Reaction to Hydroquinone
Hello all,
A loyal client of mine referred her mother to me two weeks ago, after the skin analysis, I recommended Obagi skin bleaching creme 4% to address her pigmentation issues along with other clinical products in preparation for her first resurfacing treatment scheduled 4 weeks later.
Unfortunately, I was out of the office on vacation for 2 weeks and upon my return i received a call from her letting me know that she was experiencing extreme redness, itching, edema,flakiness, and her skin felt leathery. I immediately told her to discontinue the Obagi and invited her back to the clinic so i could take a closer look at her skin.
She came in the next day, and her skin looked extremely dry and irritated. I gave her a soothing hydrating facial which seemed to calm the redness down and relieve the dryness but its been a week now and she is still complaining of slight redness and now breakouts!...she is concerned that her skin will not return to its original state, and I am concerned as well!
I have never experienced any client reaction to hydroquinone before, can anyone provide any tips on how to proceed with this client, she is coming into the clinic tomorrow for a follow-up.
Thanks!
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Replies to This Discussion
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Permalink Reply by Katrina Kulm on
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Some people are highly allergic to hydroquinone, it's best to test patch a small area first to see if they have any reaction first but since she already had a reaction, she needs to use some very calming products. Does Obagi carry anything soothing for home care use? She may want to try some over the counter Hydrocortisone with aloe vera which can really helpful to calm down skin irritation. What she thinks of as "breakouts" are most likely just irritation bumps from having an allergy to the product.
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Permalink Reply by Rita Edet, Educator Dermaplanpro on
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Thanks so much for the response, Katrina. I use image skincare products in my treatment room and so far I have had her on the ormedic line which is supposed to be calming and soothing but it has only been a week so maybe she need to give it more time for her skin to heal.
She will be coming to my clnic tomorrow for a soothing facial, and you mentioned hydrocortisone and aloe vera as a soothing agent to the irritation, at what point do i incorporate these products during the facial?
Thanks again?
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You can apply it at the end of the facial, it's a type of cream so you can apply it before moisturizer but I think it would be good if she can use it at home for a few days to use on the areas where she is having the irritation right now at least once a day. The Ormedic line should help, although the gel cleanser might be a little drying for her..maybe she could use the Vital C hydrating cream cleanser instead? Yes it does take time to heal the skin, some clients don't realize that they are overdoing it on their skin with exfoliating and trying so hard to get rid of hyperpigmentation when in fact inflammation makes it worse. It's best to treat it gradually and 4% hydroquinone seems strong to me. Although I can understand in your situation why you'd suggest Obagi with hydroquinone since Image doesn't seem to carry products with ingredients that would help assist or target hyperpigmentation.
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Just wanted to add a link of the Calm Balm with hydrocortisone from Control Correctives which is good for any of us to just have on hand to use on clients that can react from a product we use or turn red from facial treatments. It is sold through Universal Companies. http://www.universalcompanies.com/By-Category/Skin-Nail-Hair-And-Sp...
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Hello Katrina, just to let you know that the facial today was a success!..your tips were really helpful, the hydrocortisone really calmed down the redness and I gave her a sample to use after her facial regimne a few times a week.
Thanks so much!
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You're welcome! I know what it is like to have a client that has a bad reaction, it does happen and I'm just glad to be of help when situations like this comes up, it can be really stressful especially knowing the client might lose trust in us if we can't get them better fast enough. Hope all continues to go well! =-)
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Permalink Reply by jazz on
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What other products was she using? Possibly could be the mixture...Obagi does have normal side effects such a redness, peeling, flakiness..but with edema it sound she over did it..did she have pustules on the irritated areas? Have her try a skin repairing cream such as cicalfate from aveene if not available a cream base from eucrin and have her try to cleanse with a milk cleanser or a gentle cleanser such as cetaphil for the mean time..I tell my clients while using obagi to listen to his or her skin and if needed to take a break for a few days and on those days baby it using mild cleanser and hydrate skin then go back on....also find out how she is cleansing with gentle hands or using a tool such as clarisonic, sponge, or cloth and ask how she is drying skin? Hope this was helpful..( we always say when things go wrong cicalfate it) the skin repairing product is amazing..
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Hi Jazz,
Thanks for the response.. i use Image skincare products and that is what I recommend to my clients as a home care regimne. For 2 weeks straight, she used the obagi and was exfoliating even with the irritations, so she really did a number on her skin. I have her on the Ormedic line but its only been a week so i am guessing she would need to give it some time to take effect.
I will certainly raise the questions you asked to her tomorrow when she comes in for her treatment. Thanks alot!.. I appreciate your advice.
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Hi Jazz, yes turns out she was using a cloth to wipe her face after cleansing, which I feel may have contributed to the irritation. I went ahead and recommended to her facial wipes. Thanks for the tips!
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