Issue link: https://www.ascpskindeepdigital.com/i/1481047
New member benefit! Get the ASCP SkinPro app at ascpskincare.com/skinpro 83 AT SOME POINT, MOST OF US will experience irregular pigmentation. As an esthetician, this is a common concern we hear from our clients. Pigmentation appears in di erent forms, and it's important to recognize the root cause, determine how to treat it, and set expectations for improvement. TYPES OF IRREGULAR PIGMENTATION Hyperpigmentation Post-in ammatory hyperpigmentation (PIH) is a result of trauma to the skin, such as an acne breakout or an injury to the surface like a cut or scratch. This is normally located within the surface layers of the epidermis and can be treated e ectively with a series of brightening treatments, as well as a consistent home care routine. Melasma This develops from hormonal changes in the body, such as a pregnancy, menopause, or the use of birth control or hormone replacement therapy. It presents itself as large, symmetrical patches of pigment with lines of demarcation. Melasma is usually located at the dermal/epidermal junction and the stratum germinativum. It is di cult to treat, as it is deeper in the skin near the dermis and is hormonally driven. We can successfully treat the melasma, but nding the root cause and correcting it (if possible) is the best solution. It is important to know that melasma can return during the warmer months from increased sun exposure, as UVR (ultraviolet radiation) stimulates the generation of pigment. Solar Lentigos These are UVR-induced freckles or dark lesions caused by excess sun exposure. They are common in older adults. Intense pulsed light (IPL) works well for Fitzpatrick skin types I–III for freckles; however, darker lesions in adults may need to be removed using cryotherapy. Regular sun protection and home care that includes tyrosinase inhibitors are critical in the correction and prevention of their formation. There isn't one miracle product that will do everything. It's a combination of products and ingredients working in synergy. CHOOSE THE RIGHT TREATMENT Once you determine the type of pigment you are working with, talk with your client about what types of treatments would be suitable for their lifestyle. Professional options, such as chemical peels, with a consistent home care system can be most e ective. Be mindful that each client must qualify for chemical peels. Having an awareness of contraindications for particular treatments can address clients' concerns and keep them safe. There are many types of brightening treatments on the market, ranging from mild weekly treatments to more aggressive monthly treatments. Ordinarily, one treatment is not going to remove all the pigment and a series is recommended. Set those expectations with your client, and remember the cell cycle is 28–30 days, so patience is key. If your client can't have downtime with advanced, aggressive treatments, consider weekly treatments. Of course, don't forget that home care is 80 percent of the result! In home care, one product typically won't lift pigment; your client needs a routine of products: • Daily cleanser • Regular exfoliant • Skin-lightening product containing kojic acid, arbutin, azelaic acid, licorice root, and/or hydroquinone • Treatment serum, such as vitamin C serum to inuence cellular nutrition • Moisturizer for appropriate skin type • SPF, the most important element in pigmentation prevention As you can see, there isn't one miracle product that will do everything. It's a combination of products and ingredients working in synergy. Treating the skin gently on a weekly basis for 6–8 weeks may be the most powerful and most comfortable for your client. A gentle, more progressive approach may be the safest protocol to avoid complications from more aggressive chemical peels and other advanced options. Skin care customization is critical. With a comprehensive consultation, you can con dently decide what works best for you and your client.