I have a client that had been doing really well with in-office treatments and home care.

About three months ago her skin went crazy!

She now has blemishes and congestion all over her chin and nose...extremely tough to extract and they are leaving PIH.  Her skin has become oily and dehydrated. Her skin also seems to be reacting to her moisturizer with more breakouts - I had her on Ageless, and have tried both the Aloe and Acai Berry. Right now I have her on NO moisturizer - just liberal use of Ageless hydrating serum and Cucumber toner.

She was getting peels - but her skin seemed so inflamed that last visit I just did an enzyme and put her under the LED panel (I also used Radiancy CTL over the blemishes). I am having her come back in this evening for a recheck - plus I asked her to patch test her moisturizers on her inner elbow to see if she really is reacting.

We are both in agreement that she is Peri-menopausal and going thru hormonal changes, she also has Fibromyalgia. No new meds or dietary changes.

Any ideas for home and office care?

She said she wants to go to the dermatologist - we discussed what the derm would probably suggest and I know her well enough that she won't like it. But she may be desperate enough if we can't get a handle on this.

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Cindy - those hormonal issues are the hardest.  What about an NMD that can run hormone tests and even work with nutritional aspects?  Until you can get to the bottom of the hormonal issues, I would treat gently and proceed with your current plan of patch testing.  Yes, I am in favor of her seeing a derm also, as that's going to be a different route of treatment that she will have to decide upon, but maybe she can see an NMD as a second opinion to treat the root cause. 

Thanks Lisa, I will talk with her in a few hours

There is one blemish she has that is starting to really pi$$ me off...hopefully it's a little better.

So the nasty blemish was still there. It looked like it was ready for extraction - but there was no sebum plug (even tho it was white on top!), all that came out was fluid...I was using q-tips so I don't think I damaged the follicle.

Darn it...this is why I hate extractions on my mature ladies

Anyway - gentle enzyme, CTL and LED again. And I rebooked her for a month out. With instructions to text me how her skin looks tomorrow.

She made the derm appt.

Cindy:  My thoughts turn to cellular inflammation (again hormones and nutrition) that creates the red inflammation, but no sebum plug.  When you research all the things that can create inflammation, we have a large list.  What about the fibromyalgia (auto-immune) flaring up internally, yet presenting on the skin?  I'm interested in other's opinions as well.  Again, I would proceed gently and think about repairing the acid mantle.

You know what? She had to take anti-biotics for another unrelated issue and the blemishes cleared!

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