Issue link: https://www.ascpskindeepdigital.com/i/225798
Online Extra: Watch our "Hormones and the Skin" webinar by logging in as a member at www.ascpskincare.com. Look under "Education" for "ASCP Webinars." In-office treatments should be designed to increase cell turnover and decrease bacteria and oil production. These may include modified and enhanced Jessners formulas, salicylic acid treatments blended with anti-inflammatory ingredients, deep pore-cleansing treatments, and circulation-enhancing treatments. Consistent home care is essential. Encourage your acne clients to include the following products: • n antibacterial cleanser containing alpha hydroxy acids A (AHAs), benzoyl peroxide (BPO), gluconolactone, or salicylic acid. • n alcohol-free toner containing AHAs, anti-inflammatory A agents, and antioxidants. • Treatment products containing BPO, licorice extract, retinoids, or salicylic, azelaic, kojic, or lactic acids. • moisturizer containing antibacterial and antiA inflammatory ingredients. • lightweight, broad-spectrum sunscreen suitable for A breakout-prone skin. clearing the pigment deposit once lactation has ended. Effective ingredient combinations are low-percentage trichloroacetic acid (TCA), lactic acid, and retinol in conjunction with additional melanogenesis-inhibiting ingredients. For best results, treatments should be performed every three weeks until the skin is clear, with monthly maintenance treatments after that. Daily use of a broad-spectrum sunscreen is critical. Melasma worsens with ultraviolet exposure, so failing to protect the skin will slow or halt any improvement already achieved. Finally, remember that any client who is pregnant or lactating should consult her physician prior to beginning any skin treatments. MELASMA Know the Client Melasma is characterized by large, dense patches of pigmentation. According to the American Academy of Dermatology, 90 percent of all melasma cases occur in women. Melasma is still not completely understood, making it a frustrating condition to treat. It is known to be a hormonal condition, but puberty and normal menstrual cycles do not often cause it. Many melasma patients first develop the condition during pregnancy (it is sometimes called "the mask of pregnancy" for this reason). It can also be brought on by the use of hormonal contraceptives, hormone replacement therapy, or perimenopause. Consistent, long-term treatment with low doses of melanogenesis-inhibiting ingredients is key when treating melasma. Hydroquinone at 2–4 percent is the industry standard, but this ingredient is contraindicated during pregnancy and lactation, making it unsuitable for many melasma clients. Fortunately, there are many alternatives: arbutin, azelaic acid, kojic acid, lactic acid, licorice extract, mulberry extract, phenylethyl resorcinol, rumex extract, and undecylenoyl phenylalanine. Combining several ingredients often provides the best outcome. Another treatment option is blended chemical peels. Although these, too, cannot be performed during pregnancy and lactation, blended peels are an important step in Understanding the most common hormonal actions and resulting skin challenges at different life stages is a very useful addition to any esthetician's professional knowledge. Awareness of these potential issues, combined with the ability to build solid client relationships and encourage compliance, and an in-depth understanding of ingredients' mechanisms of action, will help you provide home care and in-office treatments to best suit each individual client. Jennifer Linder, M.D., is a dermatologist and Mohs micrographic skin surgeon with a private practice in Scottsdale, Arizona. She is chief scientific officer for the skin care company PCA Skin, a spokesperson for The Skin Cancer Foundation, and an editorial board member of the Cosmetics Journal. Get connected to your peers @ www.skincareprofessionals.com 21