Pigmentation, fine lines AND dark circles!!!!

[heatherp]

Hi guys, need you help yet again ( don't know what I'd do without you all these days :hug

THIS IS A LONG ONE - SORRY PEEPS

Had a new client yesterday (44 years old) Had been having micro-current facials with her previous therapist who had moved away.
She'd booked to have a micro-current facial and listed her complaints as:-
Pigmentation - on cheeks under the eyes.
Fine lines - again around the eyes.
Dark cirlces around eyes.
Spots

She cleanses and moisturises regulary but rarely tones and exfoliates as exfoliation seems to worsen her pigmentation.

I asked if she had been happy with the results of the micro-currents she had been having and she said sort of. The spots she says are not under the skin but on examination, Id have said they were.
I did the normal, drink plenty water, good diet etc which she said she did. I mentioned Microdermabrasion but she said she'd tried it and it made her pigmentation worse although I have read that you need to persevere as it gets worse before it gets better with the pigmentation getting closer to the surface of the skin?

Im thinking I can do facials with brightening masks for pigmentation, suggest dermatoligist or laser. I could do facials incorporating lymph drainage to try to help the dark circles, but I really am at a bit of a loss what I can suggest to help all three without her having to spend the equivelent a day a week at my salon .
Any suggestions guys?????

H xx

 

[miss_petite]

HI

You are right about the pigmentation getting worse first explain to her that pigmentation needs to be brought up to the surface and the dead skin is covering it also say to her that no products are going to work efficiently if there is a barrier of thick dead skin in the way i use phrases like the pigmentation is in the lower levels of the skin ( epidermis or dermis).
also make sure she is using a sunscreen with spf 30 containing zinc oxide and a vit c serum ( protect and repair) . this alone can treat the pigmentation.
retinol is great for lines and exfoliation.
i wouldnt do microderm on a pigmentated black skin thou.

personally i do alot of exfoliation on my pigmented clients some prefer peels some miroderm then if i cant see a change a refer them to are other clinic that does laser. what type of pgmentation is it is it malasma ( hormonal ) or is it from acne?? and what skin type is she?

 

[heatherp]

Hi,
Thanks for the reply
Her skin looks dehydrated and there were signs of spots under her skin. I would say her problem is more hormonal then acne as she also has alot of facial hair starting to sprout (obviously didnt tell her this!)
You said you wouldn't do microderm on ethic skin but then said you would do exfoliation or miroderm - whats miroderm??
She wasnt keen on any exfoliation as I said because it made the situation worse but will explain the process to her.
To me microderm would help her dehydrated skin, fine lines etc but are you saying you def wouldn't recommend doing this on her skin then?
I'm not sure I should be the one treating her as I'm not at all cofident in suggesting things to her, and I've never felt like this before :cry:
Many thanks for your help
H x

 

[Martin Duffy]

To me microderm would help her dehydrated skin, fine lines etc but are you saying you def wouldn't recommend doing this on her skin then?

I personally can't see how microdermabrasion is going to help a lack of free water in the epidermis. Removing the stratum corneum & thus impairing the protective skin barrier will only speed trans-epidermal water loss, and thus worsen dehydration. Whilst the skin will look lovely straight after the treatment, it will only exacerbate the dehydration & thus is not a long-term answer.

The key to treating what you're calling dehydration is to seek to increase the client's own fluid intake (which may also help the eyes) & to slow down the trans-epidermal water loss, i.e. by strengthening the skin's barrier functions (increasing the lipid content as oil sits on water and thus helps to retain it within the skin). This can be achieved in part by increased fluids & good skincare containing the right ingredients to closely mimic the skin's own protective barrier, and the use of a good partially occlusive night cream/balm (as TEWL increases at night).

If you're not confident in treating her, I'd be honest & tell her so. However, in the meantime it might be worthwhile plugging the areas you're not confident in by further research, reading & training. As a start, I'd strongly suggest purchasing Florence Barrett-Hill's "Advanced Skincare Analysis" & "Cosmetic Chemistry" books; although not cheap, they'll transform the way you approach skincare & in better understanding the skin & how it works it will give the confidence you currently feel is lacking!

 

[heatherp]

Thanks Martin, I agree with you regarding the fluid intake but when I did question her about this, she said she drinks lots of water, avoids caffeine etc. but did think along the same lines about the skin's barrier. I shall contact her and give her the advice you have given me. Thank you, I will definately look into picking up a copy of the book you advise.

Heather x

 

[heatherp]

Martin,
Just wanted to add that what has thrown me is that she has a multitude of problems ( fine lines, dark circles, pigmentation, dehydrated skin and alot of conjestion under the skin) and I wasn't sure how to deal with all of them, as she seems to want A treatment that would miraculously cure them all.
Thanks for your help, I do appreciate it and hopefully I will one day be as knowledgable as you.

H x

 

[Curly Bamboo]

When dealing with dehydration, fine lines, dark circles you need to look at the client's diet to make sure she is taking in enough essential fatty acids (EFAs). Majority of people do not consume enough EFAs in their diet, so taking omegas/fish oil supplements will really benefit the skin.

The skin has bilayers of oil and water. Oil and water do not mix so they sit in layers:

oil oil oil oil oil oil
water water water
oil oil oil oil oil oil
water water water

If you do not have enough oil then how will the skin hold the water. You could be drinking 4 litres a day and still be losing water.

See here for Florence's view of dehydration - Dehydration real or misdiagnosed

Pigmentation, excessive hair growth on face, spots are all symptons of hormonal inbalance. You should check her medical history and if necessary recommend her to see a GP for a hormone blood test. From my experience, clients who have been on a strong contraceptive pill for a long time may get pigmentation (melasma). Hormonal pigmentation is much harder to treat than sun damage pigmentation.

To boost your confidence and knowledge, why don't contact your skincare company and check what courses they have?

Also the International Dermal Institute (the education side of Dermalogica) are running alot of skin courses.
The International Dermal Institute

Hope this helps.

 

[heatherp]

Hi Curly Bamboo

Thanks for the advice, I am enrolled on a facial course at the end of March. Really looking forward to it, love doing facials but also know there is soooo much more to learn.

Thanks everyone for all the advice, I have emailed the client encorporating the advice you have given me so this will hopefully help her make an informed decision.

H x

 

[angeleyes01]

You should definitely refer her to her doctor with these symptoms. The acne and facial hair definitely suggest hormonal problems.

One of my friends had similar symptoms along with digestive problems and weight loss. After years of being severely unwell - she was finally diagnosed with Addisons Disease, a very rare condition. One of the symptoms was pigmentation problems. If her various doctors (dermatologist, gp and cardiac specialist) had joined the dots and combined all of her symptoms, she would have been diagnosed much quicker.

Hopefully your client will get medical help for her homonal problems and then will come back to you for more business because you have been so honest and helpful.