My First Severe Allergic Client Reaction!
ugh! just got the text.
Client in early 40's, history of acne/oily skin, used Accutane extensively in her 20's, has a lot of "textural" issues, and overuses an enzyme scrub, typiclly does not use moisturizer at all.
I normally start everyone out with Rasp/Peach enzyme but thought she would be okay with Pomegranate. Within one minute, no steam she was at an 8 on the sting/burn scale, so I immediately removed and neutralized. I mixed Rasp/Peach enzyme with Goji mask, no steam, and she looked good and reported all burning was gone. Used a calming gel mask over Ageless and C serums and LED light. Looked amazing.
36 hours later she woke up to swollen eyes and hives.
She just took a Benadryl and I will get an update later.
Oh - and can I mention that this client is my employer and has never had a facial?
Jeez!
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Replies to This Discussion
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Permalink Reply by Cindy Greenwood on
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It was on my recommendation that she brought in Skin Script - I just hate to have her lose confidence in ME and/or the product!
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Permalink Reply by Lisa VanBockern on
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Hi Cindy:
I like the way you handled the above situation by removing, neutralizing and starting over. Being that it was 36 hours later, it tells me she is having a reaction to something she is using at home (rather than the facial) because the homecare stays on the skin and could create swelling. I'm going to look towards the homecare. Ask her if she can do a "reboot" on the homecare and start with a cleanser and moisturizer and see how she does. Then, begin adding one product at a time until you can find a culprit.
The Benadryl should help any reaction/swelling to get her back to normal. Then, start with the "reboot" plan.
As you know, this can happen to anyone with any product. I think if you talk to her frankly and ask to help find the problem ingredient/product, the confidence returns.
Lisa
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Yes - I was just talking about this with my (adult) son. I agree that she was sensitized and the reaction was to her homecare - I sent her home with ageless Hydrating serum and Cucumber mist - but I just KNOW she used that enzyme scrub last night.
But you know how "clients" are. They will refuse to accept that it's what they used cuz after all "they've never had a problem before". But I WILL ask if she would be willing to ditch her current cleanser/scrub. She believes she is oily (frankly I think she is pretty dehydrated at this age), and I tried to get her on the Blemish Control several months ago and OFF that other cleanser. Honestly I don't think she even tried it. Do you think I should rec. the Green Tea or BC Cleanser? She won't use moisturizer , that's why I wanted her on the Hydrating serum and mist.
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My intent was to work her up to TCA peels.
Right now, I just don't see how I'm going to get there. :(
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Permalink Reply by Sandee Regier on
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Hi Cindy ~ When we have "texture" issues and client who overuse exfoliants at home we know there are skin barrier problems. They are most likely showing diffuse redness also. Perhaps obtaining their cooperation in reducing the removal of protective cell layers, and allowing their skin to maintain a more balanced pH, and leading in with very gentle products (hydration and repair like phosphatidylcholine, hyaluronic acid, antioxidants, omega 3 essential fatty acids) and seeking to reduce all inflammation will bring better results when a more agressive pH is used in a peel treatment. It's my feeling that to have a peel actually be beneficial there must be an adequate skin barrier. Skin cells are formed from the inside, so checking her diet and supplements will tell you also if she is getting essential fatty acids in her diet, adequate water intake, minerals, and antioxidants. I wouldn't be too surprised at her reaction. She is a client that needs guidance towards the right skin care routine at home as Lisa has pointed out.
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I love this answer. I start thinking about impaired acid mantle and work on repairing the barrier first before trying to treat texture. So, things like cucumber toner (and hopefully a moisturizer, big missing part right there), along with some Coconut enzyme treatments would be the best until you feel her skin is ready to move into peels.
Regarding your comment about Green Tea or Blemish Cleanser, I think you could sample those and see if she (1) would use it, and (2) if it works for her. Even though she is oily, I might lean towards Pomegranate cleanser because of the hydrating effect it will have on the dehydrated skin.
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She was still puffy and itchy when I saw her this afternoon, but the hives were gone at least.
Sent her home with the Green Tea Cleanser and she has Cucumber Toner already...so there's a start. I have the Pom Cleanser, but she wears makeup and that cleanser doesn't remove it with one cleanse (she is NOT a double cleanser)
I think you know me well enough to know I am NOT an agressive SS esthetician! I start everyone on enzyme treatments only and introduce peels gradually over time when their skin has been prepped appropriately.
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*Update*
This treatment I used only Green Tea cleanser. Rasp/Peach enzyme with no steam, Ageless Hydrating Serum and Cucumber Toner (cuz I have her on that for homecare), and Le Mieux O2 Calming Gel as masque, not time for LED this treatment.
I suspected either the AHA's in Glycolic Cleanser or Pomegranate Enzyme, and wanted to avoid using too many products so left off trying Goji or Seaweed Masque.
She again broke out in HIVES! urk
I can try the Coconut/Papaya enzyme next - I think I have enough for one more treatment. After that??
But otherwise I am stumped as to exactly WHAT to use that won't cause a reaction.
She is the first person to have problem reactions in 3+ years of using this line . -
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Oh - and best way to patch test?. I normally do inside elbow
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Hi Cindy:
Since the reaction is delayed, could the culprit be a moisturizer or spf that is staying on the skin, rather than the enzyme, masks that only stay on the skin 7-10 minutes? Some people can have a sensitivity to fruit purees also. Do you have access to a powdered enzyme that usually creates no reaction at all? Let me know what she went home with on her skin.
Also, on patch test, the inside elbow will work. I usually do the inside forearm or behind the ear.
Lisa
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I have a bioelements powdered enzyme and some softening gel...uh, it's prob 5yrs old ...and I've never liked it much. That's why it's in my closet
I removed masque and applied another layer Ageless with Cucumber. I used no spf...too paranoid for anything
I am suspecting the fruit aspect also...yet she says no previous allergies.
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I never liked powdered enzymes either (that's why I don't have any), but with someone who is very reactive like this, I would go with the most benign products available. You should patch test her with the Ageless and see if that could be it.
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