Issue link: https://www.ascpskindeepdigital.com/i/663523
30 may/june 2016 expertadvice SKIN SOLUTIONS • Postinflammatory hyperpigmentation occurs when the skin has been injured or inflamed and does not heal correctly. This condition has nothing to do with sun exposure. Examples include pigmented marks left on the skin after a pimple has healed—possibly induced by pimple picking or popping—or scabs that do not heal naturally. While pigmented macules, or dark spots, can occur on any skin, they are most prevalent on skin of color. • Solar lentigines, also known as freckles, are caused by sun exposure and can appear all over the body. HOME-CARE SOLUTIONS Addressing hyperpigmentation depends on the cause and involves a carefully planned program of topical skin treatment and lifestyle adjustments. It is important to get your clients to fully commit to a treatment program, as their cooperation is essential to success. The following are staples of home- care treatment for hyperpigmentation: • First and foremost, avoid sun and heat sources, regardless of the actual cause of hyperpigmentation. UV rays are a trigger to production and should be avoided, especially between the hours of 10:00 a.m. and 2:00 p.m. When clients must be outside, they should be encouraged to wear sunscreen, protective SPF clothing, and a hat. • Reduce sources of inflammation, including picking pimples and using incorrect products and overly aggressive skin treatments. While some lasers can be used to treat hyperpigmentation, other laser treatments may be too aggressive and can worsen conditions if not used with great care. • Use broad-spectrum sunscreen every day. Sunscreen must be applied every morning and repeated whenever clients are exposed to sun, even if they work indoors. The easiest way to accomplish this step is to suggest a suitable moisturizer that contains broad-spectrum SPF-30 protection. • Use a daily chemoexfoliant such as alpha hydroxy acids (AHAs). These products include glycolic, lactic, malic, and mandelic acids (or a blend), and, at mild levels, gently remove layers of pigmented keratinocytes from the skin surface, promoting the production of healthy skin cells via the cell turnover process. Salicylic acid or retinol can also be used to stimulate cell turnover. • Use a melanin suppressant at night. Hydroquinone, or HQ, is the only FDA- approved, over-the-counter lightening agent on the market and does a good job removing hyperpigmentation. HQ is a tyrosinase inhibitor that limits the biochemical processes in which melanin is formed, reducing its production and, therefore, improving the condition. Other agents that produce similar results are arbutin, azelaic acid, bearberry extract, kojic acid, lactic acid, licorice extract, and others; however, these are not FDA-approved lightening agents and, therefore, are referred to as brighteners. Be sure to remind your clients these products cause photosensitivity, and they should take extra precautions to avoid the sun. Stronger medical treatments include prescription drugs such as steroids, tretinoin, and higher concentrations of HQ. Of course, these require a medical referral. There are a few factors that can affect the success of the treatment program. These include: • Compliance with lifestyle changes, such as avoiding sun exposure, routine use of products, etc. • In some clients with darker skin types, melanocytes are present lower in the dermis. For these clients, topical hydroquinone cannot reach the melanocytes. These clients should receive a medical referral. Estheticians can play pivotal roles in helping address their clients' hyperpigmentation concerns; you can help them navigate the market and recommend effective products. Professional treatments can also improve the skin's appearance faster. As mentioned above, professional- strength AHAs, as well as beta hydroxy acids, can be especially helpful in reducing hyperpigmentation and improving the skin's overall appearance. Combining these home-care recommendations with your professional treatment protocols are sure to win your client's favor and loyalty.