Pigmentary disorders are among the most common complaints of clients seeking skin care. Hyperpigmentation is an important condition that requires the expertise and understanding of an esthetician. It affects many Caucasians, Blacks, Hispanics and Asians. The goal of an esthetic pigment treatment is to correct and further prevent hyperpigmentation.
Melanin and Melanocytes
Melanin is a complex molecule responsible for the pigment in the skin, hair and eyes. The content of melanin within keratinocytes determines skin color, with deeply pigmented skin having the highest content of epidermal melanin. This molecule protects by reducing the penetration of UV rays into the skin and subsequently into the nuclei of cells where DNA resides. It is important to note that both dark and light skins have the same number of melanocytes (the cells responsible for melanogenesis); however, the ways these cells respond differ greatly.
To fully understand melanin and its influence in skin, you have to acknowledge the biological differences in melanocytes. Melanocytes are dendritic cells (cells with extended arms) located in the basal layer of the epidermis. Approximately 36 keratinocytes interface with one melanocyte, forming what is identified as the epidermal-melanin unit. Distribution of these cells can vary and when isolating the facial regions, as more numerous melanocytes are found on the head and neck.
How many times has a client exhibiting pigmentation morbidity had the misimpression that you can magically make it disappear with a treatment or two, or one product? We have to always remember pigmentation is a permanent injury of the skin and requires the due diligence and continued compliance of both the esthetician and client for the rest of their lives. These disorders do not fade or go away over night and must be managed daily. Clinical treatments, continuance of skin lighteners and daily protection of SPF must become a lifestyle to manage these challenging pigmentation conditions.
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Global skin of color is the ultimate future snapshot of your skin care clientele. Skin care professionals who ignore the phenomenon of the multitude of skin races are out of touch with the reality concerning the trends that will dictate their esthetic careers in the near future, and will miss the opportunity to learn how to work with this ever-increasing population successfully. Skin care professionals must prepare for this prospect, and learn to recognize what is appropriate and inappropriate concerning skin treatments, ingredients and products for skin of color.
There are significant differences between global skin types. Just look at the rainbow of skin colors that make up the millions of skin types and where they originate. Cosmetically speaking, black skin has a wide range of color variations from a creamy light coffee color to deep ebony black. Asian skin exhibits colors that range from a light yellow hue to a dark golden tan. Native American skin colors vary with respect to different tribes, and have coloring that ranges from light to dark red-brown. Even white skin is misinterpreted visually and put into inaccurate categories. Caucasian skin ranges greatly from milky alabaster white to dark olive tones.
Darker global skin types are much more reactive to topical agents such as alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs), trichloroacetic acid (TCA) and many different ingredients, and are more sensitive to these constituents than Caucasian skin. Unfortunately, many skin care professionals misunderstand the darker global skin combinations and treat skin of color as if it were Caucasian, being overzealous in their procedures and recommending improper skin care products, triggering an inflammatory response leading to unwanted problems. This can result in devastating side effects, such as hypopigmentation and hyperpigmentation. These very avoidable mistakes not only affect the client cosmetically and emotionally, but destroy the trust between client and professional.
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