Hello All!  Need help here.  In the last month I've two clients of color, one African American, one African that have extremely dark pigmentation on an area of their forehead that is starting to move down their face to the cheeks.  Both stated that they had gone to dermatologist in the past (not recently) for acne. They both would like their skin tone to be even again. Has anyone treated this skin disorder? Is it a fungus? Should I refer to doctor?

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I look forward to everyone's responses.  If its moving and you think its out of your scope of practice, then I refer to the dermatologist.

Thanks, Lisa. Each client stated that it started out as a small spot and now covers the entire forehead.

The answer to this question will take much discussion as it will involve skin cell development (melanocyte and keratinocytes), case history, and treatments/medications provided. You will have a beginning by visiting http://www.beautymagonline.com/beauty-articles-2/938-pigmentation-q....

Interviewing these clients (male or female?) and finding out a full history of their skin care background, what medications they now use or used in the past, how their acne was treated, and their sun exposure history, etc. will help you start to piece together why this pigmentation is now being revealed. It may possibly not be able to be removed, but it may be made less apparent. 

Pigmentation is perhaps one of the most difficult aspects of skin repair. I only understood it completely by taking the time to learn all about skin cell development in depth. Skin color is an amazing and complex subject. 

Sandee, thanks for the info.  I've had a really indepth conversation this week with one of the clients. She seems a little impatient not quite accepting (notice I didn't say understanding) that she has to play a huge role in reversing this skin issue. Also, I did not feel she had followed the advice from the Dermatologist.  I referred her back to him.

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