Treating Ethnic Skin (Fitz IV-VI) for Acne Scarring

My client has healthy skin, she is in her 40's and finished taking a TXT of Accutane 3 months ago. She does have papules and scarring on her jaw line that she would like to diminish. Her pores are enlarged around her chin, nose and forehead and there were many open comedomes - none would come out easily even after an enzyme exfoliation under steam. Once her derm gives the ok, I would like to start her on a resurfacing series of glycolic treatments and then move up to a TCA peel. I'm using Dermaquest products but if you have other suggestions, I would love to hear them. I am also recommending a home care including a glycolic cleanser, B5 serum (dermal hydrator), anti-oxidant and sun screen.

Tags: acne, ethnic, peel, scarring, skin

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Permalink Reply by Cindy Greenwood on December 30, 2011 at 10:22am

Sounds like you have an excellent treatment plan, especially your home care recommendations.

I would only switch that up a little if she has naturally oily skin - and then I would have her use homecare with salacylic acid and/or BPO.

I am concerned that she has papules and that the accutane evidently wasn't effective, since she has scarring from previous papules. The Derm was SURE that it wasn't Papular Rosacea?

I have a sometime client that has very curly hair and she is always trying some kind of hair straightening product. She almost always gets horrible papular breakouts on her forehead. I only mention it because clients don't always divulge everything they are using and doing. :)

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Permalink Reply by Deborah Bonjouklian on December 30, 2011 at 10:52am

Thanks for your input Cindy. I know, having a papule after a round of Accutane does seem like something is not quite right. she is seeing the derm at the end of the month and she has seen other dr's so she is well educated about her skin care problems. I am not familar with the term papular rosacea - can you describe it to me?

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Permalink Reply by Laura Cooksey on December 30, 2011 at 12:54pm

@Deborah - I run/own an acne clinic and we have TONS of clients who break out with acne after (sometimes several rounds!) Accutane. That's usually why they seek us out - they are finally discouraged enough with the derm's protocol.

For the closed comedones and pih, there is nothing better than a good vitamin a propionate serum - glycolic and/or salicylic doesn't usually get the job done (sometimes it does, but rarely). My take on the regimen that you have put her on is that it needs to be much more "active" in order to get the noninflamed stuff under control.

By "scarring" do you mean dark spots or actual indentations in the skin?

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Permalink Reply by Deborah Bonjouklian on January 2, 2012 at 3:38pm

Thanks Laura, I will look that serum suggestion up. She does have one indentation on the forehead region but mostly they are dark spots.

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Permalink Reply by Danielle Wachowski on March 27, 2012 at 7:25pm

for ethnic skin peeling, ask the expert Pamela Springer. Her line is made for ethnic skin and she knows her stuff.

Her line is called Global Skin Solutions. Remember that with Accutane its time on = time off before performing peels, etc.