Inflamed Skin, Atopic Dermatitis and Melasma

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Table of Contents

Introduction
The treatment plan to support the practitioner
Modalities/treatments within the scope of a dermal therapist
How the procedures and treatment plans meet the patient’s objectives
Conclusion
References

Introduction

This research report examines and discusses a case study scenario of a patient suffering from loss of elasticity and inflamed skin, atopic dermatitis and post-pregnancy melasma. Followed by referral recommendation and composition of the skin pre and post-treatment. Aesthetic procedures that meet the patient skin concerns. Additionally, discussing the pre and post care including additional treatment product recommendations within the Aesthetics scope of practice. With the report on how recommended modalities and treatment plans meet the patient’s objective and a brief conclusion.

The treatment plan to support the practitioner

Justification of the referral

As it is not in the dermal clinician’s scope of practice to treat collagen injection and atopic dermatitis, Ying Yue is referred to a dermatologist to further support her with her lip sensitivity and concern. Besides the lip sensitivity patient’s condition of atopic dermatitis is also referred to a dermatologist to further assess the condition and may recommend topical solutions and medication which aestheticians are not specialized to prescribe any serious medication to patients. A dermatologist specializes in that specific area and may further assist with the condition (ASDC, 2018). Moreover, the patient must be made aware of specific triggers that can deteriorate the condition. Such triggers include stress, anxiety and certain kinds of food allergies. For a better understanding of her condition, the patient must find out about its severity as well. The issue of lip sensitivity requires a further assessment as well. It is important to tailor the treatment to the patient’s needs.

Physiology of the skin pre-and post-procedure

There are many causes of people requiring aesthetic procedures, but most of them are related to its issues prior to the treatment. For example, while aging may be caused by genetics and age, external factors such as smoking, poor diet and pollution also contribute to the problem (Halliday, 2020). The negative effects of air pollution may not only damage the skin’s functions and barrier. They may also remove its prior elasticity, thus making the patient look older than they may be. The sun is notorious for contributing to the issue of premature aging as well, thus making the use of SPF products far more crucial. At times, pregnancy can lead to certain consequences for the patient’s skin, similar to the ones depicted in the case study. One’s way of life may cause negative consequences as well; for example, an unhealthy diet with fatty foods may lead to acne.

Laser treatment and hyaluronic acid are safe treatment methods for one’s skin care. However, considering that the use of photosensitive therapy is not as thoroughly researched as botulotoxin injections, there may be some side effects after the procedure. The patient may experience possible complications after the treatment. Fortunately, these complications can easily be treated with certain medications. Issues similar to slight pain or burning may happen after the treatment; however, sometimes, they may be more severe. If the patient follows all of the necessary recommendations to preserve the achieved results, there are higher chances of their condition improving in the near future.

Pre- and post-skin care regimes for the aesthetic procedure

Skin care regimes are very important when it comes to clients’ skin care. They may either help maintain the results or have the patient lose progress. The primary focus should be to help improve barrier function and skin hydration. Therefore, some basic homecare regimes are recommended to Ying Yue. The following ingredients such as hyaluronic acid, moisturizer, and antioxidant reach products containing Vitamin C ingredients and niacinamide assist in barrier function, improves skin hydration and prevents certain skin disorders (Urdiales-Galvez et al., 2019); (ASDC, 2021).

When it comes to patient skin care, pre-and-post treatment care is very important. This will benefit not only the patient with the treatment outcome as well as the aesthetic practitioner’s treatment improvements. However, patients sometimes may not adhere to the pre-and-post-care advice and it is the aestheticians’ responsibility to properly educate the patient during the consultation process. Prior to the necessary care, patients should focus on exfoliation, cleansing and strengthening the skin. This will make the skin healthier and ensure recovery after the procedure. After the care, patients should be thoroughly educated that maintenance with the treatments may require measures in order to prevent signs of aging and maintain healthy skin. Similar to ageing, skin protection is just as crucial for maintaining a healthy skin. For example, when exposing skin to the UVA sun, protection must be worn to avoid sunburn and further cause of ageing or skin cancer. Stress and lack of sleep may be severe triggers for further aging and for conditions similar to atopic dermatitis.

Modalities/treatments within the scope of a dermal therapist

Radiofrequency

Radiofrequency is a non-invasive procedure that uses soundwaves vibrations to stimulate skin cells. It helps further stimulate the reception of collagen and neocollagenesis. Unlike other more common treatments, radiofrequency has fewer side effects and is safer in general. There are no known contraindications to RF at the moment. This treatment method can find certain layers of tissues, causing collagen contraction and tightening the skin. Monopolar RF may cause burning and pain due to the deep penetration depth. More severe reactions are less likely; however, it is advisable to cover the patient’s eyes and set a moderate radiofrequency level without intermediate overlapping (Halliday, 2020); (Lyu and Liu, 2021).

IPL

IPL is an Intensive Pulsed Light that uses different wavelengths and is not monochromatic in essence. Due to that, it is not exactly a laser, but this treatment method happens to replace the pulsed dye one in a number of circumstances. IPL uses noncoherent, polychromatic and non-collimated light that has different pulse durations. It is not highly recommended to use this laser to cure certain vascular lesions due to possible complications. Intensive Pulsed Light may sometimes lead to some complications, despite being a rather safe treatment method. Fortunately, this can be prevented by properly choosing the right patient, technique and filler (Urdiales-Galvez, et al, 2019); (Augustyniak, Rotsztejn, 2017).

Microoneedling

Microneedling has become widespread in the past few years. It is a procedure that uses needles to puncture the skin. This helps the skin stimulate the production of collagen and repair mechanisms. Dr.Alster believes that this method may help people who struggle with large pores, wrinkles, stretch marks and scars. Microneedling involves sterile needles that puncture deep enough to trigger bleeding. It is crucial to mention that since similar at home items have duller needles and do not puncture the skin severely enough, the effect is temporary. People with acne and other kinds of inflammations are at a risk of infection, thus, they are not recommended to use this procedure. Microneedling may sometimes lead to slight skin redness that can sometimes stay for a week. There is not enough research to show if this method can be more effective if paired with other ways of treatment (AAD, 2018).

How the procedures and treatment plans meet the patient’s objectives

When it comes to a treatment plan, a thorough consultation procedure is very important. In order to help create a proper treatment plan. It is also crucial to recommend a suitable treatment plan which appropriates to the patient’s needs and concerns. Since the above modalities are used to treat various skin concerns such as acne, pigmentation, especially skin rejuvenation, therefore, they are to assist Ying Yue in improving collagen production, which further supports in reduction of fine lines and wrinkles and enhances the appearance of her skin. Antioxidants akin to vitamin C may also restore the patient’s skin barrier (Pigatto and Diani, 2018). They are known for protecting the skin’s external environment and preventing specific skin diseases. Moreover, antioxidants can help Ying Yue with the aging process, since they make skin cells age more slowly. As mentioned earlier, her skin has been negatively affected by the pollution. Thus, it is important to restore the barriers that were damaged by it. Moisturizing the patient’s skin will not only restore the barriers but may amend her atopic dermatitis as well. However, since Ying Yue’s skin cannot function properly, advanced kinds of treatment are inadvisable since may irritate the skin, thus, deteriorating the patient’s severe condition. The patient’s melasma may have been caused by sun exposure. This condition is common among reproductive-aged women like her. Tyrosinase inhibitors may lighten the patient’s skin; chemical peels like lactic or salicylic may help with the woman’s condition as well. These aforementioned treatments may help the patient overcome these conditions.

Conclusion

Designing a treatment plan is complex and requires knowledge and understanding of the patient’s main concern and, more importantly, recommending suitable treatment advice that could help patients improve their skin concerns. Also, when analyzing the case study, it was complex to recommend a proper aesthetic procedure, especially for patients with several skin concerns. Therefore, require a combination of treatment to improve the condition. The patient is referred to seek further advice from a dermatologist.

References

The Role of the Environment and Exposome in Atopic Dermatitis – PMC (nih.gov).

Part Two: Atopic Dermatitis Management (dermalclinicians.com.au).

American Academy of Dermatology Association (2018) Microneedling: Experienced hands can improve the face.

Australian Society of Dermal Clinician. (2021). The Ageing Skin.

Australian Society of Dermal Clinicians.(2018) Scope of Practice. Web.

Augustyniak, A., Rotsztejn, H., (2017).Intense pulsed light (IPL) treatment for the skin in the eye area clinica. Journal of Cosmetic and Laser Therapy, VOL. 19, NO. 1, 18–24.

Choi, S., Han, J., Kim, J.H., Kim, A-R., Kim, S-H., Lee, W., Yoon, M-Y., Kim, G., Kim, Y-S. (2020). Advances in dermatology using DNA aptamer “Aptamin C” innovation: oxidative stress prevention and effect maximisation of vitamin C through antioxidation. Journal of Cosmetic Dermatology, 19(4), 970-976.

Lyu, J.; Liu, S.* (2021) Radiofrequency in Facial Rejuvenation, International Journal of Dermatology and Venereology: doi: 10.1097/JD9.0000000000000193

Pigatto, P. D. & Diani, M (2018) Beneficial Effects of Antioxidant Furfuryl Palmitate in Non-Pharmacologic Treatments (Prescription Emollient Devices, PEDs) for Atopic Dermatitis and Related Skin Disorders.

Sarkar, R., Arsiwala, S., Dubey, N., …… (2017). Chemical Peels in Melasma: A Review with Consensus Recommendations by India…: EBSCOhost.

Vashi, N.A, Wirya, S.A., Inyang, M., Kundu, R.V. (2017). Facial hyperpigmentation in skin of colour: Special consideration and treatment. American Journal of Clinical Dermatology; Auckland, Vol. 18, no. 2, pp. 215-230. Web.

Paolo, D.P., and Marco, D. (2018).DermatolTher (Heidelb) (2018) 8:339–347. Beneficial Effects of Antioxidant Furfuryl Palmitate in Non-pharmacologic Treatments (Prescription Emollient Devices, PEDs) for Atopic Dermatitis and Related Skin Disorders.

Halliday, G. (2020). Facial rejuvenation and skin-tightening using monopolar radiofrequency.Journal of Aesthetic Nursing, vol. 9, (1). Web.

Urdiales-Galvez, F., Martin-Sanchez, S., Maiz-Jimenez, M., Castellano-Miralla, A, Lionetti-Leon, L. (2019). Concomitant use of Hyaluronic Acid and Laser in facial rejuvenation. International Society of Aesthetic Plastic Surgery,vol 43. PP. 1061-1070.

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