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Permalink Reply by coldsalineplexus on September 16, 2013 at 11:07am

I do not recommend microderm, and especially not diamond tip, for anyone above a Fitzpatrick 4.  It is too easy to scratch and cause additional pigment irregularities.  For your in-office treatments, I would stick to just lactic peels, eventually (after 4-6 peels) graduating to something with about 8-10% Salicylic acid (could be a mask, etc.) if the acne persists.

I would ensure that she is on the lightening serum AND a mild retinoid AND perfect sun protection for a MINIMUM of 6 weeks before touching her.  A tyrosinase inhibitor like arbutin (or even hydroquinone at appropriate FDA approved levels) will NOT lighten the skin tone, but will prevent production of EXCESS pigment.  She also needs a good, balanced (proper proportions of emollients and humectants) moisturizer to prevent additional pigment from coming about as a result of the initial dryness/irritation that is normal with starting an advanced skincare protocol.

It is true that for those who struggle with pigmentation, it is often advised to make a tyrosinase inhibitor part of their long-term healthy skin routine.  For others, simply maintaining perfect sun protection is sufficient to prevent resurfacing of pigmented areas.  There are tyrosinase-inhibiting serums which don't cost "a ton of money," and are safe to use long-term.  Ideally they would be blended with a mild concentration of AHA's to keep skin cell turnover at an optimal rate.  The idea of seeing an esthetician for a few treatments and then going back to drugstore products is simply not realistic (especially if we are talking about acne-prone or pigment-vulnerable skin), so do yourself a favor and explain to your client that healthy, clear skin is an ongoing part of a wellness routine.  She'll be seeing you every 3 weeks for lactic acid for the next 4 months, but after that she should be able to graduate out to maintenance scheduling of 4-8 week increments (depending on the rate, depth, and severity of comedone formation, which you will determine once she is clear).  If you don't set her up with the proper expectations, you will both be disappointed.

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Permalink Reply by coldsalineplexus on September 16, 2013 at 11:32am

I would also encourage you to rethink your idea of what is a "temporary fix" when it comes to skincare.  What is your expectation as far as the duration of benefits?  Are you hoping to be able to use a product for a defined period of time, discontinue it, and then continue to receive its benefits?  If so, I think that the top 5 ingredients for healthy skin - SPF, retinoids, tyrosinase inhibitors, hydroxy acids, peptides, and antioxidants (OK, that was 6, but you get my point) will ALL disappoint you.  Not to mention wonderful ingredients like ceramides, glycosaminoglycans, fructooligosaccharides, the bounty of new anti-inflammatory ingredients being studied, and many others that moderate skin's healthy moisture balance and prompt skin to act younger than its actual age.  All of these things need to be used continuously to benefit.

To put it in perspective: I have had the opportunity within the past year to meet several estheticians, all 10+ years older than I am, who have been in the business a long time and taken great, highly consistent care of their skin.  When I say they looked younger than their age, I'm talking about 8-15 years younger!  This is the result of consistent use over time of these beneficial ingredients that we are lucky to have access to, and that continue to be studied and refined over time.  Nothing about promoting the health of your skin is a one-shot deal.  Facelifts are a one-shot deal, but they have nothing to do with how healthy the skin cells actually are, and if you look around, you can find plenty of examples of pretty bad looking skin that has been lifted and tucked - especially in Hollywood. 

My training is that it's an esthetician's job to promote the health and beauty of the skin.  It is not my opinion, through research or observation, that this can be done effectively through short-term means.  I think these incorrect expectations are often the reason that clients leave their estheticians and report that "the facials weren't doing anything for me" - and that this is entirely preventable if you set up the proper education, expectations, and responsibilities for the client to achieve and maintain healthy, beautiful skin. 

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Permalink Reply by November on September 17, 2013 at 5:46pm

 EstyStar,

I'm late in chiming in and would love to know how it went. 

I'm an AA and have ruined my face (sliding boards, monkey bars, bicycle incidents) on more than one occasion. Fade creams should permanently fix these types of hyperpigmentation (Post-inflammatory).  ON THE OTHER hyperpigmentation caused by malasma (or hormonal related) are  more difficult to correct and will require long term care to keep at bay. 

Also, in my opinion the longer one has had the spots the more of a challenge we will face in fading them; regardless of the source. 

 

Do let us know how the treatment went and progressives.

 

 

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