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Permalink Reply by Sandee Regier on April 27, 2015 at 4:41pm

Hi Kristy - Looking for advice on how to help clients with skin conditions is a tricky matter. It's very good you posted a picture because seeing what is happening really helps a great deal. There is a lot of information to be gathered in helping pinpoint why the client is having a breakout such as age, skin care history, medications, supplements, diet etc. Soothing products I've used contain Zinc oxide, tea tree oil, willow, ammonia polymere, champhor, and blue chammomile. These are normally in formulations. The client could try icing gently in the mornings and evenings for a few minutes after cleansing. If using vitamin A I would recommend bringing the use up slowly starting at a couple times a week and increasing over an 8 week period to every other day. Vitamin A palmitate is good at reorganizing the follicles and often purging of the follicles causes a breakout as follicle content is pushed out. Be absolutely certain she is using a form of makeup or coverup that isn't comedogenic by looking at each ingredient closely. Are the breakouts equally distributed on both sides of her mouth and chin? If not, perhaps habits of resting on her palm is contributing. This is typical for students in lectures. Chin areas and jawline areas are typically hormonally related breakouts. I always use MLD for those with deep jawline involvement as this is a collection area for facial lymph nodes. 

Permalink Reply by Kristy Floyd on April 27, 2015 at 5:08pm

Thank you so much!

Permalink Reply by Kristy Floyd on April 27, 2015 at 5:06pm

Here are a couple more pics. Could tretinoin do this?

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• image.jpg, 25 KB

Permalink Reply by Kristy Floyd on April 27, 2015 at 5:10pm

Here's one more.

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• image.jpg, 23 KB

Permalink Reply by Sandee Regier on May 1, 2015 at 1:41pm

Hi Kristy - Just getting to take a look at the photos. I do see the raised area on her chin with a border appearing to be irregular. Very interesting. Is this apparent anywhere else on her skin or body? I believe it's important to look at duration of the problem - when it occured and how long it lasted, is it reoccurring and how so? An analysis of exactly what the client is applying to her skin is important also and you've mentioned Tretinoin, is she using that in combination with various other acids at the current time? If not, when and how long she did use the retinoic acid is important. Initially, it seems that the raised areas may be due to increased fluids in that area, a swelling, and is there a coverup preventing the display of redness in the photos? She appears to display a fair amount of surface vascularity occuring on her cheeks seen in the last photo you sent. Her chin displays redness. She appears to have a prediposition to sensitivity from what I can see. I would try taking her back to calming and pH balanced products, no ingredients known to be sensitizing, and treat breakouts locally with anti-inflammatory/antibacterial ingredients/modalities, but no acids. Followup no less than monthly (in fact bi-weekly at first) would be good, just for a look/see or calming treatment. Those are my thoughts, but it's always very diffucult to truly evaluate the problem without more in-depth information. 

Permalink Reply by Kristy Floyd on May 1, 2015 at 4:02pm

Thank you :)

The line under her lip has been there since February.  She has trouble with breakouts so along with her facial I used the Clear Touch Lite on here breakout areas and put her on the Skin Script Mild Acne Regimen.  It's actually easier to see the raised areas with her matte finish makeup on.  The first time I saw her she told me about it but I could hardly see it.  However, with her makeup on I can definitely see it.  The other raised areas appeared after her facial.  I checked with her before we started her facial she said she hadn't used her tretinoin in weeks.  It is something she has used in the past for breakouts along her jawline, but she was prescribed it back in February again this time for breakout on her chin.  Subsequently the line appeared below her lip.  She quit using it but it hasn't gone away.  And now there are more areas.   Please let me know if you have any other thoughts.  I truly appreciate you taking the time to help.