Dayspa

JAN 2019

DAYSPA is the business resource for spa & wellness professionals! Each issue covers the latest in skin care, spa treatments, wellness services and management strategies.

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Persistent breakouts, which may be hereditary, plague medium skin tones, too. "I often see genetic acne in Latina patients, particularly if the mother has acne," says Pierce. "This is due to low levels of FOX-1, the gene that regulates the sebaceous glands. Plus, we inherit our mitochondria, the powerhouse of the cell, from our mothers." Although breakouts may be diffi cult to prevent, Pierce has several go-to options. "For pustular acne, I advise against benzoyl peroxide, as it's too drying and can cause secondary pigmentation in darker skin types," she notes."I prefer they use a salicylic acid cleanser, enzymes to exfoliate, and then follow with a sulfur product if they aren't allergic to it." Pierce also recommends fractionated or jojoba oil. "Seed oils have the same weight as sebum, so they tell the oil glands that they don't have to overproduce, which is one of the causes of acne in the fi rst place," she explains. TYPES V AND VI (DARKER SKIN TONES) Common concerns: dermatosis papulosa nigra (DPN), post-infl ammatory hyperpigmentation (PIH) Although darker tones have more melanin, which means a lower incidence of hyperpigmentation caused by sun exposure, these clients can still be susceptible to other sorts of spots on the skin. DPN is a genetic condition presenting as multiple small dots resembling moles on or around the cheekbones and eyes. Fortunately, DPN is harmless and the spots are easily removable, says Dr. Vashi—although she is careful with her technique: "I worry about lasers, which can make the skin darker, so I may use a lightening agent beforehand to quiet down the melanocytes, and then I can do the treatment in a safer way." She also frequently uses electrocautery to remove the spots, and if any follow-up treatment is needed, she'll use a Q-switched neodymium: yttrium aluminum garnet (Nd:YAG) laser. Dr. Vashi says that this option, which is often used for tattoo removal, is gentle on the skin and ensures that she doesn't create further superfi cial damage or white spots. Darker skin shades may also run an increased risk of PIH, often the result of acne and picking, as well as incorrect use of chemical peels, microneedling or lasers. At KUR Skin Lab, Oh takes a proactive approach to both treatment and prevention of these concerns. "Rule No. 1 is managing acne—so fi rst, I gently exfoliate the top layer of melanin and surface cells, and once the acne is more controlled, we do an exfoliation that we customize according to skin type," he says. "Then we use melanogenesis inhibitors—ingredients that can stop the process of hyperpigmentation—such as retinoids or lactic acid." If the PIH is stubborn, Oh may also use a laser, such as the Cutera Laser Genesis. "It gently heats the upper dermis just below the skin's surface, which improves the appearance of fi ne lines, shrinks pore size, evens out rough skin texture and fades scarring via cell turnover and collagen stimulation," he notes . u © GETTY IMAGES Clients in the middle of the skin spectrum tend to be more susceptible to solar lentigines, i.e., age spots. Januar y 2019 • dayspamagazine.com 51

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