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Permalink Reply by Dawn C on August 8, 2013 at 9:42am

You could do hyroquonone which helps to lightening it and/or dermafiling which helps exfoliation like a micro without suction then used a rosacea serum to help reduce redness. A cooling mask would also help reduce redness after a dermafiling.

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Permalink Reply by Dawn C on August 8, 2013 at 9:43am

A lactic peel without steam may help also but will take longer to get rid of since its only a surface peel.

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Permalink Reply by Jodi on August 8, 2013 at 9:54am

I use Vitamin C for lightening.  It may take longer, but gentler and safer than hydroquinone IMO. Agree on the lactic acid peel.  Enzymes are great for exfoliation for sensitive skin as well.

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Permalink Reply by Marty Glenn on August 8, 2013 at 12:48pm

Jules

The photo attached shows deep and multi-layer hyperpigmentation.  The picture on the right is after a TCA (2 Coats / 10% 1.0pH / Fan brush Application ). The picture on left is where she started and the picture on the right is where she is today.   Is what is in the circle what you are seeing? That is caused by sun and not hormonal or melasma. Look at upper lip on right side and that is more inline correct? Tammy is Fitz 3 but a fitz 2 with regards to sun exposure. She cannot sun her skin.

"The lighting is so different on the pictures but hopefully the results show through. This individual will under go 2- 3 more TCA applications at 5% or even 10% 1.0pH '1 - 3 Coats' "

Dawn has it right with Lactic Acid.  Melasma is treated best with 35% - 45% at 3.0 pH. Jodi has it right that Vit C as a lightener and also has sunscreen properties so also good advice. HQ at 2% is the max you can get and I do not think that would be best only because the HQ can really only help with future lightening and not bleach current markings.

If you have not used a Wood's lamp, do so and find out how deep the pigment goes and look out for pigment sitting on top which you will not know until you start working on it but the Wood's lamp can give you indications.

Back to picture... If what you are seeing is more like upper lip on pict on right then very difficult to treat but sun avoidance is 100% key.  If like inside circle I would follow Dawn and take a 40% Lactic Acid solution and cut it down with water to make a lighter solution, maybe say 15 - 25% and test a very small area first.  The rosacea is key here and you have not said how bad it is.  I am assuming flushing only but with that said same instructions.

Stay out of the sun is going to be the key for both the possible melasma condition and the rosacea. Slow and steady on this one and a lot of one on one time.  Fitz 1 - 2 with melasma and rosacea makes for difficult 'Results Driven' products because of adverse side affects of the harsher and stronger liquids.

Would not hurt to talk to client about MD and potential laser treatments. Just a thought. Hope this helps

Marty

SkinCareScience.com

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Permalink Reply by Dawn C on August 8, 2013 at 8:52pm

Marty is correct. Wirh her skin being sensitive and having rosacea HQ would probably be to harsh for her. Lactic and vit C would be your best bet AND definitely a sun block not sun screen. May even be able to use a topical retinoll resurfacing cream once a week, just on those areas only.

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Permalink Reply by Cindy Greenwood on August 9, 2013 at 6:07am

And I am going to add my two cents in with Marty and Dawn...

There are dangers to using HQ (as there are with laser treatments).

Do your research and then decide - but don't make a reccomendation that you don't believe in or think is safe.  For me personally, I would not carry, sell, or recommend any HQ product.

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