which will lead to PIH in women with skin of color. Finally, discuss hormones with your client. Women's hormones fluctuate daily. Estrogen maintains skin moisture by increasing glycosaminoglycans and hyaluronic acid in the skin and possibly maintains stratum corneum barrier function.8 Is your client on birth control pills? Or is she menopausal and taking estrogen replacements? EVALUATING SKIN CONDITIONS You need to be a detective and understand the skin you are seeing in your treatment room. If your client has hyperpigmentation, you need to ascertain whether it is due to melasma, medication, nutrition, or sun exposure. You must also consider that more than one factor may be involved. Hyperpigmentation is a condition that has different causes, each requiring different treatment options. Melasma is a challenging You can't depend entirely on the Fitzpatrick scale when designing a treatment plan; you must investigate beyond the information gathered from it in the consultation.