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Veronese S, Aggarwal R, Giovanelli T, Sbarbati A. Hyper- and Hypopigmentation in a Subject with Fitzpatrick Skin Phototype VI: A New Treatment Option. J Clin Med 2024; 13:1036. [PMID: 38398349 PMCID: PMC10889290 DOI: 10.3390/jcm13041036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/28/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Laser therapies can cause hyper- and hypopigmentation of the skin. There is little evidence in the literature of effective treatments for these types of problems in Fitzpatrick skin phototypes IV-VI. The main aim of this retrospective study is to evaluate the effects of a new therapy that combines the application of electromagnetic fields and vacuum on a subject with Fitzpatrick skin phototype VI, who presented extensive, laser-induced facial dyschromia. The secondary aim is to test the effectiveness of a free imaging software for assessing skin pigmentation. Methods: The level of improvement after therapy was evaluated, with a 5-point Likert scale, one month after the end of the treatment by the subject and by the doctor who performed the treatment, and by two blinded dermatologists. With the free software, a three-dimensional reconstruction of the treated area and the evaluation of the color distribution were performed. Results: Both the subject and the doctors involved in the study positively evaluated the effects of the treatment. The image analysis highlighted the homogenization of the skin color in the treated area. Conclusions: The combination of electromagnetic fields and vacuum for dyschromia treatments appears promising. The new method of assessing melanin levels resulted particularly efficient.
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Affiliation(s)
- Sheila Veronese
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Rajeev Aggarwal
- Cardiff Cosmetic Clinic, Cardiff CF24 3WD, UK; (R.A.); (T.G.)
| | | | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
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2
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Van Wicklin SA. Cosmetic Procedures in Patients With Skin of Color. PLASTIC AND AESTHETIC NURSING 2023; 43:164-169. [PMID: 37774160 DOI: 10.1097/psn.0000000000000523] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Affiliation(s)
- Sharon Ann Van Wicklin
- Sharon Ann Van Wicklin, PhD, RN, CNOR, CRNFA(E), CPSN-R, PLNC, ISPAN-F, FAAN, is the Editor-in-Chief, Plastic and Aesthetic Nursing, and is a Perioperative and Legal Nurse Consultant, Aurora, CO
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3
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Amici JM, Cogrel O, Jourdan M, Raimbault C, Canchy L, Kerob D, Madfes DC, Tian Y, Araviiskaia E. Expert recommendations on supportive skin care for non-surgical and surgical procedures. J Eur Acad Dermatol Venereol 2023; 37 Suppl 3:16-33. [PMID: 36635618 DOI: 10.1111/jdv.18855] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/04/2023] [Indexed: 01/14/2023]
Abstract
A thorough knowledge of non-surgical procedures (laser, peelings, injections, threads) and surgical procedures (combined surgeries and skin grafts), including contraindications and potential risks and side effects, (e.g. infection, hypopigmentation, hyperpigmentation, and scarring) is essential to be able to reduce their incidence and ensure the patient receives the most benefit from the procedure. Individuals with darker skin and of high Fitzpatrick phototype are at higher risk of dyschromias, notably melasma and post-inflammatory hyperpigmentation, which may be treated using aesthetic procedures but may also arise as a complication of some procedures. A group of experts in cosmetic surgery and dermatology reviewed the published literature and discussed recommendations for optimizing outcomes with practical advice on supportive skincare before, during and after non-surgical or surgical procedures. A broad-spectrum sunscreen with a high sun protection factor against UVB and high protection against UVA, especially long UVA, is essential for all treatment modalities for the prevention and potential improvement of pigmentation disorders. Supportive skin care management to prepare, cleanse and protect the skin and post-procedure skin care with healing and anti-inflammatory ingredients are recommended to speed up regeneration and wound healing whilst minimizing scarring and downtime. Additionally, adjunctive skin care to procedures with antioxidant, anti-ageing and lightening properties may enhance skin benefits.
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Affiliation(s)
- Jean-Michel Amici
- Dermatology Department, CHU Bordeaux, Hôpital Saint-André, Bordeaux, France
| | - Olivier Cogrel
- Mohs Surgery and Laser Unit, Dermatology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Marie Jourdan
- Centre Laser International de la Peau-Paris (CLIPP), Paris, France
| | | | - Ludivine Canchy
- Laboratoire Dermatologique La Roche-Posay, Levallois-Perret, France
| | - Delphine Kerob
- Laboratoire Dermatologique La Roche-Posay, Levallois-Perret, France
| | | | - Yan Tian
- Dermatology Department, Air Force Medical Center, PLA, Beijing, China
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4
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Sun C, Lim D. Chemical peels for atrophic acne scarring: Evolution of peel types and methods. Australas J Dermatol 2023; 64:18-27. [PMID: 36479667 DOI: 10.1111/ajd.13959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 12/12/2022]
Abstract
Acne vulgaris is a common condition among those of adolescent age. Prolonged inflammation associated with the disease can result in substantial scaring which is detrimental to both the physical and psychological well-being of the patient. Chemical peels are a commonly used treatment modality for acne scarring that is widely available and can be administered with a low associated cost. This article aims to illustrate the current best practice and highlight new advances in chemical peeling in the treatment of acne scarring.
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Affiliation(s)
- Cong Sun
- Mater Hospital Brisbane, Raymond Terrace, South Brisbane, Queensland, Australia
| | - Davin Lim
- Cutis Clinic, Indooroopilly, Queensland, Australia
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5
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Li Y, Zhen X, Yao X, Lu J. Successful Treatment of Minocycline-Induced Facial Hyperpigmentation with a Combination of Chemical Peels and Intense Pulsed Light. Clin Cosmet Investig Dermatol 2023; 16:253-256. [PMID: 36726812 PMCID: PMC9885878 DOI: 10.2147/ccid.s394754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/19/2023] [Indexed: 01/27/2023]
Abstract
Minocycline is a tetracycline derivative antibiotic commonly used to treat acne, rosacea, and other inflammatory skin conditions. Taking minocycline risks inducing skin pigmentation. If minocycline-induced hyperpigmentation is not treated, it may take months to years for the symptoms to subside after discontinuation of the drug, or the hyperpigmentation may never disappear completely, which can lead to cosmetic anxiety and affect people's quality of life. Previous treatment options for hyperpigmentation were mainly q-switched nd: YAG, ruby, and alexandrite lasers. This article reports a case of facial hyperpigmentation caused by minocycline using a combination of chemical peel and intense pulsed light in a patient with eosinophilic cellulitis (Wells syndrome) who was taking oral minocycline. This case suggests combining chemical peel and intense pulsed light is an effective treatment option for minocycline-induced hyperpigmentation.
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Affiliation(s)
- Yuan Li
- Dermatology Department, the Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China,Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Xiaole Zhen
- Dermatology Department, the Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Xiaojuan Yao
- Dermatology Department, the Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China
| | - Jiejie Lu
- Dermatology Department, the Fifth People’s Hospital of Hainan Province, Haikou, Hainan, People’s Republic of China,Correspondence: Jiejie Lu, Dermatology Department, the Fifth People’s Hospital of Hainan Province, No. 8 Longhua Road, Longhua District, Haikou, Hainan, 570100, People’s Republic of China, Email
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6
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Amechi M, Halpin J. Considerations for Laser Therapy, Microneedling, and Chemical Peels When Treating Patients With Skin of Color. PLASTIC AND AESTHETIC NURSING 2023; 43:14-21. [PMID: 36583583 DOI: 10.1097/psn.0000000000000483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Over the past 10 years, we have seen exponential growth in the aesthetic industry. With this growth, we have also seen an influx of patients of differing ethnicities, in all varying shades of color. Some clinicians may not have the necessary knowledge and skill to appropriately treat these patients using modalities such as laser therapy, microneedling, and chemical peels. The aesthetic industry provides courses, conferences, and educational guides for helping aesthetic practitioners determine which patients are eligible to undergo these treatments. However, there is a considerable lack of information available for clinicians about treatment modalities that can be safely and effectively used on patients with Fitzpatrick skin types IV-VI. As the population of patients of various ethnic origins seeking aesthetic treatments continues to grow, it is imperative for clinicians performing these treatments to increase their knowledge and skill related to treating patients with skin of color. The purpose of this article is to educate aesthetic clinicians about appropriate treatments, procedures, and protocols for preventing adverse reactions in patients with skin of color who are undergoing aesthetic treatments using lasers, microneedling, and chemical peels.
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Affiliation(s)
- Marisa Amechi
- Marisa Amechi, RN, CANS, is an aesthetic registered nurse in private practice in Santa Clarita, California and is cofounder of Skin of Color Aesthetics
- Jacklyn Halpin, DNP, APRN, FNP-C, is an aesthetic nurse practitioner in private practice in Highpoint, NC and is cofounder of Skin of Color Aesthetics
| | - Jacklyn Halpin
- Marisa Amechi, RN, CANS, is an aesthetic registered nurse in private practice in Santa Clarita, California and is cofounder of Skin of Color Aesthetics
- Jacklyn Halpin, DNP, APRN, FNP-C, is an aesthetic nurse practitioner in private practice in Highpoint, NC and is cofounder of Skin of Color Aesthetics
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7
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Facial Rejuvenation in Patients of Color. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00407-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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8
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Quiñonez RL, Agbai ON, Burgess CM, Taylor SC. An update on cosmetic procedures in people of color. Part 2: Neuromodulators, soft tissue augmentation, chemexfoliating agents, and laser hair reduction. J Am Acad Dermatol 2022; 86:729-739. [PMID: 35189253 DOI: 10.1016/j.jaad.2021.07.080] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 10/19/2022]
Abstract
Recent years have brought forth the undeniable practice gap in dermatology concerning knowledge and experience of cosmetic procedures in people of color (POC). A paucity in the literature regarding evidence-based recommendations for the management of POC undergoing cosmetic procedures and the rise of cosmetic procedures in dermatology serves as a call to action to provide education regarding differences in skin of color that may impact the cosmetic outcomes. To mitigate the current practice gap on the safety, use, and benefits of cosmetic procedures in POC, part 2 will discuss the authors' recommendations and clinical pearls, as well as evidence-based management for neuromodulators, soft tissue augmentation, chemexfoliating agents, and laser hair reduction in POC undergoing cosmetic procedures.
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Affiliation(s)
- Rebecca L Quiñonez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Oma N Agbai
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, California.
| | - Cheryl M Burgess
- Center for Dermatology and Dermatologic Surgery, Washington, District of Columbia
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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9
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Ye D, Xue H, Huang S, He S, Li Y, Liu J, Wang Z, Zeng W. A prospective, randomized, split-face study of concomitant administration of low-dose oral isotretinoin with 30% salicylic acid chemical peeling for the treatment of acne vulgaris in Asian population. Int J Dermatol 2022; 61:698-706. [PMID: 35285944 DOI: 10.1111/ijd.16127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/27/2021] [Accepted: 01/11/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Acne vulgaris (AV) is a common dermatosis. For moderate to severe AV, isotretinoin is the first-line treatment. Chemical peeling with supramolecular salicylic acid (SSA) was developed with water solubility and advanced skin penetration properties. In the present study, we investigated the efficacy and safety of oral low-dose isotretinoin combined with 30% SSA chemical peeling. METHODS Thirty-three moderate-to-severe acne patients were enrolled and received oral low-dose (0.2-0.4 mg/kg/d) isotretinoin and were then randomly assigned to receive 30% SSA or not on each side of the face with 2-week intervals for four sessions. Photos, the number of lesions, GAGS score, skin indices (melanin, erythema, pore, and texture), hydration, and transepidermal water loss (TEWL) were assessed at 0, 2, 4, 6, and 10 weeks. Side effects, efficacy, and satisfactory rates were recorded. RESULTS A total of 29 patients completed the study. Oral isotretinoin combined with SSA decreased response time compared to isotretinoin monotherapy, with significantly improved GAGS score, count of lesions, and efficacy (%) at 4-6 weeks. Skin indices of melanin, erythema, pore, and texture evaluated at week 10 were improved as well. Oral isotretinoin with or without SSA was effective by the lesion clearance; only SSA significantly improved the TEWL. All the side effects were temporary and tolerable, and no adverse effects were observed. CONCLUSION Oral low-dose isotretinoin combined with 30% SSA is safe and effective, which advanced the onset of action and improves lesion clearance.
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Affiliation(s)
- Dan Ye
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Huan Xue
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shiliu Huang
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shujuan He
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Youbao Li
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jing Liu
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhao Wang
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Weihui Zeng
- Department of Dermatology, The Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Adotama P, Papac N, Alexis A, Wysong A, Collins L. Common Dermatologic Procedures and the Associated Complications Unique to Skin of Color. Dermatol Surg 2021; 47:355-359. [PMID: 34328287 DOI: 10.1097/dss.0000000000002813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The skin of color (SOC) population in the United States continues to grow, and these patients are undergoing various cosmetic and surgical procedures at increasing rates. There is a paucity of data on the potential complications associated with surgical and cosmetic procedures in this patient population. OBJECTIVE We aim to educate dermatologic surgeons and clinicians on surgical and cosmetic procedures in patients of color and increase awareness of the potential complications unique to this patient population. MATERIALS AND METHODS A thorough PubMed literature search was performed to conduct this review. RESULTS There are a number of complications in SOC that require special attention, including keloids, postoperative infections, postinflammatory hyperpigmentation, and hypopigmentation. There are also various precautions to consider when performing cosmetic procedures, such as neurotoxin and filler injections, laser therapy, microneedling, and chemical peels. CONCLUSION Dermatologists should be aware of the potential cosmetic and surgical complications of this growing patient population to provide optimal evidence-based medical care.
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Affiliation(s)
- Prince Adotama
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Nicole Papac
- Department of Dermatology, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma
| | - Andrew Alexis
- Department of Dermatology, Icahn School of Medicine, New York, New York
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Lindsey Collins
- Department of Dermatology, University of Oklahoma Health Sciences Center, College of Medicine, Oklahoma City, Oklahoma
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Dorgham NA, Hegazy RA, Sharobim AK, Dorgham DA. Efficacy and tolerability of chemical peeling as a single agent for melasma in dark‐skinned patients: A systematic review and meta‐analysis of comparative trials. J Cosmet Dermatol 2020; 19:2812-2819. [DOI: 10.1111/jocd.13725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Nevine A. Dorgham
- Dermatology Department Faculty of Medicine Cairo University Giza Egypt
| | - Rehab A. Hegazy
- Dermatology Department Faculty of Medicine Cairo University Giza Egypt
| | | | - Dina A. Dorgham
- Dermatology Department Faculty of Medicine Cairo University Giza Egypt
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12
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Maymone MBC, Watchmaker JD, Dubiel M, Wirya SA, Shen LY, Vashi NA. Common Skin Disorders in Pediatric Skin of Color. J Pediatr Health Care 2019; 33:727-737. [PMID: 31655787 DOI: 10.1016/j.pedhc.2019.04.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/22/2019] [Accepted: 04/24/2019] [Indexed: 12/12/2022]
Abstract
Children with skin of color represent a large proportion of the pediatric population. There are numerous skin conditions that commonly occur in this population, including but not limited to acne, atopic dermatitis, pityriasis alba, tinea versicolor, progressive macular hypomelanosis, traction alopecia, and confluent and reticulated papillomatosis. This article highlights the clinical presentations of these conditions in skin of color and briefly addresses pathophysiology and treatment modalities.
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Lee KC, Wambier CG, Soon SL, Sterling JB, Landau M, Rullan P, Brody HJ. Basic chemical peeling: Superficial and medium-depth peels. J Am Acad Dermatol 2019; 81:313-324. [DOI: 10.1016/j.jaad.2018.10.079] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 11/29/2022]
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Abstract
Ethnic skin is quickly emerging as the norm in the United States, and as the population becomes more diverse, there is also a projected rise in the number of aging adults. Given the paucity of data regarding aging in ethnic skin, the authors have consolidated available information for this population. Literature examining structural and functional variation of aging in ethnic skin types was primarily found through PubMed and supplemental textbook chapters. Aging is comprised of two synergistic processes, intrinsic or chronologic aging, and extrinsic aging. Caucasian, African American, East Asian, and Hispanic skin each have distinguishing features of aging, but all populations share dyspigmentation, rhytides, and skin laxity. Increased melanin content predisposes skin of color to a greater degree of hyperpigmentation, but skin thickness may protect against the formation of rhytides. Tailored prevention and treatment are also paramount in attaining favorable outcomes for this growing cohort.
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Affiliation(s)
- Samantha Venkatesh
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Mayra B C Maymone
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Neelam A Vashi
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA; US Department of Veteran Affairs, Boston Health Care System, Boston, MA.
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